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Anat Block1 Spring13
Anatomy Exam Block 1 Spring 2013
| Question | Answer |
|---|---|
| Where does the rectum begin | 3rd sacral vertebrae |
| Describe the tilting of the uterus | 90 degrees anterior is the norm (antiflexion) |
| Describe the course of the ureter in the female | It crosses inferior to the uterine artery and superior to the vaginal artery |
| What makes up the broad ligament | 2 layers of peritoneum that course from the uterus to the lateral pelvic wall |
| What runs inside of the broad ligament | Uterine (fallopian) tube |
| What are the 3 parts of the broad ligament | Mesosalphinx, mesovarium, and mesometrium |
| What forms the pectinate line of the anal canal | Anal columns, anal valves, anal sinuses |
| What branch does the superior rectal artery arise from | Inferior mesenteric artery |
| At what level does the IMA branch from the aorta | L3 |
| At what level does the ovarian/testicular artery branch from the aorta | L2 |
| What does the ovarian artery anastomose with | Uterine artery which comes off the internal iliac artery (branch of the common iliac artery |
| At what level does the aorta bifurcate | L4 |
| At what level does the IVC bifurcate | L5 |
| What artery runs through the suspensory ligament | Ovarian artery |
| What are the branches off the pudendal artery | Inferior rectal, perineal, bulb, urethra, deep, dorsal |
| Internal hemorrhoids may be a sign of | Portal hypertension (due to superior rectal veins) |
| External hemorrhoids are associate with what veins | Inferior rectal veins (as opposed to superior which can cause internal hemorroids) |
| What are the branches of the posterior division of the internal iliac artery | Iliolumbar, lateral sacral, superior gluteal (I.L.S) |
| Sciatic nerve is formed by the anterior rami of which spinal nerves | L4 - S3 |
| The pudendal nerve is formed by contributions from the anterior rami of which spinal nerves | S2-S4 |
| Where does the pudendal nerve exit the pelvis | Passes inferior to the piriformis muscle |
| What kind of fibers do the pelvic splanchnics carry | Preganglionic parasympathetic |
| The pelvic splanchnic nerves arise from which anterior rami | Spinal nerves S2-S4 |
| The pelvic diaphragm is made up of which muscles | Levator ani and coccygeus muscles (+ the fascia covering these muscles) |
| What are the three muscles of the levator ani | Puborectalis, pubococcygeus, and iliococcygeus |
| Talk about the tendinous arch | The tendinous arch is a thickening of the obturator internus fascia to which the iliococcygeus muscle (part of levator ani) attaches |
| Where do the obturator internus and externus attach to | Greater trochanter of the femur (the piriformis muscle attaches here as well) |
| What motion do the obturator muscles as well as the piriformis aid in | Lateral rotation of the thigh |
| To measure the OBSTETRIC conjugate measure from the sacral promontory to the | Posterior border of the pubic symphysis |
| To measure the DIAGONAL conjugate measure from the __________ to the lower border of the pubic symphysis | Sacral promontory |
| What regions of the pelvic inlet make up the linea terminalis | Pubic crest, pecten pubis, arcuate line |
| The subpubic arch in the female is how many degrees | 80-85 degrees (which is larger than the male which is 50-60 degrees) |
| The pelvic inlet in a male is what shape | <3 |
| What divides the greater and lesser sciatic foramina | Sacrospinous ligament (sacrum to the ischial spine) |
| What other ligament closes the lesser sciatic foramen | Sacrotuberous ligament (sacrum to ischial tuberosity) |
| Is the sacroiliac joint a synovial joint | YES (but it can become fibrous or ossified with age) |
| Three parts of the pelvic bone | Ilium, ischium, pubic bone |
| Bones that make the pelvis | Two pelvic bones and the sacrum |
| What passes through the gap between the transverse perineal ligament and the pubic symphysis | Deep dorsal vein of the penis/clitoris |
| What is the corona of the penis | Prominent margin of the glans |
| Is corpora cavernosa erectile tissue | YES |
| What runs through the corpus songiosum of the penis | Spongy urethra |
| Name the superficial penile fascia | Dartos fascia |
| Name the deep penile fascia | Buck's fascia |
| What kind of muscle is the bulbospongiosus | Skeletal muscle (contraction helps expel urine or semen from urethra, also aids in erection) |
| What covers the crura of the penis or clitoris | Ischiocavernosus (skeletal muscle) |
| Attachments of the superficial transverse perineal muscles | From ischial tuberosity and insert into the perineal body |
| What male part is homologous to the labia majora | Male scrotum |
| Name something that ends at the labia majora | The round ligament of the uterus |
| The clitoris is homologous to the | Penis |
| In the FEMALE Colle's fascia is continuous with | Scarpa's fascia |
| In the MALE Colle's fascia is continuous with | Scarpa's fascia |
| What about when Colle's fascia goes to the penis and scrotum, then what do you call it | Dartos fascia |
| The internal pudendal artery arises from the | Anterior division of the internal iliac artery |
| What sciatic foramen does the pudendal artery pass through | BOTH. It leaves the pelvis through the greater sciatic foramen and then passes through the lesser sciatic foramen in the gluteal region |
| Name the two branches of the external pudendal artery | Superficial and deep external pudendal arteries (which are branches off the femoral artery) |
| The internal pudendal veins drains into the | Internal iliac veins |
| Superficial structures of the urogenital triangle have lymphatic drainage to | Superficial inguinal lymph nodes |
| Lymphatics from structures in the deep perineal space drain to | Internal iliac nodes |
| Does the pudendal nerve supply somatic innervation to the perineum | YES (if you know nothing else for the exam, know this) |
| For a pudendal nerve block where would you inject the anesthetic | Near the ischial spine |
| Where does the rectum end | Anorectal flexure (Anal canal begins here) |
| The rectum is separated from the bladder by the | Rectovesical pouch |
| What pouch is between the rectum and uterus in the female | Rectouterine pouch (of Douglas) |
| What is the anocutaneous line | Inferior boundary between the internal and external anal sphincters (also called the intersphincter groove) |
| Arterial supply to the rectum and anal canal superior to the pectinate line | Superior rectal arteries (from IMA) |
| Arterial supply to the anal canal inferior to the pectinate line | Inferior rectal arteries (off the internal pudendal arteries) |
| In the female what lies posterior to the vagina | Rectum |
| What is the fornix | Part of the superior vagina that surrounds the cervix |
| Name the layers of the uterus | Myometrium, perimetrium, endometrium |
| If the cervix has a more posterior angling we call this | Retroversion |
| Name the pouch between the uterus and urinary bladder | Vesicouterine pouch |
| Where do the pain fibers for the cervix and upper vagina originate | S2-S4 (they pass through pelvic splanchnics and the inferior hypogastric plexus to reach the vagina) |
| What type of fibers are found in the inferior hypogastric plexus | Pre- and post- sympathetic and parasympathetic, and sensory/afferent fibers |
| Is the ureter retroperitoneal | YES |
| At what locations is the ureter most constricted | Origin from renal pelvis, where is crosses the pelvic brim, passes through the bladder |
| Pain from the abdominal part of the ureter is relayed to which spinal cord segments | T11-L2 (spasms can occur due to ureteral stones) |
| Is the apex of the bladder anterior or posterior | Anterior |
| List the branches of the posterior branch of the internal iliac artery | Iliolumbar, lateral sacral, superior gluteal |
| Pudendal nerve contains fibers from what ventral rami | S2-S4 |
| Pelvic splanchnic nerves contain what kind of fibers | Preganglionic parasympathetic |
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