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Year 3 Anatomy > Reproduction 1 > Flashcards

Reproduction 1 Flashcards

1
Q

What structures make up the pelvic inlet?

A

The sacral promontory, ala of the sacrum, accurate line of the ilium, pecten pubis, pubic tubercle, pubic crest and pubic symphysis

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2
Q

What are the differences between the male and female pelvis?

A

Female pelvis is thin and light and the greater and lesser pelvis is shallow and wide - whereas male pelvis heavy and thick and narrow and deep

Pelvic inlet in females is oval-rounded, in males it is heart shaped

Subpubic angle is obtuse in females and acute in males

Pelvic outlet bigger in females

Females have a smaller acetabulum

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3
Q

What structures make up the pelvic outlet?

A

The inferior margin of the pubic symphysis, inferior rami of the pubic, sacrotuberous ligaments, tip of coccyx

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4
Q

Differentiate between the true and false pelvis.

A

True (lesser) pelvis is where the true pelvic organs are (bladder, ovaries, rectum etc.)

False (greater) pelvis consist of the ilia and provides support for the abdominal viscera, e.g. the intestines

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5
Q

What type of joint is the sacroiliac joint?

A

Synovial plane

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6
Q

What type of joint is the pubic symphysis?

A

Secondary cartilaginous

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7
Q

What is the anterior inferior wall of the pelvic cavity formed by?

A

Bodies and rami of the pubic bones and pubic symphysis

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8
Q

What muscle occupies the lateral wall of the pelvis?

A

Obturator internus

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9
Q

What muscle occupies the posterior wall of the pelvis?

A

Piriformis

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10
Q

What foramen does the obturator internus obscure?

A

Obturator foramen

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11
Q

What foramen does the obturator internus pass out from?

A

Lesser sciatic foramen

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12
Q

What foramen does the piriformis pass out from?

A

Greater sciatic foramen

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13
Q

What nerve plexus lies on the posterior wall of the pelvis (lying on top of piriformis)?

A

Sacral plexus

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14
Q

What are the two main branches of the sacral plexus?

A

Pudendal nerve (S2-4) and sciatic nerve (L4-S3)

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15
Q

Where do the femoral vessels line in the pelvis?

A

Anterior pelvic wall

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16
Q

What is the perineal body?

A

Fibromuscular mass in middle of perineum between anus and vagina
It is essential for the integrity of the pelvic floor

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17
Q

What muscles converge at the perineal body?

A

Bulbospongiosus, levator ani, external anal sphincter, superficial and deep transverse perineal muscles

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18
Q

What is the anococcygeal body?

A

Fibrous median raphe between the coccyx and anus

Composed of levator ani, external anal sphincter muscle fibres

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19
Q

What are the main parts of the pelvic diaphragm/floor?

A

Levator ani and cocygeus

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20
Q

Give two functions of the pelvic floor.

A

Support of abdominopelvic viscera (bladder, intestines, uterus…)

Urinary and faecal continence (sphincter action on rectum & urethra to resist increases in intraabdominal pressure during heavy lifting for e.g.)

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21
Q

What is the innervation of the pelvic floor?

A

Nerve to levator ani (branch of inferior rectal nerve) and coccygeal plexus

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22
Q

Injury to the pelvic floor can lead to what?

A

Urinary and faecal incontinence

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23
Q

Describe the course of the pudendal nerve.

A

Leaves the greater sciatic foramen and re-enters via the lesser sciatic foramen

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24
Q

Why might an episiotomy minimise long-term damage?

A

Doing 5 or 7o’clock episiotomy takes stress off of midline & perineal body which are most likely to rip during childbirth.

Midline/perineal body have very poor blood supply so healing would be poor and could lead to long term difficulties, e.g. with continence. Blood supply and therefore healing better with 5/7o’clock cut.

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25
Q

What structures may you feel during a digital PR examination?

A

M: prostate
F: cervix, tampon
Both: faeces, irregularities of the rectal wall/masses

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26
Q

Branches of the _________ arteries distribute blood to most of the pelvic organs, ,perineum, gluteal regions, expect testis, ovaries and upper part of the rectum.

A

Internal iliac arteries

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27
Q

Where do the superior and inferior vesicle arteries supply?

A

Bladder, seminal gland and prostate in males

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28
Q

Where do the uterine arteries supply?

A

Pelvic ureter, uterus, ligaments of uterus, uterine tube, upper vagina

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29
Q

Where do the gonadal arteries supply?

A

Testes/ovaries

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30
Q

Where does the superior rectal artery supply?

A

Upper rectum

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31
Q

Where do the middle and inferior rectal arteries supply?

A

Rectum and anal canal

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32
Q

Where does the vaginal artery supply?

A

Vagina and branches go to inferior part of bladder

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33
Q

Where does the internal pudendal artery supply?

A

Main artery to the perineum

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34
Q

Where does the obturator artery supply?

A

Pelvic muscles, ilium and femoral head

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35
Q

What arteries to pelvic organs come off of the internal iliac artery?

A

Superior and inferior vesical, uterine artery, middle and inferior rectal, internal pudendal and obturator arteries

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36
Q

What arteries to pelvic organs come off of the abdominal aorta?

A

Gonadal arteries

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37
Q

What arteries to pelvic organs come off of the uterine artery?

A

Vaginal artery

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38
Q

What artery to pelvic organs comes off of the inferior mesenteric artery?

A

Superior rectal artery

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39
Q

Venous drainage of pelvic structures involves which 5 veins?

A

Internal iliac veins, superior rectal veins, median sacral vein, gonadal veins, internal vertebral venous plexus

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40
Q

Which part of the rectum drains into the portal system?

A

Proximal rectum (drained by superior rectal vein which drains into inferior rectal vein)

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41
Q

What part of the rectum drains into the systemic circulation?

A

Middle and inferior rectum (middle and inferior rectal veins)

42
Q

What is the significance of understanding the venous drainage of the rectum?

A

Site of portosystemic anastomosis which is susceptible to haemorrhoid formation

43
Q

With which venous plexus does the prostatic venous plexus communicate with on its posterior side?

A

Internal vertebral venous plexus

44
Q

What is the significance of the prostatic venous plexus draining into the internal vertebral venous plexus?

A

Root for metastasis of prostatic cancer (–> bone cancer)

45
Q

What nerve supplies the skin of the root of the penis/labia?

A

Ilioinguinal nerve

46
Q

Where does the ilioinguinal nerve originate?

A

L1

47
Q

Where does the ilioinguinal nerve enter the inguinal canal?

A

At the superficial ring

48
Q

Where does the genitofemoral nerve originate?

A

L1-2

49
Q

What structures are supplied by the genital branch of the genitofemoral nerve?

A

Cremaster muscle and anterior scrotal skin

50
Q

What is the cremaster muscle?

A

Flat muscle that covers the testis and spermatic cord

51
Q

What is the importance of the genital branch of the genitofemoral nerve supplying the cremaster?

A

Supplies the motor portion of cremaster reflex

Cremaster reflex = contraction of cremaster when superomedial thigh touched

52
Q

From which plexus does the pudendal nerve arise from?

A

Sacral plexus

53
Q

What does the pudendal muscle innervate?

A

Skin and muscles of the perineum

54
Q

From what segmental levels does the pudendal nerve arise?

A

S2-4

55
Q

What bony landmarks are used when performing a pudendal nerve block during labour?

A

Ischial spines (pudendal nerve sits safely behind these)

56
Q

What is the sympathetic nerve supply to the vas deferens, seminal vesicles and the epididymis?

A

L1, 2 via the hypogastric plexus

57
Q

What is the sympathetic supply to the female genital tract?

A

Nerve fibres from the pelvic and ovarian plexuses

58
Q

What is the parasympathetic supply to the female genital tract?

A

Fibres from splanchnic nerves (S2-4)

59
Q

What is the parasympathetic supply to the female and male erectile tissues?

A

S2-4 via hypogastric plexus

60
Q

What are erectile tissues?

A

Tissues that have large vascular spaces that can become engorged with blood
Corpus cavernosa, clitoris, bulbs of vestibule & (to lesser extent) corpus spongiosus (urethral patency)

61
Q

Lymph from what structures drain into the external iliac lymph nodes?

A

Inguinal lymph nodes
Glans of penis, glans clitoris, membranous urethra, prostate, fundus of bladder, cervix, upper vagina,

ANTERIOR, SUPERIOR PELVIC ORGANS

62
Q

Lymph from what structures drain into the internal iliac lymph nodes?

A

Gluteal region, deep perineum and inferior pelvic viscera

63
Q

Lymph from what structures drain into the sacral lymph nodes?

A

Rectum and posterior wall mainly

POSTERIOR, INFERIOR PELVIC ORGANS

64
Q

Lymph from what structures drain into the common iliac lymph nodes?

A

Drainage from the main three groups: external, internal and sacral lymph nodes

65
Q

Reproductive organs can be split into which 3 groups?

A
  1. External genitalia
  2. Gonads
  3. Tube system
  4. Accessory (copulatory) glands
66
Q

What are the male internal reproductive organs?

A

Testis, ductus deferens, seminal gland, prostate, epididymis, bulbourethral glands

67
Q

Why are the testes located outside the abdominopelvic cavity?

A

Cooler temperature - spermatogenesis occurs optimally below body temperature

68
Q

What are the layers of the inguinal canal and what abdominal muscle/fascia do these layers relate to?

A

Inner –> outer
Tunica albiunginae
Tunica vaginalis (peritoneum) - has visceral and parietal layer
Internal spermatic fascia (transversalis fascia)
Cremaster muscle and fascia (internal oblique muscle)
External spermatic fascia (external oblique muscle)

69
Q

What are the main contents of the inguinal canal?

A

Ilioinguinal nerve
Genital branch of the genitofemoral nerve
Lymphatics and blood vessels
Vas deferens

70
Q

What are the main contents of the spermatic cord?

A

Vas deferens, testicular artery, genital branch of the genitofmoral nerve

71
Q

How are the testes suspended in the scrotum?

A

By the spermatic cord

72
Q

What is the tunica albunginae?

A

Tough, outer fibrous layer of the testis, it encloses the testes and penetrates into the parenchyma of each testicle with diaphragms, dividing it into lobules

73
Q

What are the two layers of the tunica vaginalis?

A

Parietal - covers internal spermatic fascia

Visceral - covers testis

74
Q

What material is present between the two layers of the tunica vaginalis?

A

A small amount of serous fluid

75
Q

What is a hydrocele?

A

Excess of fluid within the tunica vaginalis

Causes incl. trauma, idiopathic, tumour etc.

76
Q

What is a haematocele?

A

Blood within the tunica vaginalis

77
Q

At what vertebral level do the testicular arteries come off of the aorta?

A

L2

78
Q

The testicular arteries travel retroperitoneally and cross two important structures near the pelvic brim before they go through the inguinal canal. What are these?

A

Ureters and inferior parts of external iliac arteries

79
Q

What term is used for the 8-12 anastomosing veins associated with the testis?

A

Pampiniform plexus (formed by testicular veins emerging from the testes and epididymis)

80
Q

What is the function of the veins in the pampiniform plexus?

A

Drainage of epididymis and testis

Also acts as a heat exchange mechanism to cool down blood to keep testes at a temperature more suitable for spermatogenesis

81
Q

Into which veins do the testicular veins drain?

A

Right - IVC

Left - left renal vein

82
Q

What is a variocele?

A

Pathological dilatation & increased tortuosity of the pampiniform plexus due to a blockage proximally of the spermatic veins

83
Q

Which two lymph node groups receive lymph from the testis?

A

Right and left lumbar nodes and para-aortic lymph nodes

84
Q

What is the vas deferens?

A

Muscular tube that arises from the tail of epididymis, transverses the inguinal canal, crossing over the external iliac vessels and terminates as it joins the seminal gland duct to form the ejaculatory duct

85
Q

Where are the bulbourethral glands?

A

In the urogenital diaphragm

86
Q

Where are the seminal glands?

A

Either side of posterior surface of bladder

87
Q

What secretions are produced by the seminal vesicles?

A

A thick alkaline fluid that mixes with sperm as they pass the ejaculatory duct and urethra (main constituent of sperm)

88
Q

Where is the prostate gland?

A

Fused to the neck of the bladder

Surrounds prostatic urethra

89
Q

What secretions are produced by the prostate?

A

Prostatic fluid (slightly alkaline, milky fluid)

90
Q

What is the structure of the prostate gland?

A

2/3rd gland, 1/3rd muscle surrounded by a dense fibrous capsule

91
Q

What is PBH?

A

Benign Prostatic Hypertrophy

Enlargement of prostate leads to compression of urethra –> bladder outlet obstruction

92
Q

What part of the urethra do the bulbourethral glands empty into?

A

Penile/spongey urethra (nb - ducts pass obliquely)

93
Q

What secretions are produced by the bulbourethral glands?

A

Mucus like secretions

94
Q

What lymph nodes drain lymph from the prostate?

A

Internal iliac & sacral

95
Q

What lymph nodes drain lymph from the seminal vesicle?

A

Internal & external iliac

96
Q

What lymph nodes drain lymph from the scrotum?

A

Superficial inguinal

97
Q

What lymph nodes drain lymph from the penis?

A

Skin - superficial inguinal
Glans/distal spongey urethra - deep inguinal and external iliac
Cavernous bodies & proximal spongey urethra - internal iliac

98
Q

What do the testes look like histologically?

A

Convoluted seminiferous tubules
4-8 layers of cells
Spermatozoa in the lumen
Leydig cells in the interstitial spaces between tubules

99
Q

What does prostate look like histologically?

A

Serous alveoli with infolding epithelium Trabeculae of muscular stroma
Amorphous eosinophilic masses, called corpora amylacea in the alveoli of older men

100
Q

What do seminal vesicles look like histologically?

A

No sperm in lumen
Highly recessed and irregular lumen forming crypts and giving honeycombed appearance
Well developed muscular externa

101
Q

What does vas deferens look like histologically?

A

Lumen stellate shape
A thick walled muscular tube
Epithelial lining and its supporting lamina propria are thrown into longitudinal folds

Year 3 Anatomy (12 decks)

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