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164 Cards in this Set
- Front
- Back
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What three bones make up the pelvic girdle?
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1) Right hip bone
2) Left hip bone 3) Sacrum |
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What is the function of the sacroiliac joint?
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Transmits weight from torso to lower extremities
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What are the four ligaments of the sacroiliac joint?
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1) Dorsal sacroiliac
2) Ventral sacroiliac 3) Iliolumbar 4) Interosseous |
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Where is the interosseous ligament located?
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Deep to the dorsal sacroiliac ligament
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What does the iliolumbar ligament connect to?
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From the transverse process of L4 and L5 to the iliac crest and base of sacrum
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What are the two pelvic ligaments?
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1) Sacrotuberous
2) Sacrospinous |
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What canals do the pelvic ligaments create?
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Greater and lesser sciatic foramina
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What does the sacrotuberous ligament connect to?
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Runs from lateral margins of sacrum to the ischial tuberosity (travels vertically)
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What does the sacrospinous ligament connect to?
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Runs from lateral sacrum and coccyx to the ischial spine (travels horizontally)
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What are the two pouches that lie above the peritoneum in the female pelvis?
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1) Rectouterine pouch - between recum and uterus
2) Vesicouterine pouch - between bladder and uterus |
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What is the broad ligament of the uterus?
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Two layers of peritoneum extending from lateral uterus to lateral pelvic wall
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What is contained in the broad ligament of the uterus?
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Uterine tube, uterine vessels, round ligament of uterus, ovarian ligament, ureter, autonomic nerves, and lymphatics
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What are the three parts of the broad ligament of the uterus?
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1) Mesovarium
2) Mesosalpinx 3) Mesometrium |
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What does the mesovarium connect?
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Anterior ovary with posterior layer of broad ligament
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What does the mesosalpinx connect?
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Suspends the uterine tube anterior to the ovary
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Where is the mesometrium?
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Major part of broad ligament below the mesosalpinx and mesovarium
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Where does the round ligament of the uterus connect?
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In front of and below the attachment of uterine tube
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What embryonic structure does the uterine tube represent?
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Remains of lower gubernaculum
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Where is round ligament of uterus located relative to broad ligament of uterus?
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It runs within the layers of the broad ligament
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What are the rotations of the uterus and what holds them in place?
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Anterverted (turned forward) and anteflexed (bent forward) - held in place by round ligament of uterus
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Where does the ovarian ligament run?
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From ovary to uterus below uterine tube and through the broad ligament
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What structures run along the suspensory ligament of the ovary?
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Ovarian artery, vein, nerves, lymphatics
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Where does the suspensory ligament run?
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Upward from ovary to pelvic wall (posteriorly)
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What does ligament is contained in the rectouterine fold and what is its purpose?
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Uterosacral ligament - holds cervix back and upward
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What are the other names for the lateral cervical ligament of uterus? (3)
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1) Transverse cervical ligament
2) Cardinal ligament 3) Mackenrodt's ligament |
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Where does the lateral cervical ligament of uterus run?
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From cervix and lateral vagina to pelvic walls (laterally)
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Where is the lateral cervical ligament of the uterus relative to the broad ligament of the uterus?
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It extends laterally below the base of the broad ligament
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Where is the ovary relative to the broad ligament and what suspends the organ?
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It lies on top of the posterior aspect - suspended by mesovarium
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What structure connects the uterine cavity to peritoneal cavity?
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Uterine tube (Fallopian tube)
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Extending from the uterus, what are the five areas of the uterine tube?
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1) Uterine part
2) Isthmus 3) Ampulla 4) Infundibulum 5) Fimbriae |
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What are four variations in uterus position?
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1) Retroflexion
2) Retrocession 3) Retroversion 4) Severe anteflexion |
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From the entrance to the top, what are the areas of the uterus?
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1) Cervix
2) Isthmus 3) Body 4) Fundus |
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What is the primary blood supply to the uterus? (2)
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1) Uterine artery
2) Ovarian artery (secondary) |
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What is Sampson's artery?
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The anastomosis of the uterine artery and ovarian artery at the round ligament of the uterus
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What four structures support the vagina?
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1) Levator ani
2) Ligaments (lat. pubocervical, sacrocervical) 3) Urethral sphincter muscle 4) Perineal body |
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What is the primary blood supply to the vagina? (2)
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1) Vaginal branches of uterine artery
2) Vaginal artery of internal iliac artery |
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What are the two different areas of lymphatic drainage in the vagina?
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Upper 3/4 - inward to internal iliac nodes
Lower 1/4 - outward to perinuem and thus superficial inguinal nodes |
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What is the pouch created above the male pelvis?
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Rectovesical pouch - between rectum and bladder
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What is the primary blood supply of the rectum?
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1) Superior rect. art. (from IMA)
2) Midle rect. art. (from ant. div. of int. iliac art.) 3) Inferior rectal art. (from int. pudendal art.) 4) Median sacral art. |
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What are the veins of the rectum and where do they drain?
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Portal: superior rectal vein
Caval: middle and inferior rectal vein |
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What is the ampulla of the rectum?
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Lower dilated part where feces is stored
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Where is the pectinate line located and what is the other name for it?
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It courses along the top of the anal columns - musculocutaneous line
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What is the membrane makeup of the area above and below the pectinate line?
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Above: mucuous membrane, simple columnar/cuboidal epithelium
Below: skin, stratified squamous epithelium |
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What is the innervation above and below the pectinate line?
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Above: visceral sensory (less sensitive)
Below: general sensory (more sensitive) |
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What is the venous drainage above and below the pectinate line?
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Above: portal system
Below: caval system |
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What is the lymph drainage above and below the pectinate line?
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Above: internal iliac nodes
Below: superficial inguinal nodes |
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What type of muscle makes up internal and external anal sphincter?
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Internal: smooth
External: skeletal |
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What are the three constrictions of the ureter?
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1) Junction with pelvis of ureter in kidney
2) At pelvic brim 3) At junction with bladder |
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Where does the ureter pass in males and females?
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Male: posterior and inferior to the ductus deferens
Female: below the branches of the uterine artery |
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What makes up the trigone in the bladder?
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Triangle bound by 2 ureteric orifices and internal urethral orifice
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What is the detrusor muscle?
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Bundle of smooth muscle fibers that form the bladder
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What provides the blood supply to the bladder?
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1) Superior and inferior vesicle arteries
2) In female, also the vaginal artery |
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What are the structures from the testis to the ductus deferens?
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1) Rete testis
2) Efferent ductules 3) Epid. Head (at upper part of testis) 4) Epid. Body (descends along back of testis) 5) Epid. Tail (at lower part of testis) 6) Ductus deferens |
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What is the lymphatic drainage of the testis?
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Scrotum: superficial inguinal nodes
Testis: lymph vessels that ascend with testicular vessels and drain into lumbar nodes |
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What contains fructose to provide nutrition for spermatozoa?
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Ductus deferens
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Where does ductus deferens pass relative to ureter and where does it enteir pelvis?
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Superior to ureter - enters pelvis at deep inguinal ring lateral to inferior epigastric artery
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Where is the seminal vesicle located?
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Inferior and lateral to the ampullae of ductus deferens against the base of bladder
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What are the seminal vesicles?
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Lobulated glandular structures that are diverticula of the ductus deferens
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What is secreted by the prostate? (5)
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1) Prostate specific antigen (PSA)
2) Prostaglandins 3) Citric acid 4) Acid phosphatase 5) Proteolytic enzymes |
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Where is prostate located?
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At neck of bladder
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What are the lobes of the prostate and their general characteristics? (5)
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1) Anterior (muscle)
2) Median (benign hypertrophy) 3) Posterior (cancer) 4) Left lateral 5) Right lateral |
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What structures are located within the prostatic urethra? (3)
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1) Ejaculatory ducts
2) Prostatic ducts 3) Prostatic utricle |
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What is the somatic and visceral separation of the pectinate line?
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Above: Visceral
Below: Somatic |
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What separates the greater (false) and lesser (true) pelves?
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Pelvic inlet (or pelvic brim)
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What organs are located in the greater pelvis?
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Abdominal organs
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What organs are located in the lesser pelvis?
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Reproductive organs
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What makes up the perimeter of the pelvic outler, or "inferior pelvic aperture?" (4)
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Pubic arch, ischiopubic rami, ischial tuberosities, and the tip of the coccyx
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What two muscles form the lateral walls of the pelvis?
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1) Piriformis
2) Obturator internus |
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What two muscles form the floor of the pelvic cavity or the "pelvic diaphragm?"
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1) Levator ani
2) Coccygeus |
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What are the three parts of the levator ani?
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1) Iliococcygeus - lateral, originates from obturator fascia
2) Pubococcygeus - middle 3) Puborectalis - medial, forms loop around rectum |
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What innervates the pelvic diaphragm?
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S3, S4, S5
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What is the strongest muscle of the pelvic diaphragm?
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Pubococcygeus
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What are two potential consequences of injuring the pelvic floor in both sexes?
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Bladder incontinence (cystocele) and defecatory dysfunction (rectocele)
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What foramen does the obturator internus pass through?
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Lesser sciatic foramen
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What foramen does the piriformis pass through?
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Greater sciatic foramen
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What is the thickening of obturator fascia that provides attachment for the pelvic floor muscles?
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Arcus tendineus
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What are the four major gateways to the lower limb?
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1) Greater sciatic foramen
2) Lesser sciatic foramen 3) Obturator canal 4) Beneath the inguinal ligament |
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What are the main structures that pass through the greater sciatic foramen? (5)
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1) Piriformis muscle
2) Gluteal nerve and vessels 3) Pudendal nerve 4) Sciatic nerve 5) Internal pudendal vessels |
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What are the main structures that pass through the lesser sciatic foramen? (2)
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1) Obturator internus muscle
2) Pudendal nerve 3) Internal pudendal vessels |
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What foramina do the pudendal nerve and internal pudendal vessels pass through?
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Out the greater sciatic foramen and in the lesser sciatic foramen
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What is the main structure that passes through the obturator canal?
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Obturator nerve and vessels - into the medial thigh compartment
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What are the main structures that pass beneath the inguinal ligament? (5)
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1) Iliopsoas muscle
2) Lateral femoral cutaneous nerve 3) Femoral nerve 4) Femoral artery 5) Femoral vein |
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What makes up the vascular lacuna and where does it pass?
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Femoral artery and vein - passes beneath the inguinal ligament (medially)
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What makes up the muscular lacuna and where does it pass?
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Iliopsoas muscle, lateral femoral cutaneous nerve, femoral nerve - passes beneath the inguinal ligament (laterally)
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What is the difference between the lumbosacral plexus and the pelvic plexus?
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Pelvic plexus - innervates the pelvic organs (autonomic)
Lumbosacral plexus - innervates pelvic/lower limb muscles and skin (somatic) |
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What nerves make up the lumbosacral plexus?
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Ventral rami of spinal nerves L1 - Co1
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What are the nerve roots of the lateral femoral cutaneous nerve and what does it supply?
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L2 and L3 - sensation to anterolateral thigh (commonly entrapped beneath inguinal ligament)
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What two major nerves arise from L2, L3, and L4?
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1) Femoral nerve
2) Obturator nerve |
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What is the function of the femoral nerve?
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Innervates quadriceps muscle
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What is the function of the obturator nerve?
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Innervates addutor muscles of lowerlimb
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What is the lumbosacral trunk?
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Stout nerve formed by L4 and L5 - contributes nerves to the sacral plexuses
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What does the sacral plexus innervate?
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Lower extremity, gluteal muscle
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What is the major nerve from the sacral plexus?
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Pudendal nerve
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What are the roots of the pudendal nerve and what does it innervate?
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S2 - S4, innervates perineum
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What are the branches of the iliac artery?
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Internal and external
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What are the branches of the internal iliac artery?
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Anterior and posterior
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What are the branches of the posterior internal iliac artery? (3)
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1) Iliolumbar artery
2) Lateral sacral artery 3) Superior gluteal artery |
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What are the branches of the anterior internal iliac artery in the female? (7)
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1) Obturator artery
2) Umbilical artery 3) Uterine artery 4) Vaginal artery 5) Middle rectal artery 6) Internal pudendal artery 7) Inferior gluteal artery |
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What is the correlation to the uterine artery in the male?
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Artery of ductus deferens
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What is the correlation to the vaginal artery in the male?
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Inferior vesical artery
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What does the middle rectal artery also supply in men?
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Prostate, seminal vesicles, and ureter
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What makes up the floor and roof of the perineum?
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Floor: skin and fascia
Roof: pelvic diaphragm |
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What makes up the superficial perineal space?
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Area between the parineal membrane and the membranous layer of superficial perineal fascia (Colles' fascia)
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What makes up the deep perineal space?
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Area between the fascial layers surrounding urethrae and urethrovaginalis sphincters and deep transverse perineal muscles
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What three muscles make up each half of the urogenital triangle?
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1) Ischiocavernosus
2) Bulbospongiosus 3) Superficial transverse perineal muscle |
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What are the main structures in the superficial perineal space? (3)
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1) Perineal body
2) Bulb of vestibule 3) Greater vestibular glands |
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What is the function of the perineal body?
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Fibromuscular mass at center of perineum that provides site of attachment for surrounding muscles
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What is the function of the greater vestibular glands?
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Secrete mucus that lubricates vagina
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What is the bulb of vestibule?
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Elongated erectile tissue
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What are the main two structures in the deep perineal space in women?
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1) Deep transverse perineal muscle
2) Sphincter urethrae |
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Where can extravasated urine spread in the perineal area?
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Superficial perineal space - superiorly into the abdominal wall (into scrotum and ateriorly around penis in men)
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Where is extravasated urine prevented from spreading in the perineal area?
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Laterally or into anal region because perineal membrane and colles' fascia are continuous
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What is the action/innervation of ischiocavernosus in men?
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Nerve: perineal branch of pudendal nerve
Action: compresses crus and deep dorsal vein of penis, maintaining erection |
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What is the action/innervation of bulbospongiosus?
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Nerve: perineal branch of pudendal nerve
Action: compresses the bulb, impeding venous return and maintaining erection - constricts corpus spongiosum to expell last drops of urine/semen |
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What is the action/innervation of superficial transverse perineal muscle?
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Nerve: perineal branch of pudendal nerve
Action: stabilizes perineal body |
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What are the main structures in the deep perineal space in men? (3)
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1) Deep transverse perineal muscle
2) Sphincter urethrae 3) Bulbourethral glands |
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What are the two ligaments of the penis?
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1) Fundiform ligament (encircles penis and enters septum of scrotum)
2) Suspensory ligament (inserts into deep fascia of penis) |
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From the skin, what are the layers of the scrotum?
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Superficial (dartos) fascia, external spermatic fascia, cremaster fascia and muscle, internal spermatic fascia, parietal layer of tunica vaginalis, epididymis, testis covered by visceral layer of tunical vaginalis
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What provides blood supply to scrotum?
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Pudendal arteries
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What innervates the scrotum? (4)
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1) Ilioinguinal nerve
2) Genitofemoral nerve 3) Pudendal nerve 4) Femoral cutaneous nerve |
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What are the major parts of the penis? (3)
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1) Vascular erectile tissue (2 corpora cavernosa and 1 corpus spongiosum)
2) Root (2 crura + 1 bulb) 3) Glans penis (head) |
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What makes up deep fascia of penis?
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Continuation of deep perineal fascia and continuous with fascia of external abdominal oblique
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Where is the urethra located in the penis?
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Within corpus spongiosum
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Where is deep doral vein, dorsal artery, and dorsal nerve located in penis?
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Within dense tunica albuginea between corpora cavernosa
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Where are deep arteries of penis located?
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Within each corpus cavernosum
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Where is the ischiorectal fossae and what does it consist of?
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Lateral to rectum, filled with fat, and separated from pelvis by levator ani
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What structures pass through the ischiorectal fossae?
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Pudendal canal (contains pudendal nerve and internal pudendal vessels)
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What types of tissue are served by pudendal nerve?
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Muscle and skin - not viscera
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Where does the lymph from the perineum flow? (3)
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Goes into (1) superficial inguinal lymphy nodes which drain into (2) external iliac nodes and then (3) lumbar (aortic) nodes
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What is the homologous structure of the male bulbourethral glands?
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Greater vestibular glands
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What is the homologous structure of the scrotum?
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Labia majora
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What is the homologous structure of the ventral aspect of penis?
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Labia minora
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What is the homologous structure of the gubernaculum testis?
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Round ligament of uterus, ovarian ligament
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What is THE nerve of the perineum?
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Pudendum
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Where does lymph from the pelvis drain?
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It follows internal iliac vessels to internal iliac nodes and then to lumbar (aortic) nodes
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What are the autonomic nerve plexuses of the pelvis? (4)
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1) Aortic plexus
2) Testicular/ovarian plexus 3) Superior hypogastric plexus 4) Left and right inferior hypgogastric plexus (pelvic plexus) |
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What are the autonomic pelvic nerves that are not part of a plexus? (3)
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1) Sympathetic chain
2) Sacral splanchnics (sympathetic) 3) Pelvic splanchnics (parasympathetic) |
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What are the subsidiary plexuses of the female inferior hypogastric (pelvic) plexus? (3)
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1) Vesical plexus
2) Uterovaginal plexus 3) Rectal plexus |
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What are the subsidiary plexuses of the male inferior hypogastric (pelvic) plexus? (4)
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1) Deferential plexus
2) Vesical plexus 3) Prostatic plexus 4) Rectal plexus |
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What types of nerves are contained within the superior hypogastric plexus?
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1) Visceral motor (symp and para)
2) Visceral sensory |
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What parasympathetic nerves roots are located within the superior hypogastric plexus?
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S2 - S4
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What is served by the hypogastric nerves? (2)
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1) Sigmoid colon
2) Descending colon |
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What forms the inferior hypogastric plexus (pelvic plexus)? (3)
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1) Hypogastric nerves
2) Pelvic splanchnic nerves 3) Sacral splanchnic nerves |
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What kind of nerves and ganglia are located within the inferior hypogastric plexus? (3)
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1) Visceral motor (symp and para)
2) Visceral sensory 3) Pelvic ganglia |
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What is unique about the pelvic splanchnic nerves (nervi erigentes)?
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Only splanchnic nerves that carry parasympathetic fibers
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What are the similarities between the pudendal nerves and pelvic splanchnic nerves?
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Both arise from S2, S3, and S4
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What are the key differences between the pudendal nerves and pelvic splanchnic nerves?
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Pudendal: somatic motor innervation of skeletal muscles, general sensory innervation of skin, visceral motor/sensory innervation of glands, vessels
Pelvic Splanchnic: visceral motor parasympathetic, innervate hindgut and pelvic viscera |
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What nerve roots supply sympathetic and parasympathetic innervation to the bladder?
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Symp: T11 - L2
Para: S2 - S4 |
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What does visceral motor (parasympathetic) innervation of the bladder do?
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Contracts dtrusor muscle and relaxes internal spincter
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What does somatic motor innervation of the bladder do?
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Relaxation of external sphincter
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What nerve roots supply sympathetic and parasympathetic innervation to the testis?
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Symp: T10 - T11
Para: Vagus (CN X) |
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What nerve roots supply sympathetic and parasympathetic innervation to the male reproductive organs?
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Symp: T10 - L2
Para: S2 - S4 |
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What nerves cause erection?
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Visceral motor (parasympathetic) - dilate arteries which engorges corpora cavernosa and corpus spongiosum; this compresses veins and inhibits blood flow
Somatic motor - help maintain erection |
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What nerves cause ejaculation?
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Visceral motor (sympathetic) - contraction of epididymis, vas deferens, seminal vesicles, and prostate; also causes internal spincter of bladder to contract
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What nerve roots supply sympathetic and parasympathetic innervation to the ovary?
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Symp: T10 - T11
Para: Vagus |
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What nerve roots supply sympathetic and parasympathetic innervation to the female reproductive organs?
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Symp: T10 - L2
Para: S2 - S4 |
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What nerve roots supply sympathetic and parasympathetic innervation to the rectum?
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Symp: L1 - L2
Para: S2 - S4 |
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What effect do sympathetic nerves have on the GI tract?
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Contract internal anal sphincter to aid fecal continence
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What effect do parasympathetic nerves have on the GI tract?
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Contracts rectum; inhibits internal anal sphincter and causes defacation
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What effect do sympathetic nerves have on the urinary tract?
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Vasoconstriction of renal vessels slows urine formation - contracts internal sphincter of bladder to maintain urinary continence
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What effect do parasympathetic nerves have on the urinary tract?
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Inhibits contraction of internal sphincter of bladder - contracts detrusor muscle causing urination
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What effect do sympathetic nerves have on the genital system?
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Causes ejaculation and vasoconstriction resulting in end of erection
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What effect do parasympathetic nerves have on the genital system?
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Produces erection
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What are the sympathetic (4) and parasympathetic (1) splanchnic nerves?
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Symp: cervical, thoracic, lumbar, sacral
Para: pelvic |
