Term
| What prevents body weight from rotating the sacrum anteriorly? |
|
Definition
| Sacrotuberous and Sacrospinous ligaments |
|
|
Term
| What provides access for a caudal epidural anesthesia? |
|
Definition
| Sacrial Hiatus into the Sacral Canal |
|
|
Term
| What travels through the greater and lesser sciatic and obturator canals? |
|
Definition
Greater and Obturator- neurovasculature to the lower limb
Lesser- pelvic neruovasculature to the perineum |
|
|
Term
| What defines the pelvic brim? |
|
Definition
| Linea terminalis, (2parts- arcuate line of the ileum, pectineal line of the pubis |
|
|
Term
| What is the tilt of the pelvis from horizontal? |
|
Definition
|
|
Term
| Diagonal vs obstetric conjugate |
|
Definition
| Obstetric is from the inferior border of the pubic symphisis, diagonal is from middle of pubic symphisis |
|
|
Term
| What are the male and female subpubic angles? |
|
Definition
|
|
Term
| What makes up the sacral plexus, and it is anterior to what M? |
|
Definition
| Anterior rami and is ant to piriformis |
|
|
Term
| Obturator Internis Origin and Insertion |
|
Definition
| O-Obturator Fascia, I-through the lesser sciatic foramen to the greater trochanter of the femur. |
|
|
Term
| The Pelvic diaphragm is made up what two muscles? |
|
Definition
| Coccygeous and levator Ani |
|
|
Term
| What is the vestigial tail M |
|
Definition
|
|
Term
| What are the two openigns in the Levator Ani? |
|
Definition
| Anterior- Urogenital Hiatus, Posterior- Anal Aperture |
|
|
Term
| What three MM make up the levator ani?Antmedial to Midlaterally |
|
Definition
| Puborecatlis, pubococcygeous, Iliococcygeous. |
|
|
Term
| The midline raphe is what superficially? |
|
Definition
| The anococcygeal ligament |
|
|
Term
| What happens in pelvic MM during deficatino? |
|
Definition
| Puborectalis relaxes, levator ani contract |
|
|
Term
| What can result from a weak pelvic diaphragm? |
|
Definition
| Urinary incontinence, bowel incontinence, prolapse of the pelvic viscera through the perineum |
|
|
Term
| What are the three N projecting laterally from the Sacral plexus, AKA "posterior division"? |
|
Definition
| Superior Gluteal, Inferior Gluteal, Nerve to Piriformis |
|
|
Term
| What are the three N projecting medially from the Sacral plexus? AKA "anterior divisions"? |
|
Definition
| N to Obterator Internis, Pudendal N, N to Levator Ani |
|
|
Term
| Obturator N is from what level, goes to what plexus, and innervates what? |
|
Definition
| L2-4, Lumbar Plexus, Medial M of the thigh |
|
|
Term
| The lumbosacral Trumk is from what level? and has what end? |
|
Definition
| inf 1/2 of Anterior ramus of L4 and Anterior Ramus of L5, it enters into the sacral plexus |
|
|
Term
| What causes "Back Labor?" |
|
Definition
| Compression of the Sacral Plexus by childbirth or Pelvic tumors. |
|
|
Term
| What is the level and innervation of the Superior Gluteal N? |
|
Definition
| L4 to S1 to the Lesser Gluteal MM |
|
|
Term
| What is the level and innervation of the Inferior Gluteal N? |
|
Definition
| L5-S2 to the Gluteus Maximus |
|
|
Term
| What is the level of the posterior cutatneous N of the thigh? |
|
Definition
| S1-3, exits inferior to piriformis |
|
|
Term
| What two N make up the Sciatic and they are comprised of what levels? |
|
Definition
| L4-S3 tibial and fibular N |
|
|
Term
| What is the level of the Pudendal N? What landmark does it cross? |
|
Definition
| S2-4, crossesl the iscial spine, deep to the sacrotuberous lig. |
|
|
Term
| What levels are the nerves to the Levator Ani and obturator Internis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Iliohypogastric/Ilioinguinal |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Lateral Femoral Cutaneous N. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Inferior Gluteal, Obturator Internis |
|
|
Term
|
Definition
| Posterior Cutaneous N of the Thigh |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Levels of Nerves to Sciatic N |
|
Definition
|
|
Term
| Where does the common Iliac Artery branch? |
|
Definition
|
|
Term
| What are the differing courses of Gonadal Arteries? |
|
Definition
| Laterally through the deep ring for testes, Medial to ovaries in Female. |
|
|
Term
| What are the three branches of the posterior division of the internal Iliac? |
|
Definition
| Superior gluteal, iliolumbar, lateral Sacral |
|
|
Term
| Sup. Glut. A courses through what? |
|
Definition
| The lumbar trunk and first branch of the Sacral Plexus. |
|
|
Term
| Name the 8 Anterior branches of the Internal Iliac using general pattern lateral to medial. |
|
Definition
| Obturator-Umbilical (which splits to medial umbilical Lig and Su. Vessical A)-Inferior Vessical or Uterine-Middle Rectal- Internal Pudendal- Inferior Gluteal Artery |
|
|
Term
| What is an obturator Abberant artery? |
|
Definition
| Artery off internal epigastric that runs over the pubic ramus, have to "super watch out for this" during surgeries. |
|
|
Term
| What A supplies the superior bladder? |
|
Definition
| A branch of the Umbilical A |
|
|
Term
| What travels in Alcock's canal? |
|
Definition
| Internal Pudendal A and N |
|
|
Term
| Name the 4 arteries to the female reproductive system Superiorly to inferiorly |
|
Definition
| Ovarian A, Uterine A, Vaginal A, Internal Pudendal A |
|
|
Term
| The inferior Vessicle A in males supplies what 4 organs? |
|
Definition
| Inferior Bladder, ductus deferens, seminal vessicles, prostate. |
|
|
Term
| Trace the path of lymph in the pelvis |
|
Definition
| Internal Iliac Nodes- Common iliac nodes- lumbar node- lumbar lymphatic trunk- cysterna chyli- thoracic duct |
|
|
Term
| How do the gonads drain lymph? |
|
Definition
| odd man out, Abodminal structures in disguise, Drain to Lumbar Nodes. |
|
|
Term
| What is the 1 pelvic pouch in males and the two peritoneal pouches in females? |
|
Definition
| rectovesical, rectouterine and vesicouterine |
|
|
Term
| Is the rectum Retroperitoneal? What causes the anterior flexure? |
|
Definition
| Yes, Puborectalis contraction |
|
|
Term
| What are the valves of Houston? |
|
Definition
| Transverse folds in the rectum, give feces shape, allow movement and prevent pain. |
|
|
Term
| Where does the superior rectal vein drain? |
|
Definition
|
|
Term
| The three anastomosing rectal veins drain where? |
|
Definition
|
|
Term
| What creates the ureter/bladder valve? |
|
Definition
| Ureters enter posterior superior angle and the oblique passage creates a valve that closes w/pressure |
|
|
Term
| What is water under bridge? why is it important? |
|
Definition
| Ureters pass inferior to the Uterine AA, ureters can be damaged during a hysterectomy |
|
|
Term
| What separates the bladder from the pelvic bone? |
|
Definition
| Retropubic space of Retzius |
|
|
Term
| What are the 4 parts of the bladder? |
|
Definition
| Fundus, Apex, Trigone and Neck |
|
|
Term
| Which urethral sphincter is voluntary? |
|
Definition
|
|
Term
| What contacts the bladder in males? |
|
Definition
| Rectovesical septum, seminal glands, ampuallae of D.Def. |
|
|
Term
| What contacts the bladder in females? |
|
Definition
| Superior and anterior wall of the vagina |
|
|
Term
| How could you insert an exterior catheter w/o entering the peritoneal cavity? |
|
Definition
|
|
Term
| What three parts make up the round ligament? |
|
Definition
| Mesosaplinx (around the uterine tube), Mesovarium (around the ovaries), mesometrium (the rest, contains the round ligament) |
|
|
Term
| Define ovarian A, V, Lymph drainage |
|
Definition
| A of abdominal Aorta, V return to IVC, L goes to renal vein. Lymph to lumbar nodes. |
|
|
Term
| Why is PID common in females? |
|
Definition
| Uterine tubes are open to Peritoneal Cavity |
|
|
Term
| What are the three layers to the uterus? |
|
Definition
| Perimetrium- visceral peritoneum, Myometrium- Smooth muscle, Endometrium- lining of glandular mucosa. |
|
|
Term
| What is the site of papsmear |
|
Definition
|
|
Term
| What is normal Uterine position? |
|
Definition
|
|
Term
| What are the two major Uterine Ligaments? |
|
Definition
| Uterosacral (posterior to sacrum) and Cardinal or transverse cervical lig (contains A V) |
|
|
Term
| What is the fornix? What are the sides called? |
|
Definition
| Cervical projection into the vagina, Ant, Post, 2Lat |
|
|
Term
| What is the correlation of the posterior fornix and endoscopic exams? |
|
Definition
| It is the inferiormost portion of the peritoneal cavity |
|
|
Term
| What is the male vagina called? Where does muscle obliteration stop when correcting for BHP? |
|
Definition
|
|
Term
| what are the four things that make up semen? |
|
Definition
| Sperm, Secretions of Seminal Vessicles, Prostate, bulbourethral glands |
|
|
Term
| What is the traditional definition of prostatic lobes? |
|
Definition
| Anterior, Posterior (inferior to E.D.), Median (superior to E.D.), R,L lobes |
|
|
Term
| What is the new difinition/names of prostatic lobes? |
|
Definition
| ASII, Anteriomedial, Superiomedial, Inferolateral, Inferoposterior |
|
|
Term
|
Definition
|
|
Term
| Why can prostate cancer quickly reach the CNS? |
|
Definition
| Inferior veins have no valves and anastomose with the vertebral plexes |
|
|
Term
| What are the soft tissue boundaries of the perineum |
|
Definition
| Later Walls- Obt. Internus, Roof- Pelvic Diaphragm (with UG hiatus and Anal Aperture |
|
|
Term
| What are the three spaces in the perineum? |
|
Definition
| Deep and superficial perineal pouches and the Perineal cleft |
|
|
Term
| Vaginal Prolapse can result from the weakening of what? |
|
Definition
|
|
Term
| Where do the R and L points of the Ischioanal Fossae communicate? |
|
Definition
| Posteriorly, superior to the ancocccygeal ligament |
|
|
Term
| What is the inferiormost site of portal-caval anastomoses? |
|
Definition
|
|
Term
| What forms the division of endodermal and ectodermal parts of the rectum? |
|
Definition
|
|
Term
| What are the three physical characteristics of the pectinate line? |
|
Definition
| Columns, Valves (crescent shaped), Sinuses |
|
|
Term
| What is the A and N to the superior Anal Canal? |
|
Definition
| Superior Rectal A, ANS innervation/ Inferior rectal A, Inferior rectal N (somatic) |
|
|
Term
| What is the site of external hemmorhoids? |
|
Definition
| Anal canal inferior to the pectinate line |
|
|
Term
| What are the contents of the superficial perineal pouch? |
|
Definition
| erectile tissues and associated muscles |
|
|
Term
| What are the two types of erectile bodies? |
|
Definition
| Corpus spongiosum, corpora cavernosa |
|
|
Term
| What secures the clittoris into place (there is no "bulb") |
|
Definition
| Suspensory Ligament of the Clittoris |
|
|
Term
| What binds the corpus spongiosum to the corpora cavernosa? |
|
Definition
|
|
Term
| What lies between the deep fascia and the skin? |
|
Definition
|
|
Term
| the dorsal N of Clittoris, Penis passes through which pouch? |
|
Definition
|
|
Term
| What landmark is used for pudendal N block? |
|
Definition
|
|
Term
| The internal pudendal A travels on what side of the pudendal N? |
|
Definition
| lateral to the pudendal N |
|
|
Term
| What are the 5 branches of the internal pudendal A? |
|
Definition
| Dorsal/Deep AA of Clittoris/Penis. Perineal A, Inferior rectal A, A of bulb. |
|
|
Term
| What is the exception in normal venous return patterns in the perineum? |
|
Definition
| There is only one dorsal V of clittoris/Penis w/2 AA |
|
|
Term
| What Venous plexes are at risk during pelvic fracture? |
|
Definition
| The prostatic plexus, includes veins and autonomic plexes. |
|
|
Term
| What is the difference in lymphatic drainage b/t deep and superficial perineal tissues? |
|
Definition
| Deep= Internal Pudendal Vessels to Internal iliac nodes. Superficial to Superficial inguinal nodes, GONADs to lumbar!! |
|
|
Term
| Where does the straddle injury take place? Location? Space? |
|
Definition
| Inferior to the perineal Membrane, in the membranous urethra, space b/t perineal membrane and deep perineal fascia |
|
|
Term
| Where does the bloody urine from a straddle injury go? |
|
Definition
| Forced to break through the corpus spongiosum to enter the perineal cleft |
|
|
Term
| Where does the bloody urine from a straddle injury go ifthe injury is superior to the perineal membrane? |
|
Definition
| The urine will be restricted to the deep pouch and abdominopelvic diaphragm |
|
|
Term
| What are the 5 major plexuses of the Pelvis/perineum |
|
Definition
| Sup. Hypo, Inf. Hypo, Vesical, prostatic, rectal pelvic plexuses |
|
|
Term
| Sacral and Pelvic Splanchnic N are from what system and originate from what N? |
|
Definition
| Sacral-sypathetic, from sympathetic chain, Pelvic splanchnic- parasympathetic from sacral Rami |
|
|
Term
| What is the pelvic pain line? |
|
Definition
where the change in course of visceral nociceptive fibers return.
Aboce: along sympathetic, Below: parasympathetic |
|
|
Term
| how is the suprarenal gland innervated? |
|
Definition
| Pre-Symp from t10-L1 through the celiac plexus to chrommafin cells in the medulla. Pos-Symp from celiac to blood vessels |
|
|
Term
| What is the sensory innervation to the ureters? |
|
Definition
| Generally in superiro direction vi alumbar and throacic sympathetic splanchnics to T11-12 (hence pain w/stones) spinal cord. |
|
|
Term
| Weakness of what ligaments contribute to uterine prolapse? |
|
Definition
| the three ligaments of the uterus, Transverse cervical (Cardinal), the uterosacral, and possibly the vessicouterine |
|
|
Term
| What N innervates the site of anal columns/valves? |
|
Definition
| Inferior rectal (branch of pudendal (S2-4) |
|
|
Term
| Lymph above/below pectinate line goes where? |
|
Definition
Above-Internal Iliac
Below-Superficial inguinal |
|
|
Term
| When incising an abcess in the rectal iliorectal fossa, what structures must be avoided? |
|
Definition
|
|
Term
| If the R thigh swells with a straddle injury, what fascial layers could have been injured? |
|
Definition
| Fascia lata/colles fasica |
|
|
Term
| The perineal cleft is not continuous with what three areas? |
|
Definition
| Anal triangle, Medial thigh, the back |
|
|
Term
| Name the continuous fasces anterior to posterior begininign with EAO Aponeurosis |
|
Definition
EAO Apo- Suspensory ligament of the penis- buck's fascia-external spermatic fascia- Deep perineal fascia
S-B-E-D |
|
|
Term
| Name the continuous fasces anterior to posterior begininign with Superficial fascia of the penis |
|
Definition
SupFasica Penis- dartos- Scarpas- Colles
S-D-S-C |
|
|
