SUGER 3 - Lower limb nerves and muscles, lower urinary tract and pelvic floor

Question 1

What are the names for the male and female pelvis?

Answer 1

M: android pelvis
F: gynaecoid pelvis

Question 2

Features of the gynaecoid pelvis

Answer 2

• wider
• broader
• lighter

Question 3

The pubic inlet is oval shaped in..

Answer 3

females

Question 4

What shape is the pubic inlet in males?

Answer 4

heart shaped

Question 5

Features of the android pelvis

Answer 5

• longer sacrum

- more narrow sub-pubic arch

Question 6

What adaptations makes the female pelvis more suited to childbirth?

Answer 6

• wider, broader, lighter pelvis
• less prominent ischial spines
• oval shaped pubic inlet
• wider subpubic arch
• shorter coccyx

Question 7

3 parts of the pubis

Answer 7

• superior rami
• inferior rami
• pubic tubercle

Question 8

Parts of the ischium (sit bones)

Answer 8

• superior ischial ramus
• body of ischium
• inferior ischial ramus

Question 9

Parts of the ilium

Answer 9

• iliac crest
• wind of ilium (illac fossa)
• ASIS
• acetabulum

Question 10

Psoas major and iliacus are both..

Answer 10

flexors of the hip

Question 11

What is the trigone?

Answer 11

smooth area of mucosa on inner aspect of base of bladder

Question 12

The ridge of muscle between the ureteric orfices is the…

Answer 12

inter-ureteric bar

Question 13

How do the ureters pass into the bladder wall? What feature does this give the ureters and what does it allow?

Answer 13

• ureters pass obliquely
• gives ureters a valve-like mechanism
• prevents urine reflux when bladder contracts

Question 14

Where may kidney stones arrest in the ureter? Name the sites

Answer 14

• stones stuck in places where ureter narrows
• pelvo-ureteric junction
• over the iliac vessels
• entering the bladder

Question 15

Blood supply of the bladder

Answer 15

internal iliac arteries

Question 16

Does the ureter run under of over the uterine artery?

Answer 16

runs under (water under the bridge)

Question 17

Overview of micturition

Answer 17

• parasymp nerves stimlate detrusor muscle to contract
• sympathetic nerves inhibit external and internal spincters - sphincters relax
• detrusor contraction > bladder contraction
• spincter relaxation > urine out

Question 18

Spinal reflex for micturiton is between which nerve roots? Is this automatic or not?

Answer 18

S2-S4 - AUTOMATIC REFLEX - found in pre-potty trained children

Question 19

What happens to your ability to wee upon spinal cord transection?

Answer 19

• wee yourself as higher centres are unable to inhibit the spinal reflex

Question 20

Control of the internal and external urethral sphincter

Answer 20

INTERNAL: involuntary
EXTERNAL: voluntary

Question 21

What action does the pedunal nerve have in weeing? What are its nerve roots and fibre type?

Answer 21

• S2-S4
• somatic
• allows you to hold wee in
• contracts external urethral sphincter when we hold wee in

Question 22

What action does the pelvic nerve have in weeing? What are its nerve roots and fibre type? (AFFERENT)

Answer 22

• paraympathetic
• detect bladder stretch
• AFFERENT FIBRES TO S2-S4
• involved in automatic spinal reflex

Question 23

What action does the pelvic nerve have in weeing? What are its nerve roots and fibre type? (EFFERENT)

Answer 23

• paraympathetic
• EFFERENT FIBRES FROM S2-S4
• causes contraction of detrusor muscle
• cause sphincter relaxation

BLADDER = VOID/EMPTIED

Question 24

What action does the hypogastric nerve have in weeing? What are its nerve roots and fibre type?

Answer 24

• T10-L2
• sympathetic - stops your wee
• causes relaxation detrusor
• causes contraction of internal sphincter