Pelvic Organs Flashcards
(130 cards)
1
Q
Bones of the pelvic cavity include…
A
- Pelvic bones (2)
- Sacrum
- Coccyx
2
Q
What bones form the bowl shape of the pelvis?
A
Poteriorly: the sacrum
3
Q
Each pelvic bone is made up of 3 fused bones
A
- Ilium
- Ischium
- Pubis
4
Q
In anatomical position, what makes a flat plan horizontally?
A
- Ilium
- Pubis
5
Q
What can you palpate from pelvis?
A
Asis and you can feel the public symphysis
6
Q
When do they pelvic bones fuse together at the junction of all 3 bones?
A
Teenage Years
7
Q
Externally (laterally)- is the cup shaped depression CALLED?? of the bone where theres a midline fusion between the 3 bones and attachment site for femur bone
A
Acetabuluum
8
Q
Posteriorly, the 2 pelvic bones are connected to the sacrum at the…
A
Sacro-Iliac Joint
9
Q
Anteriorly, the 2 pelvic bones are connected to the sacrum at the…
A
Pubic Symphysis by dense fibrocartilage
10
Q
The pelvis is tilted in what direction? why?
A
Anteriorly- so that the ASIS and pubic tubercles are in the same verticle plane
11
Q
___ is the thickening of the external oblique upon Neurosis
A
inguinal ligament
12
Q
Pubic Angle
A
the angle formed by the 2 pubic bones at ischiopuvic rami (pubic arch) anteriorly
13
Q
Pelvic Inlet is formed by…
A
“circle” formed by the sacral promontory, ala of sacram, and linea terminalis of pelvis
14
Q
Pelvic inlet seperates…
A
True and False pelvis
15
Q
Gender differences on pelvis
A
- pelvic inlet in females can be more larger and circular to acoomidate childbirth
- males more narrow heart shape
- angle in women is wider VS in meale pelvic which is narrrower (finerangles)
16
Q
Pelvic Brim
A
- pelvic inlet separated by line on sacrum and pelvic bones (called PELVIC BRIM)
- brim can be felt when you look at the pelvis
17
Q
What is above and below pelvic inlet?
A
above it, still encased by pelvic bones is whats called false pevlis bc its still abdominal cavity– below it is true pevlis
18
Q
What is the abdominal cavity continuous with inferiorly
A
the pelvic cavity
19
Q
False Pelvis (greater pelvis)-where is it, what surrounds it, what does it contain
A
above the pelvic inlet
- surrounded by wings of the ilium
- contains digestive organs
- part of abdominal cavity
20
Q
True Pelvis (lesser pelvis) where is it, what surrounds it, what does it contain
A
below the pelvic inlet
- has pelvic outlet
- part of pelvic cavity
21
Q
What is the linea terminalis
A
Ridge on pelvic bones themselves
22
Q
Is there a barrier between greater and lesser pelvis?
A
NO- so organs can cross between them
23
Q
Pelvic Outlet
A
Inferior border of pelvic cavity- pelvic outlet is space marked out by bone and ligaments
24
Q
What physical barrier prevent pelvic organs from falling out?
A
Muscles of pelvic floor
if damaged, pelvic organs will fall out thru bottom of pelvis
25
Boundaries of the true pelvis
- superior pelvic inlet
- circumferential pelvic wall
- inferior pelvic outlet
26
Superior pelvic inlet
imaginary plane formed by bony ridges- imaginary plan around top of sacrum and linea terminalis
27
Circumferential Pelvic Wall
Lateral border- includes Sacrum, coccyx, pelvic bones, muscles and ligaments
28
What muscles are found in circumferential pelvic wall
Obturator Internus and periformus muscle
29
Obturator Internus:
muscle that sits on inside of obturator membrane- is border for pelvis then it goes out to attach w femur to participate in movements of femur
30
Piriformis muscle:
Starts inside sacrum of pelvis then moves out of pelvic cavity thru great sciatic notch and attaches to femur
31
What ligaments are found in Circumferential Pelvic Wall and help attach sacrum to pelvis
sacrospinous and sacrotuberous ligaments
32
Sacrospinous Ligament
attaches to sacrum and also to the ischial tuberosity- v strong and important support that helps attach sacrum to pelvic bone
33
Sacrotuberous ligaments
runs from sacrum to spine of ischium
| both cross each other
34
Whats special about sacrospinous and sacrotuberous ligaments
Ligaments cross greater and lesser sciatic notch by making them into openings (foramena)
35
Inferior pelvic outlet
plane formed by ligaments and muscles
36
Pelvic Outlet
inferior border of pelvic cavity- Curved area from Coccyx (along sacrotuberous ligaments) to pubic symphysis (along pubic arch) and ischial tuberosities laterally
37
Pelvic floor separates what?
Pelvic cavity from perineum and covers pelvic outlet
38
What is the pelvic floor composed of ?
Pelvic diaphragm muscles
1. Levator ani (bigger)
2. Coccageaous (smaller)
- muscles have opening for structures that need to exit out of the pelvis and go into perineum (vagina, end of digestive and urinary system)
39
Levator Ani- what is it and what does it connect
- Sling-like msucle with multiple parts (kegels)
| - Extends from coccyx (as anococcygeal ligament) to the pubic bone
40
What openings does Levator Ani have
- Anal aperature for anal canal
| - Anterior opening- urogenetic hiatus for opening of urethra and vagina
41
Kegal Exercises
squeezing like when u go to bathrrom
-importatnt esp for women bc pelvic cavity can stretch out when giving birth so this muscle can be strengthed by doing these--helps maintain fecal continance
42
Coccygeus- what does it connect and whats the function
Connects Ischial spine to Lateral Coccyx
Function is to support pelvic organs, sphincters of passing through organs, and rectal flexion
43
What happens with the weakening of the pelvic floor
Prolapse of any organ in the pelvis
44
Urinary organs in the pelvic cavity
Bladder, distal ends of ureters, urethra
45
Digestive organs in the pelvic cavity
terminal end of digestive tract, rectum, and anal canal
46
Reproductive organs in the pelvic cavity
Male and female repro organs
47
Perineum
inferior to the pelvic diaphragm, contains genitalia and opening of urinary, digestive, adn reproductive tracts
48
Rectum
- Most posterior pelvic structure, runs down curve of sacrum
- Expandable to store feces
- passes thru pelvic floor
49
2 things pelvic floor helps rectum do
1. Constriction of pelvic floor helps close off anal canal to help maintain continance
2. Pelvic floor orientation with rectum helps create flexure point with rectum so rectum is not facing straight down so it helps maintain continence
50
What supports the control of feces from the anal canal
Anal canal is gateway to fecal canal to outer world supported by 2 sphincters which help control of feces
- internal anal sphincter
- external anal sphincter
51
Anal Canal
- passes through the pelvic diaphragm
- Internal anal sphincter (smooth muscle) and external anal sphincter (skeletal muscle, around anal canal as it opens as the anus)
52
how does the internal anal sphincter work
Involuntary controlled by ANS (para-rest and digest would relax it and is inhibitory to it--allowing feces to exit body and sympa does the opposite- stimulation to muscle telling it to contract so u don’t poop during flight or fight mode)
53
how does the external anal sphincter work
Under somatic control- controlled by somatic nerve so we control when we go to bathroom- called PEUDENDAL NERVE
54
PEUDENDAL NERVE
means the "shameful nerve"- main nerve of perineum
55
What happens when signal is sent back to spinal cord telling it "its time to defecate"
PNS would inhibit sphincter to allow feces to exit
| -in addition to autonomic control, we have voluntary control of defecation there's an external anal sphincter
56
Pectinate Line
Embryologic division ending hindgut, important because of differential lymph drainage, blood supply, embryonic origin, and associated pathology
57
What is happening ABOVE the pectinate line?
Above the line: from embryological origin of hindgut (which has v specific venous, lympathic, blood supply, and innervation)
-part of rectum from hindgut gets blood supply from branch of IMA- Superior rectal artery
- SRA supplies rectum ABOVE pectinate line
- Venous drainage- goes back and drains back to superior rectal vein (ends up in portal system via portal vein and thru the liver)
58
What is happening BELOW the pectinate line?
Area below pectinate line: drains NOT thru portal system so its going straight to CAVAL system AKA systemic system -> branches of IVC (not the liver first) only parts that go into portal system are things that originated in hindgut
59
What are the lymphatics for above and below the pectinate line?
Lympahtics: go to more internal nodes above the pectinate line and superficial nodes below the pectinate line bc they have alternate arterial venous supply and innervation will also be different so innervation of the hindgut- already know is parasymapathetic and sympathetic. For the hindgut, parasympathetic comes from pelvic splanics and sympa comes from lumbar spnanics (these are autonomic control).
60
Bladder: description, location
- Hallow organ located on the anterior side of the pelvis
- Has an apex that points over the pubic symphysis
- Has a base with trigone
- Supeior portion lies flat but can balloon upward when full
61
In men, what does bladder sit over
Prostate gland
62
Trigone
Has points of entry for 2 ureters and exit for urethra
63
Umbilical Ligament
Embryological Reminant
- actual conenction from bladder to umbilicus
- in fetus, some toxins had to go thru umbilical cord for mom to filtrate
- this reminant has no function
64
Patent Uracus
Some conditions where ligament doesn’t close off so theres a passageway between bladder and umbilicus (patent uracus)- so theres urine that leaks out belly bottom bc there was a connection between the 2
65
Testes develop inside...
Abdominal cavity and descend with their nerves, vessels, lymphatics, and vas defernens through the inguinal canal (IN THE SPERMATIC CORD)
66
Vas Deferens
Look up why its highlighted
67
highly coiled Seminiferous tubules function
produce sperm
68
epididymis function
coiled tube where sperm gain motility and are stored on posterior side of testes
69
What are testes covered by?
- Capsule (tunica albuginea)
| - Anterior sac of peritoneum (tunica vaginalis)
70
where does sperm travel to and from (in order)
-Seminiferous tubules within testes is where sperm is made->which then travel thru epidiymus-> thru vas defeerns (main compoent of permatic cord)->ejaculatory duct -> urethra
71
Cremaster Muscle
Extension from internal oblique around scrotum and cord: draws tests up in response to cold/fear
72
Testes descend thru...
Inguinal Canal through deep inguinal ring and superficial inguinal ring
73
When testes descend through inguinal canal... what does it drag with it?
Everything it needs to survive.
- needs testicular artery
- venus plexus- eventually becomes testicular vein
- (cremaster muscle)
- ganitofemoral nerve (gential branch specifically)
- ilioinguinal nerve
74
Testicular artery originates and travels thru...
originated from abdominal aorta thru inguinal canal and into scrotum
75
-venus plexus- eventually becomes testicular vein (different on where r and l end up)- whats the difference
- testicular vein on right drains into IVC
| - testicular vein of Left drains into LEFT renal vein
76
(cremaster muscle)- made by
internal oblique
77
ganitofemoral nerve (gential branch specifically)- responsible for...
controllilng muscle in wall of scrotum
78
ilioinguinal nerve (goes thru inguinal canal), whats it do?
sneaks in between layers of muscle and partially goes thru canal- sensory innervation of portion of anterior side of scrotum comes from that nerve.
79
Vas Deferens exits where and travels where?
Exits scrotum and travels through the inguinal canal to enter the pelvic cavity
80
Vas Deferens travels through the pelvic cavity to meet with... to form...
meet with seminal vesicles to form the ejaculatory ducts
81
Where are seminal vesicles located and what do they do??
Posterior to the bladder and secretes alkaline seminal fluid
82
Ejaculatory duct pass through where to join what?
Pass through the prostate to join the postatic urethra
83
Prostate secretes...
fluid contributing to ejaculate
84
Bulbourethral glands (Cowper's glands) location
located underneath prostate in deep perineal pouch
85
Bulbourethral glands (Cowper's glands) secrete...
lubricant and preejaculate into penile urethra
86
What is the Ejaculatory duct and where is it located?
vas deferns and seminal vesicles connect together and connection part is called EJACULATORY DUCT which is in prostate
87
How many ejaculatory ducts are there and what do they do
both ejaculatory ducts from each side are going to join into urethra as urethra travels from bottom of bladder
88
Describe function of male urethra
-male urethra has dual function of being urinary and reproductive organ
89
Does the urethra urinary and reproductive function happen at the same time?
-don’t happen at the same time bc we have sphincters that control urination and sphincters that control Autonomic control of ejectualtory
90
INTERNAL URETHRAL SPHINCTER
Sphincter at base of the bladder (where first part of male urethra is) called INTERNAL URETHRAL SPHINCTER- is under autonomic control
91
What happens when INTERNAL URETHRAL SPHINCTER is under sympathetic control?
sympathetic control on this sphincter constricts it so there's no urination that occurs and sympa system controls ejaculatory control so both don’t happen at the same time and bladder is closed so sperm doesn’t enter bladder and also urine doesn’t enter into urethra
92
Water under bridge analogy
Path of vas deferns- cross pelvis and goes posterior thru bladder from abdomen. Vas crosses superior to ureter bc theyre 2 tubes they look similar, To figure out which is which remember: WATER UNDER THE BRIDGE- water (ureter since it carries pee) and bridge is vas (goes overtop of water)
93
Where do ovaries develop and descend to
- develop in the abdominal cavity
| - descend to the lateral pelvis
94
Function of Ovaries
produce ovum and release them into the peritoneal cavity
95
What attaches ovaries to uterus
ovarian ligament
96
Are ovaries attached to fallopian tubes?
no- just are in the same space
97
Describe what happens when egg is released and where it goes
- when ovary releases egg, fimbrae (finger like projections) sweep egg into fallopian tube
- wider portion (infindibulum)- part that has fimbrae which sweep egg in to ampulla
- egg sits within ampulla
- egg to get fertilized, sperm has to travel thru repro system out thru fallopian tube and has to meet up with egg in ampula (ampulla is where fertilization occurs)
- fertilized egg travels further thru fallopian tube called the ishtumus
- and will implant into the inner lining of uterus after its made its whole way back into uterus
98
Uterine/fallopian tube characteristics
- Broad infundibulum with fimbriae that collect egg
- narrowed ampulla (where fertilization occurs)
- Isthmus connects to uterus
99
Uterus
Muscular hallow structure between the bladder and rectum
100
label/name 3 parts of uterus
- fundus
- body
- cervix
101
Uterine wall layer
Endometrium: inner lining
Myometrium: thick smooth muscle layer
Perimetrium: serous membrane covering (peritoneum)
102
Round ligament of uterus
runs from the uterus through the inguinal canal to the labia major
103
What is embryologically equivalent to the scrotum in women?
Round ligament of uterus
104
Cervix
Inferior portion of the uterus
105
Cervix is composed of...
- internal os
- cervical canal
- external od
106
Effacement
During birth, the cervix dilates and thins do that the internal and external os become one (can stretch out to 10 cm)
107
What can you see through a speculum exam
External os of the cervix
108
Why do pregnant women have to pee all the time?
Uterus is tipped forward (antiverted position). It is tipped forward on the bladder and when uterus gets larger, it pushes on bladder
109
Describe the traveling of vaginal canal
Vaginal canal travels through the pelvic floor to the perineum
-travels behind the bladder, anterior to the rectum
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Vaginal Vault
the internal end terminates in this widened part
111
Vaginal Fornix
A recess formed at the junction of the cervix and vaginal canal
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What drapes over organs and extends from abdominal cavity to pelvis and forms pouches and ligaments to help stabilize organs
Peritoneum
113
What surrounds pelvic organs, pelvic walls, and vessels
Pelvic Fascia
114
Rectouterine pouch of douglas name in men
rectovesical pouch
115
Rectouterine pouch of douglas
space outlines by peritoneum between uterus and rectum
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Vesicouterine pouch
(smaller) space between uterus and bladder
117
Broad ligament
Fold of peritoneum that runs from lateral pelvic walls over uterus (mesometrium), fallopian tubes (mesosalpinx), and ovaries (mesovarium)
118
Suspensory ligament of the overy
Contains ovarian blood vessels
119
Cardinal (transverse cervical) ligament
from cervix to lateral walls of pelvis, contains uterine artery and vein
120
Which ligament is NOT a fold of peritoneum- just a different layer of fascia that supports/connects to lateral wall
Cardinal (transverse cervical) ligament
121
Pudendal Nerve
Major somatic nerve to perineal structures
| -doesnt innervate visceral organs (like bladder, uterus)
122
What travels through the posterior lateral wall of the pelvic cavity- and mostly supplies somatic innervation to muscles that move lower limb?
Lumbar, Sacrat and Coccygeal Plexuses (L4-C0)
123
What continues along the sacrum giving off fibers to innervate visceral organs and perineum
Pravertebral sympathetic trunk (SACRAL SPLANCHNICS)
124
Visceral Innvervation is organized into...
Pelvic Plexuses:
- Inferior Hypogastric Plexus
- Subplexuses
125
Pelvic plexuses carry...
Sympathetic and parasympathetic (S2-4: pelvic splanchnics) innervations as well as afferent fibers
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The common iliac artery divides into...
- External (lower extremity)
- Internal Iliac Arteries
bilaterally
127
The Internal Iliac divides into...
- Anterior trunk
| - Posterior trunk
128
Anterior Trunk supplies
Pelvic viscera, perineum, gluteal region and inner thigh
129
Posterior Trunk supplies/divides...
Pelvic Wall and Gluteal Region
- iliolumbar artery
- Lateral Sacral Artery
- Superior Gluteal artery
130
Gonadal Arteries
Testicular or ovarian arteries come off the abdominal aorta and descend into pelvis
