Block 7 Anatomy Wk 10 11 From Ta's W Xpl Prt 2

a complication of median episiotomy is fecal incontinence due to tearing of the external anal sphincter

ureter passes under uterine artery.

External urethral sphincter, innervated by somatic pudendal nerve, prevents micturition until the proper time and place.

the gonads drain blood to the L renal vein and IVC, so they drain lymph to para-aortic lymph nodes.

A finger is inserted into the vagina to palpate the ischial spine, and anesthetic is injected through the skin or vaginal wall keeping the finger between the needle and baby’s head. The distal portion of the vagina is innervated by somatic pudendal nerve (S2-4).

Submental lymph nodes drain chin and central lower lip, while submandibular nodes drains most of the central face.

glans penis drains to deep inguinal lymph nodes.

this position is in line with the vagina, so highest risk of uterine prolapse.

During labor contractions are hormonally stimulated, however at other times there is autonomic control - for instance tocolytic therapy can involve B2 agonists to postpone labor. During labor, nerve blocks do not affect contractions of the uterus as the contractions are hormonally stimulated. Remember that small, myelinated, slow conducting fibers are blocked first by anesthetics like your type B and C fibers. Alpha motor are the least sensitive even though they are myelinated.

Pudendal nerve innervates the external anal sphincter.

External Iliac Artery; Lateral Circumflex Artery

Middle rectal artery usually branches off the anterior division of internal iliac artery.

Uterine adenocarcinoma begins in the endometrium and can spread to paraaortic or lumbar lymph nodes when it is near the fundus. Not to be confused with lymph drainage near the insertion of the round ligament to superficial inguinal nodes.

To answer this question you must understand the embryological relationship of fundus of the uterus to the round ligament and to the Labia Majora (thus, there are many high yield relationships within this question). First remember that the Labia Majora is a homologue to the male’s Scrotum, then remember that the Round Ligament of the uterus is essentially the female Gubernaculum. You recall that the gubernaculum testis aids in the descent of the male testes towards the scrotum during development; in females however, the round ligament originates from the fundus of uterus and inserts on the inner surface of the Labia Majora and does not change in length or aid in descent of any gonadal organs. Regardless, because the round ligament takes this origin and insertion, it provides a lymphatic network that leads directly to the labia majora from the fundus of the uterus. As you already know, the labia majora drains to the superficial inguinal lymph nodes. These relationships can be the focus of several different types of questions.