Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
285 Cards in this Set
- Front
- Back
|
pelvis/pelvic girdle is formed by 3 bones:
|
sacrum and 2 hip bones
|
|
|
3 parts of a hip bone =
|
ileum, ischium, pubis
|
|
|
**2 functions of the pelvis:**
|
1. transfer weight form torso to lower limbs
2. protect organs and neurovasculature |
|
|
2 pelvic joints:
|
1. pubic symphysis
2. sacroiliac joint (x2) |
|
|
the pubic symphysis is purely:
|
cartilaginous
|
|
|
the sacroiliac joints:
(2) |
1. synovial
2. ~ weight transfer |
|
|
all three joints of the pelvis loosen during:
|
pregnancy
- via relaxin |
|
|
6 kinds of ligaments in the pelvis:
|
1. dorsal sacroiliac
2. ventral sacroiliac 3. iliolumbar 4. interosseous ligament 5. sacrotuberous 6. sacrospinous ligament |
|
|
iliolumbar ligament runs from:
|
lumbar vetebrae to iliac crest
|
|
|
the IO ligament of the pelvis:
(2) |
1. extremely strong
2. deep to sacroiliac ligament |
|
|
sacrotuberous ligament:
(2) |
1. extremely tough
2. runs from lateral sacrum to ischial tuberosity |
|
|
sacrospinous ligament:
(2) |
1. most tough
2. runs form lateral sacrum to ischial spine |
|
|
**both the sacrotuberous ligament and the sacrospinous ligament convert the:**
|
greater and lesser sciatic notches to greater and lesser sciatic foramina
- **both also provide resilience during weight transfer, e.g. jumping** |
|
|
pelvic fractures are usually a result of:
(2) |
1. direct trauma
2. falls (weight transfer) |
|
|
pelvic fractures ~~ internal bleeding; often result in:
|
**multiple fracture sites,**
including the *open book fracture,* in which the pubis breaks up into tiny pieces |
|
|
what drapes over the pelvic (retroperitoneal) organs?
|
the peritoneum, called the **broad ligament**
|
|
|
***the broad ligament consists of 3 parts:***
|
1. mesosalpinx
2. mesovarium 3. mesometrium |
|
|
what does mesosalpinx do?
|
suspends and covers the uterine/fallopian tubes
|
|
|
what does the mesovarium do?
|
connects the anterior of the ovary with the posterior layer of the broad ligament
|
|
|
***mesovarium does NOT:***
|
cover the ovary, only attaches to it (horizontally)
|
|
|
round ligament of the uterus:
(2) |
1. remnant of gabernaculum
2. attaches near fallopian tube |
|
|
***what's the most important function of the round ligament of the uterus?***
|
**it makes the uterus anteverted (turned forward) and anteflexed**
|
|
|
4 ligaments of the female pelvis:
|
1. ovarian
2. suspensory ligament of the ovary 3. rectouterine fold 4. transverse cervical ligament of the uterus |
|
|
ovarian ligament runs from:
|
ovary to uterus
|
|
|
***main function of the suspensory ligament of the ovary =***
|
houses ovarian vessels, as well as nerves and lymphocytes
|
|
|
rectouterine fold =
|
uterosacral ligament
|
|
|
***3 other names for the transverse cervical ligament:***
|
1. lateral cervical ligament
2. cardinal ligament 3. Mackenrodt's ligament |
|
|
transverse cervical ligament runs from:
|
cervix out to pelvic walls
|
|
|
in females, ***each ureter runs under:***
|
the uterine artery and vein
|
|
|
where does the sperm meet the oocyte?
|
in the ampulla or infundibulum of the fallopian/uterine tube
|
|
|
zygote travels back down, implants in the
|
uterus
|
|
|
fallopian tube segments:
|
uterus => uterine part => isthmus => ampulla => infundibulum => fimbriae
|
|
|
the ovary is supplied by:
|
ovarian artery, drained by ovarian vein
|
|
|
the ovarian artery is contained within:
|
the suspensory ligament of the ovary
- anastomoses with the uterine artery |
|
|
the uterus is supported by:
|
pelvic ligaments
|
|
|
**what are the primary and secondary blood supplies to the uterus?**
|
1. uterine artery
2. ovarian artery |
|
|
3 parts of cervix:
|
1. external os
2. cervical canal 3. internal os - followed by isthmus to uterus |
|
|
***what is the Sampson Artery?***
|
***anastomose of the uterine and ovarian arteries,***
at the **round ligament of the uterus** |
|
|
the Sampson Artery is commonly cut during:
|
hysterectomies
|
|
|
the vagina receives *extensive*:
|
blood supply
|
|
|
blood supply of vagina =
(2) |
1. vaginal branches of uterine artery
2. vaginal artery of the anterior division |
|
|
***lymphatic drainage of the vagina:***
|
1. upper 3/4's
2. lower 1/4 |
|
|
***the upper 3/4's of the vagina is drained:***
|
**inward,**
into the **internal iliac nodes** |
|
|
***the lower 1/4 of the vagina is drained:***
|
*outward,*
into the **superficial inguinal nodes** |
|
|
in place of a uterus, males have a:
|
rectovesical pouch
|
|
|
the rectum begins right after the
|
sigmoid colon
|
|
|
blood supply to the rectum:
(4) |
1. **median rectal** artery
2. superior rectal (from IMA) 3. middle rectal (from anterior div. 4. inferior rectal (from internal pudendal) |
|
|
veins of the rectum and what they drain into:
(3) |
1. middle and inferior rectal
- drain into **IVC** 2. superior rectal - drains into **portal system** |
|
|
*where are feces stored?*
|
in the ampulla of the rectum
|
|
|
the anal canal lies below:
|
**the pelvic diaphragm**
|
|
|
other names for the pectinate line:
(2) |
1. dentate line
2. musculocutaneous line |
|
|
***above the pectinate line:***
|
1. VSN
2. venous drainage to portal system 3. lymph drainage to **internal iliac nodes** |
|
|
***below the pectinate line:***
|
1. general sensory (skin)
2. venous drainage to CAVAL system 3. lymph drainage to **superficial inguinal** nodes |
|
|
***what kind of muscle is the internal anal sphincter?***
|
SM;
- external anal sphicter = skeletal muscle |
|
|
ureters:
(2) |
1. ~~peristalsis
2. tend to be clamped during hysterectomies |
|
|
in males, ureters pass under:
in females, run below: |
ductus deferens;
branches of the uterine artery |
|
|
what is the bundle of SM that forms the bladder?
|
detrusor muscle
|
|
|
blood supply to the bladder =
(2) |
superior and inferior vesical arteries
(+ vaginal arteries in females) |
|
|
the urethra is longer in:
|
males
|
|
|
epididymis =
|
worm, with head, tail, and body
|
|
|
pathway of sperm: testis =>
|
rete testis => efferent ductules => head => body => tail => ducus deferens
|
|
|
where do the spermatozoa mature?
|
in the tail of the epididymis
|
|
|
***lymphatic drainage of testis = ***
|
vessels that ascend with the testicular vessels
|
|
|
***lymphatic drainage of the scrotum = ***
|
superficial inguinal nodes
|
|
|
the ductus deferens dilates into the:
|
ampulla
- stores spermatozoa - contains fructose for them |
|
|
testis produce:
(2) |
sperm and testosterone
- testicular artery, pampiniform venous plexus |
|
|
seminal vesicles produce:
|
alkaline fluid that neutralizes urine
|
|
|
***the prostatic utricle is flanked by:***
|
2 seminal colliculi
- the posterior lobe of the prostate is prone to cancer |
|
|
where do ejaculatory ducts deliver spermatozoa and seminal secretions?
|
to the urethra
|
|
|
prostatic ducts ~~
|
secretions from prostate
|
|
|
pelvic fractures =>
|
injury to organs and neurovasculature
|
|
|
***structures below pectinate line are:***
|
somatic
|
|
|
what embryonic layer makes the majority of the kidneys?
|
***intermediate mesoderm***
1. nephrons 2. collecting ducts 3. ureters 4. some of bladder |
|
|
formation of kidneys: **endoderm => **
(2) |
1. most of bladder
2. urethra |
|
|
3 pairs of kidneys develop, from cranial to caudal:
|
1. pronephros
2. mesonephros 3. metanephros |
|
|
pronephros =
|
nonfunctioning tubules and nephrotomes (blood vessels)
|
|
|
***what forms Bowman's capsules?***
|
**mesonephric tubules**
|
|
|
**mesonephric tubules drain into:**
|
mesonephric (Wolffian) ducts,
which empty into the cloaca |
|
|
**mesonephric tubules and ducts regress as:**
|
*meta*nephros develops
|
|
|
a pair of metanephric blastema (blob of cells) forms in the:
|
pelvic regions
- also form tubules |
|
|
****a ureteric bud grows out of:****
|
each mesonephric duct to meet each metanephric blastema
==> final kidney is made up of both ureteric bud (mesonephros) and metanephros |
|
|
***metanephric blastemae form:***
|
the nephrons
|
|
|
***ureteric buds form:
(3) |
1. renal pelvis
2. calices 3. collecting ducts |
|
|
kidneys start caudal, ascend, and get:
|
successively higher arteries to supply them
|
|
|
horseshoe kidneys: are a result of:
|
metanephric kidneys developing too close to each other
=> caught on IMA |
|
|
horseshoe kidneys =>
(3) |
1. urinary tractinfections
2. kidney stones 3. hydronephrosis |
|
|
hydronephrosis =
|
accumulation of urine in the kidney
|
|
|
urorectal septum =>
(2) |
1. urogenital sinus
2. anorectal canal |
|
|
3 parts of the UG sinus:
|
1. bladder (includes urachus)
2. pelvic part 3. phallic part |
|
|
pelvic part of UG sinus =
(2) |
prostatic and membranous urethra
|
|
|
phallic part of UG sinus =
|
penile urethra in males
OR vestibule and external urethral orifice in females |
|
|
ureters = outgrowths of:
|
***mesonephric ducts***
|
|
|
in females, the mesonephric ducts:
|
degenerate
|
|
|
in males, the mesonephric ducts become:
|
vas deferens
|
|
|
**persistent allantois =>
|
urachal fistula => urine out of the belly button
|
|
|
when do kidneys develop, in general?
|
early
|
|
|
the ureter and mesonephric ducts are absorbed into:
|
the bladder wall, forming the trigone
|
|
|
borders of pelvic inlet:
|
sacral promontory, arcuate lines, pectineal lines, and symphysis
|
|
|
***above the pelvic brim =
|
greater / false pelvis
~~abdomen |
|
|
***below pelvic inlet =
|
true pelvis
~~reproductive organs |
|
|
skeletal muscles of the pelvis:
|
1. piriformis (L)
2. obturator internus (L) 3. levator ani (floor) 4. coccygeus (floor) |
|
|
the obturator internus is covered by:
|
thick obturator fascia
|
|
|
**pelvic diaphragm** =
|
levator ani + coccygeus
|
|
|
pelvic diaphragm facts:
(2) |
1. ~~ voluntary control
2. contracts reflexively during sneezing, lifting, etc. |
|
|
***what structures pass through the pelvic diaphragm?***
(3) |
1. urethra
2. vagina 3. anal canal |
|
|
***the pelvic diaphragm is innervated by:***
|
ventral rami of SN's S3-S5
|
|
|
3 parts of the levator ani:
|
1. iliococcygeus
- **arises from arcus tendineus) 2. pubococcygeus - strongest one 3. puborectalis - loops around rectum |
|
|
**arcus tendineus = **
|
thickening of obturator fascia
|
|
|
**tearing of pelvic diaphragm, especially of pubococcygeus, ==> **
|
weakness of diaphragm => viscera drop down
=> cystocele, rectocele, prolapsed uterus |
|
|
cystocele =
|
bladder protrudes into vagina => incontinence
|
|
|
rectocele =
|
rectum protrudes into vagina => defacatory dysfunction
|
|
|
prolapsed uterus occurs with weakness of pelvic diaphragm AND:
|
continual pressure from abdomen
- pregnancy, childbirth, weight gain, COPD => uterus falls down into vaginal canal |
|
|
treatment of prolapsed uterus =
(3) |
1. hysterectomy
2. pessary 3. pelvic floor reconstruction |
|
|
females pelvis has thinner bones,
|
wider pubic angle, and ROUND (not heart-shaped) pelvic inlet
|
|
|
where does the obturator internus tendon exit?
|
through the lesser sciatic foramen
|
|
|
where does the piriformis tendon exit?
|
through the greater sciatic foramen
|
|
|
***4 gateways to the lower limbs:***
|
1. greater sciatic foramen
2. lesser sciatic foramen 3. obturator canal 4. beneath inguinal ligament |
|
|
structures passing through greater sciatic foramen:
(4) |
1. pudendal nerve
2. sciatic nerve 3. internal pudendal vessels 4. piriformis |
|
|
passing through lesser sciatic foramen:
(3) |
1. obturator internus
2. pudendal nerve (returning to pelvis) 3. internal pudendal vessels (returning) |
|
|
passing thorugh obturator canal:
(2) |
1. obturator nerve
2. obturator vessels |
|
|
passing beneath the inguinal ligament:
(4) |
1. iliopsoas muscle (iliacus + psoas major)
2. lateral femoral cutaneous nerve 3. femoral nerve 4. femoral vessels |
|
|
lumbosacral plexus:
(3) |
1. ventral rami
2. primarily ~~ muscles of lower limbs 3. is NOT the pelvic plexus (which is ANS) |
|
|
lumbar plexus =
|
L1-L4
|
|
|
sacral plexus =
|
L4-S4
|
|
|
coccygeal plexus =
|
S5-Co1
|
|
|
lumbar plexus:
(6 nerves) |
1. iliohypogastric L1
2. ilioinguinal L1 3. genitofemoral L1, L2 4. lat. fem. cut. L2, L3 5. obturator L2, L3, L4 6. femoral L2, L3, L4 |
|
|
the genital branch in males =>
in females, => |
cremaster, skin on scrotum;
labia majorus |
|
|
**lumbosacral trunk =
|
L4, L5
- contributes to sacral plexus |
|
|
sacral plexus: most important =
|
pudendal nerve, S2-S4
|
|
|
superior gluteal artery:
(3) |
1. comes off posterior division
2. supplies muscles of buttocks 3. passes between S1 and lumbosacral trunk |
|
|
***the internal iliac artery supplies:***
|
viscera of the pelvis
- it's branch the internal pudendal supplies the perineum |
|
|
uterine artery (in females only):
(3) |
1. off anterior division
2. gives off superior branch to uterus 3. gives off vaginal branch |
|
|
the artery of ductus deferens:
(2) |
1. supplies DVD, seminal vesicles, bladder
2. ~~ uterine artery |
|
|
in place of the vaginal artery, males have:
|
the inferior vesical artery
|
|
|
in males, the middel rectal also supplies:
(3) |
1. prostate
2. ureters 3. seminal vesicles |
|
|
***the internal iliac artery supplies:***
|
pelvic viscera
|
|
|
***the internal pudendal artery supplies:***
|
perineum of the anus
|
|
|
"perineum" =
|
"around birthing region"
|
|
|
perineum:
(3) |
1. same boundaries as inferior pelvic aperture
2. roof = pelvic diaphragm 3. UG triangle and anal triangle |
|
|
urogenital triangle in females contains:
(2) |
superficial and deep spaces
|
|
|
superficial space in female perineum is between:
|
superficial perineal fascia and and perineal fascia (proper)
|
|
|
superficial perineal fascia is also called:
|
Colle's fascia
- continuous with Scarpa's fascia from abdomen |
|
|
3 muscles of the superficial perineal space:
|
1. ischiocavernous
2. bulbospongiosus 3. superficial tranverse perineal muscle |
|
|
the ischiocavernous muscle compresses:
|
the crura of the vagina
|
|
|
the bulbospongious muscle compresses:
|
erectile tissue
|
|
|
perineal body =
|
mass in center of perineuam
- site of attachment of for perineal muscles, levator ani, and external anal sphincter |
|
|
**vestibule bulbs** =
|
elongated erectile tissue on either side of vagina, on top of bulbospongiousus
|
|
|
**greater vestibular glands / Bartholin's glands:**
(2) |
1. deep to vestibular bulbs
2. secretes lubriucating mucus |
|
|
contents of deep perineal space in females:
(2) |
1. deep transvers perineal muscle
- supports vagina 2. sphincter urethrae |
|
|
the sphincter urethrae muscle:
(2) |
1. **voluntary**
2. constricts urethra |
|
|
**extravasated urine** =
|
urine out of bladder, internally
|
|
|
extravasated urine:
(2) |
1. ~~straddle injuries => damage to spongy urethra
2. urine gets into superficial perineal space - cannot pass laterally or posteriorly => anteriorly, into scrotum or penis |
|
|
female external genitalia:
|
major and minor labia, crura of clitoris, vestibule
|
|
|
in the male, which muscles maintain erection?
(2) |
ischiocavernous and bulbospongiosus
|
|
|
male: 4 continuous layers of fascia:
|
1. Scarpa's
2. superficial fascia of the penis 3. dartos fascia of scrotum 4. Colle's fascia |
|
|
deep perineal space of males:
(3) |
1. **Cowper's glands**
2. deep transverse perineal muscle - supports prostate 3. sphincter uretrhae |
|
|
***Cowper's glands are equivalent to:***
|
greater vestibular glands of females (which are in the superficial space)
|
|
|
**Cowper's glands:**
(2) |
1. create pre-ejaculatory fluid
2. its ducts pass into urethra |
|
|
scrotum layers: skin =>
|
dartos fascia => external spermatic => cremasteric => internal spermatic => parietal tunica vaginalis => epididymis => visceral tunica vaginalis
|
|
|
***blood supply to scrotum:***
(2) |
1. external pudendal arteries (off femoral)
2. posterior scrotal branches (off internal pudendal) |
|
|
nerve supply to scrotum:
(4) |
1. anterior scrotal branch of ilioinguinal nerve
2. genital branch 3. posterior scrotal branch of perineal branch off pudendal 4. perinela branch of post. fem. cut. nerve |
|
|
erectile tissue of penis =
(3) |
2 corpus cavernosa and 1 corpus spongiosum
- all filled with blood vessels |
|
|
root of penis =
|
2 crura + bulb
(crura = beginnings of CC) |
|
|
glans penis =
|
head
|
|
|
**deep fascia of penis** =
|
**Buck's fascia**
- continuation of deep perineal fascia |
|
|
the mebranous urethra is very
|
short
|
|
|
anal triangle (of both genders) contains:
(2) |
1. ischiorectal fossa
2. internal and external anal sphincters |
|
|
ischiorectal fossa =
|
space lateral to anal canal - one on each side
|
|
|
ischiorectal fossa contains:
(2) |
1. fat that you sit on
2. pudendal canal |
|
|
the pudendal canal contains:
(2) |
1. pudendal nerve
2. INTERNAL pudendal vessels |
|
|
**internal anal sphincter =
|
SM
- external anal sphincter = skeletal muscle |
|
|
*the external anal sphincter is innervated by:
|
the inferior rectal nerve
|
|
|
pudendal nerve:
(2) |
1. NOT visceral
2. after pudendal canal, gives off 3 branches (sheet) |
|
|
a pudendal nerve block targets:
|
the pudendal canal
|
|
|
lymphatic drainage of the perineum =
|
OUTER pathway => superficial inguinal nodes
=> external iliac nodes => lumbar nodes |
|
|
**lymphatic drainage of skin of scrotum =>
|
OUTER pathway**
|
|
|
lymph of testis =>
|
INNER pathway => internal iliac nodes
|
|
|
***lymph of pelvis =>***
|
inner pathway => internal ILIAC nodes
|
|
|
***what is THE nerve of the perineum?***
|
the pudendal nerve
|
|
|
the penis is homologous to:
|
the clitoris
|
|
|
bulbourethral/Cowper's glands are homologous to:
|
greater vestibular glands
|
|
|
the corpus spongiosum is homologous to:
|
bulbs of the vestibule
|
|
|
the scrotum is homologous to:
|
the labia majora
|
|
|
the ventral aspect of the penis is homologous to:
|
the labia minora
|
|
|
the gabernaculum testis is homologous to:
(2) |
1. round ligament of the uterus
2. ovarian ligament |
|
|
if a patient is hypotensive, the problem is:
|
hemorrhage until proven otherwise
|
|
|
what embryonic thing do gonads come from?
|
the **intermediate mesoderm**
|
|
|
gonads initially appear as:
|
genital ridges
|
|
|
genital ridges are comprised in part by:
|
splanchnic LPM, on the outside
|
|
|
***primordial germ cells:***
(2) |
1. form in yolk sac
2. migrate to genital ridges |
|
|
what forms the primitive sex cords?
|
**outer/ceolomic epithelium (splanchnic LPM) of genital ridges**
|
|
|
****to become male:****
(3) |
1. primitive sex cords become testis cords
2. interstitial (Leydig) cells form from *intermediate mesoderm* 3. mesonephric ducts become vas deferens and epididymis |
|
|
what do the mesonephric tubules form in the male?
|
efferent ductules
|
|
|
in the male: mesonephric ducts enter the UG sinus; =>
|
seminal vesicles branch out of them
|
|
|
**where do the prostate and Cowper's glands come from?**
|
endoderm of the UG sinus
|
|
|
what does the terminal portion of the UG sinus become?
|
penile urethra
|
|
|
primary germ cells =
|
oogonia, spermatogoonia
|
|
|
****to become female:****
(3) |
1. primitive sex cords degenerate
- secondary form instead 2. mesonephric ducts and tubules degenerate 3. paramesonephric ducts form on the surface of the urogenital ridges |
|
|
secondary sex cords are also known as:
|
cortical cords
|
|
|
cortical cords arise from:
|
ceolomic epithelium
|
|
|
cortical cords split into clusters that surround:
|
the oogonia, forming follicular cells
|
|
|
***paramesonephric (Mullerian) ducts fuse together at:***
|
the UG sinus
=> **form uterine tubes cranially, uterovaginal canal caudally** |
|
|
***paramesonephric tubercle =
|
point at which paramesonephric ducts fuse, on the UG sinus
|
|
|
the paramesoneprhic tubercle extends caudally as:
|
the vaginal plate
=> vaginal lumen |
|
|
**what leads to different/defective uteruses?**
|
defective fusion of paramesonephric ducts
|
|
|
in males, what happens to the paramesonephic duct?
why? |
it degenerates;
because testis secrete Anti-Mullerian Hormone |
|
|
remnants of the paramesonephric ducts in the male:
(2) |
1. appendix testis
2. prostatic utricle |
|
|
males favor:
|
mesonephric ducts
females, paramesonephric |
|
|
indifferent stage of external genitalia: lateral to the cloaca, what forms from somatic LPM?
|
cloacal folds
|
|
|
**cloacal folds unite cranially to form:**
|
the genital tubercle
|
|
|
cloacal folds subdivide caudally to from:
(2) |
1. UG folds
2. anal folds |
|
|
scrotal swellings from lateral to:
|
the urethral folds (formerly UG folds)
|
|
|
in males, testosterone => genital tubercle elongating, pulling:
|
the urethral plate and urethral folds on either side of the plate
|
|
|
urethral folds close over the plate, enclosing:
|
the spongy (penile) urethra
|
|
|
the ectodermal cords, at the head of the penis, meets the urethral folds, thereby:
|
completing the urethra
|
|
|
hypospadia =
|
abnormal penile urethra
|
|
|
hypospadia results from:
(2) |
1. failure of ectodermal cord to canalize
OR 2. failure of urethral folds to fuse |
|
|
when should the testis have descended into the scrotum?
|
by 33 weeks
|
|
|
failure of testis to descend =
|
crytochidism
|
|
|
what forms the scrotal cavity?
|
the process vaginalis
|
|
|
**congenital hernia ~~
|
open process vaginalis
=> intestines in the spermatic cord or scrotum |
|
|
***hydrocele =
|
ceolomic fluid in the scrotum or spermatic cord
|
|
|
failure to descend can cause
|
hydrocele
|
|
|
in females, the genital tubercle becomes:
|
the clitoris
|
|
|
in females, the urethral folds do NOT:
|
fuse,
but form the labia minora |
|
|
what forms the labia minus?
|
urethral folds
|
|
|
what forms the labia majus?
|
enlarged genital swellings
|
|
|
what 3 things have indifferent stages?
|
1. gonads
2. ducts 3. genitalia |
|
|
another name for the pelvic plexus =
|
inferior hypogastric plexus
|
|
|
how far down do the sympathetic chains extend?
|
down into the pelvis
- communicate with the sacral plexus |
|
|
"vesical" ~~
|
bladder
|
|
|
***pelvic plexus is subdivided:***
in females, the parts are: (3) |
1. vesical plexus
2. uterovaginal plexus 3. rectal plexus |
|
|
***pelvic plexus is subdivided:***
in males, the parts are: (4) |
1. vesical plexus
2. prostate plexus 3. deferential plexus 4. rectal plexus |
|
|
superior hypogastric plexus:
(3) |
1. below aortic bifurcation
2. receives lumbar splanchnic nerves from sympathetic chain 3. ends as hypogastric nerve on each side |
|
|
the superior hypogastric plexus contains:
(4) |
1. sympathetic VMF's
2. parasympathetic VMF's 3. VSN's 4. *recurrent parasympathetic* VMN's from pelvic plexus |
|
|
the hypogastric nerves innervate:
(2) |
sigmoid and descending colon
|
|
|
location of each pelvic plexus =
|
lateral to rectum
|
|
|
each pelvic plexus = grand central station composed of:
(3) |
hypogastric nerve + splanchnic nerves + pelvic splanchnic nerves
|
|
|
**the pelvic plexus contains:**
(4) |
1.sympathetic VMF's
2. parasymp VMF's 3. VSN's 4. recurrent parasympathetic VMF's |
|
|
pelvic splanchnic nerves are ONLY:
|
parasympathetics
|
|
|
other names for pelvic splanchnic nerves:
(2) |
1. nervi erigentes
2. carvernous nerves (when they innervate penis for erection) |
|
|
differences between pudendal nerve and pelvic splanchnics:
(2) |
1. pudendal = somatic/gen sense/ **sympathetic** visceral , PSN's = **parasympathetic** visceral
2. pudendal innervates perineum, PSN's innervate pelvic viscera and hindgut |
|
|
sympathetic innervation of bladder =
|
T11 - L2 synapse onto pelvic plexus
|
|
|
parasympathetic innervation of bladder =
|
PSN's onto body wall
|
|
|
urination/micturation: 300 ml in bladder => stretch receptors =>
|
VSN => S2-S4 => parasympathetic VMF's => detrusor muscle contracts, internal sphincter relaxes
- meanwhile, somatic pudendal nerve relaxes the external sphincter |
|
|
sympathetic innervation of the testis =
|
T10-T11 synapse onto testicular plexus
|
|
|
in the pelvis, the vagus nerve ~~
|
***parasympathetic innervation of testis and ovaries ONLY***
- synapses onto body wall of each |
|
|
parasympathetic innervation of other male reproductive organs =
|
PSN's
|
|
|
erection is a result of:
|
parasympathetic VMN's dilating arteries, engorging the CC and CS with blood
- pudendal nerve *maintains* erection via ischiocavernosus and bulbospongiosus |
|
|
ejaculation is caused by:
|
**sympathetic** VMN's producing SM contraction of reproductive organs, propelling semen
|
|
|
during ejaculation, what does the internal sphincter of the bladder do?
|
prevents entry of urine into urethra and reflux of semen into bladder,
by contracting |
|
|
erection ~~
|
parasympathetic system
|
|
|
sympathetic innervation of the ovary =
|
T10-T11 synapse onto ovarian plexus
|
|
|
sympathetic innervation of rectum =
|
lumbar splanchnic nerves synapse onto inferior mesenteric ganglion
|
|
|
parasympathetic innervation of rectum =
|
PSN's
|
|
|
**defecation is BOTH**
|
somatic AND visceral
somatic: contraction of diaphragms, relaxation of external anal sphincter visceral: relaxation of puborectalis, internal anal sphincter, peristalsis of colon and rectum |
|
|
feature of preganglionic fibers in the sympathetic system:
|
**short**
|
|
|
***the pelvic plexus is BOTH:***
|
sympathetic AND parasympathetic
|
|
|
blastocyst =>
(2) |
1. ICM
2. trophoblast |
|
|
trophoblast =>
(2) |
1. cytotrophoblast (inner)
2. syncytiotrophoblast (multinucleated) |
|
|
the blastocyst adheres to the ___________ of the uterus
|
endometirum;
|
|
|
at the site of contact between embryo and uterus, endometrial cells differentiate into:
|
**decidual cells**
|
|
|
placenta previa =
|
placenta partially or completely obstructs the cervical canal
- may cause lots of bleeding if placenta separates prematurely |
|
|
what causes placenta previa?
|
blastocyst implanting near internal os
|
|
|
ectopic pregnancy =
|
blastocyst implants in peritoneal cavity,
fallopian tube, surface of ovary, or wrong part of uterus - ultimately non-viable |
|
|
embryo progressively leaves:
|
the lumen of the uterus
- by day 9, implantation is complete; embryo is surrounded by syncytiotrophoblast |
|
|
migrating hypoblast cells form:
|
the yolk sac
|
|
|
***some hypoblast cells become:***
|
extraembryonic mesoderm
(surrounding yolk sac) |
|
|
extraembryonic mesoderm separates into 2 layers, forming the:
(1) |
extraembryonic ceolom
(aka chorionic cavity) |
|
|
the definitive yolk sac forms when:
|
part of the primary yolk sac is discarded
|
|
|
the embryo is attached to the:
|
connecting stalk of the extraembryonic mesoderm
|
|
|
the allantois is at the core of:
|
the connecting stalk
|
|
|
what do umbillical vessels form around?
|
the alloantois
|
|
|
***trophoblast lacunae open within:***
|
syncytiotrophoblast
|
|
|
***what do trophoblast lacunae do?***
|
anastomose with maternal sinusoids (capillaries)
- bathing the embryo with blood |
|
|
when do primary stem villi become secondary stem villi?
|
when extraembryonic mesoderm penetrates them
|
|
|
extraembryonic mesoderm within secondary stem villi gives rise to:
|
blood vessels
=> now tertiary stem villi |
|
|
***4 layers between embryonic blood and maternal blood:***
|
1. endothelium of villus capillaries
2. extraembryonic mesoderm (loose CT) 3. cytotrophoblast 4. syncytiotrophoblast |
|
|
polyhydramnios =
|
excessive amniotic fluid
|
|
|
oligohydramnios =
|
insufficient amniotic fluid
|
|
|
amniotic bands:
|
self-repairing tissue of the amnion constricts or amputate limbs
|
|
|
growing embryo bulges out into uterine cavity; covered by:
|
endometrium called decidua capsularis
- eventually disintegrates |
|
|
decidua balsalis ==>
|
placenta
|
|
|
dizygotic (fraternal) twins =
|
**two separate fertilized eggs**
- implant separately - do NOT share fetal membranes |
|
|
monozygotic (identical) twins =
|
***split of a single fertilized egg***
|
