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Flashcards in Reporductive anatomy Deck (41)
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1
Q

What are the branches of the internal iliac artery?

A

Branches in posterior (has iliolumbar, sacroilial and superior gluteal branch) and anterior (has umbilical, superior vesicle, vaginal, middle rectal, obturator, internal pudendal, inferior vesicle (uterine in female))

2
Q

Which ligament forms the greater and lesser sciatic foramen?

A

The sacrospinal ligament

3
Q

Which uterine related structure is intraperitoneal?

A

Fallopian tubes. All others are infraperitoneal as not completely surrounded by peritoneum

4
Q

What is the cardinal ligament?

A

Connects cervix to lateral pelvic wall. Carries uterine arteries.

5
Q

What is the round ligament?

A

Remnant of gubernaculum. Runs from near uterine horns to labia majora (through inguinal canal). Can become strained and painful during pregnancy.

6
Q

What is the suspensory ligament?

A

Peritoneal fold running from abdomainal wall (lateral) to ovary - has ovarian blood vessels.

7
Q

What is the ovarian ligament?

A

Runs between ovary and uterus

8
Q

What passes through the greater sciatic foreman?

A

Above piriformis: Superior gluteal A&N
Below piriformis: Internal pudendal N; inferior gluteal A,N,V; ob int. nerve; quad fem. nerve; post.fem.cut nerve; sciatic nerve

9
Q

What passes through the lesser sciatic foramen?

A

Internal pudendal artery, internal pudendal nerve, obturator internus tendon and nerve.

10
Q

Arterial supply to the scrotum

A

Anterior supplied by external pudendal artery (from femoral). Posterior supplied by internal pudendal artery

11
Q

Nerve supply to scrotum

A

Anterior scrotal nerves derived from the genital branch of genitofemoral (L1,L2 also gives upper anterior thigh) and ilioinguinal nerve (L1).Posterior scrotal nerves derived from the perineal branches of the pudendal nerve and posterior femoral cutaneous nerve.

12
Q

Scrotal layers

A

Some damn Englishman Called it The Testes
Tunica albuginea, tunica vaginalis (=peritoneum), Internal spermatic fascia (internal abdominal fascia), Cremasteric fascia (tranversus abdominus/internal oblique), external spermatic fascia (external abdominal fascia), dartos fascia (scarpas, colles in UG triangle), skin
Cremaster lifts testes, dartos wrinkles skin for temp control

13
Q

Spermatic cord has

A

-Testicular artery, ductus deferens artery and cremasteric artery
-Internal spermatic fascia, cremasteric fascia and external spermatic fascia
-Genital branch of genitofemoral nerve, sympathetic nerves and ilioinguinal nerve (runs outside)
-ductus deferens, lymphatics and pampiniform plexus
Spermatic cord twists in testicular torsion.

14
Q

Penis layers

A

-Skin
-Superficial dorsal vein, superficial lateral veins
-Dartos fascia (superficial fascia) - contains muscle helps to contract foreskin
Buck’s fascia (deep fascia)
-Dorsal artery, dorsal nerve, deep dorsal vein
-Tunica albuginea
Corpus spongeosum (with urethra), corpus cavernosum (with deep arteries in each) - corpus spongeosum separated from cavernosum compartment by intercavernous septum of deep fascia.

15
Q

Penis innervation

A

Neurovascular supply to the penis travels via deep perineal pouch and through pudendal (Alcock’s) canal.
Pudendal nerve (S2-S4) gives off perineal nerve (perineal skin and scrotum) and dorsal nerve of the penis.
Neurovascular bundle runs close to suspensory ligament of the penis.
Parasympathetic nerves enable erection (pelvic splanchnic S2,S3,S4) run to inferior hypogastric plexus, then prostatic plexus and then cavernus nerve,
Sympathetic nervous system for ejaculation - L1,L2, close off internal urethral sphincter, ductus deferens peristalsis, prostate contraction and seminal vesicles contraction as well as contraction of muscle (skeletal) over bulb of penis.

16
Q

Blood supply to penis

A

Arterial supply is from the internal pudendal artery - gives deep and dorsal penile arteries.
Penile venous drainage is from dorsal (superficial/deep) going to prostatic venous plexus and then internal iliac vein.
Erection involves straightening of helicine arteries - allows blood to fill corpus cavernosum.
Bulbospongiousus and ischiospongeosus muscles compress venous plexus to retain blood in penis.

17
Q

Bulbourethral glands

A

These are in the deep perineal pouch in the male (but superficial perineal pouch in the female).
Cowper’s glands in males, neutralises urethral for semen passage.
Batholins glands in women

18
Q

Prostate gland blood supply

A

middle rectal and inferior vesicle arteries (from anterior internal iliac).
Venous blood goes to prostatic venous plexus, then internal iliac veins.

19
Q

Prostate lymph drainage

A

Internal iliac nodes

20
Q

Prostate secretions

A

20% of seminal fluid; It contributes to semen production (e.g. zinc, proteolytic enzymes

21
Q

Prostate pathology

A

Prostate can be divided into zone (peripheral, central and transitional) - transitional zone associated with BPH, peripheral zone with cancer and can be palpated from the rectum.

22
Q

Seminal fluid

A

Seminal vesicles don’t store spermatazoa, but instead secrete an alkaline fluid (as vaginal pH is slightly acidic and this neutralises it as well as has nutrients (e.g. fructose). This makes up around 75% of semen.

23
Q

Seminal vesicles A,V,L

A

The blood supply is via the inferior vesical and middle rectal artery, while drainage is via the vesical and prostatic venous plexus.
The lymph drainage is via the internal and external iliac nodes, as well as the sacral nodes.

24
Q

Muscles assisting with erections

A

Ischiocavernosus (runs from ischium to corpus cavernosus) helps maintain penile and clitoral erections by compressing venous plexus and preventing venous drainage.
Bulbospongiosus covers the bulb of the penis so facilitates emptying urethra during ejaculation and urination (although in the female, the greater vestibular glands are emptied by bulbospongiosus). Also supports the perineal body.

25
Q

Female genitalia innervation

A

Clitoris is the pudendal nerve (dorsal nerve of the clitoris), anterior vulva (labia majora and mons pubis) is the ilioinguinal. Posterior vulva and inner labia is the pudendal branch (perineal nerve)

26
Q

Female reproductive innervation

A

Distal 1/5 of vagina of somatic pudendal S2-S4)

Above pelvic pain line, T12-L2 afferents.

27
Q

Levator ani innervation

ischiococcygeus innervation

A

Leavtor ani is S2-S4

Coccygeus is S4-S5

28
Q

Boundaries of inguinal canal

A

Roof is: Tranversalis fascia, internal olbique, tranversus abdominus
Posterior wall is transversalis fascia
Floor is lacunar ligament and inguinal ligament
Anterior wall is apeunorosis of internal oblique/external oblique

29
Q

Pelvic plexus

A

Superior hypogastric plexus has sympathetic L3-L4
Plexus splits into right and left hypogastric nerves
Parasympathetics (s2-S4) join the inferior hypogastric plexi, plus sacral part of sympthatic chain joins

30
Q

Uterine innervation

A

Sympathetic is T12-L2 (via superior, and then inferior hypogastric plexus)
Parasymathetic is S2-S4 pelvic splachnic, via inferior hypogastric plexus
Visceral afferents follow sympathetic efferent T10-L2

31
Q

Vaginal innervation

A

upper 2/3 efferent: inferior hyogastric plexus
upper 2/3 autonomic: pelvic splchanic through inferior hypogastric
Lower 1/3 somatic efferents: pudendal (S2-S4)

32
Q

Layers of ovary

A

Germinal epithelium, tunica albuginea, cortex, then medulla

33
Q

Breast lymphatic drainage

A
CHAAPS
C - central
H - humeral
A- apical
A-anterior
P-posterior
S-supraclavicular
34
Q

Genitofermoral nerve

A

Runs in spermatic cord in men, runs in inguinal canal in women

35
Q

Scrotal vs abdominal layers

A

1) skin - > skin
2) dartos - > scarpas (campers)
3) External spermatic fascia - > external oblique
4) Cremasteric - > internal oblique
5) ——— - > transversus abdominus
6) Internal spermatic fascia - > transversalis fascia
7) Tunica vaginalis - > peritoneum

36
Q

REgion of prostate for BPH?
Region of prostate for Pcancer?
Region of prostate around ejaculatory juct?

A

BPH is transitional zone
P cancer is in peripheral zone
Centrsal zone surrounds ejaculatory ducts

37
Q

Deep perineal pouch in men?

A

Has cowper’s glands (bulbourethral gland) - but these secrete into membranous urethra in superficial pouch) as well as external sphincter.

38
Q

Superficial perineal space (urethral damage)

A

Continuous with scrotum and abdominal wall, so if urethra is damaged then urine can end up in scrotum and abdo wall

39
Q

anatomical course of the ureters

A

Start retroperitoneal. Runs medial to L2-:5 transverse processes
Runs over psoas major and genitofemoral nerve.

Only structure to pass anterior in pelvic area is uterine artery/ductus deferens.

40
Q

Ischiocavernosus and bulbospongiosus innervation

A

S2-S4 somatic innervation (as skeletal muscle)

41
Q

Emission innervation

A

T11-L2 sympathetic.
Also somatic innervation of bulbospongiosus (S2-S4)

Resolution is by sympathetic