Anatomy: Pelvic And Perineum Iii

Front 1

Describe the inferior limit of the peritoneum in the pelvis in the male.

Back 1

Passes superior to the pubic symphysis, over the superior and posterior surface of the bladder. Covers the superior ends of the seminal vesicles and the superior part of the rectum.

Forms the rectovesical pouch--lowest point in the peritoneum of the male.

Front 2

Describe the inferior limit of the peritoneum in the pelvis in the female.

Back 2

Superior to the pubic symphysis, covers the superior surface of the bladder. Covers the uterus and reflects onto the rectum.

Forms two pouches: vesicouterine pouch and the rectouterine pouch.

Forms the board ligament of the uterus: double layer of peritoneum: mesentery

Front 3

How many surfaces does the bladder have? Name them.

Back 3

Four.
Superior
Inferiolateral (x2)
Posterior

Front 4

Name the four parts of the bladder.

Back 4

Apex
Body
Fundus/Base
Neck

Front 5

Name the structures that are in contact with the bladder. (4, different in males and females)

Back 5

Anterior: Pubis symphysis
Inferior: Pelvic diaphragm and UG diaphragm in females, Prostate in males
Posterior: Vaginal wall, vas deferens, seminal vesicles and rectum in males.
Superior: Uterus and intestines in females, only intestines in males

Front 6

What muscle forms the wall of the bladder?

Back 6

detrussor muscle

Front 7

What are the structures that form the trigone?

Back 7

Ureteric orifices and the internal urethral orifice

Front 8

What are the ridges of the detrussor muscle called? What are their functions?

Back 8

Rugae
To allow the bladder to expand

Front 9

What area of the bladder is always smooth?

Back 9

Trigone

Front 10

What sensory stimulus initiates urination?

Back 10

Stretch of the detrussor muscle receptors

Front 11

What type of sensory fibers initiate urination?

Back 11

Visceral afferents

Front 12

What elicits a reflex contraction of the detrussor muscle?

Back 12

Relaxation of the levator ani, which allows the neck of the bladder to descend

Front 13

Describe the nerve fibers that cause contraction of the detrussor muscles (origin, route, and fiber).

Back 13

Pelvic splanchnic fibers from S2,3,4 (parasympathetic) through the inferior hypogastric plexus to the bladder wall.

Front 14

What are the effects of parasympathetics and sympathetics on the bladder?

Back 14

Parasympathetic: Contraction of the detrussor and relaxation of the internal urethral sphincter

Sympathetics: Contraction of the internal urethral sphincter

Front 15

Where do the sympathetics to the bladder originate from? What do they do?

Back 15

Lower thoracic and upper lumbar spinal cord segments.

Maintain tonus of the bladder neck and contraction of the internal urethral sphincter.

Front 16

The ureter crosses the pelvic brim at the bifurcation of what vessels?

Back 16

The common iliac artery

Front 17

Is the ureter intra or retro-peritoneal?

Back 17

Retroperitoneal

Front 18

In the male, only one structure passes in between the ureter and the peritoneum. What is it and where does it go?

Back 18

Ductus deferens in the ureteric fold.

Front 19

The ureter enters the bladder at a posterosuperior angle. Is this point of entry superior or inferior to the seminal vesicles?

Back 19

Superior

Front 20

What is the most constant source of blood to the ureter in the male and female?

Back 20

Uterine arteries in female
Inferior vesical arteries in male

Front 21

What arteries contribute to the ureter? (Male and Female)

Back 21

Common and internal iliac

Female:
ovarian arteries
uterine arteries

Male:
inferior vesical arteries

Front 22

Describe the position of the seminal vesicle.

Back 22

Posterior to the fundus/base of the bladder
Anterior to the rectum

Front 23

Which ducts do the seminal vesicles form when joining the ductus deferens and the prostatic urethra?

Back 23

ejaculatory ducts

Front 24

What does the seminal vesicle do?

Back 24

Produce an alkaline solution to neutralize the acidity for the sperm.

Front 25

Where is sperm formed?

Back 25

Seminiferous tubules

Front 26

Where do sperm mature?

Back 26

In the epididymis

Front 27

Sperm leave the scrotum through what structure?

Back 27

Vas deferens (ductus deferens)

Front 28

Describe the route of the vas deferens from the scrotum into the true pelvis.

Back 28

Up the spermatic cord, through the superficial inguinal ring, through the inguinal canal, through the deep inguinal ring into the true pelvis

Front 29

Describe the movement of sperm from the ejaculatory duct to outside the penis.

Back 29

From the prostatic urethra into the membraneous urethra to eventually the spongy urethra. Exits penis through the external urethral orifice.

Front 30

There are a number of ducts that open into the prostatic urethra. Name them.

Back 30

1. Ejaculatory ducts (2)
2. Prostatic ducts (20)
3. Urinary Bladder
4. Duct of the Prostatic Utricle- blind diverticulum--male vagina and uterus.

Front 31

Name the structure that houses the prostatic ducts.

Back 31

Prostatic sinuses

Front 32

Name the structures that house the ejaculatory ducts and the prostatic utricle in the urethra.

Back 32

Seminal colliculus located on the urethral crest.

Front 33

Where do the bulbourethral ducts open?

Back 33

Into the spongy urethra in the bulb of the penis.

Front 34

What are the three lobes of the prostate?

Back 34

Anterior
Median
Posterior

Front 35

Which lobe of the prostate is prone to benign enlargement and tumors? Why?

Back 35

Median
Lots of active secretory tissue

Front 36

What two directions of enlargement are possible with the median lobe of prostate?

Back 36

Anterior: results in weak flow
Superior: Bladder infection, increased frequency

Front 37

What are the three parts of the broad ligament?

Back 37

1. Mesosalpinx
2. Mesovarium
3. Mesometrium

Front 38

What is the name of the small mesentery that holds the uterine tube?

Back 38

Mesosalpinx

Front 39

What portion of the broad ligament hold the ovaries?

Back 39

Mesovarium

Front 40

What is the largest portion of the broad ligament (holds the uterine body)?

Back 40

Mesometrium

Front 41

What supplies the dynamic support of the uterus?

Back 41

Pelvic diaphragm

Front 42

What supplies the passive support of the uterus?

Back 42

Its nature position.
Anteverted
Anteflexed

Front 43

The normally positioned uterus will rest on what other pelvic structure?

Back 43

The bladder

Front 44

What two ligaments provide the primary supports for the uterus?

Back 44

Transverse cervical ligament (cardinal)
Uterosacral ligament

Front 45

What four ligaments can be found in the mesometrium?

Back 45

Round ligament of the uterus
Uterosacral ligament
Pubosacral ligament
Cardinal ligament

Front 46

What vessels can be found in the mesometrium?

Back 46

Uterine artery and vein

Front 47

What two ligaments can be found in the mesovarium?

Back 47

Ligament of the ovary
Suspensory ligament of the ovary

Front 48

What vessels can be found in the mesovarium?

Back 48

Ovarian artery and vein

Front 49

What are the four parts of the uterus?

Back 49

Fundus
Body
Isthmus
Cervix

Front 50

What are the two parts of the cervix?

Back 50

Supravaginal
Vaginal

Front 51

What are the four parts of the uterine tube?

Back 51

Infundibulum
Ampulla
Isthmus
Intramural/Uterine part

Front 52

What part of the uterine tubes contain fimbriae?

Back 52

Infundubulum

Front 53

What uterine structure 'catches' the ovulated egg from the ovary?

Back 53

Fimbriae

Front 54

What is the normal angle of the cervix and vaginal canal called?

Back 54

Anteversion (90 degrees)

Front 55

What is the normal angle of the cervical canal and the uterine body called?

Back 55

Anteflexion (170 degrees)

Front 56

What is the risks associated with abnormal uterine positions?

Back 56

increased risk of ectopic pregnancy
increased risk of uterine prolapse

Front 57

Which angle of the uterus is changed with a full bladder?

Back 57

Anteversion to retroversion

Front 58

What ligament structure of the uterus maintains the anteverted position and stretches during pregnancy?

Back 58

Round ligament of the uterus

Front 59

Which spinal section is the posterior boundary to the false/greater pelvis?

Back 59

L3,4,5

Front 60

What organs can be found in the greater pelvis (always)?

Back 60

ileum and the sigmoid colon

Front 61

What boundaries demarcated the lesser/true pelvis?

Back 61

Superiorly, pelvic brim or arcuate line
Inferiorly, the pelvic diaphragm

Front 62

What portions of the GI tract can be found in the true pelvis?

Back 62

Ileum, sigmoid colon, rectum, and anus

Front 63

Identify the fornices created by the cervix and vaginal canal?

Back 63

Anterior
Right and left lateral
Posterior--most important, allows access into the pouch of Douglas--rectouterine pouch.

Front 64

Describe the surface of the prepubescent ovary ant the appearance of the ovary in a mature woman.

Back 64

Starts out smooth. Become increasing scarred and distorted with repeated ruptures.

Front 65

What structure houses the ovarian vessels?

Back 65

Suspensory ligament of the ovary

Front 66

What ligament attaches the ovary to the uterus?

Back 66

Ligament of the ovary

Front 67

What structure is a remnant of the ovarian gubernaculum?

Back 67

Ligament of the ovary and round ligament of the uterus

Front 68

List the structures (visceral and bony) that can be palpated during a female pelvic examination? (8)

Back 68

Cervix
Ischial spine
Ovary
Bladder
Rectum
Uterus
Pulse of the internal iliac
Ureters

Front 69

List the structure that can be palpated in a male rectal examination. (10, 4 boney structures)

Back 69

Prostate
Seminal vesicles
Sacrum
Coccyx
Ischial spine
Ischial tuberosities
Internal iliac lymph nodes
Ureters
Ischioanal fossae
(Possibly inflamed appendix)