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198 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Hip/coxal bones |
• Ilium • Ischium • Pubis |
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How many vertebrae? |
33 |
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How many are moveable? |
26 |
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How many intervertebral discs |
23 |
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Transmits weight of body from vertebral column to pelvis |
Sacroiliac joint |
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Strongest joint of the pelvis |
Interosseous |
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Disruption of the symphysis pubis Slight opening of the sacroiliac joints |
Open book fracture |
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Fracture of both superior and inferior pubic rami
Genitourinary injury are likely |
Straddle fracture |
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The pelvic inlet and brim divides the pelvis into |
False/greater True /lesser pelvis |
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Boundaries of the pelvic inlet and brim |
Sacral promontory
Iliopectineal line [arcuate line of the ilium] and pectineal line (pecten pubis)]
Symphisis pubis |
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Boundaries of pelvic outlet |
Coccyx Sacrotuberous ligaments Ischial tuberosities Ischiopubic rami Pubic symphysis |
5 boundaries |
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Clinically measurable in pelvic inlet |
Diagonal conjugate |
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Shortest conjugate |
Obstetrical conjugate |
Usually 10cm or more |
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Diagonal conjugate minus 1.5 or 2cm |
Obstetrical conjugate |
Usually 10cm or more |
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Smallest pelvic diameter in the midpelvis |
Interspinous diameter |
10cm or slightly greater |
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Smallest diameter of the pelvic outlet |
Intertuberous diameter |
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Typical female pelvis |
Gynecoid pelvis |
41% |
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Male shaped |
Android |
33% |
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Long, narrow and oval shaped |
Anthropoid |
24% |
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Wide pelvis flattened at brim |
Platypelloid |
2% |
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Fetal position that is predisposed in anthropoid pelvis |
Occiput posterior position |
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Fetal position predisposed position in platypelloid pelvis |
Occiput transverse position |
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Walls of the pelvic cavity |
lateral - Obturator internus Posterior - Piriformis Floor - Pelvic diaphragm |
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Heart shaped inlet |
Android |
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Shallow pelvic cavity |
Platypelloid |
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Roomier pelvic cavity |
Gynecoid |
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Cylindrical pelvic cavity |
Female pelvis |
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Funnel shaped pelvic cavity |
Male pelvis |
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Larger outlet |
Female pelvis |
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Everted ischial tuberosities |
Female pelvis |
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More rounded and wider pubic arch |
Female pelvis |
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Muscles of the levator ani |
1. Ani Puborectalis (Maintain anorectal flexure) 2. Iliococcygeous 3. Pubococcygeous |
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What's inside of the obturator canal |
Obturator vessels Obturator nerve |
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Crossed superiorly by the vas deferens |
Ureter |
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Crossed superiorly by the uterine artery |
Ureter |
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Maximum capacity of the urinary bladder |
500ml |
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Volume to desire to micturate |
300ml |
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Useful landmark for ureteral identification |
InterUreteric ridge (Mercier bar) |
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Blood supply of the urinary bladder |
Superior vesical artery
Inferior vesical artery (males) Vaginal artery (females) |
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Origin of superior vesical artery |
Umbilical artery |
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Origin of inferior vesical artery |
Internal iliac artery |
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Origin of the vaginal artery |
Internal iliac artery |
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Epithelium of the urinary bladder |
Transitional Epithelium |
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Muscle layer of the urinary bladder |
Detrussor muscle |
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Sphincter that is Involuntary and controlled by the Autonomic nervous system |
Internal urethral sphincter
Sphincter vesicae |
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Sphincter that is voluntary and controlled by the somatic nervous system.
Pudendal nerve |
External urethral sphincter
Sphincter urethrae |
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Most common type of bladder cancer |
Transitional cell carcinoma |
Painless hematuria Smoking Aniline dyes |
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Level of sigmoid colon |
At the pelvic brim S3 |
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Blood supply of sigmoid colon |
Sigmoidal arteries from Inferior mesenteric artery |
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Coffee bean sign |
Volvulus (sigmoid) |
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Most common site of volvulus |
Sigmoid volvulus |
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Hartman technique |
1.Resection of sigmoid colon 2.Closure of rectal stump 3.Formation of end colostomy |
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Number of transverse rectal folds (of Houston) left and right |
Left : two Right : one |
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The rectum lacks |
taenia coli haustra epiploic appendices |
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Indication for Lower anterior resection |
Upper and mid rectal lesions |
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Is the Sphincter mechanism presevered in Lower anterior resection |
Yes |
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Qulaity of life in lower anterior resection |
Good |
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Indication for abdominopelvic resection |
Lower rectal lesions |
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Is the Sphincter mechanism preserved in Abdomino perineal resection (APR)? |
No |
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Quality of life in abdominopelvic resection |
Bad |
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Level of sigmoidoscopy is at 1.5 inches |
Rectal ampulla |
Inserted in the direction of the umbilicus |
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Level of sigmoidoscopy at 6.5 inches |
Sigmoid colon |
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Colorectal cancer screening |
Fecal occult blood testing Flexible Sigmoidoscopy Colonoscopy |
begin at age 50 |
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Dilated inferior part of the rectum |
Rectal ampulla |
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Length of the rectum |
5 inches |
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Blood supply of the rectum |
Superior rectal artery Middle rectal artery Inferior rectal artery |
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Origin of the superior rectal artery |
inferior mesenteric artery |
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Origin of the middle rectal artery |
Internal iliac artery |
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Origin of inferior rectal artery |
internal pudendal artery |
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Venous drainage of rectum |
Superior rectal vein Middle rectal vein Inferior rectal vein |
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Drainage and circulation of superior rectal vein |
Drainage: Inferior mesenteric vein
Circulation: Portal circulation |
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Drainage and circulation of middle rectal vein |
Drainage: Internal iliac vein
Circulation: Systemic |
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Drainage and circulation of inferior rectal vein |
Drainage: Internal pudendal vein
Circulation: Systemic |
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Outer fibrous capsule of the testis |
Tunica albuginea |
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Coiled tube about 6ft |
Epididymis |
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Blood supply of the testis |
Testicular artery |
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Venous drainage of the testis |
pampiniform plexus from testicular vein |
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Expanded portion of the vas deferens |
Ampulla |
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Lining epithelium of the vas deferens |
Pseudostratified columnar epithelium with sterocilia |
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Joins the vas deferens to form the ejaculatory duct |
Seminal vesicle |
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Lining epithelium of the seminal vesicle |
Simple or pseudostratified columnar epithelium |
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Seminal fluid contains |
1. Prostaglandins 2. Ascorbic acid 3. Fructose 4. Amino acids |
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Vas deferens + seminal vesicle |
Ejaculatory duct |
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Lining epithelium of the ejaculatory duct |
Pseudostratified columnar epithelium |
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Deep perineal pouch and opens into the penile urethra |
Bulbourethral (cowpers) gland |
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Anatomical division of the prostate gland |
Anterior lobe
Median/middle lobe : central + transitional zones
Posterior lobe : peripheral zone
Lateral lobes (2)
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Homologue of uterus and proximal vagina |
Prostatic utricle |
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Openings of the prostatic ducts |
Prostatic sinus |
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Blood supply of the prostate gland |
Inferior vesical artery Middle rectal artery |
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Venous drainage of the prostate |
Prostatic venous plexus from internal iliac vein |
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% of semen content ejaculated by the seminal vesicle |
60% |
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% of semen content ejaculated by the prostate |
30% |
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% of semen content ejaculated by vas deferens |
10% |
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Life span of semen |
1-2 days |
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Normal volume of semen |
3.5ml |
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Normal number of sperm needed for fertility |
>20million sperm / ml |
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Median lobe of the prostate enlarges hence obstructs the internal urethral orifice |
Benign prostatic hyperplasia |
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Most common site for colon cancer?? Prostate? |
posterior lobe |
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Hard and irregular mass on digital rectal exam and often asymptomatic |
Prostate cancer |
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Lining epithelium and length of the prostatic urethra |
Transitional epithelium
1.25 inches |
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Lining epithelium and length of the membranous urethra |
Stratified columnar and pseudostratified epithelium
.5 inches |
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Lining epithelium and length of the penile (spongy) urethra |
Stratified columnar and pseudostratified epithelium
6 in |
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Lining epithelium of the fossa navicularis |
Stratified squamous epithelium |
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Widest and most dilatable male urethra |
Prostatic urethra |
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least dilatable male urethra |
Intermediate urethra |
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receive openings of the bulbourethral glands |
Bulbar(bulbous) urethera |
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narrowest in male urethra |
External meatus |
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Covered by germinal epithelium (of Waldeyer ); beneath is the tunica albuginea |
Ovary |
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Inside the Suspensory (infundibulopelvic) ligament |
Ovarian vessels Ovarian nerve plexus Lymphatic vessels |
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Remains of the upper part of the gubernaculum |
Round ligament of the ovary / ovarian ligament |
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Blood supply of ovary |
Ovarian artery , ovarian branches of uterine artery |
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Venous drainage of ovary |
Right ovarian vein Left ovarian vein |
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Longest and widest segment Most common site of fertilization of the fallopian tube |
Ampulla |
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narrowest part of the fallopian tube |
Interstirial part |
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folic acid antagonist (against rapidly proliferating trophoblast) |
Methotrexate |
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Mass less than 3.5 cm Embryo is dead Beta HCG < 15,000 mIU/mL |
Ectopic pregnancy |
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Left unsutured intention to heal by secondary
Indications Less than 2 cm in length Located distal to the fallopian tube |
Salphingostomy |
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Incision closed by delayed absorbable suture |
Salphingotomy |
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Removal of the fallopian tube Cornual resection |
Salphingectomy |
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Parts of the uterus |
Fundus Body Cervix Isthmus |
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Between internal cervical os and endometrial cavity |
Isthmus |
Lower uterine segment in pregnancy |
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Dark bluish or purplish red vagina and cervix
Increased vascularity
8 weeks |
Chadwick / Jacquimier sign |
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Softening of the isthmus
6 to 8 weeks |
Hegar sign |
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Softening of the cervix 6 weeks |
Goodell sign |
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Blood supply of the uterus and fallopian tube |
Uterine artery Ovarian artery |
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Venous drainage of uterus and fallopian tube |
Uterine vein Ovarian vein |
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Long axis of uterus and long axis of the cervix |
Flexion |
Position of the uterus |
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Long axis of uterus and long axis of vagina |
Version |
Position of the uterus |
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Most important ligament supporting uterus and vagina Transmits uterine vessels |
Cardinal ligament (of • Mackenrodt) |
Aka transverse cervical ligament |
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Contents of broad ligament |
uterine tube
round ligaments of the ovary and uterus
uterine and the ovarian blood vessels, lymph vessels, and nerves. |
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Ligation of uterine vessels |
Cardinal Ligament |
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Ligation of ovarian vessels |
Ligament ??? |
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Blood supply of the vagina |
Uterine artery (vaginal branch) Vaginal artery Internal pudendal artery |
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hypogastric artery will turn into |
Internal iliac artery |
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Posterior division of internal iliac artery |
Ilio Lumbar artery Lateral sacral artery Superior gluteal artery |
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Anterior rami of L4-L5 Posterior rami of S1-S4
Lumbosacral trunk — L4 and L5 |
Sacral plexus |
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L4-L5, S1-S3 Largest nerve |
Sciatic nerve |
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Level of pudendal nerve |
S2-S4 |
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Roof of perinium |
Pelvic diaphragm |
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Floor of perinium |
skin and fasia |
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Divisions of perinium |
Urogenital triangle Anal triangle |
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Anal Sphincter that is involuntary and innervated by the autonomic nervous system |
Internal Anal Sphincter |
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Sphincter that is voluntary and innervated by the pudendal nerve |
External anal sphincter |
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Internal features of the anal traingle |
anal column anal valves anal sinus pectinate (dentate) line |
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superior ends of the anal column on the anal canal |
Anorectal junction |
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Junction of the upper and lower halves of the anal canal |
Pectinate line |
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Epithelium above the pectinate line |
Simple columnar |
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Epithelium below the pectinate line |
Stratified squamous |
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Innervation above the pectinate line |
Visceral |
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Innervation below the pectinate line |
Somatic (inferior rectal nerve) |
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Blood supply above the pectinate line |
Superior rectal artery |
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Blood supply below the pectinate line |
Inferior rectal artery |
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Venous drainage above the pectinate line |
Superior rectal vein to the portal vein |
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Venous drainage below the pectinate line |
Middle and Inferior rectal veins to the inferior vena cava |
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Lymphatic drainage above the pectinate line |
inferior mesenteric nodes |
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Lymphatic drainage below the pectinate line |
Superficial inguinal nodes |
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Boundaries of the ischioanal (ischiorectal) fossa |
Medial — (anal canal) Lateral — obturator internus Superior — pelvic diaphragm Inferior — skin |
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Contents of pudendal (Alcock’s ) canal |
Pudendal nerve pudendal vessels |
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Location of pudendal nerve |
lies against the ischial spine |
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Deep transverse perineal muscle Sphincter urethrae |
Urogenital diaphragm |
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Boundaries of urogenital triangle |
Superior fascia and Inferior fascia = perineal membrane |
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Deep transverse perineal muscles |
Deep perineal pouch |
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Membranous urethra |
Deep perineal pouch |
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Bulbourethral gland |
Deep perineal pouch |
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Portion of the vagina |
Deep perineal pouch |
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Internal pudendal vessels |
Deep perineal pouch |
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Dorsal nerve of the penis/clitoris |
Deep perineal pouch |
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Between the perineal membrane (inferior fascia) and superficial perineal ( fascia |
Superficial perineal pouch |
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Bulb and crus of penis (male) |
Superficial perineal pouch |
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Bulb of vestibule, crus of clitoris (female) |
Superficial perineal pouch |
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Greater vestibular [Bartholin] gland (female) |
Superficial perineal pouch |
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Ischiocavernosus |
Superficial perineal pouch |
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Bulbocavernosus |
Superficial perineal pouch |
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Superficial transverse perineal muscle |
Superficial perineal pouch |
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Branches of internal pudendal vessels |
Superficial perineal pouch |
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Perineal branches from pudendal nerve |
Superficial perineal pouch |
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Correspond to the prostate in males |
Lesser vestibular (Skene) gland |
Aka paraurethral glands |
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Inflammation located at 4 and 8 oclock positions of the female external genitalia |
Bartholin gland cyst/abcess |
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Treatment for bartholin gland cyst or abcess |
For small cyst: sitz bath
For symptomatic cyst or abscess: Word catheter placement marsupialization |
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Degree of laceration that involves the vaginal mucosa and skin |
1st degree laceration |
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Degree of laceration that involves the fascia and muscles of the perineal body |
2nd degree laceration |
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Degree of laceration that involves the External anal sphincter |
3rd degree |
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Degree of laceration up to the rectal mucosa |
Fourth degree |
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Restricted use of episiotomy |
Shoulder dystocia and breech delivery forceps or vacuum extractor deliveries occiput posterior positions instances in which failure to perform an episiotomy will result in perineal rupture |
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Support, protection, and nutrition of the developing spermatogeniccells Blood-testis barrier |
Sustentacular(Sertoli) cells |
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Secretions of sertoli cells |
Mullerian-inhibiting factor (MIF) Inhibin due to the absence of FSH Androgen-binding protein |
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Cells that Contain testosterone in the testis |
Interstitial (Leydig) cells |
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Mild indentation of the endometrium at the uterine fundus
Failure of resorption of the midline uterine septum
Least commonly associated with reproductive failure |
Arcuate uterus |
Most common type of abnormal uterus |
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One of the paramesonephric ducts fails/incompletely develops
Associated with second trimester pregnancy loss, malpresentation preterm labor and delivery |
Unicornuate uterus |
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Partial failure of fusion of the mullerianducts
Cleft in the outer contour of the fundus
Associated with second-trimester pregnancy loss, malpresentation, and preterm labor and delivery |
Bicornuate uterus |
Treatment is surgical unification |
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Normal external contour
Septum lacks adequate blood supply
Recurrent first trimester pregnancy loss |
Septate uterus |
Treatment is operative hyseteroscopy |
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Complete failure of fusion of mullerian ducts
2 uterus 2 cervices
Pregnancy possible |
Uterine didephys |
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Mayerduct Rokitansky Kuster Hauser syndrome
(-) uterus (-) cervix
Primary amenorrhea |
mullerian agenesis |
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Once used to treat women with threatened abortion Inhibits mullerian differentiation |
Diethylstilbestrol (DES) |
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Association with Diethylstilbestrol (DES) |
Clear cell carcinoma of the cervix
Clear cell carcinoma of the vagina
Cervical incompetence
Abnormally shaped uterus |
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Most common cause is congenital adrenal hyperplasia
Genotype: 46XX
Phenotype: Masculinization of female external genitalia |
Female pseudohermaphrodism |
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Most common cause is 5a reductase deficiency leading to a decrease in DHT
Genotype: 46XY
Phenotype: stunted development of male external genitalia |
Male pseudohermaphrodism |
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MC cause is mutation in the androgen receptor (male pseudohermaphrodism )
Genotype: 46XY Phenotype
Normal appearing females Testis may be in the labia majora |
Complete androgen insensitivity syndrome |
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