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PHA 500 > 10. Pelvis I > Flashcards

10. Pelvis I Flashcards

1
Q

Pelvic Girdle

A

Os coxae (hip bones)
Sacrum
Coccyx

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2
Q

Bony Pelvis

A

Connects thoracic cavity to LE

Consists of 4 bones

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3
Q

Os Coxae

A

Ilium
Ischium
Pubis

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4
Q

Acetabulum

A

Fusion of ilium, ischium, pubis

Fuses at about age 16

Head of femur articulates here, forming hip joint

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5
Q

Obturator Foramen

A

Ischium + pubis

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6
Q

Ilium

A

Iliac crest (connects ASIS to PSIS)
Iliac fossa (concave medial surface)(iliacus sits here)
ASIS
PSIS

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7
Q

Pubis

A

Pubic tubercle

Pubic symphysis

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8
Q

Pubic Symphysis

A

Pubic bones articulate at midline to form

Fibrocartilaginous joint (not much movement)

Ligaments relax right before birth

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9
Q

Pubis + Ischium

A

Superior pubic ramus (unites ilium and ischium superiorly)
Inferior pubic ramus
Ischial ramus
Isciopubic ramus

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10
Q

Isciopubic Ramus

A

Inferior pubic ramus + ischial ramus

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11
Q

Ischium

A

Greater sciatic notch
Ischial spine
Lesser sciatic notch
Ischial tuberosity (muscle attachment)

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12
Q

Pubic Arch

A

2 ischiopubic rami

Inferior borders define subpubic angle

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13
Q

Sacrum

A

5 fused vertebrae

Base (articulates with L5/S1 intervertebral disc and L5 vertebra)

Apex (articulates with coccyx)(S5)

Sacroiliac joints

Sacral promontory

Sacral foramina

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14
Q

Sacral Promontory

A

Anterior edge of S1 projection

Obstetrical landmark

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15
Q

Sacral Foramina

A

4 pair anterior
4 pairs posterior

For transmission of ventral and dorsal rami of sacral spinal nerves

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16
Q

Coccyx

A

4 fused vertebrae

Articulates with sacrum at sacrococcygeal joint

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17
Q

Pelvic Inlet

A

Divides pelvis into greater and lesser pelvis

Normally tilted about 55 degrees from horizontal plane (tipped in anatomic position)

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18
Q

Greater (False) Pelvis

A

Superior to pelvic inlet

Occupied by abdominal viscera

Between ilium

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19
Q

Lesser (True) Pelvis

A

Inferior to pelvic inlet

Occupied by pelvic viscera

Very small region

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20
Q

Pelvic Outlet

A

Boundaries:

  • coccyx and sacrum
  • sacrotuberous ligaments
  • ischial tuberosities
  • ischiopubic rami (pubic arch)
  • pubic symphysis

Normally tilted at 15 degrees from horizontal plane (tipped in anatomic position)

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21
Q

Pelvic Diaphragm

A

Muscle separating pelvis above from perineum below

Closes up pelvic outlet

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22
Q

Sex Differences in Pelvis

A

Pelvis inlet:

  • F: larger, round/oval
  • M: heart shaped, narrower anteriorly

Pelvic outlet:
-F: ischial tuberosities and ischial spines more laterally displaced (for babies)

Subpubic angle

  • F: wider (>80)
  • M: narrower (<70)
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23
Q

Sacroiliac Ligaments

A

Anterior
Posterior
Interosseus

Ligaments relax for baby time

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24
Q

Sacrotuberous Ligament

A

Sacrum/coccyx to ischial tuberosity

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25
Q

Sacrospinous Ligament

A

Sacrum/coccyx to ischial spine

26
Q

Axis of Rotation

A

Sacrotuberous and sacrospinous ligaments resist the influence of body weight that rotates the sacrum and coccyx posteriorly and superiorly

27
Q

Greater Sciatic Foramen

A

Superior to ischial spine

Passageway to/from gluteal region

28
Q

Lesser Sciatic Foramen

A

Inferior to ischial spine

Passageway to/from perineum

29
Q

Obturator Membrane

A

Closes obturator foramen except obturator canal

30
Q

Obturator Canal

A

Passageway to medial compartment of thigh

Conveys neurovascular structures (obturator nerve)

31
Q

Muscles of Lesser Pelvis: Piriformis

A

Posterior wall of lesser pelvis

Origin: ant surface of sacrum
Courses through greater sciatic foramen
Insertion: femur

Innervation: sacral plexus

32
Q

Muscles of Lesser Pelvis: Obturator Internus

A

Lateral walls of lesser pelvis

Origin: obturator membrane and margin of obturator foramen
Courses through lesser sciatic foramen
Insertion: femur

Innervation: sacral plexus

Covered on medial surface by thick obturator fascia (attachment for muscles of pelvic diaphragm)

33
Q

Muscles of Lesser Pelvis: Pelvic Diaphragm

A

Bowl/funnel shaped

R and L fuse in midline to form median raphe

Closes inferior pelvic aperture/pelvic outlet and forms pelvic floor

Supports pelvic viscera superiorly, perineum lies inferior

Pelvic structures pass through to reach perineum (urethra, vagina, rectum)

Innervation: branches of sacral and coccygeal plexuses

34
Q

Tendinous Arch of Levator Ani

A

Obturator fascia thickens centrally as tendinous arch for attachment of levator ani

Ends at ischial spine

35
Q

Pelvic Diaphragm: Composed of 2 Muscles

A

Levator Ani

Coccygeus

36
Q

Coccygeus

A

Extends from ischial spine to coccyx/inf sacrum

Lies on internal surface of sacrospinous ligament

37
Q

Levator Ani

A

Extends from pubis/ischial spine to coccyx/median raphe

38
Q

Levator Ani: Openings

A

Posterior: anal aperture

Anterior: urogenital hiatus (passageway for urethra)(F: also vagina, vaginal canal)

Ant
urethra
vagina
rectum
Post
39
Q

Levator Ani: Portions

A

Pubococcygeus

Iliococcygeus

40
Q

Pubococcygeus

A

Fibers wrap around pelvic viscera

Muscular slings = support

Pubovaginalis (F)
Puboprostatiucs (M)
Puborectalis

41
Q

Puborectalis

A

Sling around anorectal junction
Maintains anorectal flexure

Relaxes during defecation - rest of levator ani/pelvic diaphragm contracts to prevent viscera from herniating

42
Q

Pelvic Diaphragm: Weakness

A

Urinary stress incontinence

Bowel incontinence

Prolapse of pelvic viscera

43
Q

Pelvic Arteries

A

Gonadal (ovarian/testicular)

Abdominal aorta

Common iliac

External iliac

Internal iliac

44
Q

Gonadal Arteries

A

Branches of ab aorta

Testicular: travel within spermatic cords inf

Ovarian: travel within suspensory ligaments of ovaries
-supply gonads, uterine tubes, uterus

45
Q

Common Iliac Arteries

A

Divide into external and internal iliac arteries

46
Q

External Iliac Artery

A

Supplies anterolateral ab wall and LE

47
Q

Internal Iliac Artery

A

Primary blood supply to pelvis, perineum, gluteal region

48
Q

Internal Iliac Artery: Branches

A 
Superior gluteal artery
Inferior gluteal artery
Internal pudendal artery
Umbilical artery
Obturator artery
*Aberrant obturator artery*
Superior vesicle artery
Inferior vesical artery
Uterine artery (F)
Vaginal artery (F)
Middle rectal artery
49
Q

Superior Gluteal Artery

A

Exits greater sciatic foramen

Superior to piriformis to supply gluteal region

50
Q

Inferior Gluteal Artery

A

Exits greater sciatic foramen

Inferior to piriformis to supply gluteal region

51
Q

Internal Pudendal Artery

A

Makes a U turn - exits greater sciatic foramen

Travels to perineum via lesser sciatic foramen

Supplies structures of perineum

Gives rise to inferior rectal artery (supplies anal canal)

52
Q

Umbilical Artery

A

Gives rise to superior vesical artery supplying superior aspect of bladder (and ductus deferens in M)

Obliterated portion continues on as medial umbilical ligaments

53
Q

Obturator Artery

A

Courses along lateral wall of pelvis with obturator vein and nerve

Exits pelvis via obturator canal to enter medial compartment of thigh

54
Q

Aberrant Obturator Artery

A

20% of population

Arises from inferior epigastric artery (branch of external iliac)

Courses over superior pubic ramus to exit via obturator canal

Can be accidentally damaged during inguinal hernia repairs

55
Q

Inferior Vesical Artery

A

Direct branch of internal iliac (M)

Supplies inferior bladder, urethra, seminal vesicle, prostate

56
Q

Uterine Artery

A

F

Passes superior to ureter

57
Q

Vaginal Artery

A

F

Supplies vagina, inf bladder (via inferior vesical branch), urethra

Anastomoses with uterine arteries which anastomose with ovarian arteries

58
Q

Middle Rectal Artery

A

Emerges off pudendal

Anastomoses with superior and inferior rectal arteries (branch of IMA)

59
Q

Pelvic Veins

A

Similar to arterial pattern (share names)

60
Q

Venous Plexuses

A 
Prostatic
Uterine
Vaginal
Vesical
Rectal
61
Q

Pelvic Lymphatics

A

Internal iliac nodes –> common iliac nodes –> lumbar nodes –> chyle cistern –> thoracic duct

62
Q

Gonadal Lymphatics

A

Ovaries, testes –> lumbar nodes –> chyle cistern –> thoracic duct

PHA 500 (11 decks)

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