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Anatomy > Male Pelvis > Flashcards

Flashcards in Male Pelvis Deck (63):
1

Where is the pelvic viscera relative to the pelvic pain line?

Inferior to it (pelvic pain line runs along inferior border of peritoneum)

2

What happens to the pelvic fascia when they penetrate the pelvic floor and what is this called?

The parietal and visceral pelvic fascia become continuous and thick, forming the tendinous arch

3

What is the anterior aspect of the tendinous arch of pelvic fascia called in males and females respectively?

Puboprostatic ligament (males), pubovesical ligament (females)

4

Two potential spaces of the male pelvis

Rectropubic and rectrorectal

5

Name the three leaflets of the hypogastric sheath, including alternate names and where each attaches

Anteriormost (Lateral ligament of the bladder) - attaches to bladder. Posteriormost (presacral fascia) - attaches to rectum, Middle lamina (rectovesical septum in males runs btwn bladder and rectum, transverse (cardinal) ligament in females, attaches to cervix of uterus)

6

Where are the ureters relative to the ductus deferens in males?

Posterolateral to ductus deferens

7

List the arteries that send branches to supply the ureter

Renal artery, Gonadal artery, Aorta, Common Iliac, Internal Iliac, Superior Vesical, Uterine (f), Middle Rectal, Vaginal (f), Inferior Vesical (m)

8

Where does the ureter get its innervation from?

Adjacent autonomic plexuses

9

Is the course of the ureter mostly superior or inferior to the pelvic pain line?

Superior

10

What does the bladder rest on?

Anteriorly on the pubic bone and symphysis, posteriorly on the prostate (male) or vagina (female)

11

What holds the neck of the bladder in place?

Lateral ligament of bladder and tendinous arch of pelvic fascia

12

List the four surface and four parts of the bladder

Surfaces - Superior, 2 inferolateral, and posterior. Parts - Apex, fundus, body, neck

13

What three points create the triangular-shaped trigone of the bladder?

The two ureteric orafices (superior) and the internal urethral orifice (inferior)

14

Uvula of the bladder

Elevated ridge along the wall of the inferior bladder, in the trigone region

15

Where is the detrusor muscle and what is the orientation of its fibers?

Muscle of the bladder, fibers are scattered in orientation, no particular pattern

16

What feature of the bladder is present in one sex but not the other, which sex is it present in, and what does it do?

The involuntary internal urethral sphincter is present only in males, it prevents reflux of semen into the bladder

17

Arterial supply to the bladder

Superior vesical aa, Inferior vesical aa (m), Vaginal aa (f), Obturator aa, Inferior Gluteal aa

18

Venous drainage for the bladder

Vesical venous plexuses (m/f), also prostatic venous plexuses (m), drain to internal iliac vein (m/f)

19

What system innervates the detrusor muscles?

Parasympathetic (this tells you to go to the bathroom)

20

Where do visceral afferent fibers leaving the bladder go?

Fibers from superior portion of bladder follow sympathetic fibers retrogradely, fibers from inferior portion follow parasympathetic fibers retrogradely (remember pelvic pain line)

21

Which nervous system helps you not go to the bathroom and which system helps you go to the bathroom?

Parasympathetic - go to bathroom, Sympathetic - not now

22

How long are the male and female urethrae?

Male - 18-22 cm, Female - 4 cm

23

4 parts of the male urethra and the lengths of each

Intramural (preprostatic) (1-1.5 cm), Prostatic (4 cm), Intermediate (less than 1 cm), Spongy (15-16 cm)

24

What are the widest/most distensible and shortest/least distensible parts of the male urethra?

Prostatic is widest and most distensible, Intermediate is shortest and least distensible

25

Into what structure does the female urethra open?

Vestibule of vagina

26

At what vertebral level is the rectosigmoid junction?

S3

27

What are the two longitudinal flexures of the rectum and what is the more distal flexure useful for?

Sacral and anorectal flexure (important for maintaining fecal continence)

28

List the lateral flexures of the rectum

Superior and inferior (left side), intermediate (right side)

29

What causes transverse rectal folds and lateral flexures of the rectum?

Thickening of circular muscles

30

The ampulla of the rectum is located where?

Superior to pelvic diaphragm (i.e. superior to where levator ani muscles connect)

31

What is immediately superior to the rectum?

Peritoneum

32

What is immediately anterior to the superior rectum?

Rectovesical pouch (males), Rectouterine pouch (females)

33

What is immediately lateral to the rectum?

Pararectal fossae

34

What structures are immediately posterior to the rectum?

S3-S5, coccyx, median sacral vessels, sacral sympathetic trunk

35

Give the arterial supply to the rectum and where each artery comes from

Superior rectal artery (from IMA), Middle rectal arteries (from Internal Iliac), Inferior rectal arteries (from internal pudendal)

36

How is the pattern of rectal arteries different from that of rectal veins?

Its not. Both have a superior, middle, and inferior

37

Rectal venous plexuses

Internal (submucosal) and External (subcutaneous)

38

For each of the rectal veins, give the system it ultimately drains to

Superior - to Portal system, Middle and Inferior - To Internal Iliac Vein to Caval system

39

Sympathetic innervation of the rectum

Hypogastric/pelvic plexuses, and peri-arterial plexuses via superior rectal artery

40

Parasympathetic innervation of the rectum

Inferior hypogastric/rectal plexuses

41

What fibers to visceral afferent fibers leaving the rectum follow and to where?

Parasympathetic fibers retrogradely to S2-S4 spinal ganglia

42

Which anal sphincter is voluntary and which is involuntary?

Internal is involuntary, external is voluntary

43

What is the internal anal sphincter formed from, and which nervous system makes it relax and which makes it contract?

Formed by thickening of circular muscles, forced to contract by sympathetic system, forced to relax by parasympathetic system

44

What is the external anal sphincter attached to?

Pernieal body (anteriorly), Coccyx via anococcygeal ligament (posteriorly), Puborectalis (superiorly)

45

What is anterior to the prostate gland?

Muscular retropubic space

46

What is posterior to the prostate gland?

Ampulla of rectum

47

What is along the inferolateral surfaces of the prostate?

Levator ani muscles

48

Lobes of the prostate gland

Anterior, Left, Right

49

What is another name for the anterior lobe of the prostate?

Isthmus

50

Arterial supply to the prostate

Inferior vesical arteries (majority of blood supply), middle rectal arteries, internal pudendal arteries

51

Venous drainage of the prostate

Prostatic venous plexuses to internal iliac veins (vesical venous plexus and internal vertebral venous plexus also involved)

52

Effects of sympathetic fibers on male internal genital organs

Contraction of internal urethral sphincter, rapid contraction of ductus deferens, contraction and secretion of ejaculatory ducts and prostate, ejaculation

53

Primary effect of parasympathetic fibers on male internal genital organs

Cavernous nerve causes penile erection

54

Give the number of nerves, vessel pairs, and muscles which pass through the greater sciatic foramen

7 nerves, 3 vessel pairs, and 1 muscle

55

Name the nerves which pass through the greater sciatic foramen

Sciatic nerve, Superior/inferior gluteal nerves, Internal pudendal nerve, Posterior femoral cutaneous nerve, Nerve to quadratus femoris, nerve to obturator internus (L5, S1)

56

Name the blood vessels which pass through the greater sciatic foramen

Superior gluteal artery/vein, Inferior gluteal artery/vein, Internal pudendal artery/vein

57

What muscle passes through the greater sciatic foramen?

The piriformis

58

Give the relations of the obturator artery while it is in the pelvis

Laterally with the obturator fascia, medially with ureter, ductus deferens, and peritoneum, and it is superior to the obturator nerve

59

Name the nerves which travel through the lesser sciatic foramen

Pudendal nerve, nerve to obturator internus

60

Name the blood vessels which travel through the lesser sciatic foramen

Internal pudendal artery and vein,

61

Name the miscellaneous (e.g. muscles, tendons, etc) structures which pass through the lesser sciatic foramen

Tendon of obturator internus

62

Name the blood vessels that pass through the obturator foramen (via the obturator canal)

Obturator artery and vein

63

Name the nerves that pass through the obturator foramen (via the obturator canal)

Obturator nerve

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