Pelvis/Uterus/Reproductive System Anatomy

• The narrowest part of the urethra is the external urethral orifice.

Pelvis/Uterus/Reproductive System

• Uterine carcinoma directly affects the round ligament due to its location at the top of the uterus.
• The left testicular vein drains into the left renal vein.
• Damage to the piriformis muscle can lead to damage of the superior gluteal nerve.
• Sciatic nerve damage affects the inferior gluteal nerve.
• If the inguinal canal is damaged 3 cm below, the round ligament of the uterus will be affected.
• The pelvic splanchnic nerve is parasympathetic, innervating viscera and potentially damaging the inferior hypogastric plexus.
• The ureter runs along the internal iliac artery of the uterus.
• Childbirth can cause tears in the levator ani muscle.
• Lesions in the sacral splanchnic nerves damage postganglionic sympathetic fibers; the pelvic splanchnic nerves carry preganglionic parasympathetic fibers, while sacral splanchnic carry preganglionic sympathetic fibers.
• Fertilization typically occurs in the infundibulum or ampulla of the uterine tube; ejaculation is sympathetic, and erection is parasympathetic.
• A tear in the superior boundary of the superficial perineal space involves the perineal membrane.
• The bulbourethral glands are located in the deep perineal space.
• Hypertrophy affects the transitional zone.
• During prostate cancer resection, the prostatic ducts, which receive the ejaculatory ducts, open into the prostatic sinus.
• In ectopic pregnancies, a needle may be inserted into the rectouterine pouch, accessed via the posterior fornix of the vagina.
• Superficial inguinal nodes are often the first site of lymph node metastasis.
• Weakness of the urogenital diaphragm affects the sphincter urethrae, which is innervated by the perineal nerve.
• The pubic ligament and transverse perineal ligament supply to the penis; therefore, damage affects the deep dorsal vein of the penis.
• An episiotomy with uncontrolled tearing can impact the perineal body, involving the bulbospongiosus and superficial transverse perineal muscles.
• In Colles' fracture, the bulb of the penis can be inflamed.

Deep Perineum

• Structures within the deep perineal space include the bulbourethral glands, the membranous part of the male urethra, the deep transverse perineal muscle, and the sphincter urethrae.
• Issues with micturition (urination) may indicate pudendal nerve problems.
• The usual uterine position is anteflexed and anteverted.
• Damage to the deep dorsal vein after a penile injury could affect the prostatic plexus of veins.
• Penile erection is a parasympathetic response mediated by the pelvic splanchnic nerve.
• The lumbar (aortic) lymph nodes drain structures like the ovary, found in the suspensory ligament.
• An infection in the ischiorectal fossa affects the inferior rectal nerve.
• The dorsal artery of the penis supplies the glans.
• A prolapsed uterus is related to weakness in the levator ani, which provides the most support to the uterus.
• Rupture of the penile urethra can spread damage into the scrotum.
• Common issues first seen in the male penile urethra include the scrotum.
• A benign tumor in the broad ligament can affect the uterine tube, since the uterine tube lies in the broad ligament. The ureter descends retroperitoneally.
• Severe fractures of the pelvic inlet significantly damage the promontory of the sacrum.
• Multiple pelvic fractures without cutaneous sensation issues mean the iliohypogastric nerve, which innervates above the nerve, is likely unaffected.
• In severe perineal injuries, the pubic arcuate ligament, tip of the coccyx, ischial tuberosity, and sacrotuberous ligament may be involved, but the sacrospinous ligament can remain spared.
• During a vasectomy, be mindful of the ilioinguinal and genitofemoral nerves which innervate the scrotum.
• Uterine rupture initially affects the cardinal transverse cervical ligament and can then extend into the broad ligament.
• During breech delivery, avoid touching the levator ani (pelvic diaphragm).
• The true pelvis artery is the uterine artery.
• To protect the lumbosacral plexus, avoid touching the lumbosacral trunk in the abdominal or pelvic cavity.
• The sphincter urethrae is found in the deep perineal space .
• Lumbar nodes receive lymph from the testes, where the spermatic cord is located.
• A mass on the pelvic brim can impact the lumbosacral trunk, affecting the formation of the sacral plexus from L4 and L5.
• Bulbourethral (Cowper's) glands are associated with the sphincter urethrae.
• Cryptorchid testes refer to undescended testes, and hypospadias involves the spongy urethra opening on the underside of the penis.
• The pudendal nerve (from the sacral plexus) provides sensory innervation, and a pudendal block should be administered dorsally over the ischial spine to reduce pain.
• The ischiorectal fossa is used to assess for damage on rectal vessels.
• The prostatic ducts open into the prostatic sinus, bulbourethral ducts open into the bulbous part of the penile urethra, and seminal vesicle ducts join the ampulla to form the ejaculatory duct; the seminal colliculus opens into the ejaculatory duct.
• The pectinate line of the anal canal indicates visceral sensory information.
• Failure of the urogenital folds to close results in hypospadias.
• Cancer can metastasize in the rectum via the liver through the superior rectal, inferior mesenteric, splenic, and portal veins.
• The ovarian ligament and round ligament are derived from the gubernaculum; the mesonephric duct gives rise to the vestigial epophoron in females.
• The female urethra is shorter than the male urethra.
• The cervix is the region where menstruation occurs.
• Hemorrhage in the ischiorectal fossa (anal triangle) is bound laterally by the obturator nerve.
• Mucous membrane creates Houston valve, and venous blood returns to the portal venous system via the superior rectal vein.
• The obturator nerve transmits obturator vessels and obturator nerves and is on the nearside and innervates both greater and lesser sciatic foramina.
• The greater trochanter provides a site for where obturator nerve.
• Seminal vesicles secrete fluid containing fructose.
• The iliac artery becomes the femoral artery.
• Bladder injury results in injury to the pubic symphysis on the anterior pelvic wall and visceral organs.

Thorax

• The apex of the heart is located at the left fifth intercostal space (T4) near the nipple.
• Expiration involves the contraction of elastic tissue in the lungs and thoracic wall.
• Muscles of inspiration include the diaphragm, serratus anterior, serratus posterior, and pectoralis minor.
• Damage to the greater splanchnic nerve destroys visceral afferent (VA) and preganglionic sympathetic fibers.
• Destruction at the white rami communicantes at the 6th thoracic level affects the dorsal root ganglion and lateral horn of the spinal cord.
• The mitral valve (for auscultation) is located at the midclavicular line of the left fifth intercostal space.
• Angiogram bleeding leads to middle cardiac vein damage.
• The great cardiac vein drains the anterior, and the small cardiac vein drains the marginal artery.
• The largest portion of the sternocostal surface of the heart is the right ventricle.
• An incomplete closure of the interatrial septum results from foramen ovale issues.
• The sinoatrial (SA) node is the heart's pacemaker.
• Removal of the middle lobar-secondary bronchus (bronchopulmonary segment) due to cancer affects the medial and lateral portions.
• Blockage of the eparterial bronchus means the right superior bronchus is blocked.
• Blockage of the circumflex branch of the left coronary artery affects the posterior left ventricle.
• Phrenic nerve damage causes loss of sensation in the fibrous pericardium and mediastinal pleura.
• The anterior cardiac vein drains into the right atrium, whereas the middle, small, and oblique drain into the coronary sinus.
• Thrombosis in the circumflex branch of the left coronary artery can lead to left ventricular mitral valve insufficiency. The Mitral valve is left atrium to left ventricle; left coronary artery supplies the left ventricle
• Lobectomy: The superior lobe of the left lung can be resected.
• Avoid damaging ribs 5 and 7 during midaxillary procedures.
• Tetralogy of Fallot includes pulmonary stenosis, dextroposition of the aorta, and interventricular (IV) septal defect.
• Decreased blood flow in intercostal arteries can result from issues in the lower sixth posterior portion of the rib.
• Myocardial infarction (MI) at the apex of the heart is often due to occlusion of the posterior interventricular (IV) artery.
• Carcinoma of the left lung often affects the lingula and may spread to the middle lobe.
• Forced expiration primarily affects the muscles of the abdominal wall.
• Damage to the posterior mediastinum affects the hemiazygos vein.
• Vagus nerve damage proximal to the recurrent laryngeal nerve can decrease cardiac rate.
• Cardiac echocardiogram anomalies: Pulmonary trunk AP septum may fail to develop spirally.
• Congenital heart failure with left ventricular hypertrophy can result in stenosis of the aorta.
• Damage to the left primary bronchus means it’s longer than the right primary bronchus, which is shorter.