Clinical Anatomy of the Pelvis and Perineum I (52)

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What is urinary incontinence?

Loss of bladder control

*ranging from mild leakage to uncontrollable wetting

How can prostate cancer spread to the spine?

Prostatic venous plexus to vertebral venous plexus

Which nodes first receive lymph from the prostate gland?

internal iliac nodes

What nerves are responsible for an erection? What type of nerve fibers are these nerves?

Pelvic splanchnic nerves

parasympathetic nerve fibers

What is uterine prolapse?

Uterus sags into vagina due to weakness of supporting tissues

Which structures support the uterus to prevent uterine prolapse (4)?

Transverse cervical (cardinal) ligaments

pubocervical ligaments

uterosacral ligaments

pelvic diaphragm/floor muscles

What is the major cause of uterine prolapsed?

Laxity of the pelvic floor secondary to childbirth

What is a cystocele?

Prolapse of the bladder

What is enterocele?

Prolapse of the bowel

What is a rectocele?

Prolapse of the rectum

Which dimension of the pelvic diameter is fixed?

Conjugate diameter

What is an episiotomy?

Surgical incision of the inferior-posterior vaginal wall and perineum to enlarge the vaginal orifice

What 2 structures are cut in a midline episiotomy?

Perineal body

anal sphincters

What will be affected by an epidural at L4/5? Specifically, why is it not ideal for childbirth?

Lower limbs

What will be affected by an epidural in the sacral hiatus (3)?

Entire vagina

pelvic floor

majority of perineum

What serves as the landmark for a pudendal block?

Ischial spine

What is anesthetized in a pudendal block (2)?

Lower vagina

majority of perineum

What 2 structures in the pelvis are not anesthetized in a pudendal block?

Upper vagina

cervix

Name the procedure: contrast material injected into the uterus and tubes via the cervix

hysterosalpingogram

Name the disorder: inflammation of the uterine tubes

salpingitis

How can peritonitis cause salpingitis?

Infection passes through the ostium, which is open to the peritoneal cavity

What is the name of the watershed region for the rectum and anal canal?

Pectinate line

What is the venous drainage above the pectinate line? Below?

Superior rectal vein

inferior rectal vein

What is the lymphatic drainage above the pectinate line? Below?

Inferior mesenteric nodes

superior inguinal nodes

What is the sensory nerve pathway above the pectinate line? Below?

Pelvic splanchnic nerves

pudendal nerves

Left lumbar region pain in a woman suggests possible problems in what structures (4)?

Sigmoid colon

uterine tube

ovary

ureter

appendix*

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