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141 Cards in this Set
- Front
- Back
What is a pelvis?
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the lower portion of the continuous abdominopelvic cavity
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By what structure is the greater and lesser pelvis separated?
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pelvic brim or pelvic inlet
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what is the linea terminalis?
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iliopectineal line and sacral promontary
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What makes up the pelvic outlet?
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pubic symphysis ( inferior), ischiopubic rami, ischial tuberosities, sacrotuberous ligament, coccyx
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what makes up the pelvic outlet anteriorly?
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pubic arch
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what makes up the pelvic inlet?
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pubic crest (anteriorly), iliopectineal line (laterally), sacral alae and sacral promontory (posteriorly)
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is the false/greater pelvis above the pelvic brim?
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above
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what are the boundaries of the false pelvis?
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behind it: lumbar vertebra; on the sides: iliacus muscles, iliac fossae; in front: lower abdominal wall
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The pelvic girdle articulates anteriorly at the?
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pubic symphysis
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the pelvic girdle articualtes posteriorly at the sacrum at ____ joints?
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sacroiliac joints
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what is the anatomical position of the bony pelvis?
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vertical alignment of the asis and the upper margin of the pubic symphysis
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what is the horizontal anatomical position of the bony pelvis?
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tip of coccyx and the upper margin of the pubic symphysis
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in what plane does the urogenital triangle lie?
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transverse (across)
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in what plane does the anal triangle lay?
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coronal (vertical) plane
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Name all the joints of the pelvis
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sacroiliac, pubic symphysis, sacrococcygeal joint
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what type of joint is the pubic symphysis?
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fibrocartilage
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what type of joint is the sacroiliac joint?
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synovial, between the auricular surfaces of the sacrum and the iliac bones
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what type of joint is the sacrococcygeal joint?
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cartilaginous, bt the first body of the coccyx and the last sacral
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what is the iliolumbar ligament?
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ligament that connects the transverse process of L5 to the iliac crest
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wat is the function of the iliolumbar ligaments?
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limit rotation of the LV5 on sacrum and prevent anterior gliding of LV5 on the sacrum
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what structure does the sacrotuberous ligament create?
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since it connects the sacrum to the tubercle of the ischium= lesser sciatic foreman
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what structure does the sacroiliac ligament create?
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since it connects the sacrum to the spine of the ischium= greater sciatic foreman
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what function do the sacrospinous and sacrotuberous ligaments serve?
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prevent sacrum from being pushed inferiorly and pelvis rotate anteriorly
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Which pelvis ( F/M) is more shallower?
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female
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what is the shape of the female pelvis?
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oval
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Are ischial tuberosities inverted/everted in females or males?
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everted
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what shape is the sacrum in females?
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shorter, wider and flatter
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what shape is the pubic arch in females?
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wider and rounder
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what is the goal of the pelvc diaphragm?
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to separate the pelvic cavity from the perineum
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What joint is subject to sprain and inflammation?
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the sacroiliac
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Sacroiliitis may occur in association with an injury, infection or as part of a ?
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spondyloarthropathy
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Where is pain if there is injury to the sacroiliac joint?
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referred pain to the butt, posterior thigh, and groin
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the presence of what increases movement of the pubic symphysis and sacroiliac joints, faciliating childbirth?
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relaxin and hormones during pregnancy
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Where does the piriformis muscles connects and originates?
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sacrum to the greater trochanter
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does the piriformis muscle exit the pelvis through the greater or lesser sciatic notch?
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greater
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what are the innervations and functions of the piriformis muscle?
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S1 and s2 inferior rami ( nerve to piriformis). Functions is: lateral rotator of the hip, abducts thigh
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Obturator internus muscles leaves through which foreman?
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lesser sciatic foreman
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where does the obturator internus muscle attach?
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greater trochanter
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what nerve is innervates obturator internus?
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L5 and s1, nerve to obturator internus
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the inferior pelvic diaphragm contains which two sets of muscles?
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levator ani and ischio-coccygeus
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injury to the pelvic diaphragm muscles during childbirth will result in ?
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loss of support of pelvic viscera: prolapse of the internal pelvic organs including UTERUS, VAGINA, URINARY BLADDER AND/OR RECTUM
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From where does the tendinous arch come from?
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a fascia over the obturator internus muscle
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why is the tendinous arch incomplete anteriorly in females?
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for passage of the urethra and of the vagina
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the iliococcygeus muscles takes origin from the ?
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tendinous arch to the raphe between anal canal and coccyx
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the puboccoygeus muscle goes from the ? To the?
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pubis to the vagina/prostate, anorectal junction to the perineal body
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the puborectalis muscle is part of the ? From pubis junction of anus to rectum
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external anal sphincter
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which muscle forms a anorectal flexure?
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left and right puborectis
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which muscle is used for maintaining fecal incontinence?
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puborectalis
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which muscle attaches to the pubovaginalis/puboprostaticus ?
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pubococcygeus
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what is the functionof the levator ani muscles in the female?
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resists increase intrapelvic pressure during straining and coughing, important sphincter action on the anorectal junction ( also serves as a sphincter of the vagina)
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what is the nerve supply of the levator ani?
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nerve to levator ani (perineal branches of S4)
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what is the origination and terminaton fo the ischio-coccygeus muscle?
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ischial spine to the sacrum and coccyx
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what muscle is covered anteriorly by the sacrospinous ligament?
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coccygeus
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what is the function of the coccygeus muscle?
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assisting the levator ani in supporting the pelvic viscera
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what is the nerve supply of the coccygeus muscle?
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s4 and s5
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the pelvic fascia is continuous with?
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endoabdominal fascia
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pelvic fascia may be divided into two fasciaƒwhat r they?
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parietal pelvic fascia that lines the muscle of the walls and floor of the pelvis+ visceral pelvic fascia ( directly ensheathing pelvic organs)
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what are the two pouches in the female formed by the pelvis fascia?
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rectouterine pouch and the vesicouterine pouch
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which ligament in the females provides the most passive support for the uterus?
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transverse cervical ligament
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what is another name for the mackendoft ligament?
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transverse cervical ligament
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where does the uterine artery travel in relationship to the transverse cervical ligament?
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above the ureter
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which artery is the direct continuation of the inferior mesenteric?
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superior rectal
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list the arteries of the anterior division of the internal iliac artery?
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umbilical, obturator, uterine, vaginal/inferior vesical, middle rectal, internal pudenal, inferior gluteal
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list the arteries of the posterior division of the internal iliac artery?
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superior gluteal, lateral sacral, and iliolumbar
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what is the main drainage of the pelvis?
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interal iliac vein
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at what level does the interal iliac vein merges to join the common iliac artery?
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L5
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pelvic veins: which two other veins are used for drainage in the pelvis?
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inferior mesenteric vein and the vertebral venous plexus
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which venous drainage provides a pathway for pelvic cancer to metastasize to the spinal cord and brain?
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vertebral venous plexu
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lymph drainage from the pelvis is primarily to the ?
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external and internal iliac nodes'; common iliac nodes
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which plecus provides somatic innervation? And what roots form the lumbar?
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sacral plexus ( l4-l5/s1-s4)
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which plexus provides visceral innervation?
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hypogastric
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which sympathetic and parasympathetic nerves are in the hypogastric plexus?
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sympathetic: sacral splanchnic. PARA: pelvic splanchnic
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the sympathetic chain of the pelvis is associated with the pelvic plexus?
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sacral spinal nerves
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"
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umbilical
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The pelvic splanchnic nerves primarily carry ____________ to the _____________ plexus.
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" Preganglionic parasympathetics--inferior hypogastric
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the pelvic splanchnic nerves provide parasympathetic innervation to the ? Smooth muscle
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non vascularized
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the pelvic splanchnic nerves provide sympathetic innervation to the? Muscle
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Vascularized smooth muscle
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Sacrospinal ligament"
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sacrospinal ligament: Together with the sacrotuberous ligament, it converts the greater and lesser sciatic notches into greater and lesser sciatic foramina. However, it is not near the perineum--it is more important as a landmark that creates the greater and lesser sciatic foramina which helps to organize the structures exiting the pelvis.
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"
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perineal body
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"
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deep artery of the penis/clitoris
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The part of the male reproductive tract which carries only semen within the prostate gland is the:
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Ejaculatory duct
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An intrahepatic blockage of the portal venous outflow may cause intestinal blood to drain via portal-systemic anastomoses into the:
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middle rectal artery
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The perineum is bounded by all of the following skeletal elements except:
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" spine of ischium
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into what does the internal rectal vein drain into?
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internal pudendal
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what crosses the ureter superiorly in males?
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ductus deferens
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what crosses the ureter superiorly in females?
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uterine artery
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What Autonomic fibers innervate the ureters?
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t11-L2
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Pressure from a filling bladder and detrusor muscle contraction will inhibit or allow for reflux of urine into the ureter?
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inhibit
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Passage of a kidney stone produces what time of pain?
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loin to groin
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The urinary bladder receives the right and left ureters at the angles of what smooth walled organ?
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trigone
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The base ( fundus) of urinary bladder is related to the ?
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seminal vesicles or the uterus of the vagina
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the apex of urinary bladder connects to the?
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medial umbilical ligament
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which part of the urinary bladder surrounds urethra/attached to the prostate?
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neck
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which ligaments attaches bladder to the organs from the pubic bone?
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pubovesical in the females, puboprostatic ligaments (males)
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Which artery suppies anterosuperior portion of the urinary bladder?
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superior vesical arteries (branch of the UMBILICAL ARTERY)
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Which artery supplies fundus and neck of the bladder?
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inferior vesical artery or vaginal artery in females
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vesical venous plexus is continuous with the ?
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prostatic venous plexus
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the ductus deferens, fundus of the bladder, prostates, seminal vesicles and penis are drained by which plexous?
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vesical venous plexus
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Vesical venous plexus is drained into the?
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internal iliac veins
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in addition to draining into the internal iliac veins, the vesicle venous plexus may also drain into?
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sacral veins into the vertebral venous plexus
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what are the sympathetic and parasympathetic innervations of the urinary bladder?
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t11-l2; s2-s4 (pelvic splanchnic)
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where is the internal urethral sphincter?
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neck of the bladder
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upon sympathetic innervation, Is there contraction or stimulation that inhibits bladder emptying?
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contraction
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The preprostatic part of the urethra is surrounded by the?
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internal urethral sphincter
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where is the membranous part of the male urethra?
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deep perineal pouch
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in what part of the male urethra is the external anal sphincter located
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membranous
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what is the tough outer surface of the testes?
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tunica albuginea
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which structure forms the round ligament and the ovarian ligament of the uterus and the testes in males?
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gubernaculum
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what is the arterial supply of the testes?
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testicular artery at the level of L2
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on the right side where does the testicular vein drain? The left?
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right drains into the IVC, left drains into the left renal vein
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at what level does the pampiniform plexus of veins becomes the testicular vein?
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deep inguinal ring
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define varicocoele
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defective valves results in elongation and dilation of the pampiniform plexus; bag of warms
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a persistent _____ results in accumulation of serious fluid or blood
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persistant processis vaginalis
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where would a spermatocoele occur?
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near the head of the epididymis
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what is lymphatic drainage of the testes?
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lateral nodes..
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tumor metastasis is towards the? In testicular cancer
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abdominal cavity
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what is the nerve supply of the testes?
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sympathetic fibers run with testicular artety from the renal or aortic sym. Plexuses.
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where is the sperm stored in the epididymis?
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body
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which male structure passes through the inguinal canal?
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ductus deferens
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what is the arterial supply of the ductus deferens?
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artery to the ductus deferens from the superior vesical artery
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what is produced after a vesectomy?
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seminal fluid and prostatic fluid, no sperm
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where are the seminal vesicles found?
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bt fundas of the bladder and the rectum
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the ejaculatory duct separates what two zones of the prostate?
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middle lobe and the posterior lobe
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where exactly does the ejaculatory duct open in the seminal vesicles?
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seminal colliculus near the PROSTATIC UTRICLE
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what are prostatic sinuses for?
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where the prostatic fluid enters into the urethra to mix with sperm
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what is the point of the prostate juices?
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bathes sperm in basic fluid
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which lobes are around the ejaculatory duct?
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inferoposterior and inferolateral; superiormedial <---peripheral zone
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which lobe is lateral to the urethra?
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anteromedial ( central zone)
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which zone does BPH occur?
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middle lobe by the urethra / central zon
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which zone does prostate cancer occur?
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posterior lobe
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why is prostate cancer bad?
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Metastasis to the vertebrae, brain and spinal cord is common due to numerous connection of the prostatic venous plexus to the vertebral venous plexus
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what is the lymphatic drainage of the prostate?
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internal iliac nodes
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which nerves may be injured in removal of prostate?
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cavernous nerves --> supply erectile bodies and promote erection
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at what level is the rectum continous superiorly with the rectum?
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SV3
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the external anal sphincter is innervated by?
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inferior rectal nerves --S4
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the superior rectal artery is a branch of what artery?
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inferior mesenteric
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the inferior rectal artery is a branch of?
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internal pudenda a.a
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into what vein does the superior rectal vein drain into?
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inferior mesenteric
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is the superior rectal vei portal or caval venous system?
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portal
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the middle rectal vein drains into the? Portal or caval?
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internal iliac vein; caval
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the inferior rectal vein drains into the? Portal or caval?
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internal pudendal artery --> iVC--> caval
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