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Stucture Ureters Know course of the ureter from posterior abdominal wall lecture Urinary bladder Know parts

and trigone

Notes Retroperitoneal

Vasculature Inferior vesicle Uterine (also renal, gonadal, sup. vesical and iliac) Superior vesical (M/F), inferior vesical (M)/vaginal (F), Drainage to vesical venous plexus and prostatic venous plexus (M) Internal pudendal, vaginal

Lymph Lumbar, common iliac, external iliac, internal iliac

Nerves Autonomic: Renal, aortic, sup/inf hypogastric plexus


External iliac and internal iliac

Female urethra

Male urethra

Ductus (vas) deferens Understand its course

Seminal vesicles

Ejaculatory duct Prostate Know the different surfaces and lobules

Internal urethral orifice of urinary bladder external urethral orifice in vestibule of vagina. Lies anterior to vagina. Superior part contains paraurethral (skene s) glands Urine + semen 4 parts: intramural (preprostatic), prostatic nerve plexus, intermediate (membranous), spongy (penile) urethra Continuation of duct of epididymis, enlarges to form ampulla of ductus deferens, narrowing where it joins duct of seminal vesicle Between fundus of bladder and rectum. Do not store sperm. Produce thick alkaline fluid that mixes with sperm Union of ductus deferens and seminal vesicle Surrounds prostatic urethra. 2/3 glandular, 1/3 fibromuscular, dense fibrous capsule

Sacral and internal iliac (some inguinal)

Sym: contracts internal urethral sphincter to prevent reflux of semen during ejaculation Para: motor to detrusor muscle, inhibitory to internal sphincter (M) Efferent: vesical nerve plexus and pudendal nerve Visc afferent: pelvic splanchnic Somatic afferents from pudendal Autonomic nerves from prostatic nerve plexus and dorsal nerve of the penis (spongy part)

Prostatic branches of inferior vesical and middle rectal, internal pudendal, dorsal artery of the penis

Internal iliac, external iliac, deep inguinal lymph nodes

Artery of ductus deferens (from superior vesical artery)

External iliac

Autonomics from sympathetic fibers derived from pelvic plexus

Inferior vesical and middle rectal arteries

External iliac (superior part) internal iliac (inferior part)

Autonomics from prostate nerve plexus

Artery to the ductus deferens Prostatic arteries from inferior vesical, internal pudendal, and middle rectal Prostatic venous plexus drains deep dorsal vein

External iliac lymph nodes Internal iliac, some sacral

None Autonomics from prostate nerve plexus

Structure Bulbourethral (Cowper) glands Vagina Know the different parts

Notes Mucus-like secretion enters urethra during sexual arousal Musculomembranous tube from cervix of uterus to vestibule of vagina

Vasculature Inferior vesical and middle rectal Upper: vaginal arteries from uterine arteries Middle and inferior; vaginal arteries from internal pudendal artery

Uterus Know parts of uterus and association with ligaments, esp broad ligament

Uterine (fallopian) tubes Know parts of the uterine tube


Rectum Know valves, columns, etc

Consists of body, fundus, isthmus, and uterine horns. Terminates as cervix of the uterus. 3 walls: perimetrium, myometrium, endometrium. Ligaments: ovarian ligament, round ligament, suspensory ligament, broad ligament, cardinal ligament, uterosacral ligament Extend laterally from uterine horns, open to peritoneal cavity near ovaries. Lie in mesosalpinx in free edge of broad ligament. Extend to lateral pelvic walls, ascend and arch over ovaries Almond shaped, near attachment of broad ligament to lateral pelvic walls. Associated with suspensory ligament and ovarian ligaments. Oocyte trapped by fimbriae and carried to ampulla Rectosigmoid junction at S3. Follows curvature of sacrum and coccyx, forming sacral flexure of the rectum (see pelvic cavity and anal triangle)

Uterine arteries (potential collateral supply from ovarian arteries)

Lymph External iliac (superior part), internal iliac (inferior part) Superior: internal and external iliac Middle: internal iliac Inferior: sacral and common iliac External orifice: superficial inguinal Lumbar, superficial inguinal, external iliac, internal iliac, sacral lymph noes

Nerves Autonomics from prostate nerve plexus Inferior and somatic: Deep perineal branch of pudendal Rest: autonomics from uterovaginal plexus

Autonomics from uterovaginal plexus

Ovarian arteries

Lumbar lymph nodes

Autonomics from ovarian and uterine nerve plexus

Ovarian arteries

Lumbar lymph nodes

Autonomics from ovarian and uterine nerve plexus

Superior rectal (from inferior mesenteric), middle rectal (from internal iliac), inferior rectal (from internal pudendal)

Superior: pararectal Inferior: sacral Distal ampulla: internal iliac

Autonomics from pelvic nerve plexus Distal-most portion: somatics (inferior rectal nerve) Internal anal sphincter: autonomic external sphincter: somatic