93 terms

Anatomy Lec-Pelvis

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List the Arteries of the mammary Gland off the Subclavian?
Axillary, Lateral Thoracic, Lateral Mammary, Internal Thoracic, Medial Mammary
What Lymph Nodes drain the mammary glands?
Axillary, Supraclavicular, infraclavicular, Parasternal, Internal Mammary
What are the Pelvic Spaces?
Retropubic - Between the pubic bone and the bladder
Rectorcectal Pouch - between the rectum, sacrum and coccyx,
Retrouterin Pouch (Pouch of Douglas) - Vesico-Uterine (females)
Retrovesicular pouch(males)
The 3 male urethras and what they pass through?
Prostatic Urethra - Passes through the prostate gland
Membranous Urethra - Passes through the pelvic and urogenital diaphragms
Penile Urethra - Passes through the external urethral orifice at the tip of glands
What is the path of sperm?
Testes - Collecting Ducts - Epididymis - Ductus Deferens(Sperm Duct) - Seminal Vesicles - Prostate Gland - Cowpers Duct - Urethra - Penis
Function of Testes
Sperm Production
Function of Collecting Ducts
Transport and storage
Function of Epidymis
Transport, maturation and ejaculation
Function of Ductus Deferens
Transport and ejaculation
Function of Seminal Vesicles
Secrete thick liquid to transport sperm
Function of Prostate Gland
Secrete thin alkaline solution to neutralize urine and female system
Function of Cowper's Gland
Secretions may lubricate, Flush out urine or form a gelatinous plug
Function of Urethra
Passage for the urine and sperm
Function of Penis
Copulation
What are the Anterior branches of the internal iliac?
Umblical Artery Inferior Gluteal Artery
Obturator Artery Middle Rectal Artery
Uterine Artery Inferno-Vesicular Artery
Vaginal Artery Internal Pudendal Artery
What are the Posterior branches of the internal iliac?
Superior Gluteal Artery
Iliolumbar Artery
Lateral Sacral Arteries
Adenocarcinoma
this type of cancer begins in the glandular tissue of body, in the breast this cancer originates in either the lobules (lobular Carcinoma) or the ducts (Ductal Carcinoma)
Ductal Carcinoma in Situ (DCIS)
found in milk ducts and has not spread to the walls and is almost 100% curable if detected early by mammogram. if not treated can become invasive
Invasive Ductal Carcinoma (IDC)
80% of breast cancers fall into this category. Can metastasize if left through lymphatics
Lobular Carcinoma in Situ (LCIS)
considered neoplasm found in lobules in breast.
more of a precancer but if diagnosed with this you have more of a chance of progression
Invasive Lobular carcinoma (ILC)
10-15% of breast cancers. originates in glands of breast and spread into fatty tissue with potential to metasasize
Simple Masectomy
Breast is removed to the retromammary space
Radical Masectomy
Breast, pectorals, fat and lymph nodes are removed
Lumpectomy
Current popular treatment, tumor and surrounding tissue and radiation
Lymph Drainage of breast
Axillary
Parasternal Nodes
Supraclavicular
infraclavicular
Internal Mammary
Gynecoid
normal female pelvis
Androidpelis
more common in men may cause problems in women
Lesser Pelvis
The narrow bony canal in which the fetus passes
Sacroiliac Joints
links the axial skeleton and the inferior appendicular skeleton
What passes through the Greater Sciatic Foramen?
Pudendal Nerve
Internal Pudendal Vessels
Gluteal Vessels and Nerves
Piriformis muscle
Cutaneous nerves
What passes through the Lesser Sciatic Foramen?
Pudendal Vessels and Nerve to enter the perineum
What is the Pubic Symphysis?
Joins the right and left Pubic bones at the median plane.
In males what does the Pubic Symphysis attach to?
The Suspensory Ligamet of the penis
What hormone causes the pelvic ligaments to relax during the third trimester of pregnancy?
Relaxin
What type of pelvic fracture occurs during a car accident?
Anterior-posterior compression of the pelvis results in a fracture of the public rami
Lateral Compression
This results in fraction of the acetabula and ilia
Pelvic Ring Fracture
almost always multiple fractures or a fracture with a joint dislocation
What pelvic structures are injured during pelvic injuries?
Pubic Rami
Acetabulum
Sacroiliac Joints
Soft tissue - nerves, vessels, and urethra and bladder
Aside from the vessels and nerves supplying the region in the pelvis what systems are in the region?
Digestive - Sigmoid colon and rectum
Urinary - Ureters Bladder and Urethra
Reproductive - Male = Ductus deferens, Seminal vesicles and prostate gland... Female = Ovaries, Uterus, and Uterine Tubes, Vagina.
What are the structures filing the the true pelvis are considered?
Extraperitoneal
What is the anterior Pelvic Wall consist of?
Pubic Rami and Pubic Symphysis
What is the posterior wall of the pelvic cavity formed by?
Sacrum and coccyx
What is the pelvic floor?
Funnel shaped pelvis diaphragm
What muscles does the pelvic floor consist of?
Coccygeus Muscles
Levator Ani (iliococcygeus, pubococcygeus, puborectalis)
Retropubic Space
Between the pubic bone and the bladder
Rectorectal Pouch
between the rectum, sacrum and coccyx
Retrouterine Pouch aka "pouch of douglas"
Vesico-Uterine in females
What does the diamond shaped perineum contain?
Anal (posterior) triangle contains the anus and posterior part of the pelvic diaphragm

Urogenital (anterior) Triangle
What is the relationship between the large intestine and the pelvis and perineum?
Large Intestine enters the pelvis as the sigmoid colon mid way down the sacrum it loses its mesentery and becomes the Rectum
attach the body of the penis to the line alba and the pubic symphysis?
Fundiform and Suspensory ligaments
Foreskin or prepuce
double layer of skin which covers the glans and separates the glans from the body at the neck of the penis
What are the sensory fibers of the penis?
Ilio-inguinal nerves and pudendal nerves
Parasympathetic causes what in the penis?
Arteries in the tissues dilate causing an Erection
Sympathetic cause what in the penis?
Arteries of the tissues constrict causing Ejaculation
What does the sympathetic L1-L2 cause?
closure of the vesical sphincter at the neck of the bladder
What does the parasympathetic S2-S4 cause?
contraction of the urethral muscle
What do the pudendal nerves (S2-S4) cause in the penis?
contraction of the bulbospongious muscle
Hypospadius
external urethral orifice is on the ventral surface of glands penis
Phimosis
when the prepuce of the penis fits tightly around the glands and can not be retracted
Paraphimosis
Smegma which are cheesy secretions of the prepuce gland accumulate in the prepubital sac causes irritation and swelling.... blood flow and tissue fluid are interfered with
What is done to correct a Paraphimosis?
A circumcision will be performed
Ovary
produces ova and steroid hormones
Where does the Fertilization takes place?
Fallopian Tube
What are 3 layers of the Uterus?
1) Serous outing Coat
2) Very Thick Muscular Layer
3) Inner Mucosa (Endometrium)
What is the position of the uterus?
Anteverted, retroverted and mid position
Ligaments in vagina
thickening and folds of the peritoneum covering the superior aspect of the females internal genitalia are called
What is the broad ligament?
Double layered lateral continuation of the peritoneum covering the uterus
What structures can you find in the Broad ligament?
the fallopian tubes and the ovary
Ovarian Ligament
Secondary mesentery for the ovary and the uterus
Suspensory Ligament
thickening running from the ovary toward the pelvic brim and containing the ovarian vessels
Round Ligament
Fibrous structure which runs in the broad ligament from the uterus to and through the iguinal canal and the ends up in the labium majora
Mons Pubis
Anterior to the pubic symphysis and eminence underlying the fatty connective tissue
Vaginal Orifice
Surrounded by the external genitalia
Labia Majora
Runs Posteriorly to the mons on each side and is elongated cutaneous fold
Labor Minora
Medial to each of the labia majora is a thin fold of cutaneous tissue
What nerves innervate the pelvis?
The sacral and coccygeal nerves
What is the nervous system for the pelvis?
Pelvic Autonomic Nervous System
Obturator Nerve
Arises from the lumbar plexus L2-L4 through the obturator canal supplying the thigh muscles. NO PELVIC STRUCTURES
What are the 2 main nerves of the sacral plexus?
Pudendal and Sciatic
Coccygeal Plexus
Supply a small area of skin in the coccygeal region. It lies on the pelvic surface of the coccygeus muscle
Four main arteries that enter the lesser pelvis?
Internal Iliac (paired)
Ovarian (Paired)
Median Sacral (unpaired)
Superior Rectal Arteries (unpaired)
Umblical Artery
carries deoxygenated blood to the placenta from the fetus
Inferior Gluteal Artery
Exits through the greater sciatic foramen to reach the gluteal region. Pelvic branches supply the bone and the muscle of the pelvic wall
Middle Rectal Artery
Supplies inferior part of the rectum, anastamoses with
the superior and inferior rectal arteries. Also supplies the seminal vesicles prostate and vagina
Uterine Artery
Supplies the vagina, uterus, and fallopian tubes
Inferior Vesicular Artery
distributed to the fundus of the bladder. In males, it also supplies the prostate and the seminal vesicles.
Uterine Artery
Supplies the vagina, uterus and fallopian tubes
What does the Internal Pudendal Artery give rise to?
Inferior Rectal Artery
Dorsal Artery of Penis
Posterior Scrotal Artery
Superior Gluteal Artery
Supplies the gluteal muscles in the buttocks
Iliolumbar Artery
iliac branch supplies the iliacus and ilium and lumbar branch supplies the psoas major and quadratus lumborum
Lateral Sacral Artery
Supply the skin overlying the sacrum and the erector spinous muscles
Ovarian Artery
descends to supply the ovary and anastomose with the uterine artery
Hemorrhoids
Any abnormal increase in pressure in the valveless portal system may cause enlargement of the superior rectal veins resulting in an increase in bloodflow to the internalrectal vessels