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GNK 288 > Pelvis and perineum 5.1-5.3 > Flashcards

Pelvis and perineum 5.1-5.3 Flashcards

1
Q

Explain the course of the peritoneum in males. (9)

A

-Descends at the ant abd wall.
-Reflects over the sup surface of bladder (supravesical fossa)
-Covers the sup surface of bladder and slopes down to asc at the pelvic wall (paravesical fossa).
-Descends at post surface of bladder.
-Lat form ureteric folds over the ureters, duc def and sup ends of seminal glands.
-Reflects from bladder onto rectum forming a rectovesicle pouch.
-The rectovesicle pouch extends lat and post to form a pararectal fossa.
-Ascends rectum (inf to sup)
-Engulfs the sigmoid colon at rectosigmoidal junction.

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2
Q

In which part of the male peritoneum does fluid accumulates when there is an infection?

A

The rectovesicle pouch

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3
Q

Explain the course of the female peritoneum.

A

-Descends ant abd wall
-Reflects over the sup surface of bladder (supravesical fossa).
-Covers the sup surface of bladder and slopes down sides to ascend at the lat wall of pelvis (paravesical fossa)
-Reflects from bladder to uterine body (vesico-uterine pouch)
-Covers the uterine body, fundus and post fernix (broad lig which suspends the uterine tubes, ovaries and round lig of uterus)
-Extends lat from uterus.
-Reflects from vagina onto rectum (recto-uterine pouch)
-The recto-uterine pouch extends lat and post to form the pararectal fossa.
-Asc rectum (inf to sup)
-engulfs the sigmoid colon at rectosigmoidal junction.

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4
Q

Where does fluid accumulate in the female peritoneum during an infection?

A

Recto-uterine pouch

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5
Q

What is the male equivalence of the recto-uterine pouch?

A

Recto-vesicle pouch

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6
Q

Another name for the recto-uterine/vesicle pouch?

A

Pouch of douglas

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7
Q

What is the retropubic space?

A

-A space between the pubic symphysis and the urinary bladder.

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8
Q

What makes up the ff for the retropubic space:
a. Medial border
b. Lateral
c. Ant
d. Post
e. Roof
f. Floor

A

a. Inferolateral surface of bladder.
b. Pubic bone ad obturator internus fascia.
c. Pubic symphysis and post surface of pubic bone.
d. Cord of connective tissue and internal iliac veins.
e. Covering peritoneum
f. Pelvic fascia, puboprostatic lig/ pubovesical lig, pelvic diaphragm.

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9
Q

What is the course of the ureters? (3)

A

-Runs over the external iliac vessels.
-Btwn the pelvic peritoneum and internal iliac artery.
-Enters at the base of bladder.

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10
Q

Blood supply and venous drainage of the ureters?

A

Upper portion: Renal artery and vein.
Lower portion: Vesical artery and vein.

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11
Q

Lymphatic drainage of the ureters?

A

From sup to inf:
-Common, internal and external iliac nodes.

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12
Q

Innervation of the ureters?

A

Adjacent plexuses, aortic, renal, sup and inf hypogastric.

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13
Q

Briefly explain the structure of the bladder.

A

-Has a superior and inferolateral surfaces which meet at the apex, which has the median umbilical lig attached to it.
-It has a base which consist of the openings for the ureters.
-The two openings as well as the internal urethral orifice form a trigone, which has transitional epithelium (urothelium).
-Most inf structure is the neck of the bladder which is continous with the urethra.

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14
Q

Which structures help to keep the urine in the bladder?

A

Mucosal folds

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15
Q

Muscular thickening btwn ureteric orifices?

A

Inter-ureteric torus

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16
Q

Evagination post to internal urethral orifice, for the prostate gland?

A

Uvula

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17
Q

Supporting ligaments of the bladder (2)

A

M- Puboprostatic lig
F- Pubovesical lig

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18
Q

What are the relations of the bladder in a female:
-Sup
-Post
-Lat
-Ant
-Neck
-Apex

A

Sup- Peritoneum, vesico-uterine pouch, paravesical fossa.
Post- Vagina, supravaginal part of cervix.
Lat- Ureters
Ant- Retropubic space
Neck- Pelvic and urogenital diaphragm
Apex- Connected to umbilicus via urachus

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19
Q

What are the relations of the male bladder:
-Sup
-Neck
-Post
-Ant
-Apex

A

Sup-Covering peritoneum
Neck- Pelvic diaphragm
Post-Seminal vesicles, duc def, rectum and rectovesicle pouch.
Ant- Retropubic space and contents.
Apex- connected to umbilicus via urachus

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20
Q

Blood supply of the bladder

A

Sup and inf vesical aa. which are branches of the internal iliac artery.

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21
Q

Venous drainage of the bladder

A

Vesical venous plexus.

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22
Q

Name the four parts of the male urethra.

A

-Preprostatic
-Prostatic
-Membraneous
-Spongy part

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23
Q

Which part is the most elastic and which one is least elastic?

A

Most-Prostatic part
Least-Membraneous

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24
Q

Into which part do the prostate gland and ejaculatory duct pour their contents?

A

The prostatic part

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25
Q

Which part is the longest?

A

Spongy part

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26
Q

Which structure do we have towards the end of the spongy part?

A

Navicular fossa

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27
Q

Arterial supply of the male urethra (3)

A

-Inf. vesical a.
-A. to bulb of penis
-Urethral a.

28
Q

Venous drainage of the male urethra (3)

A

-Inf. vesical v.
-V. to bulb of penis
-Urethral v.

29
Q

Innervation of the male urethra

A

Autonomic-Inf hypogastric plexus
Somatic-Pudendal nerve

30
Q

What keeps the prostate in place?

A

-Puboprostatic ligament

31
Q

Arterial supply of the prostate

A

-Inf vesical, middle rectal and internal pudendal aa.

32
Q

Venous drainage of the prostate

A

-Prostatic venous plexus

33
Q

What is the blood supply for the ductus deferens?

A

Artery to ductus deferens

34
Q

Venous drainage for ductus deferens

A

Testicular vein and vesical venous plexus

35
Q

Blood supply for the ejaculatory ducts

A

Inf vesical and middle rectal arteries

36
Q

Venous drainage of the ejaculatory ducts

A

Vesical and prostatic venous plexuses

37
Q

Briefly describe the structure of the uterus. (5)

A

Sup 2/3 is the body:
-Consist of fundus, uterine tubes and isthmus.
-Lies btwn the layers of broad ligament.
-Has two surfaces, vesical and intestinal.
Inf 1/3 is the cervix:
-Narrow and cylindrical.
-Has two parts; supravaginal and vaginal.

38
Q

What are the differences btwn the supravaginal and vaginal parts of the cervix? (6)

A

Supravaginal:
-Btwn the isthmus and vagina.
-Surrounds the internal os of uterus.
-Separated from the bladder anteriorly and the rectum posteriorly.
Vaginal:
-Protrudes into the vagina.
-Surrounds the external os.
-Surrounded by the vaginal fornix.

39
Q

Which ligament:
a. Attaches the ovaries to the uterus.
b. Attaches the ovaries to the pelvis.
c. Attaches the cervix of the uterus to the sacrum.

A

a. Ligament of ovaries
b. Suspensory ligament
c. Uterosacral ligament

40
Q

Mesentery of:
a. uterus
b. ovaries
c. uterine tubes

A

a. Mesometrium
b. Mesovarium
c. Mesosalpinx

41
Q

Ligament that supports the uterus during pregnancy?

A

Round ligament of the uterus

42
Q

What are the relations of the uterus:
A. Anteriorly
B. Posteriorly
C. Laterally

A

A. Vesico-uterine pouch and superior surface of bladder.
B. Rectouterine pouch and the rectum.
C. Ureters and the broad lig of uterus.

43
Q

Blood supply and venous drainage of the uterus

A

Uterine a. and v.

44
Q

Supporting structures of the uterus (4)

A

-Ligaments, pelvic diaphragm, urogenital diaphragm and surrounding organs.

45
Q

Four parts of the uterine tubes

A

-Infundibulum
-Ampulla
-Isthmus
-Uterine part

46
Q

Finger-like projections found in the infundibulum

A

Fimbriae

47
Q

Relations of the ovaries:
a. ant
b. post
c. lat
d. med
e. sup
f. inf

A

a. Attachment of mesovarium
b. Ureters and uterine tubes
c. Parietal peritoneum, obturator nerve and blood vessels
d. Uterine tubes and ilial loops
e. Suspensory lig ad ovarian vessels.
f. Ligament of ovary

48
Q

Blood supply of the ovaries and uterine tubes

A

O- Ovarian arteries
UT- Uterine arteries

49
Q

Venous drainage of the overies and uterine tubes

A

O- Pampiniform plexus which merges with the ovarian vein.
UT- Uterine veins

50
Q

What are the four muscles that compress the vagina?

A

-Pubovaginalis
-External urethral sphincter
-Urethrovaginal sphincter
-Bulbospongiosus

51
Q

Blood supply of the vagina (2)

A

Sup part- Uterine and vaginal aa.
Inf part- Internal pudendal a.

52
Q

Venous drainage of the vagina

A

Vaginal veins

53
Q

Normal positions of the:
a. uterus
b. body
c. fundus

A

a. Anteflexed and anteverted
b. Retroflexed, anteflexed or retrocession
c. Anteversion, and retroversion

54
Q

Which muscle forms the anorectal sling?

A

Puborectalis m.

55
Q

Ant. relations of the male rectum

A

-Recto-vesical pouch, fundus part of bladder, terminal parts of ureters, ductus deferens, seminal glands, prostate.

56
Q

Ant. relations of the female rectum

A

-Recto-uterine pouch, vagina and uterus

57
Q

Blood supply of the rectum (4)

A

Prox part- Sup rectal a.
Mid and distal part- Middle recal aa.
Anorectal jx and anal canal- Inf rectal aa.
Median sacral a.

58
Q

Venous drainage of the rectum

A

Sup, mid and inf rectal aa.
Portacaval anastomosis

59
Q

Innervation of the rectum

A

SYMPATHETIC:
Lumbar splanchnic nerves and hypogastric plexus (root: lumbar spinal cord)
PARASYMPATHETIC:
Pelvic splanchnic nerves (root: S2-S4 spinal cord)

60
Q

Ant relations of the anal canal in males (4)

A

-Perineal body
-Bulb of penis
-Urogenital diaphragm
-Membranous urethra

61
Q

Ant relations of the anal canal in females (3)

A

-Lower part of vagina
-Perineal body
-Urogenital diaphragm

62
Q

Lateral and posterior relations of the anal canal

A

Post- Anococcygeal raphe
Lat- Ischio-anal fossae

63
Q

Differences btwn the internal and external anal sphincters (2)

A

INT- Has smooth muscles (involuntary)
-Covers the sup part of the anal canal.
EXT- Has striated muscles (voluntary)
-Covers the lower part of the anal canal.

64
Q

Three parts of the external anal sphincter

A

-Subcutaneous
-Superficial
-Deep

65
Q

Innervation of the anal canal

A

Inf rectal nerve

GNK 288 (22 decks)

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