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