Pelvic anatomy

Question 1

How many layers exist in the urogenital triangle and name them.

Answer 1

4
Deep perineal pouch
Perineal membrane
Superficial perineal pouch
Perneal fascia

Question 2

What is contained within the deep perineal pouch?

Answer 2

Part of the urethra, external urethral sphincter and vagina

Question 3

What is the function of the perineal membrane?

Answer 3

Site of attachment of muscles of external genitalia

Question 4

What is contained within the superficial perineal pouch?

Answer 4

Erectile tissues of penis and clitoris
Ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles
Bartholins glands

Question 5

What makes up the perineal fascia?

Answer 5

Deep layer
Superficial layer - subdivided into deep (continuation of Scarpa’s fascia) and superficial (continuation of Camper’s fascia)

Question 6

What is the perineal body?

Answer 6

The strong muscular structure that anchors the perineal muscles, sphincter muscles and levator ani

Question 7

What separates the greater and lesser sciatic foramen?

Answer 7

Sacrospinous ligament

Question 8

Which structure divides the greater sciatic foramen, into two further foramina?

Answer 8

Piriformis

Question 9

What are the three bones that make up the pelvis?

Answer 9

Ilium
Ischium
Pubis

Question 10

What is the name of the cartilage that connects the three pelvic bones at the acetabulum?

Answer 10

Triradiate cartiliage

Question 11

Which bone makes up the obturator foramen and what is transmitted?

Answer 11

Ischium
Obturator nerve, artery and vein

Question 12

What are is the greater and lesser pelvis and what does it contain?

Answer 12

Greater (false) pelvis is superior and contains the lower abdominal viscera
Lesser (true pelvis) is inferior and consists of the pelvic cavity and viscera
Separated by the pelvic inlet

Question 13

What are the borders of pelvic brim (boundaries of the inlet)?

Answer 13

Posterior - sacral promontory
Lateral - Illiopectineal line
Anterior - pubic symphysis

Question 14

What are the borders of the pelvic outlet?

Answer 14

Posterior - tip of coccyx
Lateral - ischial tuberosities and inferior margin of sacrotuberous ligament
Anterior - public arch

Question 15

Which muscles attach to the coccyx?

Answer 15

Gluteus maximus, levator ani and anococcygeal raphe

Question 16

What type of cartilage lines the sacroiliac joint and what type of joint is it?

Answer 16

Hyaline cartilage
Synovial joint

Question 17

What are the major muscles of the pelvic floor?

Answer 17

Puborectalis, pubococcygeous, illioccoccygeous and coccygeous

Question 18

What cell types lines the urethra?

Answer 18

Stratified columnar epithelium

Question 19

What is the blood supply to the male urethra?

Answer 19

Prostatic urethra = inferior vesical artery
Membranous urethra = bulbourethral artery (internal pudendal artery)
Bulbous urethra = internal pudendal artery

Question 20

Which glands lie on either side of the female urethra and are homologous to the male prostate?

Answer 20

Skene’s glands

Question 21

Which vessels supply by the scrotum?

Answer 21

Anterior scrotal arteries - external pudendal
Posterior scrotal arteries - internal pudendal
Veins follow arteries draining into the external pudendal veins

Question 22

What is the nerve supply to the scrotum?

Answer 22

Anterior and anterolateral - genital branch of genitofemoral nerve and ilioinguinal nerve (anterior scrotal nerves)
Posterior aspect - perineal branches of the pudendal nerve and posterior cutaneous femoral nerve (posterior scrotal nerves)

Question 23

What is the function of the bulbourethral glands (Cowper’s glands)?

Answer 23

Contribute to the final volume of semen by providing a lubricating mucus secretion: lubrication, clears out urethral contents ready for ejaculation, helps to neutralise acidity

Question 24

Which muscle forms the glans penis?

Answer 24

Corpus spongiosum lies inferiorly and forms the head

Question 25

What are the fascial coverings in the penis?

Answer 25

Superficial (Colle's) fascia lies under the skin and is a continuation of Scarpa's fascia Deep (Buck's) fascia lies deeper and binds the corpus cavernousa and spongiosum together Tinea albuginea created a roff over corpus spongiosum

Question 26

Which arteries supply the penis?

Answer 26

Dorsal and deep penile arteries Bulbourethral artery All branches of the internal pudendal artery Venous is via deep and superficial dorsal penile veins which drain into prostatic plexus

Question 27

What is the broad ligament formed from and what does it cover?

Answer 27

Peritoneum Covers the ovaries posteriorly only, fallopian tubes and surround uterus

Question 28

What are the two ovarian ligaments and their features?

Answer 28

Ovarian ligament - connects the ovary to the side of the uterus Suspensory ligament of ovary - connects the ovary to the lateral abdominal wall and contains ovarian vessels and nerves

Question 29

What ligament is a remnant of the embryonic gubernaculum?

Answer 29

Round ligament of uterus - connects the uterine horns to the labia majora

Question 30

Which ligament contains the uterine arteries and nerves?

Answer 30

Cardinal ligament of the uterus Provide support for the cervix and lateral fornix of the vagina

Question 31

What does water under the bridge refer to in regards to pelvis anatomy?

Answer 31

Ureter runs under uterine artery 1cm laterally to the internal cervical os, and care must be take during hysterectomy. Ovarian arteries cross at the level of the pelvic brim

Question 32

What are the branches of the anterior division of the internal iliac artery (anti-clockwise)?

Answer 32

Obturator artery Umbilical artery (gives rise to superior vesical artery) Inferior vesical artery Vaginal and uterine arteries (in females) Middle rectal artery Internal pudendal artery Inferior gluteal artery

Question 33

What are the branches of the posterior division of the internal iliac artery?

Answer 33

Superior gluteal artery Iliolumbar artery Lateral sacral arteries

Question 34

Which veins drain into the external iliac veins?

Answer 34

Inferior epigastric Deep circumflex iliac veins

Question 35

Which veins drain into the internal iliac veins?

Answer 35

Correspond with arterial branches of internal iliac: Superior and inferior gluteal veins Middle rectal vein Vesicular veins Vaginal and uterine veins Lateral sacral veins Obturator vein Internal pudendal vein

Question 36

What is Alcock's canal?

Answer 36

AKA pudendal canal, contains pudendal nerve and internal artery and vein. Runs anterosuperior through the pelvis

Question 37

What are the sensory branches of the pudendal nerve?

Answer 37

Inferior rectal Perineal Dorsal nerve of penis/clitoris

Question 38

In men, which inferior structure cross the ureters anteriorly?

Answer 38

Vas deferens