27- Bony Pelvis & Pelvic Wall Flashcards

1
Q

What does the bony pelvis (pelvic girdle) consist of?

A

Sacrum
Coccyx
Right and Left Os Coxae (hip bones)

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2
Q

The Os Coxae are composed of three bones, which are…

A

Ilium
Ischium
Pubis

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3
Q

At what age is the fusion of the Os Coxae complete?

A

Age 17

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4
Q

The Os Coxae articulate anteriorly with each other at the ________ ________ and posteriorly with the _______.

A

Pubic Symphysis

Sacrum (S1-S3 only; at the Sacroiliac Joints)

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5
Q

The sacrum is composed of ______ vertebrae whose fusion is complete by the _______ year.

A

5

25th

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6
Q

The ________ is composed of 3 to 5 fused vertebrae.

A

Coccyx

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7
Q

The Coccyx articulates with the Sacrum at the ________ ________, which contains a fibrocartilaginous disc.

A

Sacrococcygeal Symphysis

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8
Q

In infants and children, each hip bone consists of three separate bones united by a tri-radiate cartilage at the _________, a cup-like depression in the lateral surface of the hip bone that articulates with the head of the femur.

A

Acetabulum

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9
Q

The concavity between the ischial spine and the ischial tuberosity is the _______ _______ _______.

A

Lesser Sciatic Notch

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10
Q

The larger concavity, the ________ ________ ________, is superior to the ischial spine and is formed in part by the ilium.

A

Greater Sciatic Notch

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11
Q

The _______ is an angulated bone with a superior ramus, which helps form the acetabulum, and an inferior ramus, which contributes to the body borders of the obturator foramen.

A

Pubis

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12
Q

A thickening on the anterior part of the body of the Pubis is the _______ _______, which ends laterally as a prominent swelling called the _______ _______.

A

Pubic Crest

Pubic Tubercle

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13
Q

The lateral part of the superior pubic ramus has an oblique ridge, called the _______ _______.

A

Pectineal Line

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14
Q

The ______ ______ is formed by the right and left ischiopubic rami, which meet at the pubic symphysis.

A

Pubic Arch

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15
Q

The pelvic region is described as having two divisions, which are…

A
Pelvis Major (False Pelvis)
Pelvis Minor (True Pelvis)
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16
Q

The dividing line separating the two divisions of the pelvis is the _______ _______ (pelvic inlet or superior pelvic aperture).

A

Pelvic Brim

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17
Q

The _______ _______ is a bony structure composed of the promontory of the sacrum, anterior border of the ala of the sacrum, iliopectineal line, pubic crest, and superior surface of the pubic symphysis.

A

Pelvic Brim

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18
Q

The bony boundaries of the _______ _______ include the Sacrum, Coccyx, inner surface of the Ischium and Pubis, and a small part of the Ileum.

A

Pelvis Minor (True Pelvis)

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19
Q

The _______ _______ is bounded by the Pubic Arch anteriorly, Ischial tuberosities laterally, Sacrotuberous Ligament posterolaterally, and the tip of the Coccyx posteriorly.

A

Pelvic Outlet (Inferior Pelvic Aperture)

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20
Q

This joint involves the intervertebral disc between L5 and S1, plus the two zygapophysial joints between the articular processes of L5 and S1.

A

Lumbosacral Joint

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21
Q

The large size and greater anterior depth of the IV disc between L5 and S1 allows greater movement and contributes to the _______ _______ of the spine.

A

Lumbar Curve

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22
Q

The ________ ________ stabilizes L5 vertebra on the sacrum by anchoring its transverse processes to the iliac crest, thus limiting forward motion of the L5 vertebra.

A

Iliolumbar Ligament

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23
Q

This joint occurs between S5 and the coccyx, and contains an intervertebral disc. It allows for posterior movement of the coccyx during defecation or childbirth.

A

Sacrococcygeal Joint

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24
Q

What ligaments help stabilize the Sacrococcygeal Joint?

A

Anterior Sacrococcygeal Ligament

Posterior Sacrococcygeal Ligament

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25
Q

The pubic symphysis is located along the anterior midline between the two os coxae. The pubic bones are united by a fibrocartilaginous disc and numerous ligamentous fibers, including a strong _______ _______ and a _______ _______ _______.

A

Arcuate (Inferior Pubic) Ligament

Superior Pubic Ligament

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26
Q

T/F. The subpubic angle is larger in males and less in females.

A

False. The subpubic angle is less in males and larger in females.

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27
Q

In females, the distance between the _______ _______ is greater than in males to provide additional space necessary for birthing a child.

A

Ischial Tuberosities

28
Q

This joint is a synovial joint between the lateral surface of the sacrum (S1-S3 vertebrae) and the internal surface of the ilium, posterior to the iliac fossa.

A

Sacroiliac Joint

29
Q

Several ligaments stabilize the Sacroiliac Joint, including…

A
Interosseous Sacroiliac Ligament
Posterior Sacroiliac Ligament
Iliolumbar Ligament
Sacrotuberous Ligament
Sacrospinous Ligament
30
Q

When a person is in the anatomical position and viewed from the side, the right and left _______ and the anterior aspect of the _______ _______ lie in the same vertical plane.

A

ASIS

Pubic Symphysis

31
Q

The antero-inferior wall of the Pelvic Cavity is formed by what? What does it do?

A

Bodies and rami of the pubic bones and pubic symphysis.

Bears the weight of the urinary bladder.

32
Q

The lateral walls of the Pelvic Cavity are formed by the two hip bones, each of which contains an ________ ________ closed by an ________ ________.

A

Obturator Foramen

Obturator Membrane

33
Q

The _______ _______ muscles cover the lateral pelvic walls and their tendons pass through the Lesser Sciatic Foramina to attach to the _______ _______.

A

Obturator Internus

Greater Trochanter

34
Q

The medial surface of the muscles covering the lateral pelvic walls are covered by obturator fascia, which is thickened centrally as a tendinous arch that provides attachment for the…

A

Pelvic Diaphragm

35
Q

The posterior wall of the Pelvic Cavity consists of a bony wall and roof in the midline formed by the _______ and _______.

A

Sacrum

Coccyx

36
Q

The posterolateral walls of the Pelvic Cavity are formed by the ligaments associated with the…

A

SI Joints

Piriformis Ms.

37
Q

The pelvic floor is formed by the Pelvic Diaphragm which includes what muscles and their fascias?

A

Coccygeus M.

Levator Ani Ms. (includes Iliococcygeus and Pubococcygeus)

38
Q

The Pelvic Diaphragm separates the True Pelvis from the region known as the ________, which contains the anal canal and external genitalia.

A

Perineum

39
Q

What is the origin and insertion for the Piriformis M.?

A

Origin = Lateral masses of S2-S4 vertebrae and the Sacrotuberous Ligament

Insertion = Greater Trochanter of Femur

40
Q

How does the Piriformis M. exit the pelvis?

A

Via the Greater Sciatic Foramen

41
Q

What actions does the Piriformis M. perform?

A

Laterally rotates thigh

42
Q

What innervates the Piriformis M.?

A

N. to Piriformis (S1-S2)

43
Q

What is the origin and insertion of the Obturator Internus M.?

A

Origin = Anterolateral wall of the pelvis minor and obturator membrane

Insertion = Greater Trochanter of Femur

44
Q

How does the Obturator Internus M. exit the pelvis?

A

Via the Lesser Sciatic Foramen

45
Q

What actions does the Obturator Internus M. perform?

A

Laterally rotates thigh

46
Q

What innervates the Obturator Internus M.?

A

N. to Obturator Internus (L5-S1)

47
Q

The _______ _______ forms the floor of the true pelvis and separates it from the perineum. It is comprised of two skeletal muscles and their associated fascia.

A

Pelvic Diaphragm

48
Q

The Pelvic Diaphragm is perforated by what?

A

Urethra
Anal Canal
***Also Vagina in females

49
Q

This muscle is the largest and most important part of the Pelvic Diaphragm. It extends from the pubic bone to the coccyx, and it joins with its counterpart in the midline. It is funnel-shaped and separates the pelvic cavity from the perineum below.

A

Levator Ani

50
Q

What are the parts of the Levator Ani M.?

A

Puborectalis
Pubococcygeus
Iliococcygeus

51
Q

This muscle of Levator Ani originates on the pubis and passes posteriorly to encircle the anorectal junction and fuse with its counterpart, forming a U-shaped rectal “sling”. This is medial and inferior to the Pubococcygeus.

A

Puborectalis

52
Q

The Levator Ani has dual innervation, which is…

A

S3-S4 on its pelvic (superior) surface

Inferior Rectal N. (S2-S4) on its perineal (inferior) surface

53
Q

What actions does the Levator Ani perform?

A

Supports pelvic viscera

Resists inferior thrust

Raises pelvic floor as in forced exhalation, coughing, vomiting, urination, and lifting heavy objects.

54
Q

This muscle of the Levator Ani also increases the angle between the rectum and anal canal, thereby preventing defecation and maintaining bowel continence.

A

Puborectalis

55
Q

This forms the posterior portion of the Pelvic Diaphragm. It originates on the ischial spines and sacrospinous ligaments, and inserts on the lateral surfaces of the anterior sacrum and coccyx.

A

Coccygeus M.

56
Q

What innervates the Coccygeus M.?

A

S4-S5

57
Q

What actions does the Coccygeus M. perform?

A

Supports and pulls forward Coccyx after childbirth or defecation.

58
Q

This fascia is continuous with the abdominal fascia where the two fascias are anchored to the pelvic brim.

A

Pelvic Fascia

59
Q

The Pelvic Fascia has three continuous layers which are in contact with what?

A
  1. Pelvic Diaphragm (Diaphragmatic Fascia)
  2. Hollow Pelvic Organs (Visceral Fascia)
  3. Pelvic Wall and Pelvic Floor (Parietal Fascia)
60
Q

This space is located between the pubic bones and anterior surface of the urinary bladder. Contained in this space is a large amount of subserous fat, which allow for expansion of the urinary bladder.

A

Retropubic Space

61
Q

A _________ space and fascia separate the urinary bladder from the rectum in the male.

A

Rectovesical

62
Q

The rectum is surrounded by ______ ______, which allows for expansion of the rectum before defecation. There is a potential (retrorectal) space between the rectum and sacrum.

A

Loose CT

63
Q

Injury to the pelvic floor is frequently observed during vaginal delivery of a newborn child. Most commonly injured are the ________ and ________ muscles. These muscles support the urethra, vagina, and anal canal so if they are weakened it can result in urinary stress incontinence, prolapse of pelvic organs, and fecal incontinence.

A

Pubococcygeus

Puborectalis

64
Q

What are the types of urinary incontinence?

A

Overflow
Stress
Urge

65
Q

This type of incontinence is due to urethral blockage and the bladder is unable to empty properly.

A

Overflow

66
Q

This type of incontinence is due to a relaxed pelvic floor and increased abdominal pressure.

A

Stress

67
Q

This type of incontinence is due to bladder oversensitivity from infection or neurologic disorders.

A

Urge