Anatomy - Pelvis And Perineum

Front 1

What are the male peritoneal pouch(es)?

Back 1

Rectovesical pouch - reflection of peritoneum from bladder onto rectum

Front 2

What are the female peritoneal pouch(es)?

Back 2

Vesicouterine pouch - reflection of peritoneum form bladder onto uterus
Rectouterine pouch (of Douglas) - reflection from uterus onto rectum

Front 3

Where do the ureters join the bladder?

Back 3

posteroinferior aspect by entering obliquely

Front 4

How is the bladder attached?

Back 4

firmly attached by pubovesical ligaments

Front 5

What does the wall of the bladder contain?

Back 5

contains smooth detrusor muscle and is lined by transitional epithelium

Front 6

What is the trigone?

Back 6

non-contractile triangular area with ureters entering at superolateral corners and urethral orifice at apex

Front 7

Where does the urethra leave the bladder?

Back 7

leaves neck of bladder at apex of trigone

Front 8

What is the internal urethral sphincter?

Back 8

circular arrangement of detrusor muscle around internal urethral orifice

Front 9

What are the parts of the urethra in males?

Back 9

male has prostatic, membranous and penile portions with major curve in proximal part of the penile urethra (in bulb)

Front 10

The rectum is continuous with the sigmoid colon at what vertebral level?

Back 10

S3

Front 11

What is the inferior portion of the rectum and where does it lie?

Back 11

ampulla which lies below inferior rectal fold

Front 12

What is the position of the uterus in females?

Back 12

- curves anteriorly over bladder
- angled anteriorly at juction of cervix and body (anteflexed)
- angled anteriorly at junction of vagina and cervix (anteverted)

Front 13

What is the innervation of the vagina?

Back 13

somatic to lower 1/4th of vagina

Front 14

What are the different portions of the uterine tubes?

Back 14

- isthmus is hort, thick-walled proximal portion
- ampulla is widest and longest portion
- infundibulum is funnel-shaped distal end surrounding ostium with fimbriae

Front 15

Where is the mesometrium?

Back 15

extends laterally from body of uterus to pelvic walls and contains round ligament of uterus travelling to deep inguinal ring

Front 16

Where is the mesovarium?

Back 16

on posterior surface of mesometrium and attaches to ovary and ovarian ligament

Front 17

Where is the mesosalpinx?

Back 17

above mesovarium enclosing uterine tube

Front 18

What does the ovarian ligament support?

Back 18

attaches ovary to lateral aspect of uterus

Front 19

What is the function of the round ligament?

Back 19

it is a continuation of ovarian ligament which passes through the inguinal canal to attach to labium majorum

Front 20

What is the uterosacral ligament?

Back 20

thickening of endopelivc fascia that attaches cervix to sacrum

Front 21

What is the transverse cervical ligament?

Back 21

attaches cervix to lateral pelvic wall

Front 22

What is the suspensory ligament of ovary?

Back 22

fold of parietal peritoneum covering vascular bundle and attached to lateral pole of ovary

Front 23

Where do the bulbourethral glands secrete into?

Back 23

penile urethra

Front 24

What is the ejaculatory duct?

Back 24

where ampulla of vas/ductus deferens and seminal vesicle meet to join prostatic urethra

Front 25

What are the branches of the posterior division of the internal iliac artery?

Back 25

- iliolumbar and lateral sacral
- superior gluteal leaves pelvis via greater sicatic foramen above piriformis

Front 26

What are the branches of the anterior division of the internal iliac artery?

Back 26

- obturator
- inferior gluteal and internal pudendal
- umbilical gives off superior vesicles then becomes obliterated umbilical
- middle rectal
- uterine (female)
- inferior vesicle (male)
- vaginal (female)

Front 27

Wher does the obturator artery pass through?

Back 27

obturator canal

Front 28

Where does the inferior gluteal and internal pudendal arise from and where do they pass through?

Back 28

arise from common trunk and leave through greater sciatic foramen below piriformis

Front 29

What does the inferior vesical artery supply?

Back 29

inferior bladder, prostate, seminal vesicles

Front 30

What does the vaginal artery supply?

Back 30

lower vagina and inferior bladder

Front 31

Where does lymph from the rectum drain into?

Back 31

- superior part drains to pararectal to inferior mesenteric to lumbar nodes
- inferior parte drains to internal iliac nodes

Front 32

Where does lymph from the fundus of the uterus drain?

Back 32

lumbar nodes

Front 33

Where does lymph from the body of the uterus drain?

Back 33

external iliac nodes

Front 34

Where does lymph from the cervix drain?

Back 34

internal iliac nodes

Front 35

What type of nerve fibers does the superior hypogastric plexus contain?

Back 35

sympathetics

Front 36

Peliv autonomics

Back 36

superior hypogastric containing sympathetics divides into right and left hypogastric nerves which join pelvic splanchnic nerves to form inferior hypogastric plexus

Front 37

What is the perineal membrane?

Back 37

- strong connective tissue sheet attached to ischipubic rami
- posterior border of membrance attaches to fascia of external anal sphincter
- muscles lie superior to it in deep perineal pouch
- membrane and muscles used to be called 'urogenital diaphragm'

Front 38

What is the deep perineal pouch (space)?

Back 38

- fascial space superior to perineal membrane
- contains deep transverse perineal and sphincter urethrae muscles
- contains bulbourethral gland in male
- muscle fibers around urethra form external urethral sphincter

Front 39

What are the contents of the deep perineal pouch (space)?

Back 39

deep transverse perineal, sphincter urethrae muscles, bulbourethral gland in male

Front 40

What is the perineal body?

Back 40

- connective tissue mass
- attaches posterior edge of perineal membrane to deep fascia of external anal sphincter of pelvic diaphragm

Front 41

What is the superficial perineal pouch?

Back 41

space between perineal membrane and superficial perineal fascia

Front 42

What are the contents of the superficial perineal pouch in females?

Back 42

crura of clitoris, ischiocavernosus muscles, bulbs of vestibule, and bulbospongiosus muscles, greater vestibular glands

Front 43

What are the contents of the superficial perineal pouch in males?

Back 43

crura of penis, ischiocavernosus muscles, bulb of penis, and bulbospongiosus muscle

Front 44

What is the superficial perineal fascia a continuation of?

Back 44

Scarpa's fascia and attaches to posterior edge of perineal membrane

Front 45

What does the deep perineal fascia cover?

Back 45

covers muscles on crura and bulb(s) of penis and clitoris

Front 46

What is the labia majora?

Back 46

- fat-filled, hair-bearing folds of skin
- provide protection for vaginal and urethral orifices

Front 47

What is the labia minora?

Back 47

- thin folds of skin lying medial to labia majora
- converge anteriorly/superiorly and surround glans of clitoris as prepuce

Front 48

What is the vestibule?

Back 48

- space between labia minora
- receives vagina, urethra, ducts of vestibular glands
- greater vestibular glands lie posterolaterally to vaginal orifice and secrete mucus into vestibule
- lesser vestibular glands lie anterior to greater vestibular glands and also secret mucus into vestibule

Front 49

What are bulbs of vestibule?

Back 49

- two masses of corpus spongiosum lying lateral to vestibule
- bulbospongiosus muscle is skeletal muscle covering bulbs

Front 50

What is the clitoris?

Back 50

- erectile tissue structure with body and glans
- body is paired corpora cavernosa which separate proximally as crura and attach to perineal membrane
- ischiocavernosus muscle covers crura

Front 51

What muscle covers the crura of the clitoris?

Back 51

ischiocavernosus muscle

Front 52

What muscle covers the bulbs of vestibule?

Back 52

bulbospongiosus muscle

Front 53

What is the arterial blood supply to the penis?

Back 53

deep artery of penis in each corpus cavernosum and paired dorsal arteries are branches of internal pudendal

Front 54

What is the venous drainage of the penis?

Back 54

venous drainage into deep dorsal vein

Front 55

What is the penis made up of?

Back 55

three masses of erectile tissue enclosed by tunica albuginea

Front 56

What lies superficial to the tunica albuginea in the penis?

Back 56

deep (Buck's) fascia

Front 57

Where is the penile urethra located in the penis?

Back 57

corpus spongiosum

Front 58

What is the scrotal raphe?

Back 58

represents line of fusion of labioscrotal swellings

Front 59

What is the scrotum?

Back 59

sac of skin, dartos muscle (smooth), and superficial scrotal fascia

Front 60

What are the muscles of the superficial pouch in males?

Back 60

- ischiocavernosus muscle covers crura
- bulbospongiosus covers bulb of penis

Front 61

What is the ischioanal fossa?

Back 61

fat-filled space on either side of anal canal permitting expansion of anal canal

Front 62

What are the borders of the ischioanal fossa?

Back 62

- perineal membrane and deep pouch structures lie inferior
- ischium and obturator internus lie lateral
- levator ani lie superomedial

Front 63

What does the ischioanal fossa contain?

Back 63

pudendal neurovascular bundle on lateral wall in pudendal canal

Front 64

What is the blood supply to the perineum?

Back 64

- external pudendals from femoral artery supply superficial perineal tissues
- internal pudendals from internal iliac supply deep perineal tissues

Front 65

What supplies parasympathetics to the perineum?

Back 65

pelvic splanchnics

Front 66

What supplies sympathetics to the perineum?

Back 66

sacral splanchnics

Front 67

What do branches of ilioinguinal and genitofemoral nerves do in the perineum?

Back 67

somatic sensory from external genitalia and perineal skin

Front 68

What does the pudendal nerve (S2-S4) do in the perineum?

Back 68

- somatic motor to external anal and urethral sphincters, muscles of both pouches
- somatic sensory from perineal skin, external genitalia including lower part of vagina, anal canal below pectinate line

Front 69

What is the lymph drainage of the perineum?

Back 69

- superficial (skin, external ganitalia, anal canal below pectinate line) to horizontal group of superficial inguinal nodes
- deep to internal inguinal nodes