Anatomy
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| Ligaments of pelvis | Sacro-iliac joints (ant/post sacro-iliac ligs); pubic symphysis; Sacrotuberous lig & sacrospinous lig form greater/ lesser sciatic foramina
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| Pelvic cav mx’s: Lateral wall | Obturator internus; Piriformis; Both mx’sact on lower extremity; Piriformis attach to ant body of sacrum & runs out foramen
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| Pelvic cav bounded superiorly/inferiorly by: | superiorly by abd cav; inf by pelvic floor
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| Inguinal ligament attaches: | ASIS to pubic tubercle
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| Obturator mx's attach to: | obturator membrane, which is closing the obt foramen
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| Characterize pelvic ligaments | S-I joint = synovial; pubic symph = cartilaginous pad (not really ligament)
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| sacrotub lig attaches: | sacrum to ischial tuberosity
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| sacrospinous lig attaches: | sacrum to (coccyx and) to ischial spine
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| Females pelvis: | Ilium more flared; Pelvic inlet circular; Wider sub-pubic angle
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| Males pelvis: | Ilium more upright; Heart shaped pelvic inlet; acute sub-pubic angle
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| False pelvis (=inferior abdomen) vs. true pelvis | False pelvis (=inferior abdomen): btw iliac blades; True: inferior; sep’d by the pelvic inlet (pelvic brim)
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| Weakness or damage to pelvic floor mx (& urethral & anal sphincters) can result in: | Urinary or fecal incontinence (multifactorial symptom)
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| Female external genitalia (vulva) | Mons pubis; Labia majora; Labia minora; Prepuce of clitoris; Glans of clitoris
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| Levator ani mx attachments: | Ileococcygeus & pubococcygeus end in coccygeus; puborectalis forms sling around anal aperture and attach antly to (pubic bone?)
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| Perineal membrane | Inf to pelvic diaphragm; attachment for external genitalia; openings for urethra and vagina
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| Position of uterus | Body of uterus is anteverted over bladder; laterally continues & forms fallopian tubes
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| Stretching of broad ligaments during childbirth can contribute to: | Prolapse of uterus through the vaginal canal
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| Contents of Spermatic cord: | Testicular a.; Pampiniform plexus of veins; Ductus deferens; Lymphatics and nerves to testes
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| Hydrocele= | Abnormal accumulation of fluid in the tunica vaginalis; a few poss causes (e.g., incomplete devt of parietal (scarpus fascia?)
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| Erectile tissues: male vs female | Erectile tissues covered by ischiocavernosus (corpora cavernosa), and bulbospongiosus (bulbs of vestibule/ corpus spongiosum) muscles
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| Erectile Tissues- Arterial Supply | Dorsal a. penis/clitoris; deep a. of p/cl; a. of bulb of penis (vestibular bulb)
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| NS ctrl: erection/ejaculation/orgasm | Erection = parasymp ctrl (venous supply shut off); ejaculation/orgasm = symp ctrl
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| Path of sperm flow | Testes -> Epididymis -> Ductus deferens -> Ampulla of ductus deferens -> (Seminal vesicle joins at) -> Ejaculatory ducts -> (Prostate joins at) -> Prostatic urethra -> Penile urethra
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| mx of pelvic cav: Lateral wall | Obturator internus; Piriformis
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| mx of pelvic cav: Floor (pelvic diaphragm) | Levator ani: 3 parts; Coccygeus
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| Mx forms most of pelvic diaphragm: | Levator ani
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| Levator ani mx form 3 parts: | ileococcygeus; pubococcygeus; puborectalis
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| Perineal membrane attaches to: | post surface of pubic arch
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| perineal mem attach to: | post surface of pubic arch (but not attach to ...)
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| Perineal body = | post attachment of perineal mem; what is cut during episiotomy
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| Urogenital triangle | Roots of external genitalia; Openings for urogenital system
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| Urogenital triangle formed by: | pubic symph & ischial tuberosities
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| Anal triangle includes: | Anal aperture
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| Anal triangle formed by: | coccyx & ischial tuberosities
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| Parietal peritoneum drapes over: | pelvic viscera
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| Sacral Plexus: level/type: | L4 - S4 spinal levels; All are ventral rami
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| Sacral Plexus Innervates: | Pelvic floor/wall muscles
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| Sacral Plexus Major branches: | Sciatic n. (Leg, foot); Gluteal nerves; Pudendal n. (Perineum)
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| Pelvic splanchnic nerves | Parasymp to hindgut, bladder, genitalia; S2-S4 spinal levels
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| Clin sig of pudendal n. | site of nerve block during childbirth
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| Lymph drainage: Pelvic cavity | Internal/ external iliac nodes -> lateral aortic nodes
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| Lymph drainage: Ovaries/ Testes: | Drain directly to lateral aortic nodes
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| Female external genitalia collectively referred to as: | the vulva
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| Female Erectile Tissues | Corpora cavernosa; Bulbs of the vestibule; Glans clitoris
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| Corpora cavernosa | Crura of clitoris = erectile tissue (pair)
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| Crura of clitoris attach: | along pubic arch
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| Bulbs of vestibule: | Anchored to perineal membrane; surround vaginal opening, either side
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| Female repro organs | Vagina, Cervix; Uterus; Uterine tubes; Ovaries
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| Round ligament of uterus = | remnant of gubernaculum in female
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| Vagina: Anterior wall contacts: | bladder
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| Vagina: Posterior wall contacts: | rectum
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| Vagina: Blood Supply: | Vaginal a./v.
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| Vagina: Innervation: | Upper 2/3 visceral sensory;
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| Cervix: parts | External os; Cervical canal; Internal os
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| Vagina: surgical approach to abdomen via: | posterior fornix
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| Cervix = actually part of the: | uterus
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| Uterus: parts | Body; Fundus
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| 3 layers of tissue in uterine fundus | Perimetrium; Myometrium; Endometrium
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| Uterine Blood Supply: | Uterine a./v.
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| Ovarian blood supply | ovarian a.; ovarian v. (R drains to IVC; L to L renal v.)
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| Uterine tubes (aka fallopian tubes): parts | Isthmus; Ampulla; Infundibulum; Fimbrae
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| Most fertilizations occur in: | ampulla of uterine tube
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| Some ectopic PGs can result in: | ruptured uterine tube (v dangerous)
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| Sites of poss ectopic PG | see S22
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| Broad Ligament = | Peritoneum draped over uterus, uterine tube, and ovary
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| Ovaries: size | approx 3cm long
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| Ovaries: location | On lateral wall of true pelvis; Suspended by broad ligament
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| Ovarian ligament: | Remnant of gubernaculum; Attaches ovary to uterus
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| Penis: parts | shaft; glans
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| Scrotum: function | Houses spermatic cord and testes
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| R/L compartments of scrotum divided by: | median septum
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| Spermatic cord: layers from: | anterior abdominal wall
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| Testes = | 4 cm long; Covered by tunica albuginea
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| Tunica albuginea fn: | Keeps seminiferous tubules together
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| Testes partly covered by: | tunica vaginalis
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| Tunica vaginalis = | remnant of processus vaginalis
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| Testes contain: | seminiferous tubules
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| Testes: surrounded by: | surrounded (on one side) by the epididymis
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| Testes: Connected to urethra via: | ductus (vas) deferens
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| 2 spongy erectile tissues of penis: | Corpus spongiosum (1); Corpora cavernosa (2)
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| Corpus spongiosum is (ventral/dorsal) & contains: | ventral; urethra
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| Corpora cavernosa is (ventral/dorsal)? | dorsal
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| Penis: visible | Half; root (not visible) = in perineal region
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| Penis covered by: | loose skin (prepuce) that covers the glans
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| Attached part of corpus cavernosum = | Crus (of penis/clitoris)
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| Prostate | 25-30% semen vol; at base of bladder, surrounding urethra
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| Seminal vesicles | 60% semen volume; joins ductus deferens at ejaculatory ducts
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