Pelvis and Perineum Flashcards Preview

Anatomy Block 3 > Pelvis and Perineum > Flashcards

Flashcards in Pelvis and Perineum Deck (135):
1

Boundaries of pelvic inlet

Superior margin of the pubic symphysis, posterior border of pubic crest, ileopectineal line (arcuate line and pectineal line), anterior border of the ala of the sacrum, and sacral promontory

2

Boundaries of pelvic outlet

inferior margin of the pubic symphysis, inferior rami of the pubis and ischial tuberosities, sacrotuberous ligaments, tip of coccyx

3

True conjugate

sacral promontory to top of pubic symphysis

4

Obstetric conjugate

sacral promontory to thickest part of pubic bone

5

Diagonal conjugate

sacral promontory to inferior border of pubic sympysis

6

What is the most commonly assessed conjugate?

Diagonal

7

What is the ligament that is the primary structure involved in transferring the weight of the upper body from the axial skeleton to the two ilia and then to the femurs during standing and the ischial tuberosities when sitting?

Interosseous sacro-iliac ligament

8

What resist the sacrum from moving superiorly?

Sacrotuberous and sacrospinous

9

Between Sacrotuberous and sacrospinous which is more anterior?

Sacrospinous ligament

10

What makes up the pelvic diaphragm?

Levator ani + coccygeus

11

What makes up levator ani?

puborectalis, puboccygeous, iliococcygeus

12

What is the name for an organ touching peritoneum?

Intraperitoneal

13

What is the name for an organ below/not touching peritoneum?

Subperitoneal

14

What is the peritoneal category for ureters?

Retroperitoneal

15

What are the three boundaries on one side of UG triangle?

IT, ischiopubic ramus, pubic symphysis

16

What are the three boundaries on one side of anal triangle?

IT, sacrotuberous ligament, coccyx

17

Perineal body consists of:

bulbospongiosus, external anal sphincter, superficial and deep transverse perineal

18

What are the three layers of the anal triangle?

Pelvic diaphragm (roof), fatty layer of the superficial perineal fascia (fat in ischioanal fossa), skin

19

What are the layers of the urogenital triangle?

Pelvic diaphragm (roof), superior fascia of UG diaphragm, deep perineal mm, perineal membrane (inferior fascia of UG diaphragm), superficial perineal mm, deep perineal fascia, colle's fascia (membranous layer), fatty layer of superficial fascia, skin

20

What makes up the urogenital diaphragm?

superior fascia of UG diaphragm, deep perineal mm, perineal membrane (inferior fascia of UG diaphragm)

21

What makes up superficial perineal fascia?

Deep perineal fascia and colle's fascia

22

What are the deep perineal mm?

deep transverse perineal and sphincter urethrae m

23

What are the superficial perineal mm?

bulbospongiosus, ischiocavernosus, superficial transverse perineal

24

What pouch are the bulbourethral glands located?

deep perineal space/pouch

25

What pouch are the greater vestibular glands located?

Superficial perineal space/pouch

26

What passes through both the deep and superficial pouch?

Vagina, urethra

27

Bulbospongiosus sits over?

bulb of penis

28

Ischiocavernosus sits over?

crura

29

Pudendal nerve levels?

S2-S4

30

Where does inferior rectal n come off of?

Pudendal

31

How does the pudendal n travel?

Pelvic cavity to perineum (via greater and lesser sciatic foramen

32

What passes through pudendal canal?

internal pudendal a/v, pudendal n

33

Pudendal canal is within what fascia?

fascia of obturator internus

34

What is the general innervation pattern for sympathetics in pelvis?

least thoracic/lumbar splanchnic/sacral splanchnic to hypogastric plexus/ganglia to pelvic plexus to pelvic organ

35

What is the general innervation pattern for parasympathetics in pelvis?

pelvic splanchnics to inferior hypogastric plexus to pelvic plexus to intramural ganglia to pelvic organs

36

Name pathway of male urethra:

pre-prostatic, prostatic, membranous, bulbar, penile

37

The subcutaenous tissue (camper's fascia/scarpa's fascia) in the abdominal wall becomes what in the scrotum?

Dartos fascia and dartos muscle

38

The external oblique muscle in the abdominal wall becomes what in the scrotum?

external spermatic fascia

39

The internal oblique muscle in the abdominal wall becomes what in the scrotum?

Cremaster muscle

40

the fascia of internal oblique muscle in the abdominal wall becomes what in the scrotum?

cremasteric fascia

41

The transverse abdominal muscle in the abdominal wall becomes what in the scrotum?

Nothing...

42

The transversalis fasica in the abdominal wall becomes what in the scrotum?

internal spermatic fascia

43

The peritoneum in the abdominal wall becomes what in the scrotum?

tunica vaginalis

44

The external spermatic fascia continues on as what in the penis?

deep penile fascia (buck's fascia)

45

Scarpa fascia becomes what in perineum? in penis?

Colles fascia in perineum, dartos in penis

46

Campers fascia becomes what in perineum?

Superficial fascia--fatty layer

47

Where will the extravasation pool be if there is a tear in the tunica albuginea only?

Penis only

48

Bulbar urethra injury can be caused by?

straddle injury or difficult urethral catheterization

49

Where will the extravasation pool be if there is a tear in buck's fascia?

Superficial perineal space

50

What is the posterior limit of colles' fascia?

posterior margin of perineal membrane

51

What is the inferior limit of colles' fascia?

fascia lata

52

What causes a perforation of the membranous urethra?

pelvic fracture, because prostatic urethra is fixed in position by prostate, shearing force.

53

Where will the extravasation pool be if there is a tear in the membranous urethra?

Pelvic cavity (superior to perineal membrane/deep perineal pouch/extraperitoneal space superior to pelvic diaphragm)

54

Average urine output

1-2 L/day

55

Normal bladder capcity

0.5 L

56

Urgency to urinate felt at:

150-250 mL

57

What n stimulates external urethral sphincter m in bladder filling phase?

pudendal n and n to levator ani

58

Distension of lower bladder follows what innervation?

Parasympathetics

59

Distension of lower bladder triggers?

tension and pain stimuli to spinal cord and brainstem, reflex control of bladder

60

Distension of bladder roof follows what innervation?

sympathetics

61

Distention of bladder roof results in?

transmit painful stimuli from bladder roof to spinal cord and cerebral cortex, conscious perception

62

Internal urethral sphincter is held closed by what innervation?

sympathetic

63

Describe Vescicoureteral Reflux (VUR)

Retrograde flow of urine from bladder into ureter during voiding due to deficient vesicoureteral sphincter, exposes kidneys to urinary infections

64

What is the boundary between the visceral and somatic innervation in the rectum/anus?

Pectinate line

65

What pudendal n goes to rectum/anus?

Inferior rectal nn

66

Normal anorectal flexure angle:

80 degrees

67

Anorectal angle during defication

120 degrees

68

What lymph nodes would be palpable with a cancerous lymphadenopathy?

Superficial inguinal lymph nodes/ perinal nodes

69

Which fornix is associated with the rectouterine pouch?

Posterior vaginal fornix

70

What are the two ligaments that are related to the gubernaculum in the female?

Round ligament, ovarian ligament

71

What are the two types of membranous pelvic fascia?

parietal, visceral

72

What are the two types of endopelvic fascia?

loose, condensed

73

Describe parietal fascia

Ensheaths bones/muscles

74

Describe visceral fascia

Ensheaths muscles

75

Describe loose fascia

potential spaces, accomdate expansion

76

Describe condensed fascia

"pelvic ligaments" like hypogastric sheath

77

Describe endopelvic fascia?

lying between the parietal and visceral fascia

78

What are the three ligaments formed by thickened endopelvic fascia?

uterosacral, transverse cervical (cardinal) ligament, pubocervial ligament

79

Which muscle is extremely important in active support of the uterus?

pubococcygeus

80

Lesser vestibular glands are homologous to?

prostate gland

81

Greater vestibular glands aka

Bartholin's glands

82

Greater vestibular glands are homologous to?

bulbourethral glands

83

Sympathetic levels:

T10-L2

84

Parasympathetic levels:

S2-S4

85

Caudal epidural anesthetizes what structure?

Peritoneal plus somatic areas via pudendal n

86

When doing a pudendal nerve block where is your landmark?

Ischial spine

87

What nerves are anesthetized in caudal analgesia?

sacral and coccygeal nn.

88

What is the landmark for caudal analgesia?

sacral hiatus

89

What is the most common regional anesthesia for childbirth?

lumbar (epidural) block

90

What is the landmark for (lumbar) epidural block?

widest interspace below L3, commonly L3-L4.

91

What nerves are anesthetized in (lumbar) epidural block?

thoracolumbar and sacral nn.

92

Which type of regional anethesia goes to subarachnoid space?

spinal block

93

What is the landmark for a spinal block?

L3/L4 vertebral level

94

"water under the bridge" applies to?

Uterine a, vas deferens in relation to ureter

95

What is the prostatic utricle homologous to?

vagina

96

What are the urethral lacunae?

small depressions or recesses on the surface of the mucous membrane of the urethra, location of urethral glands that protect epithelium against acid urine

97

Parasympathetics (GVE) for testes and ovaries?

Vagus (CNX)

98

Culdocentesis occurs via what fornix?

posterior

99

What are the "cruciate anastomosis"

medial circumflex femoral, lateral circumflex femoral, inferior gluteal, 1st perforating

100

What are the extracapsular ligaments?

patellar, fibular collateral, tibial collateral, oblique popliteal, arcuate

101

What are the intracapsular ligament?

cruciate, menisci, tendon of popliteus

102

Which is more superficial: fibrous or synovial membrane?

Fibrous layer

103

Which is stronger: tibial or fibular collateral ligament?

Fibular collateral ligament

104

What does the fibular collateral ligament split?

Splits biceps femoris tendon

105

What does tibial collateral ligament attach to?

Medial meniscus

106

Suprapatellar bursa is deep to?

vastus intermedious

107

Pes Anserinus is a tendinous expansion of?

gracilis, sartorius, semitendinosus

108

Oblique popliteal ligament is an expansion of?

Semimembranosus tendon

109

ACL prevents?

posterior displacement of femur on tibia/ hyperextension of knee

110

What are the three ligaments of the ball and socket joint?

Iliofemoral, pubofemoral, ischiofemoral

111

Iliofemoral resists?

hyperextension and lateral rotation

112

Pubofemoral resists?

abduction

113

Ischiofemoral resists?

extension and medial rotation

114

What is the weakest hip joint ligament?

ischiofemoral ligament

115

Ligament of head of femur houses?

artery of ligament of head of femur

116

Plantarflexion dermatomes

S1,S2

117

How do you test tibial n?

achilles tendon reflex

118

What injury will result in a foot drop?

fracture at neck of fibula

119

What is injured with a fracture of the neck of the fibula?

common fibular n.

120

What two ligaments limit inversion?

anterior talofibular and calcaneofibular ligament

121

What is the strongest lateral ankle ligament?

Posterior talofibular

122

What is the weakest lateral ankle ligament?

anterior talofibular

123

What is the role of the posterior talofibular ligament?

ensure fibula sits on top of the talus, especially in dorsiflexion

124

What makes up the deltoid ligament?

anterior tibiotalar, tibionavicular, tibiocalcaneal, and posterior tibiotalar

125

What is the strongest ligament in the foot?

Deltoid

126

What does the deltoid ligament do?

prevents over eversion, stablizes foot when you're doing external rotation and pronation of the foot

127

What is another name for Spring LIgament?

plantar calcaneonavicular ligament

128

What does the plantar calcaneonavicular ligament do?

helps maintain integrity of medial longitudinal arch

129

Ankle sprains occur with what type of motion?

Inversion

130

What side ligaments likely tear during an ankle sprain?

Lateral

131

What is plantar fascitis?

straining and inflammation of plantar aponeurosis with pain on sole and medial side of foot, especially heel

132

What ligament helps with medial arch?

plantar calcaneonavicular ligament

133

What ligament helps with lateral arch?

long plantar and short plantar ligament

134

What happens in flat feet?

Spring ligament fails

135

Describe the plantar reflex?

Lightly trace blunt object from lateral side of heel to base of big toe, toes should flex (negative babinski sign)