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Anat Block1 Spring13

Anatomy Exam Block 1 Spring 2013

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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