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Gross Anatomy 2
Musculature of Inner Pelvis & Urinary System
| Question | Answer |
|---|---|
| Obturator Internus origin | inner surface of the obturator membrane & surrounding bony rim |
| Tendon of Obturator Internus leaves the pelvis via what? | lesser sciatic foramen |
| Obturator fascia is thickened along a line from the pubis to the ischial spine called what? | arcus tendineus |
| What muscle arises from the arcus tendineus | levator ani muscle |
| Origin of the Piriformis and leaves pelvis via what? | pelvic surface of sacrum; greater sciatic foramen |
| Floor of the pelvis is formed by skeletal mm termed what? | pelvic diaphragm |
| Inner walls of the true pelvis are partially line by which two muscles | obturator internus and piriformis |
| Pelvic diaphragm components | Levator Ani Muscle and Coccygeus Muscle |
| Innervation of the Levator Ani Muscle | branches of the pudendal plexus containing S4 fibers |
| Subdivisions of the Levator Ani Muscle | pubococcygeus and iliococcygeus |
| From pubic bone to coccyx | pubococcygeus |
| From arcus tendineus to coccyx | iliococcygeus |
| Most medial part of the pubococcygeus; forms a sling around the anorectal junction, thus drawing the junction forward | puborectalis |
| Innervation of the coccygeus muscle | branches of the pudendal plexus, containing S4 & S5 fibers |
| O and I of Coccygeus Muscle | O - ischial spine & part of sacrospinous lig. I - sides of coccyx and sacrum |
| Location of the bladder | posterior to pubic symphysis |
| 4 surfaces of the bladder | superior, inferolaters(2) & posterior(inferoposter) = base |
| Junction of the inferolateral and superior surfaces of the bladder | apex of the bladder |
| What ligaments arises at the apex and extends to the umbilicus | median umbilical ligament |
| Where does the ureters enter into the bladder | superior-lateral angles of the bladder |
| Junction of inferolateral & posterior surfaces of the bladder | neck of the bladder |
| Neck of bladder surrounds what | internal urethral orfice |
| The neck of the bladder sits upon ____ in the female and ____ in the male | pelvic diaphragm; base of prostate |
| What constricts the internal urethral orfice of the bladder | internal urethral sphincter/sphincter viscerae |
| Potential space between the bladder and pubic bones and is filled with CT | retropubic space |
| Superior to the bladder | peritoneum and coils of the SI |
| The peritoneum is reflected downward behind the bladder to form what? | rectovesical pouch and vesicouterine pouch |
| Between bladder and rectum in males | rectovesical pouch |
| Between bladder and uterus in females | vesicouterine pouch |
| Muscular wall of the bladder is made of smooth muscle and sometimes termed what? | Detrusor Muscle |
| Triangular area located inside the bladder on its posterior wall. | vesical trigone |
| Superior border of the trigone between ureteric orfices | interureteric ridge |
| Special layer of smooth muscle associated with the trigone | trigonal muscle |
| Capacity of the bladder without overdistention | 500ml |
| Capacity at which the urge to urinate is felt(physiological capacity) | 200-350ml |
| Arteries of the bladder | superior, middle & inferior vesical arteries |
| Venous drainage in males | vesical-prostatic plexus to internal iliac vein |
| Venous drainage in females | vesical-vaginal plexus to internal iliac vein |
| Parasympathetic nerve supply to bladder | From pelvic splanchnic |
| Sympathetic nerve supply to bladder | From hypogastric plexus |
| Another name for urination | micturition |
| Essential initiation of normal urinatioin | descent of the neck of the bladder |
| Optimal urine volume stimulates what? | stretch receptors in bladder wall |
| Absence of conscious voluntary control causes what? | reflex relaxation of the levator ani muscle which allows the neck of the bladder to descend thus opening the internal urethral orfice |
| In kidneys what surrounds the apices of the renal pyramid, how many are there? | minor calyces; 4-13 |
| In kidney what represents the confluence of several minor calyces, how many are there? | major calyces; 2-3 |
| Concavity of the kidney and contains calyces, vessels, nerves, lymphatics, & fat | renal sinus |
| Renal fascia divides the renal fat into 2 portions | pararenal fat and perirenal fat |
| Fat outside of the renal fascia | prarenal fat |
| Fat between renal fascia and kidney | perirenal fat |
| The right kidney is slighty lower/higher than left due to ____ | lower; liver |
| Anterior relationships to right kidney | suprarenal gland superior, 2nd part of duodenum, right colic flexure, liver |
| Anterior relationships to left kidney | suprarenal gland superior, pancreas, left colic flexure, coils of jejunum, spleen, stomach |
| Posterior relationships of kidneys | respiratory diaphragm, psoas major, QL, transversus ab., subcostal, iliohypogastric, ilioinguinal nerves, 12th rib(rt kidney), 11th and 12th ribs(lt kidney) |
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