Gross 3- test 3

Card Set Information

Gross 3- test 3
2011-06-12 18:17:35
pelvis perineum

pelvis and perineum
Show Answers:

  1. bony pelvis
    • protects viscera
    • trasfers weight
    • withstands compression
    • provides attachement for muscles
  2. Hip bone
    • ilium, ischium, and pubis
    • held together by cartilage at the acetabulum prior to puberty
  3. ilium
    • ala- fan shape
    • iliac crest- superior rim of ala
    • ASIS/PSIS- projections off the iliac crest
    • iliac fossa- anterior concave portion of ala
    • body- "handle of fan", contributes to acetabulum
    • auricular surface- articulates with sacrum
  4. ischium
    • body- contributes to acetabulum
    • ramus- inferior margin of obturator foramen
    • ishcial tuberosity- large posterioinferior protuberance
    • ischial spine- small pointed projection
    • lesser sciatic notch- b/t ischial spine and iscial tuberosity
    • greater sciatic notch- superior to ischial spine
  5. pubis
    • superior ramus- forms part of acetabulum
    • inferior ramus- anteromedial part of obturator foramen
    • pubic crest- on anterior part of body of pubis
    • pubic tubercle- bump on lateral edge of pubic crest
    • pectin pubis - ridge lateral on superior ramus
  6. sacrum
    • fused
    • initially 5 separate vertebra
  7. coccyx
    • fused
    • initially 4 vertebra
  8. pelvic girdle
    • pubic symphysis- fibrocartilage
    • -pubic arch- inferior pubic rami and ischial rami, forms subpubic angle
    • sacroiliac joints- where hip bones articulate with sacrum
  9. pelvis in anatomical position
    • ASIS and pubic symphysis in same vertical plane
    • pelvic canal curves obliquely posterior to abdominal cavity
  10. pelvic inlet
    • superior pelvic aperature, open to abdominal cavity
    • bound by the pelvic brim: sacral promontory, ala, ilial arcuate line, superior pubic ramus and pubic symphysis
  11. pelvic outlet
    • closed by muscular pelvic diaphragm
    • bound by: pubic arch, ischial tuberosities, sacrotuberous lig, tip of coccyx
  12. greater pelvis
    • "false pelvis"
    • superior to pelvic inlet
    • inferior portion of abdominal cavity
    • contains abcominal viscera
  13. lesser pelvis
    • "true pelvis"
    • b/t pelvic inlet and outlet
    • contains pelvic viscera
  14. male pelvis vs female pelvis
    • male
    • heavier, thicker
    • narrow/deep lesser pelvis
    • subpubic andle <60

    • female
    • wider, shallower
    • round/oval pelvic inlet
    • subpubic angle >90
  15. pelvic fractures
    • anteroposterior compression= pubic rami compressiosn
    • lateral compression= acetabula and ilia fractures
    • can occur from ligaments being riped away
    • most likely cause damage to viscera
  16. sacroiliac joint
    • weight bearing b/t sacrum and ilium
    • posterior syndesmosis
    • anterior synovial joint
    • movements: gliding and rotation
  17. anterior sacroiliac lig
    anterior part of capsule
  18. interosseus sacroiliac lig
    between tuberosities, responsible for weight transfer
  19. posterior sacroiliac lig
    draws ilia inward with axial weight, locks ilia and sacrum together
  20. sacrotuberous lig
    from lateral sacrum to ishcial tuberosity
  21. sacrospinous lig
    • from lateral sacrum to ischial spine
    • limits upward movement of sacrum
  22. lumbosacral joint
    • anterior- IVD L5-S1
    • posterior- zygapophyseal joints b/t L5-S1
  23. iliolumbar lig
    L5 TP to medial surface of ilial ala
  24. sacrococcygeal joint
    • fibrocartilage disc b/t apex of sacrum and coccyx
    • strenthened by anterior and posterior sacrococcygeal ligs
  25. pubic symphysis
    • fibrocartilage disc b/t pubic bones
    • thickend by pubic ligs
    • superior pubic lig- pubic symphysis to pubic tubercles
    • inferior pubic lig- surrounds subpubic angle
  26. pelvic changes during pregnancy
    • increased sex hormones and relaxin= freer movements
    • sacroiliac jonit loosens
    • interpubic disc relaxes
    • pelvic diameter increases
  27. anterior pelvic wall
    bodies and rami of pubic bones and pubic symphysis
  28. lateral pelvic walls
    • hip bones with obturator foramen
    • - closed by obturator membrane
  29. obturator internus muscle
    • O: internal surface of obturator membrane, ilium, and ischium
    • I: greater trochanter of femur
    • N: nerve to obturator internus (L5-S2)
    • A: laterally rotates thigh, holds head of femur in place
    • passes through lesser sciatic foramen
  30. posterior pelvic wall
    sacrum, coccyx, sacroiliac joints, ligaments
  31. piriformis muscle
    • O: 2-4th sacral segments and sacrotuberous ligs
    • I: greater trochanter of femur
    • thru greater sciatic foramen
    • N: S1-2 rami
    • A: laterally rotates and adducts thigh, fold femur in place
  32. pelvic floor
    • formed by pelvic diaphragm
    • funnel shaped
    • separates pelvic cavity from perineum
  33. levator ani muscle
    • supports abdominopelvic viscera
    • N: S4 ventral rami and inferior rectal N
    • A: raise pelciv floor, compress abdominopelvic contents
    • made up of puborectalis M, pubococcygeus M, and iliococcygeus M
  34. puborectalis M
    • medial portion of levator ani M
    • u-shaped ring from R/L pubic bones to anorectal junction
    • surrounds urogenital hiatus
    • creates perineal flexure
  35. pubococcygeus M
    • intermediate part of levator ani M
    • from pubis to coccyx
  36. iliococcygeus M
    • posterolateral portion of levator ani muscle
    • from posteior part of tendinous arch to coccyx
  37. coccygeus muscle
    • from ischial spine to inferior sacrum and coccyx, on pelvic surface of sacrospinous lig
    • N: S4-5 rami
    • A: contributes to levator ani actions
  38. pelvic fascia
    • CT between parietal peritoneum and muscular pelvic wall
    • continuous wiht endoabdominal fascia
  39. parietal pelvic fascia
    • lines pelvic surface of muscles on pelvic floor and walls
    • covers obtuator internus, piriformis, coccygeus, and levator ani
  40. visceral pelvic fascia
    • adventitial layer around pelvic organs
    • accommodates for distension
    • continuous with parietal fascia were pelvic organ penetrates floor
  41. tendinous arch of pelvic fascia
    • from pubis to sacrum
    • in males: puboprostatic lig from prostate to pubis, sacrogenital lig from sacrum to prostate
    • in females: pubovesical lig from bladder to pubis, sacrogenital lig from sacrum to vagina
  42. Perineum
    • inferior to pelvic outlet
    • between mons pubis, proximal thigh, and gluteal folds
    • subdivided by transverse line thru ischial tuberosities
  43. anal triangel
    • posterior to isch tub transverse line
    • contains anus and 2 ischioanal fossa
  44. urogenital triangel
    • anterior to transverse line
    • covered by perineal membrane
    • contains genitalia
  45. perineal body
    • fibromuscular tissue at midpoint of transverse line
    • -posterior to genitalia
    • -anterior to anus
    • attaches to posterior border of perineal membrane
    • attachment point for superficial and deep transverse perineal Ms and external urethral sphincter
  46. perineal membrane
    • closes anterior opening in pelvic diaphragm
    • attachment point for erectile bodies of genetalia
    • perforated by urethra and vagina
  47. superficial and deep transverse perineal mus
    • spans posterior perineal membrane
    • N: deep perineal N
    • A: anchor perineal body, support pelvic floor
  48. external urethral sphincter
    • surrounds urethra superior to perineal membrane
    • N: dorsal N of penis/clitoris
    • A: constrict urethra
  49. penis
    male copulator organ (urine and sperm)
  50. root of penis
    • in superficial perineal pouch
    • attached to perineal membrane
    • contains crura and bulb of penis
  51. crura of penis
    • bilateral masses of erectile tissue
    • attach to ischial ramus
    • continuous with corpus cavernosa in penis
    • surrounded by ischiocavernosus M
  52. ischiocavernosus M
    • surround crura of penis
    • N: deep perineal N
    • A: contraction forces blood from crus into corpus cavernosum causing an erection
    • -also compresses deep dorsal V of penis
  53. bulb of penis
    • central mass of erectile tissue
    • inferior to perineal membrane
    • penetrated by spongy urethra
    • continuous with corpus spongiosum in penis
    • surrounded by bulbospongiosus M
  54. bulbospongiosus M
    • surrounds bulb of penis
    • N: deep perineal N
    • A: contraction moves blood from bulp into corpus spongiossu causing an erection
    • -compresses deep dorsal V of penis
    • -empties urethra
  55. body of penis
    • suspended from pubis by suspensory lig of penis
    • contains no muscles
    • contains 3 cylinders of erectile tissue
  56. corpus spongiosum
    • single column located ventrally in penis
    • surrounds spongy urethra
    • thinner tunica albuginia so urethra isnt constricted during erection
    • expends distally to form glans penis
  57. corpus cavernosus
    • two dorsal columns in penis
    • fused in midline
    • surrounded by thick tunica albuginea
    • dont extend into glans penis
  58. glans penis
    distal expansion of corpus spongiosus forming head of penis
  59. corona of glans
    expanded rim beyond corpus cavernosus
  60. neck of glans
    constriction between corona and body
  61. prepuce
    • foreskin, double layered skin covering glans
    • held to glans by frenulum of prepuce
  62. external urethral orifice
    distal opening of urethra from glans
  63. superficial penile fascia
    • thin fascia layer adjacent to skin
    • allows for mobility of skin on penis
    • contains neurovasculature
  64. deep penile fascia
    • surrounds corpus cavernosum and spongiosum
    • contains deep dorsal neurovasculature
  65. suspensory lig of penis
    • pubic symphysis to root of penis
    • fuses with deep penile fascia
    • anchor erectile bodies
  66. arterial supply to penis
    • internal pudendal A- to penile tissue
    • - dorsal A of penis- b/t deep penile fascia and tunica albuginea, supplies fascial CT and penile skin
    • - deep A of penis- thru center of prpus cavernosus, causes erection
    • -A of bulb- supplies bulb, corpus spongiosus, and spongy urethra
    • external pudendal A- proximal penile skin
  67. Veins of penis
    • deep dorsal V of penis- in deep penile fascia, drains erectile tissue
    • superficial dorsal V of penis- in superficial fascia, drains skin
  68. innervation of penis
    • dorsal N of penis
    • terminal branch of pudendal N
    • parallels dorsal A and deep dorsal V
    • sensory to skin and glans
    • cavernosus N
    • parasymphathetics from prostatic plexus
    • innervate deep A, causes erection
  69. Vulva
    • includes mons pubis, labia majora, labia minora, clitoris, vestibule of vagina, bulb of vestibule, and greater vestibular glands
    • Functions: sensory for sexual arousal/intercourse, directs flow of urine, prevents entry of foreign material
  70. mons pubis
    fatty prominance anterior to pubic symphysis
  71. labia majora
    • large skin folds on either side of pudendal cleft
    • protect clitoris, urethral and vaginal orifices
    • extends from mons pubis to anus
    • round lig of uterus terminates here
  72. labia minora
    • folds of skin medial to labia majora
    • surrounds vestibule of the vagina
    • from clitoris to frenulum of labia minora
    • homologus to penis skin
  73. clitoris
    • erectile tissue
    • located at anterior meeting of labia minora
    • root: 2 crura surrounded by ischiocavernosa M
    • body: comprised of 2 corpus cavernosa
    • glans: sole purpose = sexual arousal
  74. vestibule of vagina
    • b/t labia minora
    • contains external urethral orifice and vaginal orifice
  75. hymen
    • mucous membrane covering vaginal orifice
    • usually cresent shaped posteriorly
    • obliterated after coitus
  76. bulb of vestibule
    • paired masses of erectile tissue deep to labia minora
    • covered by bulbospongiosus M
    • continuous with glans of clitoris
  77. vestibular glands
    • on each side of vestibule posteriolateral to vagina
    • -bulbourethral glands
    • surrounded by bulbospongiosus M
    • open into vestibule near vaginal orifice
    • secrete mucous during arousal
  78. arterial supply to vulva
    • external pudendal A- skin and superficial fascia
    • internal pudendal A- erectile tissue in clitoris
    • -branches to deep A of clitoris
  79. venous drainage of vulva
    internal pudendal V to internal iliac V
  80. innervation of vulva
    • somatic
    • ilioinguinal N- anterior labial N
    • genitofemoral N to anteriolateral perineum
    • pudendal N- posterior labial N
    • parasympathetics
    • cavernous N from urovaginal N plexus, increase vaginal secretions, erection
  81. female circumcision
    • illegal/discourage
    • removes prepuce, clitoris, and labia minora which inhibits sexual arousal/gratification
  82. pudendal N block
    • relieves pain during child birth
    • injection to N across sacrospinous lig
    • coupled with ilioinguinal N block
  83. superficial perineal fascia
    • fatty superficial layer continuous with camper's fascia
    • females- into labia majora and mons pubis
    • males- reduced, replaced by smooth muscle
    • membransous deep layer= colle's fascia
    • posterior attachement to perineal body
    • laterally to fascia lata
    • continous with darto's fascia
  84. deep perineal fascia
    • contains ischiocavernosus M, bulbospongiosus M, and superficial transverse perineal M
    • laterally to ischiopubic rami
    • fuses anteriorly with suspensory lig
  85. superficial perineal pouch
    • space between colle's fascia and perineal membrane
    • female- crura, M, bulb of vestibule, M, greater vestibule glands, superiror transverse perineal M, internal pudendal A/V, pudendal N
    • males- crura and bulb, Ms, spongy urethra, superior transverse perineal M, internal pudendal A/V, pudendal N
  86. deep perineal pouch
    • above perineal membrane
    • open to ischioanal fossa
    • contains: membranous urethra, bulbourethra glands, external urethra sphincter, deep transverse perineal M,
  87. internal iliac A branches
    • umbilical A
    • obturator A
    • inferior vesical A
    • vaginal A
    • middle rectal A
    • internal pudendal A
    • inferior gluteal A
    • iliolumbar A
    • lateral sacral A
    • superior gluteal A
  88. ovarian A
    • from abdominal aorta
    • retroperitoneal, anterior to ureter
    • thru suspensory lig of ovary
    • to ovary and uterine tubes
    • anastomoses with uterine A
  89. testicular A
    • from abdominal aorta
    • enters deep inguinal ring thru inguinal canal to scrotum
    • to testis and epididymis
  90. median sacral A
    • off aorta b/t common ilia As
    • caudal end of embryonic aorta
  91. superior rectal A
    • terminal branch of inferior mesenteric A
    • to superior rectum
  92. pelvic veins
    • internal iliac V
    • primary pelvic drainage
    • to common iliac V
    • pelvic venous plexus
    • around rectum, urinary bladder, prostate, uterus, and vagina
    • drains to internal iliac
    • pathway for prostate/ovarian cancer
  93. pelvic somatic nerves
    • lumbar plexus Ns
    • obturator N: from L2-4, enters along psoas major M, goes to obturator canal, splits into anterior and posterior divisions
    • lumbosacral trunk: from L4-5, anterior to sacral ala to form sacral plexus
  94. sacral plexus Ns
    • sciatic N- L4-S3, thru greater sciatic foramen below piriformis, to posterior thigh, all of leg and foot
    • pudendal N- S2-4, motor and sensory to perineum, becomes dorsal N of penis/clitoris
    • Superior glueteal N- L4-S2, greater sciatic foramen, to gluteus medius, minimus, and tensor fascia lata
    • inferior gluteal N- L5-S2, greater sciatic foramen, to gluteus maximus
    • coccygeal plexus Ns- S4-5, on coccygeus M, to coccygeus and levator ani M
  95. sympathetics (pelvis)
    • sacral sympathetic trunk
    • continuation of lumbar sympathetic trunks
    • ganglion impar
    • vasomotor, sudomotor, pilomotor
  96. parasympathetics (pelvis)- pelvic splanchnic N
    • S2-4 presynaptic
    • motor to bladder and rectum
    • produces erection
    • visceral afferents
  97. superior hypogastric plexus
    • symps from lumbar splanchnic N= vasomotor
    • parasymps from pelvic splanchnic N
    • - connect superior and inferior hypogastric plexuses
  98. inferior hypogastric plexus
    • hypgastric and pelvic splanchnic Ns
    • female- ovary, uterine tubes, uterus, vagina, clitoris erectile tissue
    • male- prostate, seminal vesical, penile erectile tissue
    • rectum and urinary bladder
  99. ureter
    • from kidney to bladder
    • retroperitoneal
    • enters bladdder obliquely on inferior surface
    • A: female- uterine , male- inferior vesical
    • V: same as arteries
    • N: symps- T11-L2 renal, aortic, hypogastric plexuses
  100. urinary bladder
    • extraperitoneal, posterior to retropubic space
    • A: superior vesical A to superior bladder
    • male- inferior vesical A to fundus and neck
    • female- vaginal A to fundus and neck
    • N: parasymps- S2-4 pelvic splanchnics, motor to detrusor M, inhibit sphincter, stimulated by distension
    • symps- T11-L2 splanchnic Ns, causes contraction of sphincter during ejaculation
  101. structure of urinary bladder
    • apex- anterior, points toward pubic symphysis
    • body- central region
    • fundus- posterior wall
    • neck- inferior outflow region
  102. detrusor N
    • most of urinary bladder wall
    • thickens at neck forming internal urethral sphincter
  103. trigone
    • trangle, 2 ureter openings and internal urethral opening
    • uvula- rounded eminence in trigone
  104. male retrovesical pouch
    between bladder and rectum
  105. female vesicouterine pouch
    between bladder and uterus
  106. female rectouterine pouch
    between uterus and rectum
  107. female urethra
    • 4 cm long
    • anterior and parallel to the vagina
    • A/V: internal pudendal and vaginal
    • N: autonaumics in pudendal N
    • L: internal iliac and sacral nodes
  108. male urethra
    • 18 cm long
    • semen and urine
    • intramural urethra- in neck of bladder
    • prostatic urethra- thru prostate
    • membranous urethra- thru deep perineal pouch and perineal membrane
    • spongy urethra- in penis
  109. prostatic urethra
    • urethral crest- median ridge, continuous with uvula
    • prostatic sinus- grooves along crest, opening of prostatic ducts
    • seminal colliculus- in middle of crest
    • prostatic urtricle- slit in colliculus, vestigial vagina
    • ejaculatory ducts- in/near prostatic utricle
  110. ductus deferens
    • tail of epididymis to duct of seminal vesical
    • A: superior vesical or inferior vesical A
    • V: prostatic venous plexus
    • L: external iliac nodes
    • N: symps- lumbar splanchnic and hypogastric plexus- contraction for expulsion of sperm
    • parasymps- pelcic splanchnic and hypogastric plexus- unknown function
  111. ejactulatory duct
    • joining of ductus deferens and duct of seminal vesical
    • ampulla= enlargement of ductus deferens
    • convey sperm thru prostate to urethra in prostatic utricle
    • A: inferior vesical A
    • N: autonaumics via inferior hypogastric plexus
  112. seminal vesicals
    • between fundus of bladder and rectum, superior to prostate
    • secretes thick alkaline fluid to form semen
    • makes up 80% of semen volume
    • lots of fructose for energy
    • A/V: inferior vesical
    • N: symps- lumbar splanchnic/hypogastric plexus- contracts during emission
    • parasymps- pelvic splanchnic/hypogastric pleus- unknown function
  113. prostate
    • 2/3 glandular, 1/3 fibromuscular
    • around prostatic urethra
    • prostatic ducts- open into prostatic sinuses
    • prostatic secretions- thin, milky, 20% of semen volume, enzymatic ability
    • A: prostatic A off inferior vesical A
    • N: symps- lumbar splanchnic/inferior hypogastric plexus- contraction during emission
    • parasymps- S2-4 pelvic splanchnic, causes erection in erectile bodies
  114. lobes of prostate
    • anterior lobe- firbromuscular anterior to urethra, continuation of internal sphincter
    • lateral lobes- along sides of urethra, glandular, most prone to cancer
    • posterior lobes- posterior to urethra, inferior to ducts
    • middle lobe- between prostatic urethra and ejaculatory ducts, prone to benine hypertrophy
  115. prostate enlargement
    • benign hypertrophy- common in middle age, obstructs urethra
    • prostatic cancer- 55+ years old, usually posterior lobe, moves through lymph nodes
  116. bulbourethral glands
    • posterior to membranous urethra
    • open into spongy urethra
    • produce secretion during sexual arousal
  117. vagina
    • surrounds uterine cervix
    • passes through puborectalis
    • function: excretory duct for menstration, sex, birth cananl
    • A: uterine A, vaginal A, internal pudendal A
    • N: uterovaginal plexus- superior 80%
    • - syps via lumbar splanchnic N
    • - parasymps via pelvic splanchnic Ns
    • visceral afferents- distension only- upper 80%
    • somatic via deep perineal- touch/temp- lower 20%
  118. vaginal sphincter muscles
    • pubovaginalis
    • external urethral sphincter
    • urethrovaginal sphincter
    • bulbospongiosus
  119. vaginal fornix
    • surrounds uterine cervix
    • anterior, lateral, and postior (deepest) portions
  120. uterus
    • in anteverted and anteflexed position
    • body
    • superior 2/3, vesical surface and intestinal surface
    • uterine cavity
    • uterine horns- origins of uterine tubes
    • fundus- body superior to uterine horns
    • isthmis- below body, superior to cervix
  121. cervix
    • inferior uterus, protrudes into vagina
    • supravaginal part- b/t isthmis and vagina
    • vaginal part- surrounded by vaginal fornix, internal ox, cervical canal, external os
  122. histology of uterus
    • perimetrium- outer serosal covering
    • myometrium- thickest, middle layer
    • endometrium- changes during menstration
  123. broad ligament of the uterus
    • mesometrium- lateral to uterus
    • mesovarium- ovar ovaries
    • mesosalpinx- holds uterine tubes
  124. round ligament of the uterus
    • attaches to uterotubal junction
    • thru inguinal canal into labia majora
  125. ovarian ligament
    uterus to ovary
  126. suspensory ligament of ovary
    • extension of brad ligament toward abdomen
    • surrounds neurovasculature
  127. cardinal ligament
    • cervix, to lateral fornix, to lateral pelvis
    • along inferior margin of broad lig
  128. uterosacaral ligament
    cervix to sacrum
  129. pubocervical ligament
    pubic bones to cervix
  130. uterus
    • A: uterine A (anastomoses with ovarian and vaginal As)
    • V: uterine venous plexus
    • N: uterogavinal plexus
    • symps- lumbar splanchnic
    • parasymps- pelvic splanchnic
  131. anesthesia
    • general- not common because knocks you out completely
    • regional
    • -spinal block- L3/4, cant readminister, headaches
    • - caudal epidural- S2-4, via catheder
    • - pudendal N block- S2-4 dermatomes
  132. uterine tubes
    • function: fertilization
    • open to peritoneal cavity
    • A: uterine A and ovarian A
    • V: uterine venous plexus
    • N: autonomics via inferior hypogastric plexus
  133. parts of uterine tube
    • infundibulum- distal end, abdominal ostium, fimbrae
    • ampula- distal 2/3, site of fertilization
    • isthmis- adjacent to uterine horn
    • intramural segment- thru wall of uterus, uterine ostium
  134. ovaries
    • A: ovarian A
    • V: pampiniform plexus in broad lig to ovarian V
    • R drains to IVC
    • L drains to L Renal V
    • N: autonomics via ovarian plexus
    • symps- T11-L1
    • parasymps- pelvic splanchnic Ns
    • regulate vasculature diameter
  135. rectum
    • retroperitoneal
    • sacral flexure
    • anorectal flexure- thru pelvic diaphragm, maintained by puborectalis M
    • transverse rectal folds- 3 lateral flxures
    • ampulla- supported by levator ani muscle
  136. rectum continued
    • A: superior rectal A- off inferior mesenteric
    • middle rectal A- off internal iliac
    • inferior rectal A- off internal pudendal
    • V: superior rectal to hepatic portal V
    • middle and inferior rectal to internal iliac V
    • N: symps- lumbar splanchnic Ns- vasomotor?
    • parasymps- pelvic splanchnic Ns- muscle fibers
    • visceral afferent to S2-4- pain and distension
  137. what areas allow for expansion of the rectum?
    • males- retrovesical pouch
    • females- retrouterine pouch
    • 2 pararectal fossa
  138. defication
    • Ns thru pelvic splanchnic N
    • 1. empy ampulla
    • -internal sphincter contracted
    • -external sphincter relaxed
    • 2. sufficiently full ampulla
    • -internal sphincter relaxes
    • -external sphincter contracts
    • 3. during defication
    • -voluntary override of external sphincter contraction
    • -parasymps increase peristalsis
  139. rectal examination
    • palpation of prostate, seminal vesicals, cervix, bony processes
    • protoscope= camera in butt
  140. boundries of ischioanal fossa
    • lateral- ischium and obturator internus
    • medial- anal canal
    • posterior- sacrotuberous lig and gluteus maximus
    • anterior- external utethral sphincter and deep transverse perineal M
  141. pudendal canal
    • lateral wall of ischioanal fossa
    • contains internal pudendal A/V, pudendal N and N to obturator internus
  142. internal pudendal A
    • inferior rectal A- external anal sphincter
    • perineal A- to scrotum, labia, bulb of penis/vestibule
    • deep A of penis/clitoris- erectile tissue
    • dorsal A of penis/clitoris
  143. pudendal N
    • inferior rectal N- external anal sphincter
    • perineal N- superficial and deep perineal Ns
    • dorsal N or penis/clitoris
  144. anal canal
    • pelvic diaphragm to anus
    • normally collapsed
    • internal anal sphincter- smooth muscle, involuntary control, normally contracted
    • external anal sphincter- skeletal muscle, volunary control, blends with puborectalis, N: inferior rectal N
  145. anal columns
    • in inferior anal canal
    • longitudinal ridges of mucosa
    • anorectal junction- superior ends of anal columns
    • anal valves- inferior ends of anal columns
    • anal sinuses- recesses just superior to valves
    • pectinate line- formed by anal valves
  146. anal canal continued
    • A: superior rectal A above pecinate line
    • inferior rectal A below pectinate line
    • V: hepatic portal system above pectinate line
    • inferior rectal and internal pudendal below pectinate line
    • N: autonomic above pectinate line= inferior hypogastric plexus
    • symps to internal anal sphincter maintain tonus
    • parasymps relax the internal anal sphincter
    • somatic below pectinate line- inferior rectal N
    • motor to external anal phincter
  147. hemorrhoids
    • dialated, prolapsed Vs
    • internal- breakdown of muscularis mucosa
    • external- covered by skin
  148. sex differences in pelves
    • males
    • heavier and thicker
    • narrow and deep lesser pelvis
    • subpubic angle 60 degrees
    • females
    • wider and shallower
    • larger pelvic inlet and pelvic outlet
    • subpubic angle 90 degree
  149. erection
    • parasymps via cavernous N to deep A of penis
    • -cause relaxation of tunic media in deep A of penis
    • -increases blood flow into corpus spongiosus and cavernosum
    • bulbospongiosus M and ischiocavernosus M contract
    • -compresses venous plexuses reducing drainage from penis
    • -erectile tisssue becomes engorged
  150. emission
    • sypathetics cause peristalsis in ductus deferens and accessory glands
    • -sperm delivered to prostatic urethra
    • -seminal vesicals and prostate add gluid to produce semen
  151. ejaculation
    • contraction of bulbospongiosus M expels semen through spongy urethra
    • -internal urethral sphincter closes
    • after ejaculation, symp cuase constriction of tunica media in deep A and things return to normal