Pelvis And Perineum

Question 1

Bones of pelvis

Answer 1

Sacrum (5)
Coccyx (4)
Hipbone (2)

Question 2

Hip bone bones, what’re they joined by

Answer 2

Ilium
Ischium
Pubis
Joined by triradiate cartilage, ossifies later in life

Question 3

Joints in pelvis

Answer 3

Lumbosacral
Sacroiliac
Sacrococcygeus
Pubic symphysis

Question 4

Orientation of pelvis

Answer 4

Anteriorly inferiorly inclined
ASIS + pubic symphysis on same plane
Angle of inclination if sacral Promontory and upper margin of pubic symphysis = 55
Angle of inclination of tip of coccyx and lower margin of pubic symphysis = 15

Question 5

Pubic tubercle vs crest

Answer 5

Tubercle : pointy thing

Crest: more medial

Question 6

Pelvic inlet vs brim

Answer 6

Brims the bony rims that make up the inlet

Question 7

Inlet and outlet boundaries

Answer 7

Inlet : pubic symphysis / ilium/ sacral promontory

Outlet: ischial tuberosities/ coccyx / pubic symphysis

Question 8

How to get obstetric conjugate

Answer 8

Put left hand up vag to touch sacral promontory
Put right hand on start of left
Measure distance (diagonal conjugate)
Obstetric conjugate = diagonal conjugate - 1.5

Question 9

Types of hip shapes , characteristics , implications

Answer 9

Android (M): short AP + short transverse
Gynecoid (F): Long AP +Long transverse
Anthropoid (F, no vaginal delivery): Long ap + short transverse
Platypelloid (F, no vaginal delivery): short AP + Long transverse

Question 10

In females, which pouch is more likely to collect infection

Answer 10

Rectovesicle instead of Rectouterine

Question 11

Pelvic floor/diaphragm function

What’d happen without it

Answer 11

Supports pelvic organs and separates perineum from pelvic cavity
Incontinence / prolapse

Question 12

Muscles in superficial pouch

Answer 12

Perineal body
Ischiocavernosus
Bulbospongiosus
Transverse perineal

Question 13

Parts of deep and superficial perineal pouches

Answer 13

Deep pouch: superior fascia of urogenital diaphragm/ deep pouch muscles ( deep transverse perineal muscle + external urethral sphincter + sphincter urethrovaginalis + compressor urethrae) / perineal membrane
Superficial pouch : perineal membrane / superficial pouch muscles / superficial membranous fascia

Question 14

Ischioanal fossa shape and path

Answer 14

Wedge shaped

Bifurcate towards front

Question 15

Where does testes develop from, what’s condition for undescended testes

Answer 15

From PAW (retroperitoneal) 
Cryptochidism

Question 16

What happens to balls when temperature drops

Answer 16

Genitofemoral nerve innervation -> dartos + cremastic muscles contract -> balls go closer to body

Question 17

Inguinal canal contents male

Answer 17

External spermatic fascia / cremasteric / internal spermatic fascia
Testicular artery/ deferential artery/ cremasteric
Pampiniform plexus & testicular vein/ deferential vein/ cremasteric vein
Genitofemoral nerve/ ilioinguinal nerve/ autonomic nerves
Lymphatics

Question 18

Inguinal contents female

Answer 18

Round ligament
Genitofemoral nerve
Ilioinguinal nerve

Question 19

What separates testes

Answer 19

Raphe

Question 20

Leydig and Sertoli cells location and function

Answer 20

Leydig: produce testosterone
Sertoli: aids sperm development
In seminiferous tubules

Question 21

Path of sperms

Answer 21

Seminiferous tubules -> rete testis-> efferent ductules-> epididymis -> vas deferens -> seminal vesicles -> ejaculatory duct

Question 22

Function of prostate + seminal vesicles + bulbourethral glands

Answer 22

Prostate : secretes citrate (sperm motility) + enzymes ( break sperm clots)
Seminal vesicles: alkaline fluid with fructose + enzymes + PGs
Bulbourethral glands: lubricate urethra

Question 23

4 zones of prostate and something about them

Answer 23

1. Central: around ejaculatory duct
2. Peripheral : posterior part, probably cancery
3. Transitional: surrounds urethra; benign; hyperplasia-> blocks urethra
4. Fibromuscular stroma

Question 24

Openings in urethra

Answer 24

Prostatic sinuses

2x ejaculatory ducts

Question 25

Penis parts

Answer 25

Skin
Loose areolar tissue + superficial dorsal vein
Deep fascia
Deep dorsal vein + 2 dorsal arteries + 2 dorsal nerves
Corpus spongiosum + spongy urethra
Tunica albuginea
2x corpus cavernosa + 2x deep arteries (separates by septum penis)

Question 26

How’s an erection maintained

Answer 26

Deep fascia + tunica albuginea restrict venous drainage

Question 27

Insemination mechanism

Answer 27

Election : stimulation -> s2-4 -> vasodilation -> increased blood flow to corpus cavernosa + corpus spongiosum
Emission: sympathetic fibres L1-2 -> contraction of vas deferens + seminal vesicles -> expulsion of sperms
Ejaculation : rhythmic contraction of bulbospongious muscle (in Superficial pouch) and external urethral sphincter (controlled by pudendal nerve)

Question 28

Parts of uterus

Answer 28

Fundus 
Uterine horn 
Cavity 
Body 
Isthmus 
Cervix
Peri/myo/endo metrium

Question 29

Parts of Fallopian tube and ovary

Answer 29

Fimbrae
Uterotubular junction
Suspensory ligament of ovary
Ligament of ovary

Question 30

Are ovaries intraperitoneal or retroperitoneal?

Ligaments and mesenteries associated with uterus

Answer 30

Intraperitoneal.
Broad ligament (mesosalpinx+ mesovarium are part of it; mesometrium connects uterus to pelvic floor)
Mesosalpinx (drapes over uterine tubes)
Mesovarium (ovaries-> mesosalpinx)

Question 31

6 openings of vestibule

Answer 31

1. Urethra
2. Vagina
3. 2x skenes
4. 2x bartholin

Question 32

Clitoris and associated parts

Answer 32

1. Crura of clitoris
2. Corpora cavernosa
3. Vestibular bulbs
4. Pars intermedia
5. Glans of clitoris

Question 33

Mechanism of female erection

Answer 33

Stimulation -> s2-4 -> increased blood flow -> venous plexus of kobelt communicates venous circulation of vestibular bulbs to corpus cavernosa -> labia Minora becomes turgid