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174 Cards in this Set

  • Front
  • Back
Devarication, or ________, is caused by _____________.
dehiscence;
muscle fibers that have atrophied and form intervals of connective tissue in between fleshy fibers usually due to (multiple)birth
The fundus of the uterus is __________ (superior/ inferior) to the oviducts' entrance.
SUPERIOR
The internal os of the uterus is located about where the ___________ is.
isthmus
THe cervix is the lower 1/___ of the uterus.
1/3; surounded by internal & external cervical os (osteum--opening)
The lower 1/3 of the vagina is innervated by ________.
the PUDENDAL NERVE
The pudendal nerve supplies __________ & _________.
external genitalia & external perineum
The _________ of the vagina is vaginal cavity that surrounds the cervix as it protrudes into vag. orfice.
fornix
The oviducts (fallopian tubes) are _____ cm long.
12
The initial portion of the oviduct is through the _____ of the uterus.
wall (mural)
The isthmus (which means _____) is about ____ cm long.
contraction; 2
The ampulla represents ____ (how much) the length of the f.t. and is where ________ usually occurs.
2/3;
fertilization & ectopic pregnancy
The ______is the distal end of the oviduct. It has _____ processes, one which is attached to the ____.
infundibulum;
fimbria;
ovary
The suspensory ligament of the ovary connects ________ & covers _______.
ovary to pelvic wall;
ovarian vessels as they approach ovary
The ovarian ligament connects ___________ at the opposite end of ovarian vessel entrance.
ovary to uterus
The artery of the round ligament, or _____ will bleed profusely.
ARTERY OF SAMSON
When the round ligament is stretched (i.e. during expansion of womb in pregnancy),____ expands also.
Artery of Samson.
There is lots of ________ associated w/round ligament.
PAIN
THe cardinal ligament connects ______ & provides ____% of the ligamentus support.
cervix to pelvis walls; 90%
Cardinal ligament = _________ = _______.
transverse cervial ligament;
Mackenrodt's ligament
A _________ is dye injected into vagina to determine if female is cause of infert. (due to constriction) WHY NOT USE AIR???
hysterosalpingogram; female peritoneal sac open to outside, so air would go to diaphragm & cause pain
The anterior wall of the vagina is ______ than the posterior (longer or shorter).
shorter
An amateur abortionist may cause PERITONITIS if he isn't aware of _____ uterus.
anteverted
The _______ may be used as an approach to ovaries (like retreiving egg for i.v. fertilization).
fornices
The rectouterine pouch is also called ______, or ____.
Pouch of Douglas; cul-de-sac
Vaginal prolapse--3º. The complete prolapse is called ________.
procedentia
A weakening of the anterior wall of vagina in which the bladder passes through is called a _________.
cystocele (cyst-fluid filled sac)
A weakening of the posterior wall of vagina in which the rectal wall passes through is called a _________.
rectocele (usually caused by multiparity)
The uterine artery divides into ascending & descending branch. Ascending goes to _____. Desc. goes to ____.
uterus; vagina
The descending branch of uterine artery is also called the _________.
vaginal branch---NOT the same as vaginal artery
The vaginal artery most commonly arises from _______, but can be _______.
INTERNAL ILIAC;
from uterine artery
The vaginal artery runs ____ (superior/inferior) to URETER, while the uterine artery runs _______.
VAGINAL-below;
UTERINE-above
The ovarian vessels anastamose with ________ along ovarian ligament and/ or oviduct.
uterine vessels
Why might a hysterectomy involve clamping of the entire internal iliac artery? (as opposed to just uterine)
b/c the uterine artery anastamoses w/ ovarian artery and could circumvent blood flow.
The ovarian vessels cross the ureter from ____-____ (medial to lateral). Why is this important?
During pregnancy (3rd month), ovarian vein is engorged and could stenose ureter.
The LATERAL boundry of the PRESACRAL PLEXUS is ______.
ureter
The ureter can also be stenosed by the ______ during pregnancy.
umbilical artery
What does the location of ovaries near the ureter have to do with anything?
ovarian cyst could stenose ureter & cause hydronephrotic condition
The ovary lies in fossa between _____ & ______.
external iliac;
internal iliac
The ureter crosses the pelvic brim at _______.
bifurcation of common iliac into external & internal
The bladder is _______ (related to peritoneum).
subperitoneal (extraperitoneal)
If the bladder is empty it resides in the _______. If full it resides in ______.
true pelvis;
false pelvis, as high as umbilicus
In the male the size of the bladder is affected by ________.
rectal distention
The bladder is held in place by the ____ or ___ (females), or the ____ (males).
pubovesical, pubocervical;
puboprostatic
The bladder is held in place at the ________.
neck
The bladder lies in the _______ space or space of _______.
retropubic;
Retsius
All of the urinary system is ___________.
RETROPERITONEAL/SUBPERITONEAL
The interior of the bladder is made up of the _______ muscle.
detrusal muscle (detruse = to push out)
The interior of the bladder is innervated by the ________, also called the _________.
pelvic splanchnic nerves;
nervi eregentes (erection)
The pelvic splanchnics (nervi eregentes) also carry the afferent & efferent limbs of ___________.
bladder emptying reflex arc
Pelvic splanchnic nerves that are injured in a male could cause problems w/ ___ & ____.
erection & micturition
The bladder trigone is the smooth area of the bladder, bounded by ______ & ______.
ureters (ureteric orfices) & urethra
The urethra passes out of the bladder at ______.
the neck
The bladder is innervated by ________. Afferent or efferent?
PELVIC SPLANCHNICS;
both afferent & efferent
The urethra opens into the ______, which is a space in between the ______.
vestibule; labia minora
The male pelvic organs are the: ____, ____, ____, & ____.
vas deferns, seminal vesicle, prostate & urethra
A vasectomy usually occurs _______ to the superficial inguinal ligament.
just INFERIOR
The vas deferens is ________ (in relation to peritoneum) and runs ____ to ureteric openings in posterolateral wall.
SUBPERITONEAL; MEDIAL
The seminal vesicle lies on the _______ of the bladder.
base (posterior wall)
The fundus of the bladder usually means the ____ wall of the bladder.
inferior aspect of posterior
The prostate is located _____ to the bladder.
inferior
On the ________ aspect of the bladder, the vas deferens enlarges to form _____.
posterior; ampulla (dilation)
The vas deferens has a blind, lobulated DIVERTICULUM called the ____.
semnal vesicle
Spermatazoa are stored in the _____, NOT the seminal vesicles!
epidiydimis
The seminal vesicles produce lots of SEMEN, mainly made up of _______.
alkaline substance
The ______ & _____ form the EJACULATORY DUCT, which passes through the wall of prostate gland.
ductus deferens; duct of seminal vesicle
The base (superior) of the prostate is related to the _______, while the apex (inferior) is related to the _______.
seminal vesicle; urogenital diaphragm
The prostate has 4 lobes: ___, ___, & ____.
anterior; posterior; 2 lateral
The ________ add quite a bit of volume to semen.
prostatic glands
The ejaculatory duct (combo of vas def. & seminal vesicle) passes through ______, dividing it into ___.
POSTERIOR LOBE; median lobe & posterior lobe proper.
The _____ lobe is usually the lobe that enlarges in BPH (Benign Prostate Hypertrophy).
MEDIAN (formed by the ejac. duct passing through posterior lobe).
Benign Prostate Hypertrophy is quite common ________, and can occlude the _____.
the older you get; urethra
Prostate cancer is most commonly found in ____ lobe.
posterior lobe PROPER (behind ejac. ducts)
The male urethra has 3 portions: _____, _____, & _______.
prostatic, membranous, spongy
The membranous portion of the urethra passes through the _________. It is surrounded by _______.
urogenital diaphragm (deep perineal pouch); fibers of external urethral sphincter
The external urethra sphincter is innervated by the ______________.
pudendal nerve
The spongy urethra contains a 90º bend, which if punctured can tear the ______ and cause ______.
corpus spongiosum just below the urogenital diaphragm; urine can leak externally
The bulbourethral glands enter into the _______ part of the urethra.
proximal portion of spongy urethra
The urethral crest is located ______. In the middle of the crest is the ______, where the ejac. ducts w/semen open onto.
on the posterior surface the prostatic urethra; Seminal Colliculus (little hill) or VERUMONTANUM
The verumontanum has a openings for ________ & ______.
prostatic utricle; ejaculatory ducts
The ______is homologous to the uterus sloughing off in females.
cells which line the prostatic utricle (located in verumontanum of prostatic ureter)
When doing TURP (resectioning urethra), the prostate is removed _____ (where)?
just inferior to verumontanum; going above would interfere with emptying of semen
When doing prostate exam, you can feel the _______ while pushing anteriorly.
seminal vesicle & vas deferens on posterior aspect of bladder
The only structure more inferior than the rectum is the ________.
anal canal
The rectum is situated to fit well in the ________, decreasing ________ prevalance.
SACRAL CONCAVITY; rectal prolapse (because it isn't straight up and down).
The rectum ________ (has or doesn't have) a mesocolon.
DOESN'T HAVE (it comes off sigmoid colon, which does have one)
The ampulla usually lies ___________ to three rectal shelves.
inferior
The rectal shelves are also called ______, or ______.
shelves of Houston; rectal valves (inferior, middle, & super)
The function of the rectal shelves is in ___________.
holding up fecal material
The anal canal has 3 areas: _______, ________, ______.
cutaneous zone, transitory zone, mucous membrane
The __________ is a watershed zone which lies between ____ & ______.
pectinate line; true mucous membrane & transitional zone
________ is a synonym for transitional zone.
Pecten (pectinate line)
The mucous zone has 5-10 ______ produced by _______.
vertical columns; tributaries to the superior rectal vein
The superior rectal vein is a tributary to the ______.
inferior mesentaric vein
_______ & ________ veins anastamose in the area of the mucous zone.
middle and inferior rectal
Dilations (varicosities) of ____________ result in hemmoroids.
middle & inferior rectal veins
Internal hemmoroids occur _____, while external occur ______ (where?).
above pectinate line; below pectinate line
External hemmoroids are innervated by ___________.
pudendal nerve, which is somatic (PUDENDAL = PAINFUL)
Internal hemmoroids are innervated by __________.
autonomic nerves, which are visceral = no pain
______ is another name for hemmoroids.
Piles
Lymph inferior to pectinate line drains to ____; lymph superior to pectinate line drains to _______.
superficial inguinal lymph nodes; internal iliac (pelvic) lymph nodes
The pectinate line is dubbed a watershed because _______.
lymph above goes to one place (int. iliac/pelvic); lymph below goes to another (superfic. ing. nodes)
The _________ is similar to the pectinate line in being a watershed line.
hymen in the vagina
The internal anal sphincter is a thickening of the ____, and has ____ innervation.
internal circular muscle; AUTONOMIC (sympathetic & parasympathetic)
The external anal sphincter is supplied by the ____.
INFERIOR RECTAL NERVE (branch of pudendal; SOMATIC)
The sigmoid colon becomes the rectum @ what vertebral level?
S3
The internal anal sphincter is composed of ____ muscle.
smooth
Parasympathetic innervation causes ____ w/internal anal sphincter.
inhibition leading to relaxation
Sympathetic innervation causes ____ w/internal anal sphincter.
contraction
The puborectalis is confulent with _________.
the deep portion of the external sphincter
Where is the sinus of Morgagni?
just medial to internal anal sphincter
Which muscle crosses the pelvic brim?
NONE
The superior rectal artery is a continuation of the ____.
inferior mesenteric
What are the 4 arterirs that cross the pelvic brim?
superior rectal; gonadal; median sacral; internal iliac
The middle rectal artery comes off the _________.
internal iliac system
The inferior rectal artery comes off the ______, which comes off the ______.
internal pudendal; internal iliac system
The posterior division of ii artery has ____ PARIETAL branches.
3
The posterior division of the Internal Iliac is also called the _______.
hypogastric
The anterior division of the ii artery has ___ parietal branches & ___ visceral branches.
3; 4
The internal iliac artery supplies the buttocks by way of ________.
superior & inferior gluteal arteries
The internal iliac artery supplies the perineum by way of ________.
internal pudendal artery
The internal iliac artery supplies the medial thigh by way of ________.
obturator artery
With exception of _______, all pelvic viscera are supplied by branches of internal iliac aa.
OVARIES (ovarian artery--aorta)
When doing a pelvic exoneration, you can clamp both internal iliacs and the ptx will still have lower limbs b/c ___.
lots of anastamoses
The 3 parietal branches of the posterior division if ii artery are: ___, ___, ___.
iliolumbar a, lateral scaral aa, superior gluteal a
The iliolumbar ascends and has a branch that goes to the ______.
iliacus
The lateral sacral arteries enter the _______.
sacral foramina
The superior gluteal aretery typically passes b/tw ___ & ___ to EXIT the pelvis via ____.
lumbosacral trunk & S1 ventral ramus;
GREATER SCIATIC FORAMEN
The parietal branches of the anterior division of iia are: ____, ____, & ____.
obturator a, internal pudendal a, inferior gluteal a
80% of the time the obturator a comes off the ___. 20% it comes off the ____.
internal iliac; inferior epigastric artery
The obturator passes through the obturator canal to enter ________.
medial thigh
The internal pudendal artery EXITS pelvis through _______ with _____ nerve.
GREATER SCIATIC FORAMEN; pudendal
The inferiro gluteal aretery EXITS pelvis through _____ and emerges in ____ region w/inferior gluteal nerve.
GREATER SCIATIC FORAMEN; gluteal
The ___ & _______ arteries are ususally considered the 2 trminal branches off of ant. division of iia.
inferior gluteal; internal pudendal
The 4 visceral branches of the anterior division of the iia are: ___, ___, ___, ___.
umbilical a; middle rectal a; inferior vesicle/vaginal a; uterine a
The obliterated umbilical a becomes the __________.
Medial umbilical ligament
If you see an artery coming off iia & directly going into rectum, it's the ______.
middle rectal a.
The middle rectal a. arises near _____, and runs across the ______ to middle portion of rectum.
internal pudendal & inf. gluteal aa; pelvic floor
The inferior vesicle a. runs along with the ____ nerves, which go to the ____.
cavernous nerves; corpora cavernosa & corpus spongiosum (bring about erection)
The inferior vesicle a. supplies the ______, _____, & _____.
inferior bladder; prostate; seminal vesicles
The 'female inferior vesicle a.' is the _______. It supplies _____ & _______.
vaginal artery; vagina & bladder
The vagina is supplied by the _____ & ______(arteries).
internal pudendal (lower portion)& vaginal (upper portion) arteries
The uterine artery runs with the ______ at the base of the cervix.
cardinal ligament
The uterine artery crosses the ____ about 3cm superior to _______.
URETER; ischial spine--careful not to clamp it during hysterectomy
The ovarian artery follows the __________ as it travels within mesoovarium.
suspensory ligament
Veins of the pelvis are VALVELESS, so venous blood is based on _________.
pressure gradient.
The _____ plexus of veins (which has LOTS of blood) is important to be careful with during prostatectomy.
prostatic
Prostate cancer can spread lymphatically or _______, which means _______.
venously--if it takes venous route it will go to epidural plexus & to brain. This is why they look in brain for p.c.
The lymphatics of the pelvis are: superficial & deep _______; external & internal ______; & _________.
inguinal lymph nodes; internal iliac lymph nodes; common iliac lymph nodes
The pelvic lymph nodes drain into the PARAAORTIC, or _____ lymph nodes.
LUMBAR/PREAORTIC
The only nerve found in the pelvis from the lumbar plexus is the _______.
obturator
The sacral plexus is formed on the surface of the _____.
piriformis (hint: P's--Piriformis, Posterior wall)
A pregnant mother could have great pains if the baby's head is pressed against ____.
sacral plexus (on piriformis muscle)
The sacral plexus if formed by ____-____.
lumbosacral trunk-S5
The inferior gluteal artery usually passes between __-__
S1-S2
The sacral plexus is _____ (where?) to the piriformis.
INTERNAL
The sciatic nerve is formed by ___ - ____.
L4-S4
If an MD goes too deep on hysterectomy, the nerves to the _____ can be damaged, & ____ can occur.
pelvic diaphragm; prolapse
The PUDENDAL NERVE is almost the _________ nerve supply of the PERINEUM. It is S_-_.
sole somatic;
2-4
The ___________ nerves bring about erection and come from S2-4.
pelvic splanchnic--PARASYMPATHETIC
The pelvic splanchnics carry bladder reflex arc fibers, which have _______ limbs.
afferent & efferent
The sacral splanchnics (S2-4) provide _____ innervation.
SYMPATHETIC
The pelvic splanchnics arise from _________ of spinal chord levels S_-S_.
interomedial cell columns; 2-4
The pelvic splanchnics provide parasympathetic component to the _______.
inferior hypogastric plexus
The inferior hypogastric plexus supplies p.s. innervation to ____ & _____.
non-vascular smooth muscle to hindgut & pelvic organs; erectile tissue
The inferior hypogastric plexus contans 3 types of nerve fibers: ___, ____, ___.
parasympathetic; sympathetic; visceral afferent fibers
The preaortic plexus changes name to the ________ at ___.
superior hypogastric plexus (presacral plexus; L5, S1
The presacral plexus (superior hypogastric plexus) continues down on either side & becomes ____.
hypogastric nerves
The hypogastric nerves reach the ________ and are now called the INFERIOR hypogastric nerves.
lateral wall of rectum
The main sympathetic input for inferior hypogastric nerves comes from _________, not ________.
hypogastric nerves (which came from superior hypotastric, which came from preaortic); NOT SACRAL SPLANCHNIC
The pelvic splanchnics (S2-4 ventral rami) sned 3-10 branches to the ______.
inferior hypogastric plexus
Besides symp & p.s., the inferior hypogastric plexus also has _____ nerve fibers from pelvic organs.
visceral afferent fibers & visceral afferent pain fibers
The visceral afferent fibers that enter the inf. hypo. plexus can follow the pelvic splanchnics to _________.
back to sacral portions of spinal cord.
Sometimes the visceral afferent fibers can enter the _________ and run up to _____ before entering spinal cord.
superior hypogastric plexus; T10-L2
So, pain fibers may enter the spinal cord ________ (where).
from sacral region (S2-4) up to lumbar & even thoracic region