The Pelvic Wall Flashcards
false pelvis (___):
above the ___
portion of abdomen between the ___
greater
pelvic brim
iliac fossa
true pelvis (___)
below the ___
lesser
pelvic brim
borders of the true pelvis (2)
pelvic inlet (pelvic inlet, pelvic brim, superior pelvic aperture)
pelvic outlet (inferior pelvic aperture)
borders of the true pelvis: pelvic inlet (pelvic inlet, pelvic brim, superior pelvic aperture) (3)
pubic symphysis & crest
iliopectineal lines
sacral promontory
borders of the true pelvis: pelvic outlet (inferior pelvic aperture) (5)
pubic symphysis ischiopubic ramus ischial tuberosities sacrotuberous ligaments coccyx
pelvic diaphragm:
separates ___ from the ___ below
pelvis
perineum below
pubic tubercles & the ASIS
located on the ___ in the anatomical position
same vertical plane
walls of the pelvis: anterior wall (2)
pubic bone
pubic symphysis
walls of the pelvis: lateral wall (3)
hip bone below the pelvic inlet
obturator membrane
obturator internus muscle
walls of the pelvis: posterior wall (3)
sacrum
coccyx
piriformis muscle
membranes & ligaments of the pelvis:
obturator membrane:
___ sheet that almost completely encloses the ___
leaves a small gap (___) for the passage of the ___
fibrous
obturator foramen
obturator canal
obturator nerve & vessels
membranes & ligaments of the pelvis:
sacrotuberous & sacrospinous ligaments:
sacrotuberous - strong ligament extending from the ___ to the ___
sacrospinous ligament - strong ligament extending from the ___ to the ___
the sacrotuberous is ___ to the sacrospinous ligament
lateral part of the sacrum & coccyx
ischial tuberosity
lateral part of the sacrum & coccyx
ischial spine
superficial
membranes & ligaments of the pelvis:
sacrotuberous & sacrospinous ligaments:
functions:
the sacrotuberous & sacrospinous ligaments prevent the ___ from being ___ at the ___ by the ___
they also covert the greater & lesser ___ into the greater & lesser ___
lower end of the sacrum & coccyx
rotated upward
sacroiliac joint
weight of the body
sciatic notches
sciatic foramina
the pelvic floor (___):
consists of the extensive ___ & the smaller ___ posteriorly
a ___ sheet of muscle through which the ___, ___, & ___ pass into the ___ below
it is incomplete ___ at the ___ to allow for the passage of the ___ (males & females) & the ___ (females)
the pelvic diaphragm
levator ani muscle
coccygeus muscle
thin, funnel-shaped
urethra, vagina, & anal canal
perineum
anteriorly
urogenital hiatus
urethra
vagina
nerve supply of the pelvic diaphragm:
pelvic surface - ___
perineal surface - ___
ventral rami of S3 & S4
perineal branch of the pudendal nerve
actions of the pelvic diaphragm:
supports the ___
resists a rise in ___ during ___
has important ___ actions on the ___ & the ___
pelvic viscera
intrapelvic pressure
straining or expulsive efforts of the abdomen (e.g., during coughing)
sphincter
ano-rectal junction
vagina
sex differences of the pelvis
the sexual differences of the male & female pelvis are due mainly to the ___ build & ___ muscles of men & to the adaptation of the female pelvis for ___
the male pelvis is ___ & ___ & has more prominent ___
the female pelvis is ___, ___, & has a larger ___
heaver
larger
childbearing
heavier
thicker
bone markings
wider
shallower
pelvic inlet & outlet
the pelvic fascia:
parietal pelvic fascia:
continuous above /w the fascia lining the ___
forms relatively ___ membranes on the pelvic surface of ___ & blends with the ___ of the ___
named according to the ___ (e.g., ___)
abdominal wall (endoabdominal fascia layer: e.g., transversalis fascia)
dense
muscles
periosteum
bony pelvic boundaries
underlying muscle (e.g., obturator internus fascia)
the pelvic fascia:
visceral pelvic fascia:
___ tissue investing the ___ (e.g., ___)
looser connective pelvic viscera (e.g., bladder, vagina, uterus, rectum)
the pelvic fascia:
arcus tendinous
important as the origin of a large portion of the ___
thickening of the obturator internus fascia
levator ani muscle
the pelvic fascia:
subperitoneal pelvic fascia:
continuation of the ___ from the ___ into the ___
condensations (dense portions) of the fascia form ___
all ligaments blend medially with the ___ of either the ___, ___, ___, or ___ & laterally with the ___
extraperitoneal fascia
abdomen
pelvis
visceral ligaments
visceral fascia
prostate, bladder, vagina, or cervix
parietal pelvic fascia
examples of visceral ligaments formed by the condensations of the subperitoneal pelvic fascia in females (3)
pubovesical ligaments
transverse cervical ligaments (cardinal ligaments, mackenrodt’s ligament)
sacrouterine ligament
blood vessels of the pelvis:
common iliac artery:
bifurcates at the ___ in front of the ___ into ___ (1) & ___ (2) arteries
the ___ artery continues the course of the ___ along the ___
the ___ artery passes downward into the ___ & contributes most of the blood supply to the ___ with three exceptions
pelvic brim
sacroiliac joint
external & internal iliac
external iliac
common iliac artery
pelvic brim
internal iliac
pelvis
pelvis
the internal iliac artery contributes most of the blood supply of the pelvis with the following exceptions (3)
ovarian artery (branch of abdominal aorta)
superior rectal artery (terminal branch of the infererio mesenteric artery)
median sacral artery (branch of abdominal aorta right before bifurcation)
blood vessels of the pelvis:
internal iliac artery:
divides into ___ & ___ divisions
great ___ in the branching pattern
anterior
posterior
variation
blood vessels of the pelvis:
posterior divisions of the internal iliac arteries (3)
iliolumbar artery
lateral sacral arteries
superior gluteal artery
blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
iliolumbar artery:
ascends along the ___ in front of the ___
often separates the ___ from the ___ medial to the ___ muscles
supplies the ___ & ___ muscles
lumbosacral trunk
ala of the sacrum
lumbosacral trunk
obturator nerve
psoas major
iliacus
psoas major
blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
lateral sacral arteries:
pass medially entering the ___ supplying the ___
pelvic foramina
nerve roots
blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
superior gluteal artery:
usually separates the ___ form the ___
leaves the ___ above the ___ muscles
lumbosacral trunk
ventral ramus of S1
greater sciatic foramen
prirformis
blood vessels of the pelvis:
anterior divisions of the internal iliac artery (8)
umbilical artery obturator artery inferior vesical artery (males only) middle rectal artery uterine artery vaginal artery (females only) internal pudendal artery inferior gluteal artery
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
umbilical artery:
gives off the ___
continues forward as the ___
superior vesical arteries
medial umbilical ligament
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
obturator artery:
passes with the ___ through the ___
in 30% of cases, it arises from the ___ or the ___ & is termed the ___
obturator nerve
obturator canal
inferior epigastric artery
external iliac artery
anomalous obturator artery
an anomalous obturator artery is clinically significant b/c it runs close to or across the ___ to reach the ___
b/c of its close association to the neck of a ___, the artery is in danger of being ___ when a ___ or ___ is surgically corrected
femoral ring
obturalor canal
femoral hernia
divided
triangulated or obstructed femoral nernia
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
inferior vesical artery:
only in ___
usually gives off the ___
males
artery of the ductus deferens
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
uterine artery
passes medially within the ___ below the root of the ___
passes above the ___ near the ___ of the vagina
cardinal ligament
broad ligament
ureter
lateral fornix
“water runs under the bridge”
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
vaginal artery:
homolog of the ___ in the male
runs to the side of the ___ in the ___ & then descends into the ___
also helps supply the ___
inferior vesical artery
vagina
pelvis
perineum
bladder
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
internal pudendal artery:
exits the ___ between the ___ & ___ muscles running with the ___
pelvis
piriformis & coccygeus
pudendal
blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
inferior gluteal artery:
passes between the ___
exits the ___ through the ___ below the ___
ventral ramus of S1 & S2 or S2 & S3
pelvis
grater sciatic foramen
piriformis muscle
blood vessels of the pelvis:
veins of the pelvis:
correspond closely to the ___
the tributaries of the internal iliac vein communicate freely with ___ & ___ outside their territory of drainage
arteries
each other
others
clinically significant anastomoses b/n the ___ & the ___ via veins which pass through the pelvic foramina
metastasis of neoplasms from ___ may pass through these veins & lodge in ___ bone of the vertebrae or even reach the ___
internal iliac vein tributaries
vertebral venous plexus
pelvic viscera
cancellous
cranial cavity
nerves of the pelvis:
the sacral plexus:
forms on the ___ surface of the ___ muscle
formed by the ___ & ___
all branches leaving the pelvis exit through the ___
pelvic
piriformis
lumbosacral trunk
ventral rami of S1 - S4
greater sciatic formaen
nerves of the pelvis:
the sacral plexus:
lumbosacral trunk:
composed of the descending portion of the ___ & all of the ___
descends over the ___ & joins ___ in the pelvis just beyond the ___
ventral ramus of L4
ventral ramus of L5
sacroiliac joint
S1
superior gluteal artery
nerves of hte pelvis:
pelvic splanchnic nerves
preganglionic parasympathetic fibers of S2 - S4
nerves of the pelvis:
obturator nerve:
levels ___ from ___ plexus
runs along the lateral wall of the pelvis between the ___ & ___ within the ___
meets the ___ & ___ at the ___
L2 - L4
lumbar
external & internal iliac arteries
ovarian fossa
obturator artery & vein
obturator canal
nerves of the pelvis:
pelvic sympathetic trunk:
passes over the ___ behind the ___
the trunks descend & converge medial to the ___
the trunks fuse w/ each other in front of the ___ to form the small enlargement ___
pelvic brim
iliac vessels
pelvic foramina
coccyx
ganglion impar
