Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anatomy > Reproductive > Flashcards

Reproductive Flashcards

1
Q

ovary

1. overview

A
  1. overview
    a. suspended from posterior aspect of broad ligament by mesovarium and lateral pelvic wall by suspensory ligament of ovary
    * **accessory ovary may occur in mesovarium or adjacent area and show tumor or cyst formation
    b. joined to uterine body inferior to uterine tube by ovarian ligament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ovary

2. blood supply

A

ovarian artery from abdominal aorta and through anastomic ovarian branch of uterine artery
***the ureter may be cut during oophorectomy because it lies near the ovarian vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ovary

3. venous draining

A

ovarian vein, which joins the inferior vena cava on right and left renal vein on left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ovary problems

A

the ureter lies immediatly behind the peritoneum of the ovarian fossa on the lateral pelvic wall where it may be cut or ligated while transecting or suturing the suspensory ligament of the ovary

although ovarian tumors are common and usually benign , malignant tumors are the leading cause of gynecologic cancer deaths . unfortunantly most neoplasms are either asymptomatic or are associated with nonspecific symptoms until advanced stages. accessory ovaries are uncommon but probably underreported because their precense isnt discovered until they develop ymptomatic tumors or cysts.

streak goands consisting of fibrous connective tissue and lacking oocytes are a form of gonadal dysgenisis. they are characteristic of turner syndrome (45,X) but also may result from genetic mutations. ovarian dysgenisis causes increased risk of ovarian cancer

postpartum loss of ligamentous support may allow prolapse of an ovary into a pouch, resulting in painful intercourse (dyspareunia). the prolapsed ovary can be palpitated through the posterior vaginal fornix

**the ovary may prolapse into the rectouterine pouch following childbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

uterine tube

1. overview

A

a. drapped by the upper baorder of broad ligament between the ovary and the uterus
b. connects the uterine cavity to the peritoneal cavity near the ovary

**the fibriae of infidubulum sweep discharged oocyte from the peritoneal cavity into the uterine tube for fertilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

uterine tube

2. infudibulum

A

a. funnel shaped expansion of lateral end, fringed with fimbrae
b. abdominal ostium overlies ovary and receives oocytes at ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

uterine tube

3. ampulla

A

a. medial contiuniation of infidubulum comprising about half of the uterine tube
b. usual site of fertilization
* ***the uterine ttransports the coceptus to the uterine cavity for implantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

uterine tube

4. isthmus

A

narrowest part of tube just lateral to the uteus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

uterine tube \

5. intramural part

A

pierces uterine wall to open into the uterine cavity

**tubal scarring from pelvic inflammatory disease causes infertility or ectopic pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

uterine tube diseases

A

sexually transmitted disease can spread from the vagina to the uterus and the uterine tubes, causing pelvic inflammatory disease. the resulting salpingitis produces scarring which often causes infertility or ectopic pregnancy. in tubal pregnancy the most common form of ectopic preganancy, the uterine tube ruptures and causes potentially fatal intraperitoneal hemorrhage with intense abdominal pain. the close relationship of the appendix to the uterine tube and ovary on the rifht side mean that a ruptured tubal pregnancy may be mistaken for acute appendicitis

*****most a ectopic pregnancies are tubal pregancies ending with tubal rupture and intraperitoneal hemorrhage
symptoms from ruptured right tubal pregnancy may be confused with acute appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

uterus

1. fundus

A

rounded upper part of body above entrances of uterine tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

uterus

2. body

A
  • **anteverted, anteflexed position resting atop of the urinary bladder provids passive support for the uterus
    a. main part of the uterus between the fundus and the cervix
    b. contains triangular uterine cavity continuous superiorly with lumina of uterine tibes and inferiorly with internal os
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

uterus diseases

A

the adult uterus is usually tilted anteriorly relative to the vagina (anteverted) with the body flexed anteriorly on the cervix (anteflexed)
this position places the body of the uterus above the empty bladder providing passive support to supplement that provided by the pelvic fascial ligaments (transverse cardinal ligaments) , perneal body, perneal membrane. dynamic support for the uterus is provided by the pelvic diaphram. if the uterus assumes a retroverted position, increased intraabdominal pressure tends to push it down into or through the vagina ( prolapse of the uterus) .
other types of pelvic organ prolapse include herniation of the bladder (cystocele) or urethra( urethrocele) into the anterior vaginal wall and the small intestine ( enterocele) or rectum (rectocele).

factors contributing to pelvic organ prolapse include pregnanc or childbirth, connective tissue disorder, denervation of the pelvic diaphram , obesity , chronically increased intraabdominal pressure (chronic pulmonary disease, strenous physical exercise) and menopause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

the rectouterine puch

A

the rectouterine pouch is the lowest point in the female peritoneal cavity, and pathological fluids collect there

the peritoneum covers only the fundus and body of the uterus anteriorly, but posteriorly it descends to also cover the supravaginal cervix and posterior fornix of the vagina . therefore the shallow peritoneal recess, the vesicouterine pouch separates the uterus from the bladder anteriorly, while posteriorly the deep rectouterine puch intervenes between the uterus and the rectum. the rectouterine pouch is the lowest point of the peritoneal cavity in the female and thus is a site for pathological fluids to collect .

pregnancy, childbirth, estrogen deficiency , and chronic increases in intraabdominal pressure contribute to pelvic organ prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

uterus

3. the cervix

A

a. cylindrical lower third of the uterus projecting inferiorly into the vagina
b. cervical canal communicates with uterine cavity at internal os and with cavity of vagina at external os

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

uterus cervix disorders

A

placenta previa(when the pacenta covers the opening in the mothers cervix) with painless vaginal bleeding follows blastocyst implantation close to the internal os

Until the 1940s cervical cancer was the leading cause of cancer deaths in North American women. Papanicolaou (Pap) smears leading to the detection of premalignant conditions (called dysplasia) and regular examinations have greatly decreased the incidence to the point that it is now the least common gynecologic cancer. A vaccine is now available for the human papillomavirus (HPV), which should even further decrease the risk for developing cervical cancer.

The external os is circular in the nulliparous female and slitlike transversely in the multiparous female. If a blastocyst implants close to the internal os, the placenta bridges the opening (placenta previa) and causes painless vaginal bleeding late in pregnancy. If the decidua basalis is absent from the placenta, as may occur in a pregnancy following a cesarean section or other source of uterine scarring, villi of the chorion frondosum attach directly to the myometrium (placenta accreta). The condition is clinically important both because placenta previa often is associated with it and because life-threatening postpartum hemorrhage occurs due to failure of placental separation. A hysterectomy frequently is necessary, but embolization of the arterial supply may be attempted.

the placenta is formed by maternal decidua basalis and fetal chorion frondosum

placenta accreta causes life threatening postpartum hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

uterus

4. uterine artery

A

a. crosses the pelvic floor in base of broad ligament and ascends along the lateral wall of uterus
b. near uterus passes superior and anterior to ureter
c. vaginal branch anastomoses with vaginal artery
d. ovarian branch anastomoses with ovarian artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

uterus

5.round ligament

A

attaches to the lambium majus , transverses inguinal canal and is joined to the uterine body near the ovarian ligament with which it shares its origin from the gubernaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

the round ligament is stretched as the uterus enlarges during pregnancy

A

its attachment in the labium accounts for the sensation some patients describe as pulling in the groin. uterine prolapse may occur from damage to the pelvic floor during childbirth or after menopause because of atrophied pelvic structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

uterus

6. bimanual examination

A

bimanual examination of the uterus. by placing one hand on the lower abdominal wall and one or two fingers of the other hand in the vagina. the examiner can palpae the cervix and body of the uterus , bladder base, urethra and abdominal pelvic masses through the posterior wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

leyomas

A

uterine fibroids…are the most common benign tumors of the female genital tract. they may be symptomatic or cause urinary frequency , abnormal uterine bleeding , impaired firtility or spontaneous abortion . hysterectomy is surgical removal of the uterus through the anterior abdominal wall or vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

broad ligament

1. overview

A

double layer of peritoneum extending from the lateral border of the uterine body to the pelvic wall

prolonged superiorly over ovarian vessels at lateral pelvic wall as suspensory ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

broad ligament

2. mesosalpinx

A

covers uterine tube and extends inferiorly to base of mesovarium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

broad ligament

3. mesovarium

A

shelflike posterior extension suspending the ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

broad ligament

4. mesometrium

A

inferior to the base of the mesovarium extending to the uterine wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

vagina

1. overview

A

a.
Distensible fibromuscular tube usually collapsed in an H-shape with its anterior and posterior walls in contact

b.
Superior three-fourths in pelvis and inferior fourth in perineum

c.
Recess around uterine cervix divided into anterior, posterior, and lateral fornices

d.
Opening into vestibule may be partially closed by thin, crescentic hymen in virgins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

vagina

2. blood supply

A

vaginal branch of uterine artery , vaginal artery, and internal pudendal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

vagina

3. venous drainage

A

vaginal tributaries of internal iliac arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

vagina

4. lymphatic drainage

A

superior to hymen drains to the external and internal iliac nodes:inferior to hymen follows prineal drainage to superficial inguinal nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

vagina

5 vaginal supports

A

a. inferior part:perineal body
b. middle part: urogenital diaphram
c. superior part: levator of ani and transverse cervical , uterosacral, and pubocervical ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

vaginismus

A

Vaginismus is involuntary spasm of the muscles surrounding the lower vagina, causing inability to engage in coitus and often making pelvic examinations difficult. It may have an organic basis, be caused by past sexual abuse or trauma, or be entirely psychological in origin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

vaginismus

A

Vaginismus is involuntary spasm of the muscles surrounding the lower vagina, causing inability to engage in coitus and often making pelvic examinations difficult. It may have an organic basis, be caused by past sexual abuse or trauma, or be entirely psychological in origin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

vessels of the pelvis

A. internal iliac artery

A

arises from bifurcation of common iliac artery at the pelvic brim and descends into the pelvis anterior to sacroiliac joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

peripheral vascular disease

A

commonly affects the internal and external iliac arteries, requiring surgical bypass to restore blood flow . if only the external iliac artery is occluded , collateral circulation via the inferior gluteal artery to cruciate anatomosis may maintain the lower extremity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

vessels of the pelvis

B. ovarian artery

A

branch of the abdominal aorta descending retroperitoneally to enter the suspensory ligament of the ovary at the pelvic brim

anatomoses with ovarian branch of the uterine artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

vessels of the pelvis

C. superior rectal artery

A

direct continuation of the inferior mesenteric artery supplying the rectum and upper half of the anal canal

anatosomes with middle rectal artery (internal iliac artery) and the inferior rectal artery (internal pudendal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

vessels of the pelvis

D. veins of the pelvis

A

generally correspond to arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

vessels of the pelvis

E. lymphatic drainage of the pelvis

A

mostly follows the internal iliac vessels to internal iliac nodes and then to the common iliac and aortic (lumbar) nodes ; some lymph goes first to the sacral nodes

from the upper rectum is largely along the superior rectal vessels first to inferior mesenteric nodes and then to the aortic nodes

lymphatic drainage of ovary and the testies follows blood supply to aortic nodes

39
Q

nerves of the pelvis

A. SACRAL PLEXUS

A

the sacral plexus is a network of nerve fibers that supply the skin and muscles of the pelvis and the lower limb. it is located on the surface of the posterior pelvic wall anterior to the periformis muscle

the plexus is formed by the anterior rami of the sacral spinal nerves S1 S2 S3 AND S4 it receives contributions from the lumbar spinal nerves L4 AND L5

major branches of the sacral plexus

some irish sailor pesters polly
superior gluteal , inferior gluteal , sciatic , posterior cutaneous nerve of the thigh, pudendal

40
Q

superior gluteal nerve

A

the superior gluteal nerve leaves the pelvis via the greater sciatic foramina entering the gluteal region superiorly to the periformis muscle . it is accompanied by the superior gluteal artery and vein

roots:L4 L5 S1
motor functions: innervates the gluteus minimus gluteus medius and tensor fascia lata
no sensory functions

41
Q

inferior gluteal nerve

A

it leaves the pelvis via the greater sciatic foramen entering the gluteal region inferiorl to the piriformis muscle . it is accompinies by the inferior gluteal artery and vein for much of its course

roots : L5, S1, S2
motor functions: innervates gluteus maximus
no sensory functions

42
Q

sciatic nerve

A

roots : L4 L5LS1LS2LS3
MOTOR FUNCTIONS :
tibial portion-innervates all the muscles in the posterior compartment of the thigh including the hamstring portion of the adductor magnus , apart form the short head of the biceps femoris . all muscles in the posterior compartment of the leg . all muscles in the sole of the feet

common fibular portion : short head of biceps femoris , all muscles in the anterior and lateral compartments of the leg and extensor digitorum brevis

sensory functions-
tibial portion : innervates the skin on the posterolateral medial surfaces of the foot as well as the sole of the foot

common fibular portion: innervates the skin on the anterolateral surface of the leg and the dorsal aspect of the foot

43
Q

posterior femoral cutaneous

A

The posterior cutaneous nerve of thigh leaves the pelvis via the greater sciatic foramen, entering the gluteal region inferiorly to the piriformis muscle. It descends deep to the gluteus maximus and runs down the back of the thigh to the knee

roots: S1, S2, S3

NO MOTOR FUNCTIONS

SENSORY FUNCTIONS: innervates the skin on the posterior surface of the thigh and the leg . also innervates the skin of the perineum

44
Q

posterior femoral cutaneous

A

The posterior cutaneous nerve of thigh leaves the pelvis via the greater sciatic foramen, entering the gluteal region inferiorly to the piriformis muscle. It descends deep to the gluteus maximus and runs down the back of the thigh to the knee

roots: S1, S2, S3

NO MOTOR FUNCTIONS

SENSORY FUNCTIONS: innervates the skin on the posterior surface of the thigh and the leg . also innervates the skin of the perineum

also the external genitalia

45
Q

pudendal nerve

A

S2 S3 S4 KEEPS POO OFF THE FLOOR

This nerve leaves the pelvis via the greater sciatic foramen, then re-enters via the lesser sciatic foramen. It moves anterosuperiorly along the lateral wall of the ischiorectal fossa, and terminates by dividing into several branches.

roots: S2, S3, S4
MOTOR FUNCTIONS: innervates the skeletal muscles in the perineum, the external urethral sphincter, the external anal sphincter, levator ani

sensory functions: innervates the penis and clitoris and most skin of the perineum

46
Q

caudal epidural anesthesia

A

the needle is inserted into the sacral hiatus using a cornua as guides , and anesthetic is injected into the extradural space to numb the sacral nerve roots. the birth canal , pelvic floor, and most of the perineum are anesthetized, but the pain from the body of the uterus is unaffected . the anterior perineum wich is innervated by the ilioinguinal and gentofemoral nerves is unaffected

47
Q

nerves of the pelvis
B. branches of the lumbar plexus in pelvis
1. lumbosacral trunk

A

L4-L5

forms the psoas major and descends into the pelvis to contribute to the sacral plexus

48
Q

branches of the lumbar plexus in the pelvis

2. obturator nerve

A

roots- L2, L3, L4
forms the psoas major and enters the pelvis

enters the medial thigh through the obturator canal with the obturator vessels

49
Q

tumos of the adjacent vicera

A

tumors of the adjacent viscera may compress or invade the obturator nerve. an inflammed appendix hanging inferiorly across the pelvic brim may irritate the nerve. pain in the medial thigh and/ or weakness occurs when adducting the thigh (crossing the legs)

50
Q

autonomic nerves of the pelvis

1. sacral sympathetic trunk

A

four paravertebral ganglia joined by grey rami communicates to corresponding spinal nerve

contains preganglionic sympathetic and general viceral afferent fibers derived from L1 and L2 spinal nerves

51
Q

autonomic nerves of the pelvis

2. sacral splanchic nerves

A

a. visceral branches of the sacral sympathetic ganglia
b. contain postganglionic sympathetic and visceral afferent fibers
c. join inferior hypogastic plexus

52
Q

autonomic nerves of the pelvis

3. pelvic splanchnic nerves (nervi erigentes)

A

a. only “splanchnic “ nerves containing parasympathetic fibers
b. preganglionic parasympathetic cell bodies in sacral parasympathetic nucleus of S2-4 with fibers branching from anterior rami; postganglonic cell bodies in terminal ganglia in inferior hypogastric plexus or in wall of organ innervated
c. source of parasympathetic innervation to descending colon, sigmoid colon , pelvic organs , and external genitilia

53
Q

pelvic splanchnic nerves mediate

A

parasympathetic influences on defectation, micturation, and erection

54
Q

autonomic plexus of the pelvis

1. inferior hypogastric plexis (pelvic plexus)

A

a. supplies the pelvic organs and GI tract distal to left colic (splenic) flexure
b. formed by contributions from hypogastric nerves , pelvic splanchnic nerves, and sacral splanchic nerves
c. divided into parts named according to organ to which it is related (this vesical, prostatic, rectal, and uterovaginal plexuses)

55
Q

autonomic plexus of pelvis

2. hypogastric nerves

A

left and right nerves connect superior and inferior hypogastric plexuses

56
Q

sympathetic fibers in hypogastric plexuses

A

originate in spinal cord segments T10-L2 and are accompanied by visceral afferent fibers

57
Q

sympathetic fibers in hypogastric plexuses

A

originate in spinal cord segments T10-L2 and are accompanied by visceral afferent fibers from nerve cell bodies in posterior root ganglia at the same levels. consequently , pain from the pelvic viscera may be referred to dermatomes of these segments lying at and inferior to the umbilicus . unlike the rest of the trunk, visceral pain from pelvic organs inferior to and not in contact with peritoneum (uterine cervix and upper vagina) probably travels with sacral parasympathetic fibers to enter spinal cord segments S2-4. the boundary at which visceral afferent fibers carrying pain impulses start accompanying parasympathetic rather than sympathetic fibers is known as “pelvic pain line”

58
Q

perineum

a. overview

A
  1. diamond shaped area below the pelvic diaphram with same boundaries as inferior pelvic aperture: pubic symphasis, ischipubic rami, ischial tuberosities , sacrotuberous ligament , and coccyx
  2. roof formed by pelvic diaphragm and floor formed by skin and fascia
  3. divided by line connecting ischial tuberocities into anterior urogenital triangle and posterior anal triangle
59
Q

perineum
B. anal triangle
1. overview

A
  1. continuous with rectum at pelvic diaphragm and open externally at anus
  2. bends posteriorly at junction with the rectum (perineal or anorectal flexure) because of forward pull of puborectalis muscle
  3. kept close by puborectalis and internal and external sphincters except during defecation
60
Q

perineum
B. anal triangle
2. internal anal sphicter

A
  1. circular smooth muscle surrounding superior two-thirds of anal canal
  2. controlled by reflexy and involuntarily , with the parasympathetic nervous system promoting relaxation and smpathetic nervous system promoting contraction
61
Q

perineum
B. ANAL TRIANGLE
3. external anal sphincter

A
  1. three adjacent rings of skeletal muscle surrounding inferior two thirds of anal canal as subcutaneous , superficial, and deep parts
  2. attaches anteriorly to perineal body (central tendon of perineum)
  3. controlled volunatarily by inferior rectal branches of pudendal nerve
62
Q

perineum
B. anal traingle
4. internal features of the anal canal

A

anal columns
longitudinal ridges of mucosa in the upper half of the anal canal (related to underlying rectal veins)

anal valves
crecentric mucosal folds joining the bases of adjacent anal columns

anal sinuses
pocket like recess above anal valves (receive opening of anal glands, obstruction and infections of anal glands can produce fistulae and painful abcess )

pectinate
serrated line joining lower margins of anal valves ( marks the junction of embryonic hindgut and proctoderm , divides visceral and somatic arterial supply , venous drainage , lymphatic drainage , and innervation

63
Q

perineum
B. anal triangle
anal canal
1. overview

A
  1. continuous with rectum at pelvic diaphragm and open externally at anus
  2. bends posteriorly at junction with the rectum (perineal or anorectal flexure) because of forward pull of puborectalis muscle
  3. kept close by puborectalis and internal and external sphincters except during defecation
64
Q

perineum
B. anal triangle
anal canal
2. internal anal sphicter

A
  1. circular smooth muscle surrounding superior two-thirds of anal canal
  2. controlled by reflexy and involuntarily , with the parasympathetic nervous system promoting relaxation and smpathetic nervous system promoting contraction
65
Q

perineum
B. ANAL TRIANGLE
anal canal
3. external anal sphincter

A
  1. three adjacent rings of skeletal muscle surrounding inferior two thirds of anal canal as subcutaneous , superficial, and deep parts
  2. attaches anteriorly to perineal body (central tendon of perineum)
  3. controlled volunatarily by inferior rectal branches of pudendal nerve
66
Q

perineum
B. anal triangle
anal canal
4. internal features of the anal canal

A

anal columns
longitudinal ridges of mucosa in the upper half of the anal canal (related to underlying rectal veins)

anal valves
crecentric mucosal folds joining the bases of adjacent anal columns

anal sinuses
pocket like recess above anal valves (receive opening of anal glands, obstruction and infections of anal glands can produce fistulae and painful abcess )

pectinate
serrated line joining lower margins of anal valves ( marks the junction of embryonic hindgut and proctoderm , divides visceral and somatic arterial supply , venous drainage , lymphatic drainage , and innervation

67
Q

perineum
B. ANAL TRIANGLE
anal canal
5. characteristics of the rectum and anal canal

A

epthelium

  • columnar ( endodermal region)
  • above the pectinate line : columnar endodermal region
  • below the pectinate line : stratefied squamous ( ectodermal region)

innervation

  • visceral
  • above the pectinate line: visceral
  • below the pectinate line : somatic (from the pudendal nerve)

arterial supply: superior rectal from inferior mesenteric artery and middle rectal from the internal iliac artery

  • above the pectinate line : superior rectal to potal system
  • below the pectinate line : inferior rectal to inferior vena cava

lymphatic drainage: inferior mesenteric and internal iliac nodes

  • above the pectinate line: inferior mesenteric nodes
  • below the pectinate line: superficial inguinal nodes
68
Q

carcinomas developing above the pectinate line

A

tend to be painless, whereas those developing below the pectinate line are painful because of transition of vicseral to somatic innervation . the pectinate line is a site of dilation of prtocaval anastosomes in portal hypertension

69
Q

PERINEUM

ISCHIOANAL FOSSA

A

a. wedge shaped space on each side bounded by anal canal medially , obturator internus muscle laterally pelvic diaphram superiorly and skin inferiorly

70
Q

PERINEUM
B. anal triangle
ISCHIOANAL FOSSA

A

a. wedge shaped space on each side bounded by anal canal medially , obturator internus muscle laterally pelvic diaphram superiorly and skin inferiorly
b. has anterior recessabove the urogental diaphragm and posterior recess above the gluteus maximus
c. filled with ischioanal fat pad which cushions perineum and llows distension of the rectum
d. contains inferior rectal nerves and vessels

71
Q

ischioanal infection

A

infection commonly sprads laterally from the anal mucousa into the ischianal fossa. an ischianal infection may spread to the opposite ischioanal fossa by tracking behing the anal canal. an abscess may be localized in the anterior and posterior recesses or open onto the surface of the anal canal or the skin (anal sinus) or open in both surfaces ( anal fistula)

72
Q

perineum
b. anal triangle
pudendal (alcock) canal

A

a. tunnel formed by split in the obturator internus fascia on lateral wall of ischioanal fossa
b. gives passage to pudendal nerve and internal pudendal vessels which supply the perineum

73
Q

perinueum
c. urogenital traingle
urogenital diaphram

A

a. connect the ischipubic rami inferior to the pelvic diaphragm
b. composed of deep transverse perineal and external urethral sphincter muscles sandwitched between superior and inferior fascia or urogenital
c. inferior fascia is tough perineal membrane

d. penetrated by membranous urethra in male and membranous uretha and vagina in females

74
Q

perinueum
c. urogenital traingle
urogenital diaphram

A

a. connect the ischipubic rami inferior to the pelvic diaphragm
b. composed of deep transverse perineal and external urethral sphincter muscles sandwitched between superior and inferior fascia or urogenital
c. inferior fascia is tough perineal membrane

d. penetrated by membranous urethra in male and membranous uretha and vagina in females

75
Q

perinueum
c. urogenital traingle
deep perineal pouch

A

closed space lying between the superior fascia and inferior fascia of urogenital triangle

a. deep transverse perineal muscle
- joins contralateral muscle to help support pelvic viscera and stabilize the perineal body
- external urethral sphincter
- curculary arranged skeletal muscle fibers that surround and compress membranous urethra to provide voluntary control of micronutrion

  • membranous urethra
  • internal pudendal muscles
  • dorsal nerve of penis ans clitoris
  • bulbourethral glands of the male
  • portion of vagina in female
76
Q

perinueum
c. urogenital traingle
superficial perineal pouch
overview

A

space between the inferior fascia of urogenital diaphragm and membranous layer of superficial perineal fascia containing erectile bodies in both sexes

closed, except anteriorly where puch communicates over pubis with ptential space deep to membranous layer of superficial abdominal fascia (scarpa fascia)

77
Q

perinueum
c. urogenital traingle
superficial perineal pouch
ischiocavernosus muscle

A

arises from the ischipubis muscle and ishial tuberocity and inserts into and covers crus ot penis and clitoris

helps maintain erection of penis and clitoris by compressing crus and impeding venous return

78
Q

perinueum
c. urogenital traingle
superficial perineal pouch
bulbospongiosus muscle

A

paired muscle joining in midline in males, remaining separate in females
1. in male, arises from the central tendon and median raphe, inests buld of penis and inserts into dorsum of the penis and perineal pouch
2. in female, it arises from perineal body , invests in bulb of vestibule and inserts into the dorsum of clitoris and pubic arch
3. in male compressed bulb of penis to help maintain erection and to expel urine and semen from the urethra
4 in female compressed buld of vestibule and greater vestibular gland

79
Q

perinueum
c. urogenital traingle
superficial perineal pouch
overview

A

space between the inferior fascia of urogenital diaphragm and membranous layer of superficial perineal fascia containing erectile bodies in both sexes

closed, except anteriorly where puch communicates over pubis with ptential space deep to membranous layer of superficial abdominal fascia (scarpa fascia)

80
Q

perinueum
c. urogenital traingle
superficial perineal pouch

bulb of vestibule, crus of clitoris, and greater vestibular (bartholin) gland in female

bulb and crus of penis in male

branches of internal pudendal vessels

perineal branches of pudendal nerves

superficial transverse muscle

superficial perineal (colles) fascia

A

superficial transverse perineal muscle

  • often poorly developed paired muscle arising near ischial tuberocity and inserting into perineal body
  • helps stabilize perineal body

superficial perineal fascia
- membranous layer continuous with dartos layer of the scrotum , superficial fascia of the penis , and deep layer of superficial abdominal mass

81
Q

episiotomy

A

prevents uncontrolled tearing of perineal body and external anal sphincter

82
Q

perinueum
c. urogenital traingle

perineal body(central tendon of the perineum)

A
  1. median fibromuscular mass at the posterior edge of the urogenital diaphragm midway between the vagina and anal canal
  2. provides support for pelvic organs through attachment for pelvic diaphragm , perineal membrane, and perineal muscles or urogenital and anal triangles
83
Q

during childbirth the perineal body

A

is susceptable to stretching and tearing which may cause perminant weakness of the pelvic floor. to prevent tearing and to control damage , an episiotomy may be performed either through the posteriolateral vaginal wall or through the vaginal wall and the perineal body in the posterior midline. because the perineal body anchors perineal structures , an injury may effect urination , defecation, and sexual finctioning

84
Q

pudendal nerve

A

lies against the ischial spine as it passes through lesser sciatic foramen to transverse pudendal canal on lateral wall of ischioanal fossa

the pudendal nerve gives the inferior rectal, perineal, and dorsal nerve of penis/ clitoris branches

the pudendal nerve can be readily blocked at the ischial spine as it enters the perineum

85
Q

to relieve pain for the mother and to prepare for and episiotomy

A

a pudendal nerve block may be administered during early labor. the nerve may be blocked either by piercing the vaginal wall posteriorlaterally near the ischial spine or percutaneously along the medial side of the ischial tuberosity. complete anethesia of the perineal skin requires additional injections to block the perineal branches of the ilioinguinal, gentofemoral, and posterior femoral cuaneous nerves . pain from the uterine contractions is unaffected because the uterine body pain is carried by visceral afferent accompanying sympathetic nerve fibers in the pelvic plexus

86
Q

pudendal nerve

1. inferior rectal nerve

A

a. arises from the pudendal nerve proximal to or in pudendal canal
b supplies external anal sphincter muscle and sin around the anus

87
Q

pudendal nerve

2. perineal nerve

A

a. deep branch is motor nerve to muscles and urogenital triangle
b. superficial branch gives cutaneous posterior scrotal and labial branches

88
Q

deep perineal nerve

A

supplies the muscles of the superficial and deep perineal poches

89
Q

pudendal nerve

3. dorsal nerve of the penis and clitoris

A

a. runs on dorsal surface with the dorsal artery and deep dorsal vein
b. supplies the body, prepuce, and glands of the penis and clitoris

90
Q

internal pudendal artery

A
  1. arises from the internal iliac artery and transversus greater and lesser sciatic foramina
  2. transverses pudendal canal and pudendal nerve
91
Q

branches of the internal pudendal artery

A
  1. inferior rectal - supplies the skin and muscle of the lower anal canal -arises proximal to or within pudendal canal
  2. perineal artery- supplies the perineal body and posterior scrotal or labial branches
  3. labia artery of bulb of penis or clitoris - supplies the bulb of the penis and bulbourethral glands (males) and bulb of the vestibular gland and greater vestibular gland (females)- arises in deep perineal space and pierces the perineal membrane to enter the bulb
  4. deep artery of the clitoris or penis- runs in crus of penis or clitoris to supply erectile tissue of corpus cavernosum - terminal branch of internal pudendal in deep perineal space ; pierces perineal membrane to enter cus
  5. dorsal artery of the penis and clitoris- supplies body of penis or clitoris - terminal branch of internal pudendal in deep perineal space ; pierces perineal membrane to run with dorsal nerve
92
Q

veins of the perineum

A
  1. corresponding mostly to branches of internal pudendal artery and follow internal pudendal vein to internal iliac vein
  2. superficial dorsal vein drains into external pudendal vein , a tributary of great saphenous vein
  3. deep dorsal vein of penis enters the pelvis to drain into prostatic venous plexus in male
  4. deep dorsal vein in clitoris enters the pelvis to drain into vesical venous plexus in female
93
Q

lymphatic drainage of perineum

A
  1. is mostly to superficial inguinal nodes along the external pudendal vessels, including drainage of lower parts of vagina and anal canal
  2. deep perineal pouch , membranous urethra, and most of the vagina drain into the internal iliac nodes along the internal pudendal vessels
  3. glans and body of the penis drain into deep inguinal and internal iliac nodes
  4. lymph from the testies drains along the testicular vessels to aortic (lumbar) nodes

Anatomy (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions