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Front 1

what does that bladder do?

Back 1

muscular organ in the pelvis that temporarily holds urine so you don’t have to constantly use the restroom/tree/ally next to mason inn. When filled with about 1⁄2 pint, people begin to feel discomfort and with 3 pints, the bladder extends above the pubic bone into what would normally be the abdominal space.

Front 2

Whats different about a child's bladder

Back 2

In children, the bladder normally extends above the pubic bone, even when empty.

Front 3

What is a suprapubic custotomy

Back 3

is used to access the bladder in patients who have an obstructed urethra and are otherwise unable to tolerate a catheter. These patients have an elevated bladder allowing you to poke the patient right above the pubic bone without puncturing the peritoneum.

Front 4

Where is the bladder in women

Back 4

located anterior to the uterus, posterior to the pubic bone, and superior to the urethra. The Utero-vesicular pouch is a fold in the peritoneum that separates the uterus from the bladder. This pouch does not extend down to the cervix or anterior fornix.

Front 5

where is the bladder in men

Back 5

Posterior to pubic bone, anterior to the rectum, inferior to Small intestines, and superior to the prostate.

Front 6

what is the blood supply and lymph drainage of the bladder for both men and women

Back 6

Blood supply is by vesicular branch of the internal illiac artery. Lymph drains to internal illiac nodes.

Front 7

what are the three part of a urthra in men

Back 7

Spongy (in the shaft)
Membranous (UG diaphragm part)
Prostatic (in the prostate)

Front 8

what do you have to be wary of when putting a catheter

Back 8

When placing a catheter it’s very important to note the curvatures in the urethra.

Front 9

explain the ureter in women

Back 9

is short and straight, making the placement of a catheter much easier. The female urethra extends through the UG diaphragm making it a Perineal and Pelvic structure.

Front 10

who is more likely to get a bladder infection

Back 10

Infections of the urethra and bladder are more common in women - due to shorter urethra and a
more distensible urethra.

Front 11

explain the through where a full bladder can be cannulated

Back 11

A full bladder may be cannulated through anterior abdominal wall just above pubic bone (suprapubic cystotomy); peritoneum is peeled off the anterior body wall as bladder becomes intra-abdominal – no danger of peritonitis.

Front 12

what do you use for a transurethral resection of a bladder tumor

Back 12

a cytoscope

Front 13

what is a cystocele

Back 13

herniation of the bladder into the vaginal wall

Front 14

describe the vagina

Back 14

normally 8-10cm long with a gutter type deal that extends around the cervix called the fornix.

Front 15

what is important about the location of the fornix

Back 15

directly anterior to the Rectal-Uterine pouch (Pouch of douglas)

Front 16

what does the pouch of douglas contain

Back 16

contains the peritoneal wall and abdominal cavity.

Front 17

what could happen in an amateur abortion

Back 17

the posterior fornix is punctured and results in a fistula between the vagina and abdominal cavity => peritonitis.

Front 18

what do you do if you have peritonitis at the pouch of douglas

Back 18

you can insert a needle into the posterior fornix to drain the area

Front 19

where is the ureter in a girl

Back 19

lateral to vagina

Front 20

what do obstructions of the ureters develop into

Back 20

renal damage--> failure

Front 21

uterine extension to the superficial inguinal nodes is via the _________________

Back 21

uterine extension to the superficial inguinal nodes is via the round ligament

Front 22

how do you diagnose a neoplasm in the pouch of douglas

Back 22

A neoplasm in the pouch of Douglas can be felt with an examining finger in the vagina.

Front 23

what happens to the fornix as you age

Back 23

it shrinks

Front 24

what instrument is used to exam the vagina

Back 24

speculum

Front 25

what are teh 3 parts of the uterus

Back 25

The fundus, Body, and cervix.

Front 26

explain the uterovesicular pouch.where is it?

Back 26

lies Anterior to the uterine body and is a pocket of peritoneum. Apparently, the sigmoid colon can wrap around and sit in this region. There is also always the possibility of small intestine getting down there

Front 27

where is the pouch of douglas

Back 27

lies posterior to the uterus and extends down to the top 1/4 of the vagina. colon or small intestine can move in here

Front 28

what is the consistency of a non-pregnant vs pregnant uterus

Back 28

The non-pregnant uterus has the consistency of a nose, while the pregnant uterus has the consistency of lips

Front 29

what is the blood supply for the uterus

Back 29

Ovarian artery and Uterine artery

Front 30

what is the lymph drainage for the lymphatics

Back 30

Fundus, fallopian tube, ovaries-->Para-Aortic nodes
Body-->Iliac nodes or superficial inguinal
Cervical-->Iliac nodes. (Note that these are general trends and not absolutes).

Front 31

what are the 3 structures that give support for the uterus

Back 31

cardinal, broad, and round ligament

Front 32

describe the cardinal ligament

Back 32

lies just over the pelvic floor above the perineum and wraps around the cervix. Not seen when looking down into the peritoneal cavity.

Front 33

describe the broad ligament

Back 33

Double layer of peritoneum draping down over the fallopian tubes

Front 34

describe the round ligament

Back 34

Extends from the uterus, through the inguinal canal, and into the labia majora

Front 35

how can the uterus give us kidney disease

Back 35

The ureter may be compressed by a growth from the uterus or cervix leading to kidney disease.

Front 36

what is uterine prolase

Back 36

Damage to levator ani and ligaments may lead to downward displacement of the uterus. common after menopause

Front 37

what is the most gynecologic malgnanices

Back 37

endometrial cancer

Front 38

what is a cervicectomy

Back 38

a conservative procedure for early carcinoma of the cervix. The cervix and upper vagina are resected. The body of the uterus is anastomosed to the remainder of the vagina. Fertility is maintained.

Front 39

what are the 4 parts of a uterine tube

Back 39

The Infundibulum (contains fimbrae), the Ampulla (dilated region where fertilization often occurs), Isthmus, and Intramural part (window to the uterus)

Front 40

pathway of what PID inflames

Back 40

vagina ⇒ uterus ⇒ uterine tube ⇒ peritoneal cavity

Front 41

what is salpingitis

Back 41

A major cause of infertility in females is blockage of the uterine tubes resulting from infection

Front 42

what is tubal ligation

Back 42

quite common and is considered irreversible, although some claim a 20% anastomosis success rate. Most often done via laparoscopy.

Front 43

what is laparoscopy

Back 43

commonly used to examine the uterus, ovaries, and uterine tubes, and to diagnose a number of pelvic diseases.

Front 44

how do you get for patency of the tubes

Back 44

hsg

Front 45

describe the ovaries and the ovary ligament

Back 45

The ovarian ligament connects the ovary to the back wall of the broad ligament. Ovarian position is pretty variable, especially during pregnancy when uterine growth pulls the little guy up.

Front 46

what is the lymph drainage of the ovaries and why is this important in cancer

Back 46

Lymphatics drain to Para-Aortic nodes making ovarian cancer especially difficult to detect.

Front 47

where is the ovary located

Back 47

extremely variable; it may be found in the pouch of Douglas; this descent may occur after pregnancy as well; in this location it may be palpated through the posterior fornix of the vagina; it may also be the source of pain during intercourse

Front 48

what abdominal structure is close to the ovary on the right side?

Back 48

appendix

Front 49

what is a teratoma

Back 49

germ cell tumor

Front 50

what structures get drained by the illiac nodes

Back 50

Upper 2/3 of vagina
Most of uterus
Bladder, urethra

Front 51

what structures get drained by superficial inguinal nodes

Back 51

Lower 1/3 of vagina.
Part of upper uterus via round ligament
Urethra

Front 52

what structures get drained by the para-aortic nodes

Back 52

Fundus of the uterus, ovaries, and uterine tubes

Front 53

describe the prostate

Back 53

a pelvic organ superior to UG diaphragm, inferior to the bladder, posterior to pubic bone, and anterior to rectum

Front 54

what is the Blood supply of the prostate

Back 54

from the internal iliac artery and lymph drains to the internal iliac nodes.

Front 55

from where in the prostate is semen secreted

Back 55

secreted out of 15 -20 little ductules that line the urethra

Front 56

what are the 3 surgical approaches for the prosate

Back 56

– Transurethral Resection of the Prostate (TURP) – simplest procedure but not always possible
– Perineal – difficult approach due to important anatomical structures blocking access.
– Suprapubic

Front 57

when does Benign prostatic enlargement occur? what does this cause

Back 57

Benign prostatic enlargement (BPH) occurs in all men over 50; can be felt during a rectal exam.
Affects every male who lives long enough. Leads to nocturia (awakening from sleep at night to
pass urine).
BPH impedes urination by distorting the prostatic urethra.

Front 58

how do you diagnose prostate cancer? from what do these people usually die from

Back 58

prostatic cancer can invade the ureter and block the kidneys thus causing renal failure

Front 59

explain the 3 ways lymph drains in the prostate

Back 59

– Direct invasion of an adjacent organ by the cancer. – Via venous drainage; many connections exist between prostatic and vertebral veins; prostatic cancer cells can enter the skull by moving up the valveless vertebral veins
– Via lymph channels.

Front 60

describe the seminal vesicles

Back 60

Lie just posterior/superior to the prostate gland. NOT A PRIMARY SOURCE OF CANCER. concerned with producing semen (to a lesser extent than the prostate).

Front 61

how do we form the ejaculatory duct

Back 61

When the Vas Defferens join the proximal ends of the seminal vesicles

Front 62

can we get an infection that goes up to the epididymis

Back 62

Connection between the ejaculatory duct and urethra allows for some Urinary track infections to invade the seminal vesicles and extend all the way to the epididymis.

Front 63

explain the effects of a vasectomy

Back 63

this procedure is irreversible after a couple of years (definitely after 5). The exact mechanism is unknown but after the procedure, the testicles tend to shrink and develop a thick basement membrane where the sperm use to thrive.
the ejaculated fluid contains no sperm; the sperm is absorbed in the tail of the epididymis and proximal part of the vas.