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Anatomy Topnotch > 13. Pelvis > Flashcards

13. Pelvis Flashcards

1
Q

region of the trunk that lies below the abdomen

A

pelvis

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2
Q

4 bones that make the pelvis

A

2 hip boes
sacrum
coccyx

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3
Q

bony projection at the supero-lateral border of the body of the pubic bone

A

pubic tubercle

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4
Q

surface landmarks of the pelvis

A 
iliac crest
anterior superior iliac spine
pubic tubercle 
symphysis pubis 
posterior superior iliac crest
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5
Q

pelvic brim boundaries

A

anterior - symphisis pubis
lateral- iliopectineal line
post- sacral promontory

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6
Q

above the pelvic brim

are these structures

A

false pelvis
greater pelvis
pelvis major

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7
Q

below the pelvic brim

are these structures

A

true pelvis
lesser pelvis
pelvis minor

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8
Q

forms part of the abdominal cavity
bounded behind by lumbar vertebra
laterally by iliac fossa and iliacus muscle
in front by anterior abdominal wall

a. false pelvis
b. true pelvis

A

a. false pelvis

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9
Q

great important for obstetrics (bony canal through which the baby passes during birth)

A

true pelvis

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10
Q

pelvic inlet

borders

A

Ant- symphisis pubis
lat- ileopectineal line
post- sacral promontory

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11
Q

pelvic outlet borders

A

Ant- pubic arch
lat- ischia tuberosities
Post - tip of coccyx

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12
Q

contents of Male pelvic cavity

A 
urinary bladder
ureter 
vas deferens
seminal vesicle
prostate gland
prostatic urethra
sigmoid colon
rectum
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13
Q

female pelvic cavity

A 
urinary bladder
ureter
ovary
uterine tube
uterus 
vagina
sigmoid colon
rectum
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14
Q

ligaments of the pelvic cavity

A

sacrotuberous ligament - lateral

sacrospinous ligament - lateral

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15
Q

ligaments of the pelvis divide the sciatic notches to

A

greater sciatic foramen

lesser sciatic foramen

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16
Q

nerves in greater sciatic foramen

A 
pudendal nerve 
nerve to obturator internus 
internal pudendal vessels
piriformis 
superior and inferior gluteal vessels and nerves 
sciatic nerve 
post. femoral cutaneous nerv e 
nerve to quadratus femoris
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17
Q

lesser sciatic foramen

nerves

A

pudendal nerve
nerve to obturator internus
internal pudendal vessels
tendon of obturator internus

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18
Q

is an opening (foramen) in the posterior human pelvis. It is formed by the sacrotuberous and sacrospinous ligaments. The piriformis muscle passes through the foramen and occupies most of its volume.

A

greater sciatic foramen

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19
Q

is an opening (foramen) between the pelvis and the back of the thigh. The foramen is formed by the sacrotuberous ligament which runs between the sacrum and the ischial tuberosity and the sacrospinous ligament which runs between the sacrum and the ischial spine.

A

lesser sciatic foramen

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20
Q

this nerve passes through both greater and lesser sciatic foramens

A

pudendal nerve

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21
Q

tearing of the pelvic diaphragm during childbirth leads to paralysis of

A

levator ani

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22
Q

closed except where it transmits the urethra and anal canal (vagina- females)

A

pelvic outlet

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23
Q

urogental diaphragm is formed by

A

sphincter urethrae

deep transverse perineal m.

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24
Q

pelvic diaphragm formed by

A

levator ani - puborectalis, pubococcygeus, iliococcygeus

coccygeus

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25
Q

seals the opening of bony pelvis
supports pelvic organs
pierced by rectum, urethra, vagina

A

pelvic diaphragm

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26
Q

The pelvic viscera (bladder, rectum, pelvic genital organs and terminal part of the urethra) reside within the

A

pelvic cavity (or the true pelvis)

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27
Q

lateral walls of the pelvis include

A

obturator internus

piriformis

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28
Q

what muscle forms posterior wall of the pelvis

A

piriformis

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29
Q

pelvic floor is also known as the

A

pelvic diaphragm.

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30
Q

muscles that make up the inferior lining of the pelvic cavity

A

pelvic diaphragm

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31
Q

an anteriorly situated gap, which allows passage of the urethra (and the vagina in females).

A

urogenital hiatus

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32
Q

centrally positioned gap, which allows passage of the anal canal.

A

rectal hiatus

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33
Q

Between the urogenital hiatus and the anal canal lies a fibrous node known as the

A

perineal body

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34
Q

joins the pelvic floor to the perineum

A

perineal body

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35
Q

functions of pelvic floor muscles

A

Support of abdominopelvic viscera

Resistance to increases in intra-pelvic/abdominal pressure

Urinary and faecal continence.

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36
Q

levator ani m. innervated by

A

anterior ramus of S4 and branches of the pudendal nerve (roots S2, S3 and S4).

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37
Q

broad sheet of muscle. It is composed of three separate paired muscles; pubococcygeus, puborectalis and iliococcygeus.

A

levator ani

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38
Q

thickened fascia of the obturator internus muscle, known as the

A

tendinous arch

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39
Q

attachments of levator ani m

A

Anterior – pubic bodies of the pelvic bones.
Laterally – thickened fascia of the obturator internus muscle, known as the tendinous arch.
Posteriorly – ischial spines of the pevlic bones.

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40
Q

is a U-shaped sling, extending from the bodies of the pubic bones, past the urogenital hiatus, around the anal canal

A

puborectalis m.

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41
Q

Its tonic contraction bends the canal anteriorly, creating the anorectal angle (90 degrees) at the anorectal junction (where the rectum meets the anus).

A

puborectalis m.

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42
Q

main fx of puborectals muscle is to

A

maintain faecal continence – during defecation this muscle relaxes.

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43
Q

These fibers are very important in preserving urinary continence, especially during abrupt increase of the intra-abdominal pressure i.e. during sneezing.

A

pubovaginalis or sphincter urethrae / vaginae)

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44
Q

Some fibers of the puborectalis muscle (pre-rectal fibers) form another U-shaped sling that flank the urethra in the male and the urethra and vagina in the female

A

pubovaginalis or sphincter urethrae / vaginae

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45
Q

main constituent of the levator ani.

A

Pubococcygeus

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46
Q

They arise from the body of the pubic bone and the anterior aspect of the tendinous arch. The fibres travel around the margin of the urogenital hiatus and run posteromedially, attaching at the coccyx and anococcygeal ligament.

A

Pubococcygeus

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47
Q

has thin muscle fibres, which start anteriorly at the ischial spines and posterior aspect of the tendinous arch. They attach posteriorly to the coccyx and the anococcygeal ligament.

A

Iliococcygeus

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48
Q

This part of the levator ani is the actual “levator” of the three: its action elevates the pelvic floor and the anorectal canal.

A

Iliococcygeus

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49
Q

Coccygeus

innervated by

A

anterior rami of S4 and S5

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50
Q

is the smaller, and most posterior pelvic floor component – as the levator ani muscles are situated anteriorly.

A

coccygeus (or ischiococcygeus)

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51
Q

this m. originates from the ischial spines and travels to the lateral aspect of the sacrum and coccyx, along the sacrospinous ligament.

A

coccygeus

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52
Q

During the second phase of childbirth, these structures are at high risk of damage.

A

levator ani muscles and/or the pudendal nerve

Pubococcygeus and puborectalis are the most prone to injury due to them being situated most medially.

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53
Q

injury to the pelvic floor muscles during childbirth lead to

A

urinary stress incontinence and rectal incontinence

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54
Q

Prolapse of the vagina can also occur if there is damage to the ___ during childbirth

A

perineal body

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55
Q

If the medial fibres of the puborectalis are torn within the perineal body, then this can occur

A

rectal herniation

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56
Q

There are a number of risk factors which can increase the chances of prolapse

A

Age
Number of vaginal deliveries
Family history of pelvic floor dysfunction
Weight
Chronic coughing (e.g from a lung disorder)

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57
Q

levator ani

innervation

A

pelvic side - lower sacral n.

perineal side - inferior hemorrhoidal n.

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58
Q

cervix, isthmus, and body of the uterus protrude into the superior aspect of the vagina , bleeding and discharge into the vagina

A

uterine prolapse

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59
Q

bladder herniates into the upper part of the anterior wall of the vagina
•urinary problems

A

cystocele

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60
Q

rectum herniates into the lower part of the posterior wall of vagina

A

rectocele

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61
Q

divides the perineum into the posterior anal triangle and anterior urogenital triangle.

A

theoretical line connecting the two ischial tuberosities of the pelvis

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62
Q

is an anatomical region in the pelvis. It is located between the thighs, and represents the most inferior part of the pelvic outlet.

A

perineum

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63
Q

separated from the pelvic cavity superiorly by the pelvic floor.

A

perineum

64
Q

shape of the perineum

A

diamond shaped

65
Q

anatomical borders of the perineum

A 
Anterior – pubic symphysis.
Posterior – tip of the coccyx.
Laterally – inferior pubic rami and inferior ischial rami, and the sacrotuberous ligament.
Roof – pelvic floor.
Base – skin and fascia.
66
Q

The perineum can be subdivided by a theoretical line drawn transversely between the

A

ischial tuberosities

67
Q

The perineum can be subdivided by a theoretical line drawn transversely between the ischial tuberosities. This split forms the

A

anterior urogenital triangle and the posterior anal triangle

68
Q

surface borders of the perineum

A

Anterior – mons pubis in females, base of the penis in males.
Laterally – medial surfaces of the thighs.
Posterior – superior end of the intergluteal cleft

69
Q

posterior half of the perineum. It is bounded by the coccyx, sacrotuberous ligaments, and a theoretical line between the ischial tuberosities.

A

anal triangle

70
Q

main contents of the anal triangle are:

A

Anal aperture – the opening of the anus.
External anal sphincter muscle – voluntary muscle responsible for opening and closing the anus.
Ischioanal fossae (x2) – spaces located laterally to the anus.

71
Q

this nerve supplies the whole perineum with somatic fibers

A

pudendal nerve

72
Q

anal aperture is located centrally in the triangle with these structure on either side

A

ischioanal fossae

73
Q

anterior half of the perineum.

A

urogenital triangle

74
Q

boundaries of the urogenital triangle

A

pubic symphysis, ischiopubic rami, and a theorectical line between the two ischial tuberosities

75
Q

Unlike the anal triangle, the urogenital triangle has an additional layer of strong deep fascia; the

A

perineal membrane

76
Q

The layers of the urogenital triangle (deep to superficial):

A
  1. deep perineal pouch
  2. perineal membrane
  3. superficial perineal pouch
  4. perineal fascia
  5. skin
77
Q

potential space between the deep fascia of the pelvic floor (superiorly) and the perineal membrane (inferiorly).

A

deep perineal pouch

78
Q

It contains part of the urethra, external urethral sphincter, and the vagina in the female. In males, it also contains the bulbourethral glands and the deep transverse perineal muscles.

A

deep perineal pouch

79
Q

a layer of tough fascia, which is perforated by the urethra (and the vagina in the female). The role of the membrane is to provide attachment for the muscles of the external genitalia.

A

perineal membrane

80
Q

a potential space between the perineal membrane (superiorly) and the superficial perineal fascia (inferiorly)

A

superficial perineal pouch

81
Q

this layer contains erectile tissues that form the penis and clitoris, and three muscles – the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles.

A

superficial perineal pouch

82
Q

The greater vestibular glands (Bartholin’s glands) are also located in the

A

superficial perineal pouch

83
Q

superficial perineal pouch

bounded posteriorly to the

A

perineal body

84
Q

this layer of urogenital triangle is a continuity of the abdominal fascia

A

perineal fascia

85
Q

layers of the perineal fascia

A 
Deep fascia: covers the superficial perineal muscles and protruding structures (e.g. penis & clitoris).
Superficial fascia is composed of a further two layers of fascia:
Superficial layer – continuous with Camper’s fascia of the anterior abdominal wall
Deep layer (Colles’ fascia) – continuous with Scarpa’s fascia of the anterior abdominal wall
86
Q

irregular fibromuscular mass. It is located at the junction of the urogenital and anal triangles – the central point of the perineum

A

perineal body

87
Q

perineal body acts a s a point of attachment of

A

Levator ani (part of the pelvic floor).
Bulbospongiosus muscle.
Superficial and deep transverse perineal muscles.
External anal sphincter muscle.
External urethral sphincter muscle fibres.

perineum

88
Q

it acts as a tear resistant body between the vagina and the external anal sphincter, supporting the posterior part of the vaginal wall against prolapse. In the male, it lies between the bulb of penis and the anus.

A

perineal body

89
Q

The major neurovascular supply to the perineum is from the

A

pudendal nerve (S2 to S4) and the internal pudendal artery.

90
Q

The pudendal nerve (along with the internal pudendal artery and vein) travel along the inner surface of the ischial tuberosities, through a “canal” formed by a thickening of the obturator fascia

A

Alcock’s canal

91
Q

Bartholin’s glands are not detected on physical examination. However, if the duct becomes blocked, then these glands can swell to form fluid-filled cysts.

These cysts can become infected and inflamed, a condition known as

A

Bartholinitis

92
Q

Bartholinitis

most common cause

A

Staphylococcus spp. and Escherichia coli.

93
Q

incision is made in the perineal body from the midline of the hymenal ring through the connective tissue that unites the bulbocavernous muscle, the superficial transverse perineal muscles, and the perineal membrane (urogenital diaphragm).

A

midline episiotomy

94
Q

the anatomic structures involved in this episiotomy include

A

vaginal epithelium, transverse perineal muscle, bulbocavernosus muscle, and perineal skin.

95
Q

3 cylinders of erectile tissue of males are enclosed by

A

Buck’s fascia

96
Q

penis contains

A

root - 3 erectile tissues (bulb of penis and r/l crura of penis )
•bulb forms corpus spongiosum
•crura forms corpora cavernosa
body - 3 cylinders enclosed by buck’s fascia

97
Q

blood supply of the penis

A

deep arteries and dorsal arteries of the penis- internal pudendal

98
Q

lymph drainage

penis

A

skin- superficial inguinal nodes

deep structures- internal iliac nodes

99
Q

outpouching , contains testes, epididymis, lower ends of spermatic cord

A

scrotum

100
Q

wall of the scrotum

superficial -> deep

A 
skin 
superficial fascia with dartos muscle
external spermatic fascia
cremasteric muscle
internal spermatic fascia 
tunica vaginalis
101
Q

contents of the female urogenital triangle

A
  • external genitalia of the urethra and vagina
  • clitoris
  • body
  • glans
102
Q

this structure is situated at the apex of the vestibule

A

clitoris

103
Q

boundaries of the ischioanal fossae

A

base - skin overlying anal triangle
lateral - obturator internus m. and fasci a
medial- levator ani

104
Q

contents of ischioanal fossae

A

fats
inferior rectal A/V
inferior rectal N
perineal branch of the femoral cutaneous n.

105
Q

each common iliac artery ends at this structure

A

pelvic inlet

in front of sacroiliac joint

106
Q

common iliac artery divides into

A

external iliac a.

internal iliac a.

107
Q

at this structure the internal iliac divides into anterior and posterior division

A

greater sciatic foramen

108
Q

anterior division of the internal iliac a.

A 
umbilical- superior vesical
obturator 
inferior vesical (male)/ vaginal (female)
middle rectal
internal pudendal
inferior gluteal
uterine
109
Q

posterior division of the internal iliac a.

A

iliolumbar
lateral sacral
superior gluteal

110
Q

blood supply of the superior part of UB

A

superior vesical

111
Q

blood supply of the pelvic muscles; medial compartment of the thigh

A

obturator a.

112
Q

blood supply of the base of UB, rostate, seminal vesicle, ductus deferens, lower ureter

A

inferior vesical

113
Q

blood supply of the rectum and anal canal

A

middle rectal

114
Q

blood supply of the m. of the anal canall skin and muscles of the perineum

A

internal pudendal

115
Q

blood supply of the uterus

A

uterine

116
Q

branches of the internal pudendal artery

A 
inferior rectal
perineal
superficial perineal
deep artery of the penis/ clitoris 
dorsal artery of penis/ clitoris 
perineum, skin  and m. of anal triangle and urogenital triangle and erectile bodies
117
Q

leaves the main pelvic cavity through greater sciatic foramen and enters perineu through lesser sciatic foramen

A

pudendal nerve

118
Q

branches of the pudendal nerve

A

inferior rectal - perianal skin, ext. anal sphincter, mucous membrane - lower anal canal
dorsal nerve of the penis/ clitoris
perineal - perineal m. / skin

119
Q

this structure serves as a hallmark in doing pudendal block anesthesia through transvaginal approach

A

ischial spine

120
Q

bony landmark in doing pudendal nerve block, perineal procedure

A

ischial tuberosity

121
Q

motor fx of pudendal nerve

A 
maintain voluntary urinary continence
maintain voluntary fecal continence 
supports pelvic viscera 
maintain erection
facilitates expulsion of urine from the penile urethra during micturition; sperm and seminal fluid during ejaculation
122
Q

early genital systems in 2 sexes are similar and is referred to as indifferent stage and lasts until __ week of human development

A

7th week

123
Q

gonadal sex is determined by

A

testis determining factor on the Y chromsome

124
Q

directs testicular differentiation

A

TDF

125
Q

induces masculine differentiation of mesonephric ducts and external genitalia

A

testosterone

126
Q

___ week leydig/ interstitial cells secrete testosterone and androstenedione which induce masculine differentiation of mesonephric ducts and external genitalia

A

leydig/ interstitial cells

127
Q

secretes mullerian inhibiting substance/ MIH or antimullerian hormone / AMH which inhibits development of paramesonephric ducts

A

sertoli cells

128
Q

how ovaries develop

A

absence of Y chromosome
ovaries develop
mesonephric duct regress
paramesonephric duct develop

129
Q

dev of male genital ducts

A

fetal testes product testosterone (8th week) -> mesonephric duct -> epidymidis, vas deferens and ejaculatory duct develop

130
Q

failure of the fusion of paramesonephric duct may give rise to

A

bicornuate uterus

131
Q

paramesonephric duct gives rise to

A

uterine tubes
uterus
vagina

132
Q

gametogenesis is controlled by this hormone

A

FSH from anterior pituitary gland

133
Q

primary oocytes formed ___ month remain dormant until puberty

A

5th month

134
Q

primary oocytes arrested in this stage of cell cycle

A

prophase of Meiosis I

135
Q

primordial germ cells form gonad at week

A

week 4 q

136
Q

after puberty, primary oocyte completes meiosis I forming

A

secondary oocyte and 1st polar body

137
Q

secondary oocyte are arrested at this stage until fertilization occurs

A

metaphase Meiosis II

138
Q

at fertilization, secondary oocyte completes meiosis II forming

A

mature oocyte and second polar body

139
Q

at puberty, gonad diff into spermatogonia ->

A

primary spermatocytes (meiosis I) -> two secondary spermatocytes (Meiosis II) -> 4 spermatids

140
Q

growth and differentiation of spermatogenesis occurs

A

puberty until old age

141
Q

oogenesis

growth and differentiation

A

fetal life until birth

142
Q

meiosis I

spermatogenesis

A

reductional and equal

143
Q

oogenesis

meiosis I

A

reductional and unequal

144
Q

meiosis II in spermatogenesis

A

always take place and completed

145
Q

meiosis II in oogeness

A

not always completed

146
Q

transformation

spermatogenesis

A

present

147
Q

transformation

oogenesis

A

absent

148
Q

gametes formed

spermatogenesis

A

4 sperm cells

149
Q

gametes formed

oogenesis

A

1 egg

150
Q

normal meiosis, disjunction

gametes with ___ chromosomes are produced

A

23 single chromsomes

151
Q

in nondisjunction- abnormal gametes

___ chromosomes are produced

A

gametes ith 24 or 22 chromosomes

152
Q

fetilization between normal gamete and abnormal gamete forms

A

47, trimomy

45, monosomy

153
Q

47, XXY

only in males

A

klinefelter syndrome

154
Q

45, XO only in females

A

turner syndrome

155
Q

s and sx of klinefelter

A

sterility,
testicular atrophy
gynecomastia

156
Q

incidence of klinefelter’s syndrome

A

1 in 500

157
Q

turner syndrome

s and sx

A 
absence of ovaries 
short stature 
webbed neck 
skeletal deformities 
broad chest with widely spaced nipples

Anatomy Topnotch (26 decks)

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