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94 Cards in this Set

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Where does the rich venous plexus in the endopelvic fascia surround? (2 strucuters). What vein drains in here and what structure does that vein run inferior to?
Rich venous plexus surrounds the prostate, bladder. Deep dorsal vein drains here. It is inferior to the pubis.
What covers the superior surface of the bladder?
In which sexes is the peritoneum reflected onto the rectum?
Both sexes.
How many pouches do males have in the pelvis?
Where is the male pouch found? What is its name.
Between the rectum and the urinary bladder. Retrovesicular pouch.
What is the lowest postion in the male pelvis?
The retrovesicle pouch
What muscle is found in the bladder?
The detrusor.
In what sex does the detrusor act on the neck of the bladder?
When does the detrusor muscle close off the urethra?
During an erection.
What does the bladder rest on in males? What does that structure rest on?
The bladder rests on the prostrate gland which rests on the pelvic floor.
What runs through the core of the protrate gland?
The prostratic portion of the urethra and the ejaculatory ducts.
Describe the path the urethra takes as it passes through the pelvis and its name changes as it does. Seperate its names in the two sexes.
In male Pass through prostrate gland = prostratic poriton, pass through the diaphragm of pelvis = membranous part, runs to shaft of penis = spongy part (penile). Females have membranous urethra only!
What covers the prostrate? What does this divide the prostrate into?
Thick CT capsule that separetes it into lobes. Also can be separated into zones.
Where do the ureters enter the urinary bladder?
On the posterior aspect.
Describe the course of the ureters as they enter the bladder.
What tube runs just superior to the ureters?
The Vas deferens (pairs.
Describe the vas deferens as it moves toward the posterior aspect of the urinary bladder.
It dialates.
What flanks the Vas deferens inferiorly?
Seminal vesicles.
Where do sperm mature?
In the epididymis.
What produces the majority of the semen?
Seminal vesicles.
What do the seminal vesicles and vas deferens together form?
The ejaculatory duct (2)
Where is the ejaculatory duct found?
Right at the surface of prostrate.
Describe the path of the ejaculatory duct.
From the posterior aspect of the bladder pierces the prostrate gland and connects with the prostatic urethra. Each has own opening into prostratic urethra.
What does the ejaculatory duct carry? How about the seminal vesicles? How about vas deferens?
Vas deferens carries sperm and fluid. Seminal vesicle contains secretions. Ejaculatory duct carries both.
Describe the structure of the seminal vesicle.
Single tube highly coiled that forms the gland.
What gland is found in the deep pouch?
Camper's or bulbourethral gland.
What borders the anterior lobe of the prostrate?
Only urethra.
What tubes border the median lobe of the prostrate?
Anteriorly Prostratic urethra, inferiorly, ejaculatory duct.
What tubes border the posterior lobe of the prostrate?
Anteriorly prostatic urethra, superiorly, ejaculatory duct.
Which prostatic lobe has the most problems in men?
Median lobe
Which lobe can you palpate the most during a prostratic exam?
The posterior lobe
What percentage of men develop benign enlargement of the prostrate gland? What is the acronym for this?
80-90%. BPH = Benign prostratic hypertrophy
What are the two ways the prostrate can encroach upon other structures?
Superiorly into bladder, or anteriorly into urethra.
What is the primary symptom of the prostrate encrouching on the urethra?
Weak stream of urine, trouble starting urination.
What pathology occurs when the median gland encroaches on the bladder?
Allows urine to pool and bacteria are able to grow there. They are thus more to bladder infections.
Where is the urethral crest located on the prostrate?
On the posterior wall.
Where is the seminal collicus?
ON a widened area on the urethral crest in the prostrate.
What are the 2 side by side openings in the seminal colliculus most superiorly?
THe ejactulatory ducts.
What is the prostratic utricle?
The male vagina, it is an embryonic vestige and it is a blind shallow pouch. Not of any clinical significance.
Approximately how many ducts from the prostrate open up on the posterior aspect of the protratic urethra?
What does Cowper's gland make?
Preejactulate, neutralizes acidity of vagina/urethra.
Where is semen formed?
In the prostratic urethra.
What is the action of the prostrate gland contracting?
Squeezes prostrate secretions into semen and squeezes semen out towards the external urethral aperature.
What percentage of semen do the testes and epidymis supply? What do they supply?
Secretions and sperm, 10% of semen.
What percentage of semen do the seminal vesicles supply?
60% of semen.
What sort of things are in the secretions of the seminal vesicles (5)?
Citric acid and nutrients
What is the action of the prostaglandins the seminal vesicles release?
The y react w/ teh cervical mucus to make the environment more conducive to sperm movement. They also initiate reverse peristalsis in the uterine tube which helps move sperm toward the distal tube (Only takes 5 min).
What percentage of semen does the prostrate gland deliver?
What is found in the prostrate gland's secretions? (6)
Alkaline,thin,milky substance
What is the purpose of the fibrinogen that the seminal vessicles release?
Holds semen in the upper vagina and keeps the mucoid consistancy of the ejaculate.
What does the profibrinolysin do that the prostrate gland releases?
Converted to fibrinolysin which causes lysis of a mucoid clot of semen.
What are the 4 responses of the male reproductive system?
Erection, Emission, Ejaculation, Detruescence.
What nervous system is the erection under the control of?
What is emission? What nervous system is it under the control of?
Emission = Formation of semen from the secretions of glands
It is mostly sympathetic
What nervous system controls ejaculation?
What is detruescence? What nervous system is it under the control of?
Detruescence= return of the penis to a flaccid condition. It is under sympathetic control.
What foramen does the tendon of obturator internis go through?
The lesser sciatic foramen.
What coveres obturator internus?
What forms the tendonous arch?
Obturator internus.
What forms the pudendal canal?
Oburtator internus fascia.
What is enclosed in the pudendal canal?
Internal pudendal artery, vein and pudendal nerve.
What does the tendonous arch form?
The pudendal canal.
What is just superior to the pudendal canal?
A thickening of the obutrator internis fascia that provides an attachment for muscles of the pelvic diaphragm
What 3 muscles form the pelvic diaphragm?
Ischiococcygeus, pubococcygeus, Iliococcygeus.
What muscle runs from the ischial spine to the coccy?
Ischiococcygeus (allso called just coccygeus)
What forms the levator ani? What muscle is not a part of it?
The pubococcygeus, iliococcygeus and Puborectalis. The ischiococcygeus is NOT a part of it.
Describe the position of muscles of the pelvic floor as you move posterior to anterior.
Posterior medial all the way to anterior medial = pubococcygeus. The part of pubococcygeus that surrounds the anorectal hiatus is the puborectalis. Most posterior lateral is the piriformis (paired). Anterior to that muscle is the ischiococcygeus muscle. Anterior to the ischiococcygeus is the iliococcygeus. Lateral to that is the obterator internus muscle.
Describe the path of the puborectalis muscle.
Forms a "swing" around the ano/rectal junction.
What is the action of the puborectalis muscle?
It pulls the anorectal jucntion toward the pubic symphysis. It releases during defecation.
The loss of control of what muscle will result in incontinence?
There are 2 hiatuses that run through the pubococcygeus muscle. What are they and which is most anterior?
The hiatus for deep dorsal vein is anterior to the hiatus for the urethra.
What closes the gaps of the pubococcygeus muscle? (genital hiatus)
The urogenital diaphragm
From where to where does the urogenital diaphragm run?
From ischiopubic ramus to ischiopubic ramus (flat).
What makes up the UG diaphragm?
Perineal membrane, muscle and contents of deep pouch, transverse perineal ligament.
What nerves form the sacral plexus?
S2, S3, S4
What is the source of the pudendal nerve?
The sacral plexus.
What do the ventral rami of the sacral plexus lie on?
The piriformis muscle.
What level does the aorta bifurcate at?
What are teh divisions of the internal iliac?
Anterior and posterior.
What is the iliolumbar artery? What is its source? Describe its path.
Iliolumbar is small branch that recurves out of the true pelvis and is from the posterior division of the internal iliac.
What is the lateral sacral artery? What is its source? What does it supply?
It is a series of vessels (2-4) which supply blood to the cauda equina. IT is from the posterior division of the internal iliac.
What is the largest branch of the posterior division of the internal iliac artery?
Superior gluteal artery.
What is the superior gluteal artery? What is its source? Describe its path.
It is a branch of the posterior division of the internal iliac. It leaves between the lubarsacral trunk and S1.
What does the obturator artery run with? Describe the artery's termination. What is the artery a branch off of?
Runs with the obturator nerve. It becomes a fibrous cord all the way up to the umbilicus and forms the medial umbilical fold. The artery is a branch off of the anterior division of the internal iliac.
What source are the superior vesicular arteries from?
Anterior division of the internal iliac.
What artery from the anterior division of the internal iliac is found in males but not in females? How about in females but not in males?
Females have a branch to the vagina (vaginal artery) with some branches to the artery. Males have an inferior vesicular artery.
What foramen do the internal gluteal, internal pudendal and superior gluteal run through?
Sciatic foramen.
What is the relationship between the uterine artery and the ureter?
The uterine artery crosses over the ureter (water under the bridge).
What veins come onto the sides of the cervix?
The uterine veins.
What are the arteries off of the posterior divison of the internal iliac? (from proximal to distal)
Iliolumbar, lateral sacral, superior gluteal
What are the arteries off of the anterior division of the internal iliac? (from proximal to distal)
Umbilical artery
Obturator artery
Vaginal artery (Inferior vesicular)
Middle rectal
internal pudendal
inferior rectal
Where does the inferior rectal artery come from?
Internal pudendal artery
What is the source of the superior rectal artery?
Inferior mesenteric trunk
What arteries does the iliolumbar artery anastamose with?
Obturator artery, superior gluteal artery, iliac circumflex artery and lateral circumflex femoral artery.