Urology Anatomy

False (greater) pelvis

#3

-Superior region, part of the abdominal cavity

True (lesser) pelvis

#2

-Inferior region, encloses pelvic cavity

Pelvic brim

#1

Pelvic cavity

Bowl shaped cavity, continuous with the abdominal cavity

fibromuscular, perineum

Pelvic Floor

-_____________ structure

-Separates the pelvic cavity from __________

inferior, outlet, terminal, urinary, reproductive, external

Perineum

-________ to pelvic floor, margin formed by the pelvic ________

-Contains → ________ openings of GI and ________ systems, external opening of _____________ tract, and roots of _________ genitalia

Pelvic inlet

What is being described?

-Rim of pelvic cavity, encircled by bone

-Where the bladder sits

anteriorly, horizontal

Pelvic Axis

-Top of pubic symphysis and anterior superior iliac spine lie in the same vertical plane

-Pelvic inlet is tilted ____________

-Bodies of pubic bones and pubic arch position in ____________ plan facing ground

pelvic, coccyx, L5, sacrum, pelvic

Pelvis Bones and Joints

Bones

-Right and left _____ bones

-Sacrum

-_________

Joints

-Lumbosacral (LS) joint → sacrum and __

-Sacroiliac (SI) joints → pelvic bones and _______ (posterior)

-Pubic symphysis → right and left _______ bones (anterior)

ilium, pubis, ischium

Label the parts of the pelvic bone (#1-3)

ridge, ilium, lateral, true, margin, inlet

Ilium: Arcuate Line

-_______ that separates _______ into upper and lower parts

• Upper = _______ wall of false pelvis, part of abdominal cavity

• Lower = lateral wall of ____ pelvis, part of pelvic cavity

-Linea terminalis (lower 2/3rds of the arcuate line), contributes to _______ of pelvic ____

muscle, fascia, back

Ilium: Iliac Crest

-Site for _______ and _______ attachment of abdomen, _____, and lower limb

• Anteriorly = anterior superior iliac spine

• Posteriorly = posterior superior iliac spine

Iliac crest

#1

Arcuate Line

#2

Body

Pubis: _______ (#1)

-Articulates anteriorly with the body of the opposite pubis at the pubic symphysis

-Pubic tubercle has an anterior and superior surface

Superior pubic ramus

Pubis: __________ _____ _____ (#2)

-Projects posterolateral from body

-Joins with ilium and ischium

Inferior Pubic Ramus

Pubis: _________ _____ _______ (#3)

-Projects laterally and inferiorly

-Joins with ramus ischium

Body

Ischium: ____ (#1)

-Projects superiorly to join the ilium and superior pubic ramus

Ischial Ramus

Ischium: ________ _____ (#2)

-Projects anteriorly to join the inferior pubic ramus

Ischial tuberosity

Ischium: _______ _________

-Posteroinferior aspect of the bone

-Site of attachment of lower limb muscles

-Supports body when sitting

abdominal, pelvic

Pelvic Inlet

-Opening between the __________ and ______ cavities

-Margins → sacral promotory midline posteriorly, sacral ala posterior/laterally, linea terminalis

sacrospinous, sacrotuberous, obturator

Pelvic Wall

-Bones → sacrum, coccyx, pelvic bones

-Ligaments → _____________ ligament (#1), ___________ ligament (#2), stabilize the sacrum on the pelvic bones, and creates foramina from greater and lesser sciatic notches

-Muscles → _________ internus (#3), piriformis (#4), which both aid in hip joint movement

midline, laterally

Pelvic Outlet

-Pubic symphysis → ________ anteriorly

-Body of pubis/inferior pubic ramus/ramus of ischium/ischial tuberosity → ________

-Sacrotuberous ligament and coccyx → posteriorly

muscular, levator, pelvic, hiatus, urethra

Pelvic Floor: Pelvic Diaphragm

-Pelvic Diaphragm → __________ portion shaped like a bowl or funnel

-Muscles

• _______ ani (#1) and coccygeus muscles (#2)

• Originates at ______ bones and comes together midline and around the anal aperture

• Posterior to anal aperture, the coccygeus muscle comes together as the ligament or raphe called the anococcygeal ligament and attaches to coccyx

-Urogenital _______

• U-shaped gap allowing _______ in both sexes and vagina in women to pass through the diaphragm

external, muscles, perineal, urethral, position

Pelvic Floor: Perineal Membrane and Deep Perineal Pouch/Space

Perineal Membrane (#1)

-Thick fascial, triangular structure

-Attached to pubic arch with free posterior edge

-Provides attachment for roots of _________ genitalia and genitalia ________

Deep Perineal Pouch/Space (#2)

-Above _________ membrane, contains layer of skeletal muscle

-External ________ sphincter → in both sexes, closes urethra

-Deep transverse perineal muscle → in both sexes, stabilizes the ___________ of the perineal body

inferior, urinary, reproductive, genitalia, anus, sphincter, pudendal

Perineum

-Diamond shaped region _______ to pelvic floor

-Boundaries → pelvic outlet, pelvic diaphragm, walls of pelvic cavity

-Urogenital triangle (#1) → anterior, associated with openings of the _______ and ___________ system, anchors external _________

-Anal triangle (#2) → posterior, contains the ____ and external anal _________

-_________ nerve and internal pudendal artery are the major nerve and artery of the region

wider, shorter, round

The female pelvis is _______, _________, and ______. This is in stark contrast to the male pelvis, which has a deeper pelvic cavity and is heart shaped.

inlet, iliac, bifurcation, bladder, deferens, uterine

Ureters
-Enter pelvic cavity from the abdomen by passing through the pelvic _____

-Enters in the area anterior to the common _____ artery ___________, continues along pelvic wall and floor to join the base of the _________

-In pelvis, crossed by the ductus ________ in men and ________ artery in women

apex, trigone, ureters, urethra, detrusor, neck

Bladder

-_____ → directed towards top of pubic symphysis

-Base → shaped like inverted triangle, faces posterior inferior

• _______ → smooth, triangular area firmly attached to wall. Between openings of the ________ and _______

-Bladder wall → _________ muscle, except in the bladder _____

-Superior surface → slightly domed when empty and balloons upward when full

urethra, inferior, fixed, fibromuscular, puboprostatic

Neck of Bladder

-Surrounds the origins of ________ where the two inferolateral surfaces and base intersect

-Most _______ and ______ part of bladder, anchored by pair of ___________ bands

• _______________ ligament in males

short, Skene’s

Female Urethra

-______ (4 cm long)

-Travels a slightly curved course passing inferiorly through pelvic floor before opening in the vestibule that lies between labia minora and anterior to vaginal opening

-_______’_ glands = paraurethral mucous glands, keep the area moist

long, base, prostate, internal, retrograde, semen, prostate, ducts, narrow, skeletal, erectile, penis, slit

Male Urethra

-____ (20 cm)

-Preprostatic Urethra (#1)

• Extends from _____ of bladder to the ________

• Associated with cuff of smooth muscle fibers called the ________ urethral sphincter

• Prevents _________ movement of _______ into bladder during ejaculation

-Prostatic Urethra (#2)

• Surrounded by _________

• Prostate gland and ejaculatory _______ open up into this portion

-Membranous Urethra (#3)

• __________ and passes through the deep perineal pouch

• Surrounded by _________ muscle (external urethral sphincter)

-Bulbar/Penile/Spongy Urethra (#4)

• Surrounded by ________ tissue (corpus spongiosum) of penis

• Enlarged at base and end of _______

• Exits penis through sagittal ____ (external urethral orifice)