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Anatomy of Pelvis

Soft Tissue Anatomy of the Pelvis-WVSOM Class of 2012

what is the primary source of digestive enzymes to the small intestine? pancreas
what lies directly posterior to the neck of the pancreas? superior mesenteric vessels
main pancreatic duct joins common bile duct at what junction? hepatopancreatic ampulla
the opening of the hepatopancreatic ampulla into the duodenum is called what? major duodenal papilla
bare area of the liver contacts what organ? diaphragm
what 2 things sit within the right saggital fossa of the liver? IVC and gallbladder
what 2 things sit within the left saggital fissure of the liver? falciform and round ligaments
what is contained in the porta hepatis? portal vein, hepatic artery proper, and right and left hepatic ducts
what are the 5 impressions on the liver? colic, duodenal, pyloric, renal, and gastric
what are the 4 impressions on the spleen? gastric, pancreatic, renal, and colic
splenic vessels are held within what two ligaments? splenorenal (lienorenal) and gastrosplenic
right renal artery passes deep to what structure? IVC
each renal artery gives off one or more vessel to the suprarenal glands; what is this vessel? inferior suprarenal artery
middle suprarenal arteries come off of what vessel? abdominal aorta
what arteries are given off inferior to the renal arteries? gonadal arteries
what arteries supply the thoracic diaphragm? what arteries do these anastamose with? inferior phrenic arteries; pericardiophrenic and musculophrenic arteries
what arteries will branch off of the inferior phrenic arteries? superior suprarenal arteries
what arteries supply the posterior wall of the pelvis? what is important about the first one on the left? lumbar arteries; gives origin to the medullary branches
what autonomic structure is found over the iliac arteries? what fibers come off of this structure? what structures does this connect to? superior hypogastric plexus; sympathetic fibers; mesenteric and intermesenteric plexi
where do parasympathetic fibers come from in the pelvis? pelvic splanchnic nerves
inferior epigastric artery supplies what structure? rectus sheath
deep circumflex iliac artery supplies what muscle? iliacus
what 2 vessels supply the skin around the lateral and medial ends of the inguinal ligament? superficial circumflex iliac and superficial external pudendal arteries
what is the only contribution from the peritoneal organs into the IVC? hepatic veins
which renal vein is usually shorter? the right
the left renal vein is usually covered by what artery? superior mesenteric
the gonadal vein usually goes into which renal vein? left
lumbar vein branches are usually joined together by what vein? ascending lumbar vein
the ascending lumbar vein usually joins which of 2 veins? azygos on right or hemiazygos on left
which kidney is slightly lower? right
renal fascia separates what two layers? pararenal fat (adjacent to body wall) and perirenal fat (adjacent to kidney)
what does renal fascia adhere to? connective tisuue around the renal vessels
where does the right kidney sit? 1.5 cm lower than left; at the level of the transpyloric plane
renal artery branches into what? upper, lower, and posterior branches
venous drainage to the suprarenal glands is usually through which possible veins? IVC or renal veins
ureter surgery should be performed from which direction? laterally
what is spatial relationship of renal veins, ureter, and arteries? vein is anterior; ureter is posterior; arteries are in between and superiorly
what are the 3 locations that kidney stones get hung up? junction of renal pelvis and ureter; where ureter crosses iliac vein; wall of bladder
where are glomeruli and convoluted tubules located? in the renal cortex
where are the loops of henle and collecting ducts located? in the renal medulla
what separates renal pyramids from each other? renal columns
renal calyces, pelvis, and blood vessels are located in what space? renal sinus
what is the intermediate mesoderm called? nephrotome
3 urinary organs during development? pronephros, mesonephros, and metanephros
what structure remains from the mesonephros? mesonephric (wolffian) duct
what does the wolffian duct produce? ureteric bud
ureteric bud will grow into what structure? metanephros
all collecting structures are formed from what tissue? metanephros
do kidneys ascend or descend? ascend from differential growth of the lumbar region
which vessels usually remain from the aorta following kidney ascent? only the most superior usually
where is the subcostal nerve? what does it supply? along lateral margin of quadratus lumborum just inferior to 12th rib; muscle and skin of body wall
what is the most inferior of the thoraco-abdominal nerves? subcostal nerve
where does the quadratus lumborum attach? from 12th rib to iliac crest, then attaches to lumbar vertebrae
what is the function of the quadratus lumborum? unilateral contraction will sidebend the spine to the same side; bilateral contraction will assist in spinal flexion
iliohypogastric and ilioinguinal nerves arise from what spinal nerve? L1
ilioinguinal nerve exits from where? what does it innervate? superficial inguinal ring; skin of base of scrotum and penis
genitofemoral nerve arises from what? L1 and L2
genitofemoral nerve emerges from where? where does it ascend to? near origin of psoas major; along its anterior surface
where does the femoral branch of the genitofemoral nerve travel? the genital branch? deep to the inguinal ligament with the femoral artery; enters deep inguinal ring, through canal and superficial ring
what does the genital branch of the genitofemoral nerve supply? cremaster and dartos muscles
what is the course of the lateral cutaneous nerve of the thigh? passes deep to inguinal ligament near ASIS
what forms the lumbar plexus? what nerves does it give rise to? ventral rami or L2-L4; femoral and obturator nerves
what is the course of the femoral nerve? courses deep and lateral to psoas major muscle, visible between iliacus and psoas major
what is the course of the obturater nerve? runs deep and medial to the psoas to the obturator foramen in the pelvis
where does the sympathetic trunk terminate? mid-sacral level
what nerves come off of the sympathetic trunk, supplying all spinal nerves, including coccygeal nerves? grey rami communicantes
the central portion of the thoracic diaphragm is what? what is thie a remnant of? central tendon; septum transversum
embryologically, where does the thoracic diaphragm begin? near occiptal region of the embryo
when does the thoracic diaphragm gain its innervation from C3-C4? when it lies adjacent to the cervical somites
how are the pleuroperitoneal membranes formed? pleuroperitoneal folds grow ventrally and medially to fuse with the septum transversum
the central portion of the diaphragm is innervated by what nerve? phrenic nerve
3 openings of the diaphragm are? vena caval foramen, esophageal hiatus, and aortic hiatus
spatial relationship of the 3 openings of the diaphragm? vena caval foramen is anterior; esophageal hiatus is to the left of vena caval foramen; aortic hiatus is posterior
vena caval foramen is at what level? TV8
esophageal hiatus is what level? TV10
what passes through the esophageal hiatus? esophagus and anterior/posterior vagal trunks
level of aortic hiatus? TV10
GERD can eventually lead to what malady? esophageal cancer
esopohageal hiatus is a complex arrangement of muscle from what two structures? right and left crura
thoracic diaphragm takes what origin? lumbar vertebra
where do the right and left crus attach? right: LV1-LV3, left LV1-LV2
the crura are united across the midline through what structure? median arcuate ligament
what nerves pierce the crura to gain access to the abdomen? thoracic splanchnic nerves
what anchors the thoracic diaphragm to the iliac crests? quadratus lumborum
thoracic diaphragm is attached to the body wall by what two structures? medial and lateral arcuate ligaments
where does the medial arcuate ligament pass? what muscle runs deep to it? from vertebral bodies to transverse process of TV12; psoas major muscle
what nerve passes deep to the medial arcuate ligament? sympathetic trunk
where does the lateral arcuate ligament pass? what muscle runs deep to it from transverse process of TV12 to the 12th rib; quadratus lumborum
left and right crura extend from what to what? posterior central tendon to the anterior spine
what are the 3 areas of connective tissue reinforcement of the posterior fibers of the central tendon? lateral arcuate, medial arcuate, and median arcuate ligaments
what prevents constriction of the IVC, aorta, and esophagus? IVC: caval foramen surrounded by noncontractile central tendon; aorta is locted between two crura; esophagus is a space in the left crus
how does the diaphragm contribute to venous and lymphatic circulation? by creating thoracic and abdominal pressure gradients
spatial relationship of the bladder in the male? in the female? between rectum and pubis; between uterus and pubis
superior surface of bladder is covered by what? peritoneum
body and neck of bladder is covered by what? pelvic fascia
as bladder fills, what happens? it extends cranially along abdominal wall
what are some visceral causes of back pain? kidney or ureteral disease; prostate or bladder conditions, metastatic cancer of the spine, aortic aneurysm, or cauda equina syndrome
apex of bladder meets what area? anterior abdominal wall
u-shaped space created by infolding of the peritoneum between pubis and bladder? retropubic space
in the 4th week of development, the cloaca is divided into what portions? what divides the cloaca? urogenital and anal; urorectal septum
urogenital portion of the cloaca will develop what? what will this give rise to? urogenital sinus; major portions of the urinary system outside of the kidney
superior and largest portion of the urogenital sinus will become what? bladder
the bladder is originally continuous with what structure? allantois
the connection between the bladder and allantois is converted into a fibrous cord called the what? urachus
in the male, inferiorly, the pelvic part of the urogenital sinus will differentiate into what two things? prostatic and membranous urethra
the prostatic urethra will join with the ejaculatory ducts developing from the mesonephros to create the what? urinary/genital continuum
the prostatic portion of the urinary/genital continuum will later form outgrowths into the surrounding mesenchyme that will become what? prostrate gland
in the female, the cranial portion of the urethra will give rise to what things? urethral and paraurethral glands
the distended bladder and uterus can be approached surgically via what route? through the retropubic space
neck of bladder secured how? pubovesical ligaments in females, puboprostatic ligaments in males
what defines the trigone of the posterior aspect of the bladder? ostia of ureters and urethra
what muscle in the bladder maintains urinary continence and prevents retrograde ejaculation? internal urethral sphincter muscle
layers of internal bladder? mucous membrane, submucosa, smooth muscle
smooth muscle of the bladder? detrusor (urinae) muscle
umbilical artery continues along what portion of abdominal wall as the medial umbilical fold? anterior
what portion of the uterus is 2/3? body
dome-like portion of uterus at superior portion of body? fundus
the fundus and 2/3 of body project into peritoneal cavity and are covered by what? visceral peritoneum
1/3 of the body and cervix inferior to the peritoneum are covered by what? pelvic fascia
space between anterior and superior surface of the uterus is what? vesicouterine pouch
what is the space between the posterior surface of the uterus and the rectum? rectouterine pouch
lateral portions of the peritoneum from the body of the uterus? broad ligament
gonads in both sexes appear initially as what? gonadal ridge
where is the gonadal ridge? medial to the mesonephros
what exactly is the gonadal ridge? coelomic epithelium and condensation of mesenchyme
germ cells influence development of what structures? primitive sex cords and surface epithelium that constitutes the gonad
in females, cells of primitive sex cords disperse into clusters in the portion of the gonad that will become what? what will this then become? medulla; ovarian medulla
surface epithelium of the gonad produces cortical cords which do what? penetrate the medulla and surround germ cells that migrated there
germ cells near the medulla become what? surrounding epithelium becomes what? primitive oocytes; follicular cells
in males, what happens to the primitive sex cords? proliferate and penetrate the medulla to become testis cords
testis cords do what? break up distally to become the rete testis and seminiferous tubules
connection between the sex cords and surface epithelium is lost, and what layer develops? tunica albuginea
seminiferous tubules connect to what derivative? wolffian duct derivative, the efferent ductules
the ovary migrates in which direction? inferiorly
on which side does the ovarian vein drain into the renal vein? left side
what is the peritoneal fold associated with the ovarian artery and vein? suspensory ligament of ovary
ligament between ovary and uterus is what? ovarian ligament
what is the ligament that is a continuation of the ovarian ligament that passes from the uterus to the internal inguinal ring? round ligament of the uterus
a complete round ligament in the female terminates where? labia majora
the base of the broad ligament passes posteriorly and laterally to the uterus to form what? rectouterine folds (arc-shaped)
attachment of rectouterine folds to sacrum is called what? uterosacral ligament
a second development of pelvic fascia that extends from the lateal sacral wall to vagina and cervis uteri? lateral cervical (cardinal) ligament
what is the function of the uterosacral ligament and the lateral cervical ligament? maintains uterus in anteverted position; prevent prolapse
what are the 3 named parts of the broad ligament? mesometrium, mesosalpinx, and mesovarium
what is the part of the broad ligament that extends laterally from the uterus to the pararectal spaces? mesometrium
these spaces lie alongside the rectum and communicate with one another through the rectouterine pouch: pararectal spaces
the mesentery that suspends the oviduct is what part of the broad ligament? mesosalpinx
mesentery that suspends the ovary from the posterior leaf of the broad ligament is what? mesovarium
funnel of oviduct is what? infundibulum
abdominal ostium presents finger-like projections with roughened appearance on the ovary that are called what? fimbriae
infandibulum leads into what part of oviduct? ampulla
how long is the ampulla of the oviduct? 2/3 of the duct
what narrowed part of the oviduct joins the uterine horn? isthmus
what passes through the uterine wall to enter the uterine cavity? uterine part of the oviduct
what is the only opening into the peritoneal cavity from the external environment in the uterus? ostium of the oviduct
what are the two sex ducts that develop in both sexes? mesonephric duct and paramesonephric duct
what is the paramesonephric duct derived from? coelomic mesnchyme lateral to the mesonephric duct
the paramesonephric duct opens proximally into what cavity? coelomic
the paramesonephric duct meets its partner where? then what? in the midline; projects into the urogenital sinus at the paramesonephric tubercle
the mesonephric ducts open seperately on either side of this tubercle: paramesonephric tubercle
in the female, the uterine tubes will develop from what? cranial portion of the paramesonephric ducts
conjoined caudal parts of the uterine tubes will become what? then what does this become? uterine canal; body and cervix of the uterus
in the male, which ducts persist? what do they form? mesonephric ducts: efferent ductules, epididymis, ductus deferens, seminal vesicles, and ejaculatory duct
what is the constricted portion of the uterus inferior to the body and about 1 cm long? isthmus of uterus
portion of uterus between isthmus and vagina? cervix
cervix communicates with the vagina through what? uterine ostium (external os)
uterine ostium projects into the vagina, forming what? anterior and posterior cervical lips
cavity between the uterine ostium and the vaginal wall is what? fornix (anterior, posterior, and lateral)
which part of the vagina is most closely related to the rectouterine pouch? posterior fornix
what can the posterior fornix be used for surgically? to drain ascites or visualize abdominal organs
what is the course of the uterine artery? passes medially within the mesometrium to the uterus; passes superiorly along lateral wall of uterus to anastomose with ovarian artery at the ovary
in its course to the uterus, the uterin artery passes where in relation to the ureter? anterior to the ureter, which is closely related to the lateal fornix of the vagina
parietal branches of the internal iliac artery are found where? along the posterior pelvic wall; usually most proximal branches
ilio-lumbar artery course? passes superiorly to supply psoas major muscle through lumbar branch, supplies iliacus through iliac branch
course of lateral sacral arteries? run medially to enter ventral sacral foramina to supply sacral nerve roots and spinal meninges; then they pass through dorsal sacral foramina to supply musculature and skin near posterior sacrum
course of gluteal arteries? pass between roots of sacral plexus to gain access to the greater sciatic foramen
what is the course of the superior gluteal artery? what does it supply? passes through greater sciatic notch superior to piriformis muscle; gluteus medius, minimus, and tensor fascia lata
what is the course of the inferior gluteal artery? what does it supply? passes through greater sciatic notch inferior to piriformis muscle; gluteus maximus and cranial portion of hamstrings
what is the course of the internal pudendal artery? what does it supply? passes through greater sciatic foramen, around the sacrospinous ligament, entering the lesser sciatic foramen; musculature of pelvic diaphragm and perineum; terminal part of digestive tract; cavernous tissues of clitoris or penis
umbilical artery continues as what ligament? umbilical ligament
in addition to the rectum, what does the middle rectal artery supply in males and females? prostate and seminal vesicles; vagina
the uterine artery anastomoses with what artery? ovarian artery
what artery in the female corresponds to the inferior vesicle artery in the male? vaginal artery
in addition to the inferior bladder, what else does the inferior vesicle artery in the male supply? prostate and seminal vesicles
the lumbosacral trunk comes from what nerves? what does it join inferiorly? L4-L5; S1
what nerves comprise the sacral plexus? L4-S3
what does the sacral plexus become? sciatic nerve
what nerves form the superior gluteal nerve? where is it located? L4-S1; superior to piriformis
what nerves form the inferior gluteal nerve? where is it located? L5-S2; inferior to piriformis
sciatic, gluteal, and pudendal nerve all exit pelvis how? through greater sciatic foramen
parasympathetics from seacral plexus supply what two general regions? what kind of nerves are these? external genitalia and bladder; pelvic splanchnic
pelvic splanchnic nerves come from which nerves? what kind of nerves do they come from? ventral rami of S2-S4; parasympathetic preganglionic fibers
spatial relationship of the prostate? between neck of bladder and superior fascia of urogenital diaphragm
nerve plexus around the prostate? prostatic plexus
the prostatic plexus contains nerves from where? what kind? parasympathetics from pelvic splanchnic nerves
veins to prostate form what structure? prostatic venous plexus
3 parts of urethra? prostatic runs through gland; membranous runs in deep perineal space; penile/spongy is inferior to perineal membrane
trans-urethral resection of the prostate destroys what important structure? ejaculatory duct
where does the ductus deferens run? passes through the deep inguinal ring to enter the pelvis
terminal part of ductus deferens is enlarge to form what structure? ampulla of the ductus deferens
what forms the ejaculatory duct? ampulla of the ductus deferens and the duct of the seminal vesicle
ejaculatory ducts empty into the prostatic urethra at what point? prostatic utricle
blood supply of structures inferior to the anal triangle and perineal membrane is provided by what artery? internal pudendal artery
what does the pudendal nerve innervate? muscles in perineum, sensory nerves to skin and external genitalia
pudendal nerve internal pudendal artery and vein exit from pelvis where? greater sciatic foramen
how do the pudendal nerve and vessels run? pass lateral to sacrospinous ligament and through the lesser sciatic foramen to enter the ischiorectal fossa
what is the fat filled space lying inferior to the pelvic diaphragm on either side of the anus? ischiorectal fossa
what is the thickening of the deep fascia of the internal oburator muscle? what vessels run through here? pudendal canal; pudendal nerve and internal pudendal vessels
what is the branch from the pudendal nerve, artery, and vein starting at the pudendal canal? inferior rectal nerve, artery, and vein
what do the inferior rectal nerve, artery and vein supply? external anal sphincter muscle, anal canal, and skin around the anus
collateral circulation occurs between which two veins of the internal iliac and inferior mesenteric veins? which is portal and caval? middle rectal and superior rectal vein; middle and inferior are caval, superior is portal
most superior boundary of the ischiorectal fossa is the origin of what muscle? levator ani muscle
levator ani originates from what? pubis and arcus tendineus
what is the arcus tendineus? a thickened development of the obturator internus fascia passing between the iliopubic ramus and ischial spine
course of levator ani muscle? runs from pelvic wall to anal canal
shape of ischiorectal fossa? what are the borders? triangular; apex is arcus tendineus; lateral wall is obturator internus muscle; medial wall is levator ani; base is skin of perineum
left and right ischiorectal fossae communicate posteriorly through what space? retrorectal space
what separates the ischiorectal fossae? anal canal and elements of the urogenital system anteriorly
what is the extension of the ishirectal fossa that lies between the pelvic diaphragm and urogenital diaphragm? anterior recess
what does the perineal nerve supply? musculature of the superficial perineal pouch (ischiocavernosus m., bulbospongiosus m., and superficial transverse perineus m.; deep transverse perineus and sphincter urethrae m.
what is the course of the dorsal nerve of the penis? female dorsal nerve of clitoris? goes through anterior recess of ischiorectal fossa and pierces the sphincteric urethre muscle and perineal membrane to emerge on dorsal surface of the penis; same path
what is the course of the posterior scrotal nerves? female posterior labial nerves? emerge from termination of pudendal canal and cross posterior edge of deep perineal pouch to skin of scrotum; same path
internal pudendal artey emerges from the pudendal canal and gives off what branches? what do they supply? transverse perineal artery and posterior scrotal/labial artery; perineal body and musculature; skin of scrotum/labia
what does the deep artery of the penis/clitoris supply? via what route? cavernous tissue of corpus cavernosum penis/clitoris; enters crus of penis/clitoris
dorsal artery of the penis/clitoris follows what route? follows dorsal nerve of penis/clitoris to supply corpus cavernosum of penis/clitoris
what artery supplies blood to corpus spongiosum in male? vestibular bulb in female? artery to the urethral bulb; artery to the vestibular bulb
what comprises the pelvic diaphragm? coccygeus and levator ani muscle and their fascia
spatial relationship of the coccygeus muscle? more posterior, lies on superior surface of the sacrospinous ligament
what are attachments of coccygeus muscle? ventrolateral surface of sacrum and coccyx, and ischial spine
levator ani is subdivided into what 3 muscles? iliococcygeus, pubococcygeus, and puborectalis muscles
spatial relationship of iliococcygeus muscle? most posterior of levator ani; originates from arcus tendineus and inserts on anococcygeal ligament
where does the anococcygeal ligament pass? between anus and coccyx
pubococcygeus muscle origin and attachment? originates from iliopubic ramus and inserts on anococcygeal ligament
describe the puborectalis muscle: u-shaped sling passing posteriorly from pubis, around anal canal, where it intermingles with external anal sphincter muscle, to the opposite pubis
tension in what muscle is essential for fecal continence? puborectalis muscle
in the male, some fibers of the puborectalis pass between the prostate gland and anus to form what muscle? levator prostatae muscle
in female, fibers from puborectalis pass between vagina and uterus to form what muscle? pubovaginalis muscle
two levator ani muscles are fused at midline posteriorly, but are separated anteriorly to allow passage of urethra or vagina. what separates them? urogenital hiatus
junction between sigmoid colon and rectum? what indicates this junction? rectosigmoid junction; taenia coli enlarge to create continuous outer layer
upper end of rectum is at what level? SV2
which portions of rectum lack peritoneum? inferior 1/3
what are the folds in the lumen of the rectum? what is the spatial relationship? transverse rectal folds; upper from right side; middle from left side; larger lower at level of bladder from anterior side
where does the rectum terminate? anorectal flexure (anteior to coccyx)
origination and termination of anal canal? pelvic diaphragm and anus
longitudinal elevations on surface of anal canal? what is in them? depressions? anal columns; terminal branches of the superior rectal arteries and veins; anal sinuses
terminal branches of the superior rectal arteries and veins connect with what? somatic inferior rectal vessels
what demarcates the proximal end of the anal columns? anorectal line
distal ends of anal columns have what folds? anal valves
line marked by anal valves? significance? pectinate line; columnar to stratified epithelium, visceral to somatic nerve (pelvic plexus to pudendal nerve)
3 parts of external anal sphincter? deep, superficial, subcutaneous
deep part of external anal sphincter info? encircles anal canal, fuses with puborectalis m.
superficial part of external anal sphincter info? oval, attaches to anococcygeal ligament posteriorly and perineal body
perineal body is located where? what does it connect? central point of perineum; bulbospongiousus m., external anal sphincter, superficial and deep transverse perineal mm., muscle slips from levator ani and rectum
what contains the structures lying between the perineal membrane and superficial fascia of the perineum? superficial perineal pouch
superficial fascia of penis contains what? superficial dorsal vein of the penis
superficial fascia of penis is continuous at inferior abdominal wall with what? suspensory ligament of the penis
what tissue completely envelops all of the functional structures of the penis? deep fascia of the penis
deep to deep fascia in dorsal midline of penis are what vessels? deep dorsal vein of the penis; dorsal arteries of the penis(2), dorsal nerves of the penis
deep fascia of penis is continuous with what layers of fascia? scarpa's and colle's fascia
how does erection happen? dorsal arteries fill with blood, engorge spongy corpora cavernosa, smooth muscle of corpora relax, outflowing veins are pressed up against tunica albuginea closing them off
what forms the shaft of the penis? left and right corpus cavernosum penis
proximally, the corpus cavernosa separate to form what? crura of the penis
what do the crura of the penis attach to? inferior aspect of the ischiopubic remus and perineal membrane
each crus of the penis are covered inferiorly by what? ischiocavernosus muscle
cavernous tissues of corpus cavernosa are enclosed by what? tunica albuginea
as crura of penis come together, the tunica albuginea forms what? septum penis
septum penis is fenestrated where? proximally
penile urethra as surrounded by what? corpus spongiosum
which tunica albuginea is more elastic, the corpus spongiosum or cavernosum? spongiosum
why is the urethra in the male subject to rupture? change in direction between the membranous and penile urethra
what happens if urethra is ruptured? extravasation of urine into superficial perineal pouch
if deep layer of fascia is intact, where does extravasated urine go? in deep perineal space between perineal membrane and deep fascial layer
if deep layer of fascia is torn, where does extravasated urine go? superficial perineal pouch, limited by colle's and scarpa's fascia
when deep layer of fascia is torn, where will extravasated urine continue on to? perineum and scrotum to lower abdominal wall
proximally, corpus spongiosum is enlarge to form what? urethral bulb
what does the urethral bulb fuse with? perineal membrane of the deep perineal space
midline urethral bulb is covered by a pair of what? bulbospongiosus muscles
where do the bulbospongiosus muscles originate and attach in the male? originate from perineal membrane and meet in midline raphe
posteriorly, the bulbospogiosus muscles blend with the superficial part of the what? at what point? external anal sphincter; perineal body
what muscles attach to the ischiopubic ramus laterally and the perineal body medially to form a triangle? superficial transverse perinei muscles
where do the superficial transverse perinei muscles lie? posteriorly in the deep perineal space
by 6th week of development, embryos of both sexes have developed a cloacal membrane subdivided into what membranes? urethral and anal membranes
in the embryo, the urethral membrane is flanked by what? urethral folds
in the embryo, the anal membrane is surrounded by what folds? anal folds
a pair of what are present on the lateral aspect of the urethral folds? genital swellings
what develops cranially to the urethral membrane and folds? genital tubercle
what elongates to form the phallus in the embryo? genital tubercle
the two urethral folds are pulled ventrally when the phallus grows; what will these form? penile urethra
what will the urethral swellings form? scrotum
in the female, the genital tubercle elongates slightly to become what? clitoris
in the female, neither the genital folds or genital swellings fuse along the midline; instead, what do they form? labia minora and majora
what are the structures of the vulva (pudendum) mons pubis, labia majora, labia minora, clitoris, vestibule, and greater vestibular glands
exit point of the urethra is called what? external urethral orifice
crura from the corpora cavernosa clitoridis attach where? come together where? attach to ischiopubic rami and perineal membrane proximally, come together anteriorly to form body of clitoris
body of clitoris terminates at what point? glans clitoris
crura of corpora cavernosa clitoridis are where spatially? on either side of the urogenital triangle
clitoris is capped by fold of tissue originating from labia minora called: prepuce of the clitoris
inferior surface of each crus of the corpora cavernosa clitoridis is covered by what muscle? ischiocavernosus muscle
corpus spongiosum in females splits to form what? vestibular bulbs
where are the vestibular bulbs? on either side of the vaginal orifice just posterior to the labia minora
what is found at the inferior ends of the vestibular bulbs? greater vestibular glands
on each side of the vestibular bulb and greater vestibular gland are covered by what muscle in the female? bulbospongiosus muscle
what is the course of the bulbospongiosus muscle in the female? they fuse with fibers of the superficial part of the external anal sphincter muscle and the superficial transverse perinei in the perineal body
an episiotomy cuts through what sections? posterior vaginal wall and perineal skin into central tendon
what muscles must be avoided from being cut in an episiotomy? external anal sphincter, puborectalis, and levator ani
fascia that bounds superficial perineal pouch is continuous with what fascia? lower abdominal wall
superficial perineal fascia has how many layers? 2: fatty and membranous
in males, which fascial layer is not present in the male perineum? camper's fascia
posteriorly, colle's fascia continues beneath the skin or the urogenital triangle and attaches where? to posterior edgs of perineal membrnae
deep perineal fascia of the shaft of the penis is also called what? buck's fascia
what does buck's fascia cover? shaft, ischiocavernous muscle, and bulbospongiosus muscle
bucks' fascia is continous with what other fascia? deep fascia of external abdominal oblique and rectus abdominis muscles
the deep perineal space allows passage of what structure in males and females? urethra in both, vagina in females
what forms the boundaries of the deep perineal space? superior- inferior fascia of pelvis; inferior-perineal membrane
what defines the deep perineal space in both sexes? space between the inferior fascia of pelvis and perineal membrane
in male, what are structures in the deep pouch? deep transverse perineus muscles; fibers of the deep transverse perinei that encircle the membranous urethra, and bulbourethral glands
deep transverse perineus muscles in male attach where? right and left ischiopubic rami and meet in the midline
fibers of the deep transverse perinei encircle what? what will this form? membranous urethra; sphincter urethrae muscle
bulbourethral ducts pass where? inferior to the glands, pierce the perineal membrane to empty into penile urethra
in female, deep perineal space consists of: sphincter urethrae muscle and deep transverse perineus muscles
how do the fibers of the sphincter urethre muscle run in females? only covers anterior surface of urethra
what reinforces the pubic symphysis superiorly? inferiorly? superior pubic ligament; arcuate pubic ligament
two pubic bones are connected over joinot surface by what fibrocartilage? interpubic disc
which is broader, anterior or posterior longitudinal ligament? anterior
what connects the spinous processes of LV5 and the sacrum? supraspinous ligament
what ligament runs from transverse processes of LV5 to adjacent iliac crest? iliolumbar ligament
what connects the posterior sacrum with the ischial tuberosity? sacrotuberous ligament
what connects the posterior sacrum with the ischial spine? sacrospinous ligament
what do the sacrotuberous and sacrospinous ligament prevent? upward rotation of the lower end of the sacrum (nunation)
the posterior sacroiliac ligament attaches wherre? posterior to sacroiliac joint between posterior ilium and 3rd and 4th segments of the sacrum
dura mater runs where? from foramen magnum of occiput to CV2; inferiorly to SV2 and coccyx
what is an important indicator of coxal shear, where one ox coxa is higher or lower than the other? sacrotuberous ligament
what is a transversly-oriented sheet of fibers that run from ala of sacrum to anterior surface of ilium? anterior sacroiliac ligament
where does the anterior sacroiliac ligament run? ala of sacrum to anterior surface of ilium
Created by: mhassan