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pelvis- internal genitalia Flashcards

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1
Q

which testicle lies lower?

A

left

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2
Q

what do the visceral and parietal layers of the tunica vaginalis cover?

A

Visceral covers epididymis & testicle

Parietal lines internal spermatic fascia

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3
Q

what two structures is the epididymis continuous with?

A

Continuous with rete testis (via mediastinum) & ductus deferens

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4
Q

what is the firm muscular continuation of the epididymis?

A

ductus/vas defrens

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5
Q

what does the ductus defrens pass anteromedially to?

A

ureter, to merge with seminal vesicle

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6
Q

what path does the ductus defrens take come from the testes, through the inguinal canal and out of the deep ring? (where does it go from here?)

A

Crosses external iliac vessels to enter pelvis

Passes along lateral pelvic wall deep to peritoneum

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7
Q

where does the vas defrens get its blood supply from?

A

branches from superior vesicle artery (forms ductus defrens artery)
branches from inferior vesicle artery (more to lower- ejac duct area)

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8
Q

what covers the superior end of seminal vesicle?

A

by peritoneum of ureteric fold

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9
Q

where do the seminal glands/vesicles get there blood supply from?

A

Supplied by branches of inferior vesical arteries & middle rectal arteries

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10
Q

what is the path of the ejac ducts?

A

formed from vas defrens and seminal gland duct
Pass anteroinferior to enter prostate
Open into urethra via apertures on seminal colliculus

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11
Q

what type of fluid does the prostate secrete?

A

Contributes alkaline, milky fluid to semen

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12
Q

the superior base of the prostate contacts what? what about it’s inferior apex?

A

Superior base contacts bladder neck

Inferior apex contacts external urethral sphincter

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13
Q

what are the anterior and posterior surfaces of the prostate in contact with?

A

Anterior surface separated from pubic symphysis by retropubic (prevesical) space
Posterior surface contacts rectal ampulla

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14
Q

what portion of the prostate is palpable on exam?

A

inferior portion of posterior lobe

*BPH is most commonly here

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15
Q

what are the 5 different lobes of the prostate?

A
  • anterior/isthmus lobe
  • middle lobe
  • posterior lobe
  • right lateral lobe
  • left lateral lobe
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16
Q

what was the prostate historically divided into? what is the prostate currently divided into?

A

old- 5 “ lobes”

now- 4 “ zones”

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17
Q

which lobe has no glandular tissue (mostly muscular) AND has the prostatic commissure?

A

anterior lobe (isthmus)

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18
Q

what are the boundaries of the middle prostate lobe?

A

between urethra and ejac ducts

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19
Q

what is the posterior prostate lobe behind?

A

ejac duct

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20
Q

what separates the right and left lateral prostate lobes?

A

“furrow” - slight indentation

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21
Q

what are the 4 “zones” that prostate is now divided into? (kinda weeds)

A

anterior, intermediate, central (includes “posterior lobe”), peripheral (lateral lobes)

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22
Q

how many prostatic ducts are there? where do they open into?

A

20-30 prostatic ducts open into prostatic sinuses of urethra

Lateral to seminal colliculus

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23
Q

what artery supply the prostate?

A

Supplied by prostatic branches of inferior vesical artery

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24
Q

what is the purpose of the SNS and PSNS for the prostate/vas/seminal glands?

A

SNS: Stimulates peristalsis of vas, secretion by seminal glands/prostate
PSNS: function unclear

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25
how does the innervation of the testes reflect posterior abd. origin?
PSNS: Vagal (CN10) SNS: T10, T11
26
the ovary is truly intraperitoneal. its Suspended within the ________ portion of broad ligament Not covered by _________
``` mesovarium peritoneum (mesothelium) ```
27
what are the lateral and medial attachments of the ovary?
lateral: attach to pelvic wall via SUSPENSORY LIGAMENT medial: attach to uterus via OVARIAN LIGAMENT
28
what runs through the suspensory ligament?
ovarian neurovasculature
29
what runs through the ovarian ligament?
uterine branches (veins and artery)
30
what ligament is a remnant of the fetal gubernaculum?
ovarian ligament
31
what are the fallopian tubes located (where do they run?) and what are they suspended by?
Extend from uterine horns to ovaries | Suspended by mesosalpinx- portion that holds the tubes in place on superior edge of broad ligament
32
fallopian tubes are analogous to what male structure (in terms of function)?
vas defrens
33
what is the most superior structure in the broad ligament?
fallopian tubes
34
describe the mesosaplinx, mesovarium and mesometrium: where area they located and how many layers in each?
superior mesosalpinx: double layer on either side of fallopian tube posterior mesovarium: double layer around ovary inferior mesometrium: double layer around the bottom- under fallopian tube, round ligament, ovary
35
what is the infundibulum portion of the fallopian tube like?
Funneled distal end Opens into peritoneal cavity via ostium Numerous fimbria drape around ovary Ovarian fimbria provide attachment
36
what is the isthmus of the fallopian tube like? where is it?
Thick-walled | Enters uterine horn
37
what is the uterine portion of the fallopian tube like?
Intramural segment | Opens into uterine cavity via ostium
38
what are the arterial supply of the ovaries and fallopian tubes?
by abdominal & pelvic sources: Ovarian arteries from abdominal aorta Ascending branch of uterine artery from internal iliac
39
where do the ovaries and fallopian tubes drain to (venous drainage) ?
Ovarian veins drain to IVC & left renal vein
40
where is the uterus in relation to bladder and rectum?
Lies between (& superior to) bladder & rectum
41
how are most uteruses sitting in the body? describe these terms
Anteverted (angled anteriorly relative to vagina) Anteflexed (bent anteriorly relative to cervix) --Typically transverse & mostly rests on bladder
42
how many supports are there for the uterus, what plane are they in?
``` 2 coronal (really more like 3) 2 transverse ```
43
what are the two (really 3) uterine supports in the coronal plane?
1. ovarian ligament & round ligament (lie between layers of broad ligament) 2. broad ligament
44
what is the broad ligmament?
Double layer of peritoneum -Drapes over ovarian/round ligaments & uterine tube -Covers ovarian vessels laterally -Extends from sides of uterus to pelvic walls & floor Mesometrium
45
what are the two uterine supports in the transverse plane?
cardinal and uterosacral ligaments
46
what forms the cardinal ligament and what does it attach and what does it contain?
Condensation of endopelvic fascia Attach cervix to lateral pelvic wall Contains uterine vessels
47
what does the uterosacral ligaments attach?
Attach cervix to sacrum (coming off posterior uterus)
48
ovarian and round support lateral uterus. ovarian on _____ side, round on _____ side
ovarian- anterior | round- posterior
49
what is the superior portion of the birth canal?
cervix (lower 1/3 of uterus)
50
how is the uterus broken down into body and cervix ?
body: superior 2/3 cervix: inferior 1/3
51
which part of the uterus is "mobile" ?
body (upper 2/3)
52
how is the uterus demarcated from the cervix? | where is the superior fundus" ?
Demarcated from cervix by isthmus constriction | Superior fundus above uterine ostia
53
cervix: supravaginal vs vaginal portions
Supravaginal portion: between isthmus & vagina Bears internal os Vaginal portion: protrudes into vagina Bears external os Surrounded by vaginal fornix
54
where does the uterine "cavity" extend from? what provide the entry point for uterine tubes into the cavity?
``` Extends from fundus to external os Superolateral horns (cornua) provide entry for uterine tubes ```
55
where is the inferior fusiform cervical canal? (between what and what? )
Between internal & external os
56
what are the 3 parts of the uterus wall?
perimetrium (outermost) myometrium endometrium (innermost)
57
what is the perimetrium portion of the uterus wall?
Visceral peritoneum
58
what is the myometrium?
Thick muscle coat | Hormonally responsive
59
what is the endometrium? what is it responsive to?
Functional layer Cyclical changes in response to ovarian hormones Uterine (menstrual) cycle
60
which two layers of uterus wall are hormonally responsive?
myometrium and endometrium
61
where does the vagina extend from? (from where to where?)
Extends from mid cervix to vaginal orifice | Cleft between labia minora
62
where are the lateral walls of the vagina collapsed? where are the anterior/posterior walls collapsed?
Lateral walls usually at orifice | Anterior/posterior walls in canal
63
what are the 3 different portions of the vaginal fornices? which is right near the rectouterine pouch?
Anterior, lateral, posterior portions | Deep posterior fornix abuts rectouterine pouch
64
what is the arterial supply of the vagina?
``` vaginal branch of uterine (upper) internal pudendal (lower) arteries ```
65
why is pelvic pain referred?
visceral afferents follow autonomics (SNS and PSNS)
66
where do pelvic visceral afferents follow SNS? where do they enter the CNS?
in abdominal cavity -Abdominopelvic splanchnic/lumbar splanchnic nerves Sympathetic trunk White rami communicantes Enter CNS at inferior thoracic/upper lumbar levels T6-L2
67
where do pelvic visceral afferents follow PSNS? enter the CNS where?
Travel with parasympathetics distal to mid-sigmoid | Enter CNS at S2-S4
68
what is the term for the "inferior/lower limit of the peritoneum"? what is the significance of this? where is it?
pelvic pain line: threshold/boundary determining the course of visceral pain sensation - runs just along the inferior peritoneum (top of bladder) - -> females: crosses just above cervix (lower 1/3 uterus)
69
structures above or in contact with inferior peritoneum (pelvic pain line) convey visceral pain sensation via what nerves? what about those below inferior peritoneum (pelvic pain line)
above/in contact: pain via SNS lumbar splanchnic nerves | below: pain via PSNS pelvic splanchnic nerves
70
which nerves have white rami communicantes?
sympathetics: T12-L2 | so only for those visceral afferents above pelvic pain line
71
where does the digestive tract "switch" in regards to innervation?
mid-sigmoid colon (pelvic pain line level)
72
which have longer postsynaptic nerves, SNS or PSNS?
SNS

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