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Anatomy Week 12 BT > Pelvis II > Flashcards

Pelvis II Flashcards

1
Q

What makes up the pelvic fasica and what layers are these continuous with?

A

Parietal layer - continuous with Transversalis Facia

Visceral Layer - continous with extraperioneal tissue in the abdomen

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2
Q

Which layer of pelvic fascia envelopes the muscles that line the pelvic wall?

A

Parietal layer

  • Visceral layer cushions and supports the organs
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3
Q

What fascial layer lies superioly to pelvic organs?

A

Lower extent of Peritoneum

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4
Q

What lies inferiorly to pelvic viscera?

A

Pelvic Diaphragm

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5
Q

T or F: the parietal pelvic fascia lines the walls of the true pelvis.

A

True

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6
Q

What is the origin for the intermediate portion of the levator ani fibers?

A

Tendinous Arch of Levator Ani

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7
Q

What important suture point in pelvic surgery runs from the pubis to the sacrum?

A

Tendinous arch of the pelvic fascia (aka White line)

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8
Q

What is the relationship betwen the tendinous arch of the levator ani and the tendinous arch of the pelvic fascia?

A

Tendinous Arch of Pelvic Fascia

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9
Q

What are the 3 important thickenings of the visceral pelvic fascia?

A
  1. Pubovesical/Puboprostatic ligament
  2. Transverse cervical ligament (female only)
  3. Uterosacral/Sacrogenital ligaments
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10
Q

What is the job of the pubovesical (female) and puboprostatic (male) ligaments (folds)?

A

Stabilize the neck of the bladder/ prostate (males)

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11
Q

What is the job of the transverse cervical ligament (Cardinal Ligament)?
- where does it extend to?

A

Carries the Uterine vessles

  • Cervix to lateral walls of pelvis
  • Water under the bridge
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12
Q

What is the job of the uterosacral and sacrogenital ligament (fold)?
-where does it extend to?

A

Stabilize uterus and prostate gland

  • Wall of pelvis covering the Sacrum to prostate or uterus (posterior aspect)
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13
Q

What pouch in the female is continous with the uterosacral fold?

A

Pouch of douglas

*note that this circumscribes the rectum

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14
Q

What is the distal expansion of the vas deferens called and what does it empty into?

A
  • Ampulla of the Vas Deferens

- Seminal Vesicle

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15
Q

T or F: the vas deferens runs over the top of the ischium and bladder.

A

False, it runs over the pubic (think about the inguinal canal)

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16
Q

Decribe the path of the vas derens around the ureter entering the bladder?

A

Moving posteriorly it runs medial to the ureter then hooks around the back to cross the ureter again and insert on the seminal vesical that lies more lateral than the ureter

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17
Q

What touches the prostate?

A 
Superiorly: Bladder
Inferiorly: UG diaphragm
Anteriorly: Pubic Symphysis 
Posteriorly: Rectum
Laterally: levator ani
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18
Q

What lies anterior and posterior to the ampulla of the vas deferens, what about the seminal vesicle?

A

Ant: Bladder
Post: Rectum

*Same for the seminal vescial except its LATERAL to the ampulla

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19
Q

What is formed at the junction of the seminal vescicle and the ampulla of the vas?

A

ejaculatory duct

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20
Q

What is the flow of secretions through from the vas deferens to the prostatic urethra?

A

vas deferens –> ampulla of the vas + seminal vescile = ejaculatory duct –> prostatic urethra (via seminal collicus)

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21
Q

Where do the prostate gland’s secretions come together to join the other ejaculatory fluids?

A

Prostatic sinuses (on either side of the seminal collicus)

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22
Q

What part of the prostate is related to the superior fascia of the UG diaphragm?

A

Apex

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23
Q

What part of the prostate relates to the neck of the bladder?

A

Base

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24
Q

What divides the anterior, median, and posterior lobes of the prostate?

A

Anterior and Median divided by urethra
Lateral lobes divided by urethra
Posterior and median lobes divided by ejaculatory duct

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25
Q

What lobes of the prostate can be felt via digital examination?

A

Posterior and median

26
Q

What prostatic lobe is most commonly involved in cancer?

A

posterior - feels rock hard

27
Q

Which lobe of the prostate is most commonly responsible for difficulty urinating?

A

Median Lobe

28
Q

What zones are most commonly involved in cancer and hyperplasia?

A

Cancer - Peripheral zone

Hyperplasia - Transitional zone

29
Q

Where does the abdominal aorta bifurcate into the L and R iliac?

A

L4

30
Q

Where does the common iliac bifurcate into the internal and external iliac?

A

Sacroiliac joint

31
Q

Does the external iliac have any contribution to the pelvis?

A

NO

32
Q

Where does the internal illiac divide into anterior and posterior divisions?

A

The greater sciatic foramen

33
Q

What is the ONLY part of the pelvic viscera not supplied by the internal illiac arteries?

A

Ovaries (supplied by gonadal (ovarian a.) from aorta)

34
Q

What are the 3 parietal divisions of the internal illiac and where do they go?

A
  1. Obturator a. - medial compartment of the thigh
  2. Internal Pudendal a. - to the perineum
  3. Inferior Gluteal a. - to the gluteal region
35
Q

What are the 3 or 4 visceral branches of the internal pudendal?

A
  1. Superior Vesical Artery - to bladder [OBLITERATED umbilical a.]
  2. Inferior Vesicle Artery/Vaginal Artery - to bladder and vagina
  3. Middle Rectal a. - to the rectum
  4. Uterine artery - to uterus (females only)
36
Q

What are the 3 parietal branches of the posterior division of the internal illiac a.?

A

Iliolumbar a. - to iliacus and quadratus lumborum

lateral sacral a. - sacral canal and muscles on sacrum

Superior gluteal a. - gluteus muscles (terminal branch)

37
Q

What artery runs between psoas major and the vertebral column?

A

Iliolumbar a.

38
Q

What branch of the posterior division of the internal iliac goes through the greater sciatic foramen.

A

Superior Gluteal n.

39
Q

What is the path of the obturator a. and what part of the iliac a. is it a part of?

A
  • Passes through obturator canal to enter medial thigh (w/ the nerve)
  • anterior Internal iliac parietal branch
40
Q

What is the path of the internal pudendal a. and what part of the iliac a. is it a part of?

A
  • Exits pelvis through greater sciatic foramen between piriformis and coccygeus (w/ pudendal n.)
  • anterior internal iliac parietal branch
41
Q

What is the path of the inferior gluteal a. and what part of the iliac a. is it a part of?

A
  • Exits through the greater sciatic foramen between S2 and S3 ventral rami (usually larger than internal pudendal)
  • anterior Internal iliac parietal branch
42
Q

What is the path of the umbilical a. and what part of the iliac a. is it a part of?

A
  • umbilical a. is the first branch off and passes toward bladder
  • **gives off superior vesicular aa. to bladder and a. to vas deferens
  • anterior internal illiac visceral branch
43
Q

What does the umbilical a. continue as distally?

A

medial umbilical ligament

44
Q

What is the path of the middle rectal a. and what branch of the iliac does it come off of?

A
  • travels medial to the middle portion of the rectum

- anterior internal illiac visceral branch

45
Q

T or F: inferior vesicle and middle rectal aa. may come off as a common branch from the anterior internal iliac and then branch

A

True

46
Q

What does the inferior vesicle a. supply?

A

Men: inferior bladder, prostate, semial vescicles

Women: Inferior bladder and sometimes 2-3 vaginal branches

47
Q

T or F: the middle rectal a. has no anastomoses.

A

False, it anastomoses with both the superior and inferior rectal a.

48
Q

What artery crosses the floor of the pelvis in the in a ligament that is at the base of the broad ligament?

A

Uterine a. contained in the cardinal ligament
supplies the uterus

*Water under the bridge

49
Q

What arteries supply blood to the uterus?

A
  1. Ovarian a.
  2. Uterine a.
  3. Vaginal aa.
50
Q

What artery that helps supply the uterus travels in the mesovarium?

A

Ovarian a.

51
Q

What artery follows the suspensory ligament of the ovaries?

A

ovarian a.

52
Q

What arteries supply the upper portion of the vagina?

A

Vaginal aa.

*Note these arise from the inferior vesicle a.

53
Q

What nerve roots compose the sacral plexus?

A

S1-S4 ventral Rami

L4 and L5 via lumbrosacral trunk

54
Q

What do the branches from the sacral plexus control?

A

Pudendal n. - serves perineum

all other nn. suerce the lower limb and gluteal region

55
Q

Does the sacral plexus and its branches typically lie superficial or deep to the internal iliac and its branches?

A

Sacral Plexus is deep

56
Q

What forms the coccygeal plexus and what does its branches innervate?

A
  • Branches innervate the anal ∆ via anococcygeal nn.

- Formed from a little bit of S4 and ventral rami of S5 and co.

57
Q

What does the sacral plexus rest on?

A

The internal surfaces of piriformis and coccygeus muscles

58
Q

What nerve plexus lies under the bifurcation of the aorta on the sacral promontory and what are its contributors?

A 
- Superior Hypogastric n. 
Contributions from:
Aortic plexus
Inferior hypogastric plexus
Lumbar Splanchnics (sympathetic)
59
Q

What are the hypogastric nn?

A
  • Superior Hypogastric gives off L and R bundles of nn.
  • Bundles contain mostly preganglionic fibers
  • PRINCIPAL SYMPATHETIC ROOTS to the inferior hypogastric plexus
60
Q

What nerve plexus is located on the pelvic floor on either side of the rectum?

A

Inferior hypogastric plexus

61
Q

What 3 nerve contributions give rise to the Inferior hypogastric plexus?

A
  1. Hypogastric nn. from the superior plexus (SYMPATHETIC)
  2. Sacral Splanchnics (Sympathetic)
  3. Pelvic splanchnic S2-S4 (parasympathetic)
62
Q

What is the difference between where the lumbar and sacral splanchnics synapse in the inferior hypogastric plexus vs. the pelvic splanchnics?

A
  • Lumbar and sacral splanchnics synapse in unnamed collateral ganglia in the plexus
  • Pelvic synapse in terminal ganglia in the walls of the hindgut and pelvic viscera.

Anatomy Week 12 BT (4 decks)

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