Pelvic Viscera Flashcards
(39 cards)
Trigone of the bladder
Smooth area on posterior surface of bladder w/ openings for the ureters
Detrusor muscles
Three-layered smooth muscle of the bladder wall that are parasympathetically innervated by the pelvic splanchnic nerves (S2-S4)
Internal Sphincter of Bladder
Involuntary sphincter muscle surrounding the neck of the bladder that is sympathetically innervated
Microtuition
Is a result of parasympathetic stimulation => Relaxation of internal sphincter of bladder and contraction of detrusor muscles
Suprapubic Cystostomy
Removal of urine from the bladder thru the anterior abdominal wall; performed if there is a blockage in the urethra and normal catheterization is not possible
*Distended bladder is reached above the pubis w/o breaching the peritoneal cavity
Referred pain of the bladder
S2-S4 = tip of the penis
L1= hypogastric region
Rectal Relations
Posterior: Coccyx, sacrum, piriformis, sympathetic trunk
Anterior: (M) prostate, urinary bladder, seminal vesicles
(F) Cervix, Uterus
Lateral : Ischial spine, ischial tuberosity, sacrospinous ligament,
Rectovesical Pouch
Lowest part of male peritoneal cavity; exudates will drain to here when sitting down
Rectouterine pouch
Lowest part of female peritoneal cavity; acid from duodenal ulcer or ruptured ectopic pregnancy leads to fluid accumulation here
=>Abdominal tenderness
Transverse rectal folds
2 to the left and middle to the right
*Hard stool or probe can tear these folds => infxn
Ejaculatory Duct
Formed by the distal part of the vas deferens and the seminal vesicle tube
Lobes of the prostate gland
Anterior: Secretes alkaline fluid to counter acidic environment of vagina (other lobes do this too)
Median: Primary site of BPH; causes nocturia
Posterior Lobe: Common site of carcinoma
Lateral lobes: May develop BPH
Route for metastatic prostate caricnoma
Prostate venous plexus => Vesical venous plexus => Internal iliac vein => Lateral sacral vein => internal vertebral plexus and radicular veins
Seminal colliculus
Rounded eminence on the urethral crest in the prostatic urethra; *contains openings for the ejaculation duct
Iatrogenically induced sterility
Disruption to sympathetic fibers of the prostate, vas deferens, and the seminal vesicles resulting in reduced emission
*Occurs during pelvic surgery
Parts of the uterus
- Fundus (superior)
- Body (thick walled)
- Cervix (opening to vagina is the external os)
Normal position of the uterus
Anteverted (90 degrees to vagina) and anteflexed (slight angle from cervix to fundus)
Broad ligament of the uterus
Two-layered reflection of peritoneum covering the uterus which includes the:
- Mesosalpinx
- Mesovarium
- Mesometrium (majority of ligament)
- Suspensory ligament of the ovary (contains NAV to ovary)
Contents of broad ligament of the uterus
Round ligament of the uterus (remnant of the gubernaculum)
Round ligament of ovary
Uterine and ovarian artery and vein
Uterine Tube
Lymphatic drainage of the uterus
Fundus => lumbar para-aortic nodes
Body and Cervix => Internal iliac nodes
Cervical ligaments
Consists of the transverse, pubocervical, and uterosacral ligaments; fnxns to prevent prolapse of uterus into vagina during childbirth
*Are thickenings of endopelvic fascia
Components of the uterine tube
- Fimbria
- Infundibulum
- Ampulla (widest part; where fertilization takes place)
- Isthmus
- Intramural
* Has pre-aortic lumbar drainage
Ectopic tubal pregnancy
Occurs during blockage of the uterine tube; can lead to fatal hemorrhage after rupture
*Test for w/ a hysterosalpingogram
Boundaries of the ovarian fossa
Superior: External illiac vessels
Inferior: Internal illiac vessels and ureter
*Obturator nerve passes along obturator internus; diseased ovary can compress causing pain
