Flashcards in Repro 6 Deck (27)
What is the pelvic brim?
What is the pelvic inlet?
Inlet - junction between greater and lesser pelvis.
Brim - the bony edges of the pelvic inlet
What are the boundaries of the pelvic inlet?
Posterior - sacral promontory
Anterior - pubic symphsis
Lateral - arcuate line on the inner surface of the ilium and the pectineal line on the superior ramus.
What type of pelvis do men and women have?
Men - android
Women - gynecoid.
Compare and contrast the adaptations the female pelvis has, when compared to males.
- a greater sub-pubic angled arch, more than 80-90 degrees
- shorter sacrum, more curved with a less pronounced sacral promontory
- oval shape inlet compared to the android heart shape inlet.
- wider and broader structure but yet it is lighter than android.
How does the size of the pelvic outlet increase?
Progesterone secretion causes the sacrospinous and the sacrotuberous ligaments to become a little lax, which causes the outlet to open up a bit more.
What are the urogenital hiatus and the rectal hiatus
UGH - allows the passage of the urethra, and vagina in females
RH - allows the passage of the anal canal
What are the functions of the pelvic floor muscles?
- Support the abdominal and pelvic viscera
- resistance to increase in intra-abdominal pressure and intra- pelvic pressure during exertion such as lifting heavy objects or sneezing
- sphincter action - some of the fibres allow for urethral and rectal continence, by acting as sphincters. Relaxation allows defacation and micturition.
What are the 3 components of the pelvic floor?
- levator ani muscles
- coccygeus muscle
- fascial coverings of the muscles.
With respects to the pelvis, which pelvis do the pelvic viscera lie in?
What's the name of the other one?
They lie in the true (lesser) pelvis.
The 'other' pelvis is the false (greater) pelvis. This supports the lower abdominal viscera.
Describe the shape of the puborectalis muscle and the course it takes
U shaped muscle, can be thought of as a sling
Extends from the bodies of the pubic bones, passing the urogenital hiatus and around the anal canal.
- contracts tonically which gives the control of defacation.
Describe the path of the pubococcygeus muscle in males and females
Some of its fibres pass around the prostate in men and the vagina in the female.
Which component of the pelvic floor muscles lie anteriorly and which lie posteriorly ?
The levator ani muscles lie anteriorly
The coccygeus lies posteriorly.
What are the nerve innervations of the levator ani and the coccygeus?
- pudendal nerve S2-S4
- anterior rami of S4 and S5
What embryonic structure does the scrotum develop from, and what is the contents?
Develops from the labioscrotal folds.
- first section of spermatic cord
What is the scrotal raphe?
The fusion of the genital folds
What is the function of the dartos muscle? Where is it located?
Located just below the skin.
This wrinkles the scrotum skin - decreasing surface area - hence decreasing heat loss, when needed.
How is the parenchyma of each testicle divided into lobules?
The inner fibrous capsule called the Tunica Albuginea penetrates into the parenchyma, dividing it.
Describe the arterial supply of the testicles, their journey to the testicles and any coverings they may have.
- paired arteries called the Testicular arteries.
- direct branches off the abdominal aorta.
- they pass through the abdomen, through the inguinal canal and into the scrotum.
- they travel in the spermatic cord, which is the covering the question related to.
Describe the venous drainage of the testicles.
The pampiniform plexus, which is a network of veins that wrap around the testicular arteries, drain into the testicular veins.
The left testicular vein drains into the left renal, while the right testicular vein drains into the IVC.
Explain the following pathologies
Hydrocoele - serous fluid in the tunica vaginalis
Haematocoele - blood in the tunica vaginalis
Varicocoele - varicosities of the pampiniform plexus
Spermatocoele - aka epididymal cyst
- collection of fluid in the epididymis.
What is the basis for differentiation between haematocoele and hydrocoele?
When a light is passed through the area, if the problem is hydrocoele then the light passes through as its serous fluid.
However if the light doesn't pass through, then it's blood.
What is the risk in testicular torsion?
Necrosis of the testicles.
What is the course of the spermatic cord?
It originates from the deep inguinal ring and enters the inguinal canal and then the scrotum. It attaches to the posterior border of the testes, where the contents open up into the testicles, supplying it with the various structures.
What is the cremasteric reflex?
Stroking the superior and medial part of the thigh produces a contraction of the cremaster muscle.
This immediately elevates the testicle on the side that has been stroked.
Describe the lymphatic drainage of the testicles and scrotum
Very important to know the difference.
Just as the ovaries do in females, the testicles in men drain to the para aortic nodes
The scrotum drains to the superficial inguinal nodes.
In the penis, what does the ischiocavernosus do?
It compresses the veins, allowing the maintenance of an erection.