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Pelvis & Perineum
IUSM Exam Block II
331
Anatomy
Professional
10/06/2013

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Term
Buck's fascia
Definition
superficial perineal pouch in male
deep fascia of penis
continuous with perineal membrane
encases corpora cavernosa, corpus spongiosum (binds them together)
Term
Colle's fascia
Definition
membranous layer of superficial fascia in urogenital triangle
Term
Dartos fascia
Definition
superficial perineal pouch in male
superficial fascia of penis, surrounds
posteriorly continuous with Colle's fascia
anteriorly continuous with Scarpa's fascia of abdomen
Term
Sampson's artery
Definition
tubal/ovarian branches from uterien and ovarian arteries
forms an anastomosis between the ovarian and uterine arteries
Term
Spinal block
Definition
anesthesia for childbirht
spinal anesthesia introducded into subarachnoide space at L3/L4 level
anesthetizes structures approx. from waist down
perineum, pelvic diaphragm, birth canal, subperitoneal structure and lower limbs
Term
TAH-BSO
Definition
total abdominal hysterectomy-bilateral-salpingo-oophorectomy
removal of uterus, uterine tubes, and ovaries
Term
accessory obturator artery
Definition
arises from inferior epigastric artery in 20% of population
course through obturator canal
anastomosis of inferior epigastric and obturator artereis
Term
acetabulum
Definition
socket of ball-and-socket joint
concave surface of the pelvis
where pelvis and femurs articulate to form the hip joints
Term
ala
Definition
on eitehr side of sacra base
large triagnle surface seen from superior
continuous with iliac fossa
Term
ampulla (of uterine tubes)
Definition
dilated portion of the uterine tube between infundibulum and isthmus
fertilization usually occurs here
Term
ampulla of vas deferens
Definition
terminal portion of vas that converges with the ducts of the seminal glands to form the ejaculatory ducts
Term
anal canal
Definition
extends from anorectal junction to anus
about 4 cm
surrounded by/consists of levator ani mm., anal columns, pudendal canals puborectalis mm, internal anal sphincter, pectinate line, pecten, perianal skin, intersphincteric grove
Term
anal column
Definition
5-10 longitudinal folds of mucosa
contain a small artery and vein (terminal branches of superior rectal)
superior ends of anal columns marks the anorectal junction
Term
anal sinuses
Definition
recesses between and at the base anal columns
where anal glands open into anal canal
Term
anal triangle
Definition
boundaries: sacrotuberous ligaments, coccyx, imaginary line that spans between the two ischial tuberosities
contains: external anal sphincter, pudendal canal, pudendal nerve, internal pudendal artery, internal pupdendal vein
Term
anal valves
Definition
folds connecting the lower ends of the anal columns
Term
annococcygeal raphe
Definition
where right and left levator ani mm. meet-up
contains anal aperture to coccyx
Term
anococcygeal nerves
Definition
arise from coccygeal plexus (S4-Co)
sensory to skin posterior to anus
Term
anterior division of internal iliac
Definition
inferior gluteal a, umbilical a, superior vesical aa, obturator a, inferior vesical a, middle rectal a, internal pudendal a
Term
anterior gluteal line
Definition
site of attachment for gluteus minimis
Term
anterior inferior iliac spine (AIIS)
Definition
bony eminence on the anterior border of the wing of the ilium
Term
anterior lobe (isthmus)
of prostate
Definition
anatomical division
devoid of glandular substance
made of fibrous tissue and smooth muscle
Term
anterior longitudinal ligament
Definition
lines the anterior side of the vertebral bodies
helps to keep L5 from slipping forward in the pelvic region
Term
anterior medial thigh sensory
Definition
ilioinguinal, genitofermoral, and genital nerves
Term
anterior recess of ischioanal fossae
Definition
between perineal membrane and pelvic floor
pudendal n. course into these to innervate the more anterior muscles
Term
anterior sacroiliac ligaments
Definition
anterior surface of lateral sacrum to the margin of the auricular surface of the ilium
secure the sacrum to each ilium
Term
anterior superior iliac spine (ASIS)
Definition
bony projection of the iliac bone
anterior termination of the iliac crest
Term
anterior vaginal fornix
Definition
positioned between urinary bladder and cervix
Term
anterior/posterior labial commissures
Definition
superficial perineal pouch in female
where the left and right labia majora converge anteriorly and posteriorly
Term
apex of urinary bladder
Definition
points toward pubic symphysis and from it extends the obliterated urachus
Term
arcuate line of the ilium
Definition
smooth rounded border on internal surface of ilium
immediately inferior to iliac fossa
divides upper ilium from body of ilium
continuous with pectineal line of pubis
Term
arcuate pubic ligament
Definition
aka inferior pubic ligament
thick, triangular arch of ligament
fibers intertwine with fibrocartilaginous disk
Term
artery of vestibular bulb (female)
Definition
branch of internal pudendal a.
supplies bulb of vestibule and greater vestibular glands
Term
articular surface of ilium
Definition
where sacrum and ilium articulate
Term
bening prostatic hypertrophy (BPH)
Definition
enlargement of periurethral/transitional zone of prostate
can cause urethral obstruction
occurs in 50% of men over 50
present with nocturia, dysuria, urgency
Term
blood supply to bladder
Definition
superior and inferior vesical aa. in males
superior vesical and vaginal aa. in females
vesical venous plexus in both
Term
body of ilium
Definition
portion of ilium inferior the arcuate
is in contact with pubis and ischium
Term
body of ischium
Definition
enters into and constitutes about 2/5ths of acetabulum
Term
body of pubis
Definition
wide, strong, medial, flat portion of pubis
Term
body of urinary bladder
Definition
region betweenn apex and fundus; relatively unbound to other internal surfaces
Term
body of uterus
Definition
upper 2/3rds of uterus
vesical surface rests against the urinary bladder
intestinal surface is adjacent to small bowel
Term
broad ligament (of uterus)
Definition
made of two layers of peritoneum and extends from uterus to lateral walls and floor of pelvis
composed of three sections: mesometrium, mesovarium, mesosalpinx
Term
bulbospongiosus mm. (female)
Definition
superficial perineal pouch in female
origin: perineal body
insert: clitoris anterior to ischiocavernosus
nerve: deep perineal (S2-S4)
function: support and fix perineal body, act as vaginal sphincter, assist in erection of clitoris, compress vestibular glands
Term
bulbospongiosus mm. (male)
Definition
superficial perineal pouch in male
origin: perineal body
insert: corpus spongiosum and corpora cavernosa
nerve: deep perineal (S2-S4)
fucntion: compress bulb of penis during urination, rapid contract to eject semen during ejaculation
Term
bulbourethral glands
Definition
male deep perineal pouch
aka Cowper's glands
small, pea shaped mucous glands
positioned lateral to membranous urethra
secrete pre-ejaculate that lubricates urethra and neutralizes traces of acidic urine
ducts open into proximal penile urethra at base of penis
peirce perineal membrane to reach penis
Term
cauda equina syndrome
(etiology, symptoms)
Definition
loss of lumbosacral plexus
weakness of lower limb muscles
sciatic nerve pain
urinary retention
fecal incontinence
cutaneous perineal numbness
Term
central zone
of prostate
Definition
clinical division
suuround the ejactulatory ducts
Term
cervical canal
Definition
extends from external os (inferior) to internal os (superior)
Term
cervix of uterus
Definition
cylindrical neck composing inferior 1/3rd
protrudes into the vagina
Term
circumcision
Definition
foreskin that covers glans penis is surgically removed
approx. 65% of boys in the U.S.
reduces risk of infection and STDs
Term
clitoris
Definition
superficial perineal pouch in female
female erectile organ
crura and body are corpora cavernosa
crura separate at deep section of body and attach to ischiopubic rami
small suspensory ligament extends from pubic symphysis to body of clitoris
glans is external visible
Term
coccygeal plexus
Definition
S4-Coccygeal nerves
Term
coccygeus
Definition
origin: apex of ischial spine and sacrospinous ligament
insert: margin of coccyx, lowest sacrum
nerve: S4, S5
function: pulls coccyx forward after defecation, closes back part of pelvic outlet
Term
coccyx
Definition
tailbone
final segment of vertebral column
3-5 fused vertebrae
Term
common iliac arteries
Definition
bifurcation of of abdominal aorta at L4 into left and right branches
give rise to external and iliac arteries at L5/S1 level
Term
compressor urethrae (female)
Definition
female deep perineal pouch
origin: isciopubic ramus
insert: opposite side m. forming flat, band-like tendinous raphe around anterior urethra
nerve: perineal branch of pudendal (S2-S4)
function: accessory urethral sphincter
Term
corona of penis
Definition
part of the glans that overhanges theneck of the penis
Term
corpora cavernosa
Definition
superficial perineal pouch in male
paired, sponge-like erectile tissue
have crura (lateral extensions attached to the ischiopubic rami
Term
corpus spongiosum
Definition
superficial perineal pouch in male
mass of spongy tissue surrounding the male urethra within the penis
Term
cruciate anastomosis
Definition
provides connection between the inferior gluteal and circumflex femoral arteries
collateral supply to lower limb
Term
crura of corpora cavernosa
Definition
superficial perineal pouch in male
formed with corpora cavernosa separate at root of penis
anchor penis to ischiopubic rami
Term
deep branch of perineal nerve (male)
Definition
innervates superficial transverse perineal, bulbospongiosus, ischiocavernosus and constrictor urethrae mm.
gives rise to the nerve to the bulb
Term
deep branch of perineal nerve (female)
Definition
superficial perineal pouch in female
branch of perineal branch of pudendal
supplies vaginal orifice and mm. of superficial and deep perineal pouches
innervates skin of vestibule and mucosa of inferior vaginia
Term
deep clitoral artery
Definition
branch of internal pudendal artery
supplies crura and corpora cavernosa (responsible for engorgement during arousal)
Term
deep dorsal vein of clitoris
Definition
runs in slit between arcuate ligament and perineal membrane
Term
deep dorsal vein of penis
Definition
drains cavernosus spaces through and ornate venous plexus
cources inferior to pubic symphysis to enter the pelvic cavity near arcuate ligmanet through a hole left by the perineal membrane
dumps to prostatic venous plexus
Term
deep penile artery (male)
Definition
branch of internal pudendal artery
run longitudinally through the center of each corpus cavernosum
pierces inferior fascia of UG diaphragm
give rise to helicine arteries of penis
Term
deep perineal nerve (male)
Definition
terminal branch of perineal nerve
innervates mm. of deep and superficial perineal pouch in males
Term
deep perineal pouch
Definition
begins at perineal membrane and extends deeper to pelvic diaphragm (superior layer of fascia of UG diaphragm)
very thin area (esp. compared to superficial pouch)
Term
deep transverse perineal mm. (female)
Definition
female deep perineal pouch
origin: ischial ramus
insert: perineal body
nerve: perineal branch of pudendal (S2-S4)
function: stabilizes perineal body, resist increase in intra-abdominal pressure
Term
deep transverse perineal mm. (male)
Definition
male deep perineal pouch
origin: inferior ischial rami
insert: opposite side m.
nerve: deep perineal (S2-S4)
function: stabilize perineal body
Term
detrusor muscle
Definition
composes the walls of urinary bladder
aids urination
gives internal empty bladder a convoluted, folded topology
Term
diagonal conjugate
Definition
extends from inferior pubic ligament to promontary
can be measured in physical exam
fixed diameter - relaxin will not help widen
Term
disruption of perineal body
Definition
childbirth can cause stretching or tearing of muscle attachments to perineal body
compromises support of pelvic floor
can result in prolapse of pelvic organs
requires surgical repair
Term
dorsal clitoral artery
Definition
branch of internal pudendal a.
supplies the glans clitoris
Term
dorsal nerve of penis (male)
Definition
superficial perineal pouch in male
deepest branch of pudendal nerve
innervates corpora cavernosa, Buck's fascia glans penis (sensory)
laterally flanks deep dorsal vein
Term
dorsal nerve of the clitoris (female)
Definition
superficial perineal pouch in female
branch of pudendal nerve
innervates glans clitoris
Term
ejaculation
Definition
semen expelled through external urethral orifice
sympathetic control
internal urethral sphincter closes at neck of urinary bladder (L1-L2 symp)
bulbospongiosus rhythmically contracts expelling semen from the penile urethra
external urethral sphincter dilates (S2-S4 parasymp)
Term
ejaculatory ducts
Definition
formed by union of vas deferens and ducts of seminal vesicles
open into the prostatic urethra at the seminal colliculus
transmit sperm and semen mixture to urethra for ejactulation
Term
emission
Definition
sperm migrate from testes and epididymus to prostatic urethra
sympathetic control
smooth m. of epididymal ducts and vas contract in peristaltic fashion propelling spermatozoa toward urethra
fluid from seminal vesicles and prostate mix with spermatozoa forming semen
bulbourethral glands secrete pre-ejaculate that lubricates penile urethra
Term
endometrium
Definition
innermost layer of uterine wall
mucosal lining
blastocyst implants in this layer after fertilization (usually supero/anterior wall)
absence of blastocyst implantation causes this layer to shed during menstruation (hormone induced)
Term
episiotomy
Definition
surgical incision of perineum and inferoposterior vaginal wall
made to enlarge the vagina orifice
decreases excessive trauma to pelvic diaphragm during birth
performed in over 50% of vaginal deliveries
midline incision or mediolateral incision (spares anal sphincter)
Term
erection
Definition
penis becomes turgid and erect
parasympathetic from S2-S4 through prostatic nerve plexus
relaxation of smooth mm. in helicien aa. leads to dilation and straightening of aa.
cavernosus spaces of corpora cavernosa and corpus sphongiosum dilate (engorge with blood)
ischiocavernosus and bulbospongiosus diminish venous return from deep dorsal penile vein
Term
esterna os (ostium)
Definition
opening at the mouth of the cervix
communicates with cervical canal above and vaginal lumen below
Term
external anal sphincter
(origin, insert, nerve, action, blood)
Definition
origin: perineal body
insert: coccyx via anococcygeal raphe
nerve: inferior rectal (S4)
action: clase anal canal and orifice
blood: inferior rectal aa
Term
external hemorrhoid
Definition
dilated veins below the pectinate lines
covered by skin
more painful because pain fibers through GVA of inferior rectal nerves
Term
external pudendal artery (male)
Definition
branch of femoral artery
supplies anterior scrotum and skin of penis
Term
external urethral orifice (female)
Definition
superficial perineal pouch in female
lies within the vestibule between external glans clitoris (anterior) and vaginal orifice (posterior)
Term
external urethral sphincter (female)
Definition
female deep perineal pouch
origin: internal surface of inferior pubic ramus
insert: anterior wall of vagina
nerve: perineal branch of pudendal (S2-S4)
function: compresses urethra to maintain urinary continence
Term
external urethral sphincter (male)
Definition
male deep perineal pouch
origin: ischiopubic ramus (R)
insert: ischiopubic ramus (L), wraps around membranous urethra
nerve: dorsal nerve of the penis (S2-S4)
function: compress the membranous urethra to maintain urinary continence (relax to urinate)
Term
false pelvis
Definition
greater pevlis
part of abdomen
separated from true by oblique plane that extends from sacral promontory to pubic tubercles
ilium protects abdominal contents here
Term
female deep perineal pouch
Definition
contains: external urethral sphincter, sphincter urethrovaginalis, compressor urethrae, deep transverse perineal mm.
Term
female pelvis characteristics
Definition
circular/oval pelvic inlet
subpubic angle >80*
ischial spines are more rounded and less prominent
shallow (short) pubic symphysis
Term
female peritoneum reflection pathway
Definition
anterior abdominal wall
superior to pubic bone
superior surface of urinary bladder
(vesico-uterine pouch)
mid-uterus
fundus and body of uterus
(recto-uterine pouch)
anterior/lateral rectum
sigmoid mesocolon
posterior abdominal wall
Term
female urethra
Definition
short, only about 4cm
runs from internal urethral orifice (bladder) to external urethral orifice (vestibule)
does not have internal urethral sphincter
supplied by internal pudendal a. and vaginala aa
Term
fenulum of clitoris
Definition
superficial perineal pouch in female
on the under-surface of glands
Term
fimbriae
Definition
finger-like projections atdistal end of infundibulum
sweep ejected oocytes into uterine tubes
Term
fundiform ligament of penis
Definition
superficial perineal pouch in male
thickening of Scarpa's fascia
made of collagen and elastic fibers
additional support for penis
slings around body of penis
Term
fundus of urinary bladder
Definition
dome-shaped part opposite the apex (posterior)
Term
fundus of uterus
Definition
rounded dome-like portion above the uterotubal junction
Term
ganglion impar block
Definition
receives afferent pain fibers from perineum, distal rectum anus, distal urethra, vulva, and distal 1/3 of vagina
alleviates pain from these regions
needle into sacral coccygeal joint
Term
ganglion impar
Definition
aka coccygeal ganglion
convergence of right and left sacral sympathetic trunks
converge anterior to coccyx
Term
genital branch nerve (female)
Definition
superficial perineal pouch in female
branch of genitofemoral branch from lumbar plexus
innervates mons pubis and anterior portion of labia (minora and majora)
Term
glans clitoris
Definition
superficial perineal pouch in female
external visible portion of the clitoris
erectile tissue in female
highly innervates by dorsal nerve of the clitoris
Term
glans penis
Definition
expansion of corpus spongiosum, head of penis
Term
gluteal surface
Definition
external, posterior surface of ilium
convex
Term
greater sciatic foramen
Definition
bounded by greater sciatic notch of ilium, sactrotuberous ligament, and anterior sacroiliac ligament
contains piriformis, superior and inferior gluteal vessels and nerves, pudendal n., sciatic n., posterior femoral cutaneous n, n. to obturator, n. to quadrator femoris
Term
greater sciatic notch
Definition
superior to ischial spine
concavity formed by concavity of coxal bones
Term
greater vestibular glands
(Barholin's glands)
Definition
superficial perineal pouch in female
ducts open within the vestibule on each side of vaginal orifice
lie postero-laterally to vaginal orifice
partially overlapped by vestibular bulbs internally
secrete lubricant mucus into vestibule during sexual arousal
Term
helicine arteries of penis (male)
Definition
branches of deep penile arteries
open directly into cavernous (sinus) spaces of erectile tissue
remain coiled when penis is flaccid and elongate during erection
Term
hymen
Definition
superficial perineal pouch in female
ring-like fold of memebrane that partitions or completely covers the vaginal orifice in adolescents/sexually abstinent women
rupture indicates coitus or injury
Term
hypogastric nerves
Definition
bifurcations of superior hypogastric plexus
purely sympathetic nerve fibers (pre- and post-ganglionic)
fibers from T10-L2
Term
hysterectomy
Definition
removal of uterus; 2nd most common surgery in women
Term
iliac artery
Definition
branch of iliolumbar artery
supplies m. in iliac fossa (iliacis)
Term
iliac crest
Definition
superior border of the wing of the ilium
superolateral margin of greater pelvis
common site for muscle attachment for back, pelvis, and lower limb
Term
iliac fossa
Definition
large, smooth concave surface
internal surface of the ilium
filled by iliacus m.
Term
iliococcygeus
Definition
origin: (ilium) fascia of obturator internus
insert: coccyx:
VPR S4, pudendal
blood: inferior gluteal a.
posterior-most of levator ani m.
Term
iliolumbar artery
Definition
branch of posterior division of int. iliac
gives rise to iliac and lumbar branches
Term
iliolumbar ligament
Definition
strong ligament passing from tip of L5 transverse process to posterior inner lip of iliac crest
helps prevent L5 from slipping forward
Term
inferior gluteal artery
Definition
branch of anterior division of internal iliac artery
courses posteriorly between S2/S3
supplies buttocks
Term
inferior gluteal nerve
Definition
arises from sacral plexus: L5-S2
supplies gluteus maximus
Term
inferior hypogastric plexus
Definition
contains sympathetic innervation from hypogastric nerves and sacral splanchnic nerves
contain parasympathetic innervation from pelvic splanchnic nerves
Term
inferior pubic ramus
Definition
thin and flat, passes laterally and downward from superior ramus
continuous with ramus of ischium
Term
inferior rectal nerve
Definition
nerve found in anal triangle
branch of pudendal nerve before pudendal canal
innervates external anal sphincter
Term
inferior vesical a
Definition
branch of ant. division of int. iliac a.
found only in males
supplies inferior bladder, prostate, and seminal glands
Term
infundibulum (of uterine tubes)
Definition
funnel-shaped distal end of tube that opens via abdominal ostium into the peritoneal cavity
Term
innervation to vas deferens
Definition
sympathetic - superior hypogastric plexus (T10-L2)
parasympathetic - pelvic plexus
Term
internal anal sphincter
Definition
thickening of circular smooth muscle
extends from base of rectum to surround the anal canal
innervated: sympathetic (superior rectal and inferior hypogastric plexus maintains tone); parasympathetics (pelvic splanchnic relax sphincter)
Term
internal hemorrhoids
Definition
dilated veins above pectinate line
pain fibers are GVA carried along parasympathetic (S2-S4)
anus is inferior pelvic pain line
Term
internal iliac arteries
Definition
one of two branches of common iliac artery on each side
supplies the pelvic viscera, musculoskeletal structures of the pelvis, perineum, and buttocks
Term
internal os (ostium)
Definition
formed by internal narrowing of the isthmus of the uterus
Term
internal pudendal artery
Definition
branch of ant. division of internal iliac artery
gives off inferior rectal arteries (after pudendal canal)
exits greater sciatic foramen inferior to piriformins, reenters the lesser sciatic foramen, runs in pudendal canal, supplies perineum
Term
internal pudendal artery (male)
Definition
leaves pelvis via greater sciatic foramen, passes between piriformis, and coccygeus m., enters perineum via lesser sciatic foramen, courses in pudendal canal
inferior rectal, perineal, posterior scrotal, artery of the bulb of penis, dorsal artery of penis, and deep artery of penis
Term
internal pudendal artery (female)
Definition
leaves pelvis via greater sciatic foramen, passes between piriformis, and coccygeus m., enters perineum via lesser sciatic foramen, courses in pudendal canal
inferior rectal, perineal, posterior labial, artery of the bulb of vestibule, dorsal artery of clitoris, and deep artery of clitoris
Term
internal urethral orifice
Definition
point of exit for urine from bladder into urethra
Term
internal urethral sphincter
Definition
wraps preprostatic urethra in smooth muscles
contraction of sphincter prevents retrograde movement of semen during emission
Term
interosseous sacroiliac ligaments
Definition
supports sacroiliac joint (transfers weight)
deep to posterior ligament
series of short, strong fibers connecting tuberosities of the sacrum and ilium
Term
interspinous diameter
Definition
between two ischial spines
narrowest part of pelvic canal
not a fixed distance (widened by relaxin)
Term
ischial spine
Definition
posterior border of body, backward to thin pointed triangular eminence
sacrospinous ligament attaches here
very prominent
Term
ischial tuberosity
Definition
attacment for sacrotuberous ligament, biceps femoris, semitendinosus and other muscles of lower limb
located postero-inferiorly
butt bone
Term
ischioanal fossae
Definition
wedge-shaped gutters (lateral) between the pelvic diaphragm and pelvic wall
filled with adipose ande loose connective tissue that support the anal canal
function: allows movement of pelvic diaphragm during defecation, allows vaginal expansion during childbirth
Term
ischiocavernosus mm. (female)
Definition
superficial perineal pouch in female
origin: medial ischial tuberosity and ischial ramus
insert: aponeurosis around clitoris crura
nerve: deep perineal (S2-S4)
fucntion: contraction prevents venous outflow from clitoris (maintain clitoral erection)
Term
ischiocavernosus mm. (male)
Definition
superficial perineal pouch in male
origin: ischial tuberosity
insert: crura of penis
nerve: deep perineal n. (S2-S4)
function: contraction compresses tributaries of deep dorsal veins (maintains erection)
surround the crura
Term
isthmus (of uterine tubes)
Definition
narrow, thick-walled portion of the uterine tube that is continuous with the uterine horn
Term
isthmus of uterus
Definition
constricted area between the uterine body and cervix (waist-like narrowing)
Term
labia majora
Definition
superficial perineal pouch in female
continuous with mons pubis
bilateral folds of fatty subcutaneous tissue
round ligament of uterus terminates here
Term
labia minora
Definition
superficial perineal pouch in female
smaller, rounded bilateral folds positioned within the vulva
made of hairless skin and fland the vestibule
Term
lacunar ligament
Definition
spans from inguinal ligament to the pecten pubis
sometimes is cut to repair hernia
Term
lateral sacral arteries
Definition
branches of posterior divison of internal iliac
enter the anterior sacral foramina
supply spinal meninges, roots of sacral nerves, and small patch of skin posterior to anus
Term
lateral sacral crest
Definition
formed by fused transverse processes of sacral vertebrae
Term
lateral vaginal fornices
Definition
viewed on coronal section or upon examination with vaginal speculum
Term
lesser sciatic foramen
Definition
bounded by: ischial tuberosity, ischial spine, sacrospinous ligament and sacrotuberous ligament
contains obturator internus, internal pudendal vessels, pudendal nerve, nerve to obturator internus
Term
lesser sciatic notch
Definition
inferior to ischial spine
concavity formed by contour of coxal bones
Term
lesser vestibular glands
(Skene's glands)
Definition
superficial perineal pouch in female
aka paraurethral glands
lie laterally between external urethral and vaginal orifices
secrete mucus that moistens labia and vestibule
Term
levator ani mm.
Definition
puborectalis, pubococcygeus, iliococcygeus
Term
levator ani syndrome
Definition
episodic rectal pain with unknown etiology
pain results from a spasm of the levator ani m..
Term
linea terminalis
Definition
pubic crest, pectineal line, arcuate line
antero-lateral part of pelvic brim
Term
lithotomy view
Definition
position of an individual's feet above or at the same level fo the hips
Term
lumbar artery
Definition
branch of iliolumbar artery
supplies psoas major and quadratus lumborum
Term
lumbar plexus
Definition
network along lumbar vertebrae, T12-L4
gives rise to iliohypogastric, ilioinguinal, lateral cutaneous of thigh, femoral, obturator, genitofemoral nerves
Term
lumbosacral plexus
Definition
sacral and lumbar plexuses combined
T12-S4
Term
lumbrosacral ligament
Definition
from sacral ala to the transverse process of L5
Term
male deep perineal pouch
Definition
contains: external urethral sphincter, deep transverse perineal mm., bulbourethral glands
Term
male pelvis characteristics
Definition
heart-shaped pelvic inlet
subpubic angle <70*
ischial spines are pointy and project more medially into pelvic cavity
deep (tall) pubic symphysis
iliac wings are less flared
Term
male peritoneal reflections pathway
Definition
anterior abdominal wall
superior to pubic bone
superior surface of bladder
posterior surface of blader
superior ends of seminal glands
rectovesical pouch
covers rectum
forms sigmoid mesocolon
posterior abdominal wall
Term
male urethra
Definition
extend from internal urethral orifice (bladder) to external orifice (glans penis)
about 8 inches
both urine and semen pass through
Term
median sacral crest
Definition
formed by fused spinous processes of sacral vertebrae
Term
membranous urethra
Definition
within the male deep perineal pouch
passes through urethral hiatus of perineal membrane an through the external urethral sphincter
narrowest portion of urethra
Term
mesometrium
Definition
part of the broad ligament of the uterus
largest part of broad ligament
like cling wrap around back and front of uterus
Term
mesosalpinx
Definition
part of broad ligament of uterus
composes free margins of broad ligament that envelopes the uterine tubes
Term
mesovarium
Definition
part of broad ligament of uterus
positioned perpendicular to mesometrium and contains the ovarian ligament
Term
middle (AP) distal perineum sensory
Definition
posterior femoral cutaneous nerve
Term
middle (medial) lobe
of prostate
Definition
anatomical division
lies between urethra and ejaculatory ducts
more prone to BPH that can obstruct the internal urethral orifice
Term
middle rectal artery
Definition
branch of ant. division of int. iliac
very variable where it comes from
supplies part of rectum
anastomosis between inferior and superior rectal arteries
Term
mons pubis
Definition
superficial perineal pouch in female
eminence anterior to pubic symphysis
formed by fatty subcutaneous tissue
continuous with Camper's fascia
Term
myometrium
Definition
middle layer of uterine wall
composed of smooth muscle
well supplied with blood and highly innervated
responsible for uterine contractions during parturition and menses ("cramps")
contains multiple fiber directions
Term
neck of urinary bladder
Definition
inferior region leading to urethra; secured to pelvis waslls
Term
nerve to the bulb
Definition
branch of deep perineal nerve
supplies the corpus cavernosum
Term
oblique diameter
Definition
sacroiliac joint to the midline of iliopectineal eminence of opposing side
Term
obstetric conjugate
Definition
extends from promontory to the mid-point of the posterior part of pubic symphysis
fixed-diameter (relaxin does not widen)
respresents shorted anterior-posterior diameter through which the fetal head must pass
must be greater than 11.0 cm for natural birth
Term
obturator artery
Definition
branch of ant. division of int. iliac a.
passes through the obturator canal
supplies the medial thigh mm.
Term
obturator canal
Definition
passageway formed in obturator foramen by part of obturator membrane
obturator n. and vessels pass through
Term
obturator foramen
Definition
hole created by ischium and pubis bones of the pelvis
lined by: superior pubic ramus, inferior pubic ramus, ischial ramus, body of ischium
Term
obturator internus
Definition
origin: ischiopubic ramus and obturator membrane
insert: medial aspect of greater trochanter of femur
nerve: nerve to obturator internus (L5, S1, S2)
blood: inferior gluteal a.
function: lateral rotation and abduction of hip
gives off slender tendon that wraps around ischial spine and ischial tuberosity (lesser sciatic notch)
Term
obturator membrane
Definition
thin, fibrous sheet
almost completely closes obturator foramen
Term
oophorectomy
Definition
removal of ovaries
Term
openings of ejaculatory ducts
Definition
found along the seminal colliculus
Term
operculum
Definition
cervical mucus plug formed during pregnancy that acts as physical and chemical barrier to protect fetus
thick, sticky mucus
contains antimicrobial and immunoglobulins
cervix dilation during labor discharges
Term
os coxae
Definition
pelvic bones or coxal bones
develop from fusion of ilium, ischium, and pubis bones
fuse by age 18
Term
ovarian artery
Definition
supplies the ovary
branch of abdominal aorta just inferior to the renal arteries
course along posterior abdominal wall, cross over external iliac artery
enveloped in the IP ligament
Term
ovarian gubernaculum
Definition
guided gonads in their descent from posterior abdominal wall during development
remnants are the ovarian and round ligament of the uterus
Term
ovarian ligament
Definition
attaches from the uterotubal junction to the proximal ovary
remnant of the ovarian gubernaculum
Term
ovarian plexus
Definition
parasympathetic from vagus nerve (CNX)
sympathetic - mainly T10 lesser thoracic splanchnic nerves
above pain line, T11-L1 spinal ganglia
Term
ovarian veins
Definition
drain the ovaries
right ovarian vein dumps into IVC
left ovarian vein dumps to left renal vein --> IVC
Term
ovaries
Definition
female gonads in which the ova (oocytes) develop
secrete estrogen, progesterone, and small amounts of testosterone
suspended within the pelvic cavity by three ligaments
Term
pectinate line
Definition
demarccates the visceral from the somatic portion of anal canal
transition point for epithelial cell type, nerve supply, arterial supply venous drainage, and lymphatics
Term
pectineal ligament
Definition
follows the cure of the pectineal and arcuate lines
aka inguinal ligament of Cooper
thickening of periosteum along pectineal ligament
good for sutures
Term
pectineal line of pubis
Definition
ridge of superior pubic ramus
part of pelvic brim
continuous with arcuate line of ilium
aka pecten pubis
Term
pelvic cavity
Definition
continuous with abdominal cavity via the pelvic inlet
walls:
anterolateral - pubis and ischium
posterior - sacrum and coccyx
inferior - muscles/fascia
contains: urinary, gastrointestinal, and reproductive system elements
Term
pelvic diaphragm
Definition
pelvic floor
separates pelvic cavity above from perineum below
fibromuscular structure
consists of levator ani mm. anococcygeal raphe, and coccygeus m.
Term
pelvic girdle
Definition
right and left coxal bones, sacrum, sacroiliac joints, pubic symphysis
Term
pelvic inlet
Definition
superior pelvic aperture
formed by heart-shaped ridge of bone, aka pelvic brim
boundaries: sacral promontory, sacral alae, pelvic bones, and pubic symphysis
Term
pelvic outlet
Definition
diamond-shaped, formed by bones and ligaments
bounded by pubic arch, sacrotuberous ligaments, and coccyx
Term
pelvic pain above line (female)
Definition
organ pain -> uterovaginal nerve plexus -> inferior hypogastric plexus -> hypogastric nerve -> superior hypogastric plexus -> T12-L2 spinal ganglia -> spinal cord -> brain
Term
pelvic pain below line (female)
Definition
organ pain -> uterovaginal plexus -> inferior hypogastric plexus -> pelvic splanchnic nerves -> spanal cord -> brain
Term
pelvic splanchnic nerves
Definition
parasympathetic system
arise from S2-S4
Term
penile (spongy) urethra
Definition
positioned within the corpus spongiosum in superficial perineal pouch
extends from external urethral orifice to the root of the penis
supplies by urethral a (small branch of internal pudendal a)
Term
perimetrium
Definition
outermost layer of peritoneum and connective tissue surrounding the uterus
very, very thin, derived from vsiceral peritoneum
Term
perineal artery (female)
Definition
branch of internal pudendal, supplies most of the skin, external genetalia, and perineal mm.
gives rise to posterior labial aa., transverse perineal a, and inferior rectal a.
Term
perineal artery (male)
Definition
branch of internal pudendal a.
gives rise to posterior scrotal arteries
Term
perineal body
Definition
centrally located irregular mass of collagen, elastic fibers, and muscle
site at which bulbospongiosus, superficial transverse perineal, external anal sphincter, and small area of levator ani mm. attach/converge
Term
perineal membrane
Definition
thick triangular band of fascia attached to pubic arch
divides superficial and deep pouches
lies in horizontal plane and has a free posterior margin
creates slit between arctuate ligament (deep dorsal vein of penis/clitoris passes)
floor of deep perineal pouch
anchor point for roots of external genitalia and mm
urethra penetrates at urethral hiatus (vagina penetrates in females)
Term
perineal nerve (female)
Definition
inferior terminal branch of pudendal, large
gives rise to posterior labial nerve, deep branch of perineal nerve
Term
perineal nerve (male)
Definition
terminal branch of pudendal
give rise to superficial and deep branches
Term
perineal raphe
Definition
superficial perineal pouch in female
extends from posterior labial commisure to the anus
Term
perineum (external)
Definition
diamon-shapted region between the thighs
contains openings to urogential, reproductive, and GI tracts
bound by pubic arch, ischial tuberosity, coccyx and ligaments
divided into urogential and anal triangles
Term
peripheral zone
of prostate
Definition
clinical division
posterior and inferior, 70-80% of prostate cancers found here
Term
piriformis
Definition
origin: sacrum
insert: greater trochanter of femur
nerve: nerve to piriformis (L5, S1, S2)
blood: inferior gluteal a.
function: lateral rotation of hip (external rotate)
posterior-lateral wall of pelvis
Term
posterior cutaneous nerve of thigh
Definition
arises from sacral plexus: S1-S3
cutaneous to buttocks and uppermost medial and posterior thigh
Term
posterior division of internal iliac artery
Definition
iliolumbar a, lateral sacral aa, superior gluteal a
Term
posterior gluteal line
Definition
shortest gluteal line
iliac crest to upper part of greater sciatic notch
attachment point for gluteus maximus
Term
posterior labial nerves
Definition
superficial perineal pouch in female
branch of superificial perineal nerve
innnervate labia
Term
posterior lobe
of prostate
Definition
anatomical division
lies posterior to urethra and inferior to ejaculatory ducts
Term
posterior sacroiliac ligaments
Definition
lies in deep depression between the sacrum and ilium behind
strong, chief force that holds the ilium and sacrum together
Term
posterior scrotal arteries (male)
Definition
branches of the perineal artery or internal pudendal
supply the scrotum
Term
posterior scrotal nerve (male)
Definition
branches of superficial perineal n.
sensory to scrotum
Term
posterior superior iliac spine (PSIS)
Definition
projection from posterior border of ala
smaller than anterior
attachment for posterior sacroiliac ligaments
posterior termination of iliac crest
Term
posterior vaginal fornix
Definition
positioned between rectouterine pouch and posterior cervix
largest of vaginal fornices
Term
posteriorly labial arteries
Definition
superficial perineal pouch in female
branches of perineal a.
supply the labia and bulbospongiosus
Term
posteromedial/lateral skin before buttocks (sensory supply)
Definition
pudendal nerve
Term
preprostatic urethra
Definition
from base of bladder to prostate
surrounded by the internal urethral sphincter
Term
prepuce of clitoris
Definition
superficial perineal pouch in female
extension of labia minora; hood over the glans clitoris
Term
prepuce of penis
Definition
foreskin, double-layerd fold of skin and mucous membrane that covers the glans penis
often removed by circumcision
Term
promontory
Definition
superior-most portion of the sacrum
part of border of pelvic inlet
part of linea terminalis
Term
prostate
Definition
located at base of urinary bladder
secretes fluid component of semen that contains prostatic-specific antigens, prostaglandins, citric acid, acid phosphatase and proteolytic enzymes
Term
prostatic urethra
Definition
3-4 cm in lenth
courses through the prostate
Term
prostatic-specific antigen
Definition
esent in small quantities in the serum of men with healthy prostates
elevated in case of prostatic cancer, BPH, or prostatitis
Term
pubic arch
Definition
made of pubic symphysis, contour of ischiopubic rami, ischial tuberosities

anterior part of pelvic outlet
Term
pubic crest
Definition
rough superior edge of pubis
medial to pubic tubercle
Term
pubic symphysis
Definition
non-synovial, amphiarthrodial joint
articulating surfaces are covered with thin layer of hyaline cartilage
fibrocartilage disk securely adjoins left and right pubis bones
reinforced by series of ligaments
Term
pubic tubercle
Definition
distinctive feature of lower part of abdominal wall
lateral to the pubic crest
attachment of inguinal ligament
Term
pubococcygeus
Definition
origin: lateral posterior pubis
insert: coccyx
nerve: VPR S4, pudendal
blood: inferior gluteal a.
middle m. of levator ani mm.
Term
puboprostatic ligament
Definition
condensation of the pelvic fascia that extends from prostate gland to the pelvic bones
parallel and lateral to the pubovesical ligament
Term
puborectalis
Definition
origin: lower pubic symphysis on one side
insert: lower pubic symphysis on other side
nerve: VPR, S4, pudendal n.
blood: inferior gluteal a.
anterior most of levator ani mm
forms sling around rectum
acts as sphincter to maintain fecal continence
Term
pubovesicle ligament
Definition
secures neck of urinary bladder to pelvic walls
Term
pudendal canal
Definition
aka Alcock's Canal
runs along lateral wall of ischioanal fossa
contains: internal pudendal a. and v., pudendal nerve, nerve to obtruator internus
Term
pudendal nerve (male)
Definition
S2-S4
exits greater sciatic foramen (inferior to piriformis), reenters lesser sciatic foramen, runs lateral to wall of ischioanal fossa within the pudendal canal, runs to perineum
gives rise to inferior rectal n, perineal n., dorsal n of the penis
Term
pudendal nerve (female)
Definition
superficial perineal pouch in female
S2-S4
gives rise to inferior rectal, perineal nerve (deep and superficial branches) and dorsal n. of the clitoris
Term
pudendal nerve block
Definition
used for analgesia in late stages of labor
provides pain relief to vaginal canal and perineum (but no contraction relief)
performed via transvaginal approach (palpate ischial spines, Iowa trumpet used to inject anesthetic into pudendal canals bilaterally)
1hr relief
lidocaine and chloroprocaine
Term
ramus of ischium
Definition
thin, flattened part of ischium
arises from ischial tuberosity and joins with inferior pubic ramus medially
Term
rectouterine pouch (of Douglas)
Definition
peritoneal refelction between rectum and uterus
Term
relaxin
Definition
hormone that helps relax ligaments in pelvic region during pregnancy
can increase pelvic movement 10-15%
allows for lateral expansion of pelvic girdle
Term
retroprostatic (Devnonvilliers') fascia
Definition
extension of rectovesical pouch inferiorly
between rectum and prostate
separates bladder, seminal glands, and prostate from rectum
Term
retropubic space (of Retzius)
Definition
separates bladder from internal anterior pubic wall
Term
right and left lateral lobes
of prostate
Definition
anatomical division
form the main mass of the gland and are positioned on either side of urethra
Term
round ligament of uterus
Definition
attaches near uterotubal junction
courses laterally to enter the deep inguinal ring, runs through inguinal canal, exits through the superficial ring and fibers terminate on labia majora
remnant of ovarian gubernaculum
Term
rupture of male urethra
Definition
bulb of penis is common site for tear of spongy urethra
"saddle injury"
results in escape of urine into superficial perineal space
urine pases into scrotum, penis, subcutaneous tissue of lower abdominal wall
surgical intervention required
Term
sacral canal
Definition
continuous with vertebral canal
dura sac ends at S2
ends at sacral hiatus
Term
sacral cornua
Definition
articulate or fuse with coccyx
Term
sacral foramina
Definition
anterior - ventral primary rami exit
posterior - dorsal primary rami exit
Term
sacral hiatus
Definition
inferior opening of sacral canal
marked by cornua
Term
sacral plexus
Definition
lumbosacral trunk L4-L5 and S1-S4
gives rise to superior gluteal, inferior gluteal, posterior cutaneous of thigh, pudendal, sciatic nerves
Term
sacral splanchnic nerves
Definition
sympathetic system
arise from sympathetic chain S2-S4
Term
sacral sympathetic trunk
Definition
descends anterior surface of sacrum medial to the sacral foramina
right and left converge to inferiorly
Term
sacroiliac joint
Definition
strong, weight bearing, synovial
limited joint mobility: gliding and rotary
transfer weight from axial skeleton to appendicular through this joint
relaxation during pregnancy due to added weight --> lordosis
Term
sacrospinous ligament
Definition
thin, triangular
ischial spine to sacrum and coccyx
deep to sacrotuberous ligament
fibers of posterior sacroiliac
Term
sacrotuberous ligament
Definition
flat, triangular, narrower in middle
lower transverse sacral tubercles to ischial tuberosity
creates sciatic foramen between itself and the sciatic notches of the coxal bones
Term
saddle injury
Definition
forceful blow to perineum
can tear the corpus spongiosum and penile urethra in males
Term
sciatic nerve
Definition
arises from sacral plexus L4-S3
supplies articular branches to hip joint, flexors of knee, and all muscle in leg and foot
Term
scrotum/medial UG and anal triangle sensory
Definition
pudendal nerve
Term
seminal colliculus
Definition
enlargment of urethral crest
Term
seminal vesicles
Definition
produce alkaline component of semen that contains fructose and choline
found lateral to ampulla of vas and lie angainst posteroinferior aspect of bladder
give rise to seminal ducts that converge with vas to form ejaculatory ducts
Term
somatic anal canal
(ep cells, blood, vein, nerve, lymph, clincial)
Definition
lower 1/3, below pectinate line
ep cells: stratified squamous
blood: inferior rectal artery
vein: internal rectal plexus -> middle/inferior rectal veins -> caval system
lymph: drain to superficial inguinal nodes
clinical: external hemorrhoids
Term
sphincter urethrovaginalis (female)
Definition
female deep perineal pouch
origin: perineal body
insert: opposite side m. to form sling around anterior side of urethra
nerve: perineal branch of pudendal (S2-S4)
function: accessory urethral sphincter
Term
subcutaneous perineal tissue
Definition
akak superficial perineal fascia of urogenital triangle
made of fatty and membranous layers
Term
superficial dorsal penile veins
Definition
drain blood from skin and superficial fascial coverings of penis
lie between Dartos and Buck's fascia
Term
superficial perineal nerve (male
Definition
branch of perineal nerve
sensory supply to scrotum and bulb
Term
superficial perineal pouch
Definition
begins at deep boundary fo Colle's fascia and extends deeper to the perineal membrane
cotains: erectile tissues, associated mm., glands, and neurovasculature
Term
superficial transverse perineal mm. (female)
Definition
superficial perineal pouch in female
origin: anterior ischial tuberosity
insert: perineal body
nerve: deep perineal (S2-S4)
function: support and fix perineal body, help to resist increase in intra-abdominal pressure
Term
superficial transverse perineal mm. (male)
Definition
superficial perineal pouch in male
origin: anterior ischial tuberosity
insert: perineal body
nerve: deep perineal nerve (S2-S4)
function: contract with I and B provides firm base for penis during erection
covered by superficial perineal (Colle's fascia)
Term
superior articular process
Definition
articulate with L5 vertebra
Term
superior gluteal arteries
Definition
branch of posterior division of internal iliac a.
exits pelvis through greater sciatic formen above the piriformis m
courses between lumbosacral trunk and S2
supplies gluteal mm. and one lateral leg m.
Term
superior gluteal line
Definition
site of attachment for gluteus medius
Term
superior gluteal nerve
Definition
arises from sacral plexus: L4-S1
supplies gluteus medius and gluteus minimus
Term
superior hypogastric plexus
Definition
formed by lower lumbar splanchnic nerves
continuous above with aortic nerve plexus
mostly situated on vertebral bodes below the aortic bifurcation
purely sympathetic nerve
amasses and bifurcates into hypogastric nerves
Term
superior hypogastric plexus block
Definition
controls pelvic pain that does not respond to oral medications
contains sympathetic fibers and afferent pain fibers
relieves pain of structures above the pelvic pain line
needle into L5/S2 iv disc
Term
superior pubic ligament
Definition
extends laterally as far as the pubic tubercles
fibers intertwine with fibrocartilaginous disk
Term
superior pubic ramus
Definition
forms a portion of the obturator foramen
extends from body to the median plane, articulates with opposite side pubis
continuous with ilium superiorly
Term
superior vesical arteries
Definition
branches of the umbilical artery
supply the urinary bladder
sometimes give rise to artery of vas
Term
suspensory ligament of penis
Definition
superficial perineal pouch in male
suspends penis from pubic symphysis
attaches to tunica albuginea
Term
suspensory ligament of the ovary
Definition
aka infundibulopelvic (IP) ligament
lateral swelling of mesovarium that spancs from the ovary to the pelvic wall
Term
symphyseal surface
Definition
fibrocartilage attaches here
forms pubic symphysis joint with opposing pubic body
Term
transition zone
of prostate
Definition
clinical division
aka periurethral zone
portion around proximal urethra
Term
transtubercular distance
Definition
between the two ischial tuberosities
Term
transverse cervical (cardinal) ligament
Definition
extends from cervix and lateral vaginal fornices to the internal portion of the lateral pelvic walls
during surgical repairs, can be used to anchor wide loops of sutures
Term
transverse diameter of pelvic inlet plane
Definition
extends across the greatest width of superior aperture in a coronal plane
Term
transverse perineal artery
Definition
branch of perineal a.
supplies the superficial transverse perineal mm.
Term
trigone
Definition
smooth triangular-shaped region on the internal inferoposterior wall of urinary bladder
bound by ureteric orifices superiorly and internal urethral orifice inferiorly
Term
tubal veins
Definition
small veins in ovary that dump into the ovarian veins or uterine venous plexus
Term
umbilical artery
Definition
branch of ant. division of int. iliac a.
fetal remnant forms the medial ligament in the medial fold
patent part gives rise to superior vesical arteries
Term
ureteric orifices
Definition
where ureters enter the bladder
surrounded by loops of detrusor m. that tighten during micturition to prevent reflux of urine into ureters
kidney stones can become lodged here
Term
urethral crest
Definition
mucosal fold along the posterior wall of the prostatic urethra
Term
urethral sinuses
Definition
recesses created on either side of urethral crest where the ducts of prostate open
Term
urinary bladder
Definition
hollow, distendable organ with strong muscular walls
located in true pelvis when empty; rises to false pelvis above pubic symphysis when full
after micturition, contains virtually no urine
when empty, size and shape of pear
can hold 400-500mL
Term
urinary bladder innervation
Definition
parasym - detrusor contract, internal urethral sphincter relax
sym - detrusor m. relax, external urethral sphincter contract
pudendal nerve - external urethral sphincter
Term
urogenital triangle
Definition
bound by ischiopubic rami, imaginary line between both ischial tuberosities and inferior margin of the symphysis
roof is the levator ani mm.
consists of superficial and deep perineal pouches
Term
uterine artery
Definition
supplies superior vagina and uterus
branch of internal iliac artery
found in the broad ligament of the uterus
runs over the ureters (water runs under the bloody bridge)
Term
uterine cavity
Definition
triangular shape region, uterine tubes enter here
Term
uterine horn
Definition
tube between uterine cavity and uterine ossa
Term
uterine ossa (ostia)
Definition
site of uterine tube termination proximal to the uterine cavity
Term
uterine ostium (of uterine tubes)
Definition
opening of uterine tube at the uterine horn
Term
uterine part (intramural segment)
(of uterine tube)
Definition
tube passes through wall of uterus, opens into uterine cavity (at uterine horn)
Term
uterine prolapse stages
Definition
Stage 0: normal
Stage I: descent of uterus to any point in vagina above hymen
Stage II: descent to hymen/vestibule
Stage III: descent beyond hymen/vestibule
Stage IV: total eversion or procidentia (uterine prolapse)
Term
uterine tubes
Definition
aka fallopian tubes, oviducts
conduct ovum (oocyte) from the ovary to the uterus
extend laterally from uterine hones and open into the peritoneal cavity neart he ovaries
Term
uterosacral ligaments
Definition
span from posterior cervix to middle of anterior sacrum; palpable during rectal exam
Term
uterotubal junction
Definition
external region that is the transition between uterine tube and uterus
Term
uterovaginal nerve plexus
Definition
supplies visceral innervation to upper vagnia and uterus
travels with uterine artery
careis GVE and GVA fibers
extension of inferior hypogastric plexus
sympathetic - lower thoracic cord levels
parasympathetic - pelvic splanchnic nerves (S2-S4)
somatic - deep perineal nerve, senses touch and temperature from lower 1/4th of vagina
Term
uterovaginal venous plexus
Definition
provides venous communication between vaginala nd uterine venous plexuses
dumps to uterine vein --> internal iliac vein --> common iliac vein --> IVC
Term
uterus
Definition
hollow organ with thick muscular walls
in the true pelvis (when non-gravid)
body sits on top of urinary bladder
cervix lies between rectum and fundus of bladder
anteverted and anteflexed
Term
vagina
Definition
fibromuscular tube, extends from cervix to vestibule
communicates superiorly with cervical canal via the external os
usually collapsed such that the anterior and posterior walls are in contact with one another
Term
vaginal artery
Definition
supplies middle vagina
branches from either uterine artery or internal iliac artery
Term
vaginal fornix
Definition
recess created by cervix extension into collapsed "H" shaped vagina
Term
vaginal orifice
Definition
superficial perineal pouch in female
external opening of vagina
located posteriorly in the UG triangle
Term
vaginal venous plexus
Definition
drains vagina
dups to uterovaginal venous plexus
Term
vasectomy
Definition
surgical excision of a portion of vas deferens performed through scrotum
outpatient procedure, 30 minutes
spermatozoa stil produced, eaten by macrophages
can be reversed
Term
vesicouterine (Dunn's) pouch
Definition
perintoneal reflection between urinary bladder and uterus
Term
vestibular bulbs
Definition
superficial perineal pouch in female
paired masses of erectile tissue along the side of vaginal orifice
lie deep to labia minora
anchored to perineal membrane and are covered by bulbospongiosus mm.
Term
vestibule
Definition
area/space/opening between the right and left labia minora
Term
visceral anal canal
(ep cells, blood, vein, nerve, lymph, clincial)
Definition
upper 2/3 of canal, above pectinate line
ep cells: columnar or cuboidal
blood: superior rectal artery
vein: internal rectal plexus --> superior rectal vein --> IMA to portal system
nerve: pelvis plexus (sym and para)
lymph: drain to internal iliac nodes
clinical: internal hemoorrhoids
Term
vulva (pudendal cleft)
Definition
superficial perineal pouch in female
opening/space between two labia majora
Term
zyagopophyseal joints
Definition
right and left
inferior L5 articular porcess with superior sacral process
prevents L5 from slipping foward
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