week 10 Flashcards
Pelvic Viscera
what is the Pelvic region?
Trunk area between
abdomen and lower limb. Has 2 components:
– Pelvic cavity
* Bowl-shaped space
enclosed by bony pelvis
– Perineum
* Diamond shaped area
inferior to pelvic floor
what is a Pelvic inlet?
– Superior bony aperture
– Promontory of sacrum,
arcuate line of ilium,
pectineal line of pubic
bone & superior border of
pubic symphysis
what is a Pelvic outlet?
Inferior bony aperture
– Line connecting coccyx,
sacrotuberous ligs., ischial
tuberosities, ischiopubic
rami, inferior border of
pubic symphysis
what is a false pelvis?
Above pelvic brim. Includes; Cecum, appendix, sigmoid colon, loops of
small intestine.
what is a true pelvis?
Below pelvic brim. Includes: Bladder, rectum, pelvic genital structures
what is the Pelvic girdle formed by?
Formed by
– Left & right hip bones
– Sacrum
what is the Pelvic bone?
-also called:Innominate/hip bone
-has 3 parts: Ilium, Ischium, Pubis
-includes Acetabulum
what are the parts of the ilium?
Ala
* Iliac crest
* Iliac tuberosity
* Anterior superior iliac spine
* Anterior inferior iliac spine
* Posterior superior iliac spine
* Greater sciatic notch
* Iliac fossa
* Auricular surface
what are the parts of the ischium?
- Body
- Ramus
– Ischiopubic ramus - Obturator foramen
- Ischial spine
- Sciatic notches
–greater sciatic notch
–lesser sciatic notch - Ischial tuberosity
what are the parts of the pubis?
Body
* Ramus
–superior pubic ramus
–inferior pubic ramus
* Symphyseal face
* Pubic symphysis (joins 2 pubic bones together inbetween the pubises)
* Pubic crest
* Pubic tubercles
what are the Pelvic urinary organs?
Ureters, Urinary bladder, Urethra
ureters function
- found in Pelvic portions
- carries Urine from kidneys to
urinary bladder
Urinary bladder function
Temporary storage of
urine
Urethra function
Conducts urine from
bladder to exterior
what are the ureters?
Muscular ducts
* 25-30cm long
are ureters retroperitoneal or intraperitoneal?
the Abdominal part is Retroperitoneal
what is the Pathway of the ureters?
Pathway
– From apices of renal pelves
– Passes over pelvic brim
* Bifurcation of common iliac
arteries
– Run along lateral wall of
pelvis
– Enter the urinary bladder
label this diagram
where does the ureters pass under in males?
Passes under the pelvic
portion of the ductus
deferens
where does the ureters enter in males?
Enters bladder lateral to
free ends of seminal
vesicles
where does the ureter pass in females?
Passes inferior to the
uterine arteries within
cardinal ligaments
what is the Ureter blood supply
what is the Urinary bladder?
Muscular reservoir for
temporary storage of urine
where is the urinary bladder found?
Normally found in true
pelvis – May extend into false pelvis
when distended
what is the anterior relation of the urinary bladder?
Anterior relation
– Pubic symphysis
– Retropubic space
what is the posterior relation of the urinary bladder?
Posterior relation:
– Males: rectum
– Females: upper vagina
which part of the Peritoneum is the urinary bladder found?
– Superior surface
what shape is the Urinary bladder?
Tetrahedral in shape
what are the 4 parts of the urinary bladder?
Four parts:
– Apex
* found near Pubic symphysis
* Median umbilical lig.
extends from apex to
umbilicus
– Fundus
* Base, posterior wall
– Body
* Most of the bladder
– Neck
* Lowest and least mobile
region
what does the Urinary bladder include?
- Walls
–detrusor muscles - Neck of male bladder
– Muscle fibres form
involuntary internal
urethral sphincter - Trigone of bladder
– Ureteric orifices
Urinary bladder in pregnancy
A growing fetus inside your uterus can pressure or squish your bladder so it holds less pee. Also, hormone changes during pregnancy cause the pelvic floor muscles that hold your bladder in place to loosen and weaken. An increase in progesterone causes these muscles to become more flexible. not enough space for bladder to expand during pregnancy.
what is the Urethra?
Muscular conduit for
urine & semen
where does the urethra extend from?
Extends from internal
urethral orifice to
external urethral orifice
urethra in females?
–4cm long(its tiny-from the neck of the urethra)
– Lies anterior to vagina
– Passes through hiatus in
pelvic diaphragm
– Opens within vestibule of
vagina directly anterior to
vaginal orifice
Urethra in males
– 18-22cm long
– Four parts:
* Intramural part
(preprostatic part)
– Neck of bladder
* Prostatic part
– Surrounded by prostate
gland (major clinical complications)
* Membranous part
– Passes through perineal
membrane
* Spongy part
– found within the Corpus spongiosum
what is the rectum?
comes after sigmoid colon, Continuation of
gastrointestinal tract in
pelvis
function of rectum?
Functions:
– Temporary storage of
fecal matter
what does the rectum lie anterior to?
Lies anterior to sacrum
anterior relations of the rectum in males?
Males: bladder, seminal
vesicles & prostate
anterior relations of the rectum in females?
Females: vagina
does the rectum have a mesentery?
no mesentery- nothing holding it to the posterior wall because it lies against the posterior wall.
in the superior 2/3 of rectum it is retroperitoneal (behind the peritoneum). in inferior 1/3 of rectum it is subperitoneal (below the peritoneum)
what does the rectum lack?
unlike the rest of the large intestine, it does not contain taeniae coli, haustra & epiploic appendages
where does the rectum begin?
Begins at rectosigmoid
junction
– S3
where does the rectum Terminate?
Terminates at anorectal
junction
what are the Internal walls of the rectum?
Internal wall: three transverse
rectal folds
what is the lowest part of the rectum?
Ampulla (Most distal segment). Ampulla means large opening or pouch like structure
what are the Seminal glands (vesicles)?
Paired elongated, coiled tube
where do the Seminal glands (vesicles) lie?
- Lies between fundus of bladder and
rectum - Lies superior to prostate in an
oblique direction
what is the peritoneal location of the seminal glands?
Subperitoneal: This indicates the location of the seminal glands, meaning they are situated beneath the peritoneum, the membrane lining the abdominal cavity.in males its positioned in the Rectovesical pouch: area (between the rectum and the bladder).
what is the Ejaculatory duct?
Slender tubes. This is a part of the male reproductive system formed by the union of the duct of the seminal vesicle and the ampulla of the ductus deferens. It serves as a passageway for semen during ejaculation.
what is Duct of seminal vesicle and ampulla of ductus deferens?
These are the structures that merge to form the ejaculatory duct. The seminal vesicle duct carries seminal fluid from the seminal vesicles, while the ampulla of the ductus deferens is a dilated portion of the vas deferens (ductus deferens).
what are the Seminal glands (vesicles) supplied by?
Supplied by:
– Inferior vesicle artery; This artery provides blood supply to various structures in the pelvic region, including the seminal glands.
– Middle rectal arteries;These arteries supply blood to the middle part of the rectum and adjacent structures, which would include the area where the seminal glands are located.
where dies the ejaculatory duct arise ?
Arise near neck of
bladder
where does the ejaculatory duct pass through and drain into?
- Passes through
posterior prostate - Drains into prostatic
urethra
what are the Lobes of prostate?
– Isthmus
* Anterior
– Left & right lobes
* Inferoposterior lobule
* Inferolateral lobule
* Superomedial lobule
* Anteromedial lobule
what is the bulbo-urethral glands?
glands that also contribute to seminal fluid, used to be called cowper glands, they are Paired pea-sized mucus secreting glands
where are the bulbo-urethral glands located?
Below prostate glands, Embedded within external urethral sphincter
what are the Bulbo-urethral gland ducts ?
– pass through perineal
membrane
– Open into proximal spongy
urethra
what are the Ovaries?
Paired almond shaped female
gonads
function of ovaries
–Development of oocytes and Reproductive hormones
where do the ovaries reside?
Reside in lateral wall of pelvis
what is the ligament of the ovary attached to?
Ligament of the ovary
– Attached to superolateral uterus
what is the suspensory ligament of ovary?
Peritoneal fold coverings ovarian
vessels & nerves crossing pelvic
brim
what is the Mesovarium and its function?
– Subdivision of broad ligament
– Suspends ovary
what are the ovaries supplied by?
Supplied by ovarian artery
– coming from Abdominal aorta (L2)
what are the Uterine tubes?
also called Fallopian tubes or oviducts,10cm long Paired muscular tubes
function of uterine tubes
Conducts oocyte from ovary
to uterine cavity and Provides usual site of fertilization
location of uterine tubes
Extend laterally from uterus
– opens into peritoneal cavity
near ovaries
what is the Mesosalpinx?
– Narrow mesentery forming
free edges of broad lig
what are the Four parts (lateral to
medial) of the uterine tubes?
– Infundibulum
* Funnel shaped, abdominal
ostium, fimbriae
– Ampulla
* Longest, widest part
* Usual site of fertilization
– Isthmus
* Thick-walled part
– Uterine part
* Intramural part passing
through wall of uterus
what is the uterus?
Thick-walled, pear shaped,
hollow muscular organ
functions of the uterus
Functions
– Site of implantation of
fertilized egg
– Development of the embryo
– Parturition of the fetus
* Muscular wall adapt, provide
power
what are the Two parts of the uterus?
– Body (sup ⅔)
* Fundus
* Isthmus
– Interal os of uterus
– Cervix (inf ⅓)
* Supravaginal part
* Vaginal part
– External os of uterus
what is the uterine cavity?
Narrow space within
body of uterus
what are the Positions of the uterus?
A-G
what are the 3 uterine wall layers?
Three layers:
– Perimetrium
*outer serous layer
– Myometrium
*middle muscular layer
– Endometrium
* inner mucous layer
what prevent prolapse of the uterus?
the ligaments of the uterus will keep it in place
what is the very large structure that holds the uterus in place?
Broad ligament of the uterus.
what is the broad ligament if the uterus?
Double fold of peritoneum and extends from uterus to sidewalls of pelvis
what are the parts of the broad ligament of the uterus?
Parts:
* Mesosalpinx
– Ensheaths uterine tubes
* Mesovarium
– Suspends ovary
* Mesometrium
– Uterine body to walls of pelvis
where is the Ligament of the ovary found?
Postero-inferior to utero-tubal junction
where does the round ligament of the uterus originate?
Originate near fundus
where does the round ligament of the uterus pass?
Pass through deep inguinal ring & inguinal canal
where does the round ligament of the uterus insert?
Inserts in the labia majora
What are the uterine ligaments from cervix?
to prevent prolapse we need to ensure the cervical part of the uterus, the cervix is held in place. Cervix has paired cardinal ligaments towards the lateral side, this is called the transverse cervical ligaments, goes from cervix to pelvic sidewall. it also has ligaments that connect to the sacrum, called the paired uterosacral ligaments. They go around the rectum and these are called the uteral sacral ligaments. There are quite a few ligaments that sort of hold the cervix in place together with the broad ligament of the uterus that holds that in place.
what is the vag?
Distensible fibromuscular tube
