Anatomy - Pelvic Cavity

Front 1

Why does the spleen have notches?

Back 1

It developed from several splenic buds

Front 2

What determines the border between pelvis and perineum?

Back 2

above levator ani = pelvis
below = perineum

Front 3

Going deep --> superficial what are the layers from the L. Ani to superficial muscles?
1. L. Ani
2.
3.
4. (2 things)
5. 3 female, 4 male structures
6. 7 female, 6 male structures

Back 3

1.L. Ani
2. Fat/fascia
3. External urethral spincter & other muscles
4. Deep perineal vessels ( dorsal nerve & vessels of penis/clitoris) and perineal membrane
5. Body of clitoris/Copus Songiosum & Cavernosum, Crus and bulb of penis/clitoris
6.External Urethral orifices, vaginal orifice, Ischiocavernosus, Bulbospongiosus, perineal body, anus, external anal spincter

Front 4

What does and does not pass through perineal membrane?

Back 4

Vagina & urethra do, anus does NOT

Front 5

Back 5

Front 6

In men and women what are 2 homologous structures?

Back 6

Corpora cavernosa in both genders
Penis and clitoris
**The bulb is split in women

Front 7

Back 7

Front 8

The gubernaculum is analagous to what in the female?

Back 8

The round ligament of the uterus and the ligament of the ovary

Front 9

Which uterine ligament carries the arteries, veins, lymphatics and nerves?

Back 9

The suspensory ligament of the ovary

Front 10

Back 10

Front 11

What nerves supply the right ovary? Where will pain from ovary be referred?

Back 11

L2,3,4
inner thigh

Front 12

Where does uterus/ovary lymph drain to? (2 options)

Back 12

Vena caval and Aortic nodes, OR via round ligament to the iliac nodes

Front 13

Back 13

Front 14

What 4 groups of nodes are ovarian tumors going to spread to? (in order of frequency starting with most)

Back 14

- Aortic nodes
- mediastinal nodes
- inguinal nodes
- supraclavicular

Front 15

If an ovarian tumor metastasizes, where is it most likely to go to?

Back 15

Peritoneal cavity

Front 16

What's one sign of lymphatic involvement of an ovarian tumor?

Back 16

Ascities b/c aortic nodes under the diaphragm have been blocked

Front 17

The cervix is _______ in relation to the vagina. The uterus is _______ in relation to the cervix.

Back 17

anteverted
antiflexed

Front 18

Why does the layout of the female reproductive tract make an illegal abortion so risky?

Back 18

B/c the uterus is almost perpendicular to vagina. So an amateur instrument could go along axis of vagina and pierce the peritoneum, missing the uterus. Will cause horrific peritonitis.

Front 19

How does the cervix dilate for labour?

Back 19

The lower segment is drawn upwards and this thins it out.

Front 20

What structural arrangement is important to keep in mind during a hysterectomy?

Back 20

The uterine artery (which will need to be ligated) is superior (perpendicular) to the ureter. Must be careful not to cut the ureter with the artery!

Front 21

Back 21

Front 22

Back 22

Front 23

If a man fell and straddled a pipe, where would his swelling and bruising be? Where would it not be? why? (assuming he tore his spongy urethra)

Back 23

The hematoma would be confined to the superficial perineal pouch formed by Colles fascia. Swelling in the scrotom or penis (in this case) would be contained and NOT extend into the thighs.

Front 24

Back 24

Front 25

Back 25

Front 26

If a man had a tear in his urethra, below the prostate, where would the blood leak to? Where would it not leak to?

Back 26

- would leak into the pelvis, but would NOT leak below the peritoneum, (provided this layer is intact). It will NOT be able to enter the perineal pouch, because the Colles fascia is fused to the perineal membrane and thus this cavity does not communicate with the pelvis!

Front 27

What is an important surgical marker to be used in protectomy?

Back 27

The verumonatnum (or the prostatic utricle). The sphincter is below this structure so if you stay above it, you will avoid making the person incontinent.

Front 28

Describe the lymphatic drainage of the prostate

Back 28

Front 29

Describe venous drainage of prostate. Why is this significant?

Back 29

Because this means that prostatic tumors often invade vertebra. However this tendency is also d/t adhesion properties of the bones and affinities of the tumor cells!

Front 30

Back 30

Front 31

Which tissue in the penis is erectile? Which is ejaculatory?

Back 31

Erectile: corpus spongiosum & cavernosum
Ejaculatory: corpus spngiosum

Front 32

Back 32

Front 33

What nerves are responsible for:
- erection
- emission
- ejaculation
sensory nerves?

Back 33

erection - parasympathetic (S2,3,4)
emission - sympathetic motor (T10- L2)
ejaculation - somatic motor (S2,3,4)
Sensory - pudendal

Front 34

What are the ateries, veins, nerves, and lymph for the upper and the lower anus?

Back 34

Upper:
a - (IMA becomes) superiror rectal artery; middle rectal
v - portal vein
n - autonomic
l - internal illiac nodes
Lower:
a - inferior rectal artery (from internal pudendal)
v - systemic
n - pudendal (somatic thus ++ sensitive)
l - superior inguinal nodes (lumps in groin)

Front 35

From what embryological tissue are the upper and lower anus derived from?

Back 35

Upper - endoderm
lower - ectoderm

Front 36

Back 36

Front 37

Back 37

Front 38

What are the two types of hemorrhoids? Which is more painful? Why?

Back 38

External- thromboses in the external rectal venous plexus
Internal - prolapse of rectal mucosa in upper anus
External hurt more d/t pudendal, somatic innervation

Front 39

Where do most aortic aneurysms occur?

Back 39

Below the renal arteries - usually involving the inferior mesenteric.

Front 40

What is one of the dangers of removing the inferior mesenteric artery?

Back 40

In some people the marginal artery doesn't communicate between the transverse and the descending colon. So if IMA is removed, descending colon will loose it's blood supply.

Front 41

Back 41

Front 42

What determines the behaviour of the spine?

Back 42

Behaviour of entire spine is a composite of each of the 25 motion segments. Cervical has more motion than thoracic. Lumbar can flex and extend.

Front 43

What causes/allows a disk to herniate? Why does this become more likely with age?

Back 43

A weakened annulous allows the nucleus to bulge. With age vertebral disks dehydrate thus losing normal mechanical properties.

Front 44

Back 44

Front 45

What's in the intervetebral foramen?

Back 45

Spinal nerve

Front 46

Starting from the vertebral bone what are the layers of the meninges?

Back 46

- epidural space
- dura mater
- arachnoid mater
- subarachnoid space (csf!!)
- pia mater

Front 47

What are the three groups of muscles in the thigh? What nerves supply them?

Back 47

Ant = Quadracepts + femoral
Medial = Adductors + obturator
Post = Extensors + sciatic