Anatomy: Pelvis & Perineum Ii

Front 1

urinary bladder is located _______ in pelvic (abdominal) cavity

Back 1

retroperitoneally

Front 2

urinary bladder is covered only on its

Back 2

superior surface

Front 3

in males, the peritoneum reflects posteriorly as

Back 3

rectovesical pouch

Front 4

in females, the uterus & vagina lie between these two structures

Back 4

the rectum & the bladder

Front 5

in females, the peritoneum reflects as

Back 5

uterovasical pouch & rectouterine pouch

Front 6

urinary bladder has thick smooth muscular wall known as

Back 6

detrusor muscle

Front 7

detrusor muscle is extremely

Back 7

distensible

Front 8

urinary bladder, portions of

Back 8

body, neck, apex, base, fundus

Front 9

body of urinary bladder is

Back 9

main portion

Front 10

neck of bladder lies

Back 10

inferior

Front 11

apex of bladder lies

Back 11

anterior/anterosuperior and is continuous with median umbilical ligament

Front 12

base of bladder lies

Back 12

posterior

Front 13

fundus of bladder, location

Back 13

dependent upon amount of urine in bladder

Front 14

trigone

Back 14

internal triangular area in bladder; contains openings of right & left ureters & urethra

Front 15

mucosa of urinary bladder adheres to

Back 15

smooth muscle in the area of the trigone (looks smooth)

Front 16

urinary bladder, other than trigone, contains

Back 16

rugae (folds)

Front 17

urinary bladder lies posterior to

Back 17

pubic bone

Front 18

space between urinary bladder & pubic bone known as

Back 18

retropubic space (of Retzius)

Front 19

in females, urinary bladder lies anterior to

Back 19

the vagina (mainly) & the uterus

Front 20

in females, urinary bladder lies inferior to

Back 20

the uterus (with ileum)

Front 21

in males, the urinary bladder lies anterior to

Back 21

the seminal vesicle and the ductus deferens

Front 22

in either sex, the pelvic diaphragm lies

Back 22

lateral to the urinary bladder

Front 23

in females, pelvic & UG diaphragms lie

Back 23

inferior to urinary bladder (bladder rests on diaphragm)

Front 24

in males, the prostate lies

Back 24

inferior to the urinary bladder

Front 25

ureters take an oblique course through the

Back 25

bladder wall

Front 26

ureters act as a

Back 26

"sphincter" preventing backflow of urine when bladder contracts

Front 27

ligaments that hold urinary bladder, in males

Back 27

puboprostatic

Front 28

ligaments that hold urinary bladder, in females

Back 28

pubovesical

Front 29

urethral sphincter located in

Back 29

deep perineal space

Front 30

uritheral sphincter aka

Back 30

sphincter urethrae muscle

Front 31

sphincter urethrae mm innervated by

Back 31

perineal branch of pudendal n. (somatic innervation)

Front 32

superior vesical a. is a branch of

Back 32

umbilical a.; provides several branches to anterosuperior aspect

Front 33

inferior vesical a. is a branch of

Back 33

the vaginal a. (in females) or the internal iliac a.

Front 34

portion of fundus of bladder is supplied by

Back 34

vaginal a. in females & deferential a. in males

Front 35

veins of pelvis

Back 35

names correspond to aa and form vesical plexus

Front 36

in males, vesical plexus drains to

Back 36

prostatic plexus

Front 37

prostatic plexus drains to

Back 37

internal iliac vein, vertebral venous plexus

Front 38

in females, vesical plexus drains to

Back 38

uterovaginal plexus

Front 39

uterovaginal plexus drains to

Back 39

internal iliac vein, vertebral venous plexus

Front 40

urinary bladder, lymphatics - superior surface goes to

Back 40

external iliac nodes

Front 41

urinary bladder, lymphatics - fundus goes to

Back 41

internal iliac nodes

Front 42

urinary bladder, lymphatics - neck to

Back 42

sacral & common iliac nodes

Front 43

mictruition reflex, nn responsible for

Back 43

parasympathetics (S2-4) & their visceral afferent fibers

Front 44

mictruition reflex, impulses travel

Back 44

from stretch receptors within bladder to drosal root ganglia S2-4; parasympathetics act on detrusor to expel urine

Front 45

sympathetic nn cause

Back 45

contraction of internal sphincter (smooth muscle) of bladder

Front 46

sympathetic nn have two routes to bladder

Back 46

superior hypogastric plexus (main route) and sacral splanchnics (fibers that course down chain ganglia to pelvis)

Front 47

pain from bladder courses with

Back 47

visceral afferents that travel with sympathetics (T11-L2)

Front 48

pudendal n, levels

Back 48

S2-4

Front 49

pudendal n, type

Back 49

somatic

Front 50

deep perineal n. is a branch of

Back 50

pudendal n.

Front 51

deep perineal n. innervates

Back 51

sphincter urethrae m of deep perineal space

Front 52

muscle within UGD is

Back 52

voluntary (external) sphincter

Front 53

rectum means

Back 53

straight

Front 54

rectum begins

Back 54

at SV3 as continuation of sigmoid colon

Front 55

rectum passses through pelvic diaphragm and becomes

Back 55

anal canal (renamed)

Front 56

rectum is located

Back 56

in pelvis

Front 57

anal canal is locates

Back 57

in perineum (ischioanal fossa of anal triangle)

Front 58

upper 1/3 of rectum is

Back 58

retroperitoneal

Front 59

upper 1/3 of rectum is covered on

Back 59

anterior & lateral sides only

Front 60

middle 1/3 of rectum is

Back 60

retroperitoneal

Front 61

middle 1/3 of recrum is covered on

Back 61

anterior surface only

Front 62

lowest 1/3 of rectum is

Back 62

inferior to perineum

Front 63

upper 2/3 of rectum has

Back 63

serosa

Front 64

lower 2/3 of rectum has

Back 64

adventitia

Front 65

major internal feature of rectum

Back 65

three transverse folds ("valves of Houston")

Front 66

function of valves of Houston

Back 66

support fecal mass

Front 67

composition of valves of Houston

Back 67

circular smooth muscle, submucosa, & mucosa; causes curvatures

Front 68

rectal ampulla is

Back 68

bulge just superior to pelvic diaphragm

Front 69

these spread out to form anterior & posterior muscle bands on rectum

Back 69

teniae coli

Front 70

anal canal has

Back 70

90 degree angle, directed posterior, from rectal ampulla due to pubocrectalis m.

Front 71

internal sphincter of anal canal

Back 71

involuntary, circular smooth m. and innervated by ANS

Front 72

extrenal sphincter of anal canal

Back 72

voluntary, skeletal m. and innervated by inferior rectal n. (branch of pudendal n)

Front 73

portions of anal canal

Back 73

subcutaneous, superficial, & deep

Front 74

Hilton's white line aka

Back 74

intersphincteric line

Front 75

Hilton's white line is site

Back 75

where internal & external sphincters meet

Front 76

Hilton's white line lies inferior to the

Back 76

(important) pectinate line (divide line)

Front 77

longitudinal m passes between

Back 77

sphincters and some fibers form corrugator cutis ani

Front 78

superficial part of external sphincter attaches to

Back 78

perinal body & coccyx

Front 79

anal columns are

Back 79

vertical folds of mucosa caused by veins

Front 80

anal sinuses are

Back 80

depressions between columns

Front 81

anal valves connect

Back 81

bases of contiguous columns by bridging across sinuses

Front 82

anal valves form

Back 82

pectinate line, which serves as a "divide" line with respect to vasculature & innervation

Front 83

arterial supply to rectum & anal canal

Back 83

superior rectal a, middle rectal a, & inferior rectal a.

Front 84

superior rectal a. is

Back 84

chief a to rectum

Front 85

superior rectal a. is terminal branch of

Back 85

IMA

Front 86

superior rectal a. unpaired, but divides when

Back 86

reaching rectum

Front 87

superior rectal a. supplies submucosa

Back 87

above pectinate line

Front 88

middle rectal a. arises from

Back 88

internal iliac "system," often from the internal iliac itself or from internal pudendal or from another branch

Front 89

middle rectal a. courses superior to

Back 89

pelvic diaphragm

Front 90

middle rectal a. supplies

Back 90

muscle

Front 91

inferior rectal a. arises from

Back 91

internal pudendal

Front 92

internal rectal a. courses

Back 92

inferior to pelvic diaphragm

Front 93

inferior rectal a. supplies submucosa

Back 93

below pectinate line

Front 94

middle (median) sacral a. provides minor supply to

Back 94

rectum & anus

Front 95

superior & inferior rectal vv drain

Back 95

submucosa, above & below pectinate line, respectively

Front 96

veins of rectum & anus are

Back 96

a major site of porta-caval anastomoses

Front 97

superior rectal vv drain to portal system via

Back 97

splenic or SMV, or portal directly

Front 98

middle & inferior rectal vv. Drain to

Back 98

IVC via internal iliac

Front 99

hemorrhoids

Back 99

suck

Front 100

pectinate line serves as divide line for

Back 100

lymphatics

Front 101

below pectinate line, lymphatics drain

Back 101

to superficial inguinal nodes (in groin)

Front 102

above pectinate line, lymphatics drain

Back 102

to pararectal nodes

Front 103

pararectal nodes follow blood vessels to

Back 103

internal iliac nodes for middle & inferior rectal vessels & inferior mesenteric nodes for superior rectal vessels

Front 104

muscle of rectum is

Back 104

smooth muscle

Front 105

muscle of rectum innervated by _____ types of nerves

Back 105

visceral; sympathetic & parasympathetic

Front 106

external anal sphincter is

Back 106

skeletal muscle & receives inferior rectal branch of pudendal n.

Front 107

parasympathetics act to

Back 107

increase peristalsis & decrease tone of internal sphincter

Front 108

sympathetics act to

Back 108

decrease peristalsis & increase tone of internal sphincter

Front 109

innervation superior to pectinate line supplied by

Back 109

visceral afferents that course with the sympathetics (L1 & L2) and with the parasympathetics (S2-4)

Front 110

inferior to pectinate line supplied by

Back 110

somatic innervation (pudendal n.)

Front 111

internal iliac a., posterior division goes to

Back 111

superior gluteal (exits superior to piriformis), lateral sacral, & iliolumbar

Front 112

internal iliac a., anterior division goes to

Back 112

umbilical, obturator, inferior vesical, middle rectal (in females, uterine & vaginal)

Front 113

terminal branches of internal iliac aa.

Back 113

internal pudendal & inferior gluteal

Front 114

sacral plexus formed by

Back 114

ventral rami L4-S3

Front 115

anterior division of sacral plexus consists of

Back 115

tibial, n. obturator internus, n. quadratus femoris

Front 116

posterior division of sacral plexus consists of

Back 116

common fibular, superior gluteal, inferior gluteal

Front 117

peritoneum covers the

Back 117

uterus

Front 118

peritoneum reflects onto

Back 118

rectum & bladder

Front 119

rectouterine pouch aka

Back 119

pouch of Douglas