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Abdomen and pelvis: S12 checklist/ Pelvic viscera

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الكلية كلية الطب     القسم  التشريح والانسجة     المرحلة 2
أستاذ المادة فراس محمد غازي الخفاجي       20/05/2018 00:57:32
Pelvis and perineum
GIT and Urinary viscera
Curricular Objectives: By the end of this session students are expected to:

Theory
1. Name the viscera of the male and female pelvis and their location within the cavity
2. Describe the gross features and relations of sigmoid and rectum
3. Describe the sigmoid mesocolon, and its role in development of volvulus
4. Summarize the location, parts and internal features of anal canal
5. Outline the blood vessels supplying the sigmoid, rectum, and anal canal
6. Define hemorrhoids and outline the vessels involved in different types
7. Underline the role of puborectalis muscle in supporting continence
8. Outline the location, boundaries and content of the ischiorectal fossa
9. Compare the course of the ureter within the male and female pelvis
10. Describe the urinary bladder, its main relations, its nerve supply
11. Outline the relations of the distended urinary bladder and its applied anatomy
12. Compare the male and female urethra, and describe the anatomy of cathterization

Practical
1. List and identify various viscera within the male and female pelvis
2. Follow the peritoneum as it passes over the pelvic viscera
3. Locate and Compare the pouches of the peritoneal cavity related to the pelvic viscera
4. Trace the sigmoid meso-colon noting the structures related to its line of attachment
5. Follow the ureters and recall the three sites at which their lumen is narrowed
6. Distinguish the urinary bladder and its external and internal features
7. Locate the median umbilical ligament and name its embryological origin
8. Identify different parts of male urethra

Selected references and suggested resources
? Clinical Anatomy by Regions, Richard S. Snell, 9th edition
? Grant s Atlas of Anatomy, 13th Edition
? McMinn s Clinical Atlas of Human Anatomy, 7th Edition
? Anatomy for Babylon medical students (Facebook page)
? Anatomy for Babylon medical students (YouTube channel)
? Human Anatomy Education (Facebook page)
? Human anatomy education (YouTube channel)


Session check list

? Clinical highlights

? Common emergency situations related to this region include hematuria, urine retention, bleeding per rectum and fracture pelvis. Comprehensive knowledge on the anatomy of the urinary system, and pelvic parts of the GIT is of great importance in emergency departments
? External and internal hemorrhoids, in addition to anal Fissure may develop within anal canal, understanding the nerve supply of the anal canal is of great importance in clinical practice

Lab Activity List
For each task below, identify the listed structures then answer the related questions

? Task 1: Arrangement of pelvic viscera (Gross features and relations)
? GIT: Sigmoid colon / rectum/ anal canal/ coils of small intestine/ appendix??
? Urinary tract: ureters/ urinary bladder/ urethra
? Reproductive system:
a. Male: vas difference/ seminal vesicles/ ejaculatory duct/ prostate
b. Female: uterus/ ovaries/ uterine tubes/ vagina
? Peritoneal spaces: Recto vesical pouch/ Rectouterine pouch/ uterovesical pouch

? What space lies posterior to the bladder in male?
? What lies anterior to the rectum in female?
? The sigmoid continues as the rectum at the level of which vertebra?

? Task 2: Sigmoid and rectum
? Sigmoid colon (terminal part): tinea coli/ appendices epiploica/ sigmoid mesocolon
? Rectum: three lateral curves/ rectal ampulla/ anorectal junction/ superior rectal artery
? Puborectalis/ anorectal angle/ internal and the external anal sphincters

? Name the main artery supplying the sigmoid colon and rectum
? The sigmoid continues as the rectum at the level of which vertebra?
? The sigmoid colon is drained directly to the inferior vena cava. (True/False)
? Tenia coli, omental appendices, & haustra are characteristics of upper rectum (True/False)


? Task 3: Anal canal and ischioanal fossa
? Anal canal: visceral & somatic parts, pectinate line, internal & external anal sphincters
? Ischiorectal fossa, pudendal nerve, internal pudendal vessels
? The junction between upper and lower parts of the anal canal is marked by which landmark?
? The internal anal sphincter is supplied by which nerve type? (Somatic/ Autonomic)

? Task 4: Ureters, Urinary bladder and Urethra
? Ureters (right and left)
? Urinary bladder: Base/ Trigone/ Urethral opening/ Ureteral opening
? Urethra: Pre-prostatic/ Prostatic/ Membranous/ Spongy (penile)/ External urethral orifice
? Superior and inferior vesical arteries












Review questions:
1. List the pelvic veins involved in porto-sytemic anastomosis
2. What space lies anterior to the upper 2/3rd of the rectum?
3. What pelvic structures that can be palpated during digital rectal examination in male?
4. Define the terms “urine retention” and “suprapubic aspiration of bladder”
5. List the layers of AAW traversed during suprapubic aspiration

Homework:
1. A 25 years old female was in labor room for 6 hours. The attending doctor noticed that the baby started to show signs of fetal distress with slow progress of labor. Clinical decision was made to convert to caesarian section to save the baby and his mother.
A. Name the skin incision used in this operation
B. List the layers encountered during this incision, which layer is not incised?
C. Is it possible to accidently incise the urinary bladder during this procedure? Why?


المادة المعروضة اعلاه هي مدخل الى المحاضرة المرفوعة بواسطة استاذ(ة) المادة . وقد تبدو لك غير متكاملة . حيث يضع استاذ المادة في بعض الاحيان فقط الجزء الاول من المحاضرة من اجل الاطلاع على ما ستقوم بتحميله لاحقا . في نظام التعليم الالكتروني نوفر هذه الخدمة لكي نبقيك على اطلاع حول محتوى الملف الذي ستقوم بتحميله .
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