27- Bony Pelvis & Pelvic Wall

Question 1

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

Answer 1

Sacrum
Coccyx
Right and Left Os Coxae (hip bones)

Question 2

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

Answer 2

Ilium
Ischium
Pubis

Question 3

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

Answer 3

Age 17

Question 4

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

Answer 4

Pubic Symphysis

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

Question 5

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

Answer 5

5

25th

Question 6

The ________ is composed of 3 to 5 fused vertebrae.

Answer 6

Coccyx

Question 7

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

Answer 7

Sacrococcygeal Symphysis

Question 8

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.

Answer 8

Acetabulum

Question 9

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

Answer 9

Lesser Sciatic Notch

Question 10

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

Answer 10

Greater Sciatic Notch

Question 11

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.

Answer 11

Pubis

Question 12

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

Answer 12

Pubic Crest

Pubic Tubercle

Question 13

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

Answer 13

Pectineal Line

Question 14

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

Answer 14

Pubic Arch

Question 15

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

Answer 15

Pelvis Major (False Pelvis)
Pelvis Minor (True Pelvis)

Question 16

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

Answer 16

Pelvic Brim

Question 17

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.

Answer 17

Pelvic Brim

Question 18

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

Answer 18

Pelvis Minor (True Pelvis)

Question 19

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

Answer 19

Pelvic Outlet (Inferior Pelvic Aperture)

Question 20

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

Answer 20

Lumbosacral Joint

Question 21

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.

Answer 21

Lumbar Curve

Question 22

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

Answer 22

Iliolumbar Ligament

Question 23

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.

Answer 23

Sacrococcygeal Joint

Question 24

What ligaments help stabilize the Sacrococcygeal Joint?

Answer 24

Anterior Sacrococcygeal Ligament

Posterior Sacrococcygeal Ligament

Question 25

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 _______ _______ _______.

Answer 25

Arcuate (Inferior Pubic) Ligament Superior Pubic Ligament

Question 26

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

Answer 26

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

Question 27

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

Answer 27

Ischial Tuberosities

Question 28

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.

Answer 28

Sacroiliac Joint

Question 29

Several ligaments stabilize the Sacroiliac Joint, including...

Answer 29

``` Interosseous Sacroiliac Ligament Posterior Sacroiliac Ligament Iliolumbar Ligament Sacrotuberous Ligament Sacrospinous Ligament ```

Question 30

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.

Answer 30

ASIS | Pubic Symphysis

Question 31

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

Answer 31

Bodies and rami of the pubic bones and pubic symphysis. Bears the weight of the urinary bladder.

Question 32

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

Answer 32

Obturator Foramen | Obturator Membrane

Question 33

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

Answer 33

Obturator Internus | Greater Trochanter

Question 34

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...

Answer 34

Pelvic Diaphragm

Question 35

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

Answer 35

Sacrum | Coccyx

Question 36

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

Answer 36

SI Joints | Piriformis Ms.

Question 37

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

Answer 37

Coccygeus M. Levator Ani Ms. (includes Iliococcygeus and Pubococcygeus)

Question 38

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

Answer 38

Perineum

Question 39

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

Answer 39

Origin = Lateral masses of S2-S4 vertebrae and the Sacrotuberous Ligament Insertion = Greater Trochanter of Femur

Question 40

How does the Piriformis M. exit the pelvis?

Answer 40

Via the Greater Sciatic Foramen

Question 41

What actions does the Piriformis M. perform?

Answer 41

Laterally rotates thigh

Question 42

What innervates the Piriformis M.?

Answer 42

N. to Piriformis (S1-S2)

Question 43

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

Answer 43

Origin = Anterolateral wall of the pelvis minor and obturator membrane Insertion = Greater Trochanter of Femur

Question 44

How does the Obturator Internus M. exit the pelvis?

Answer 44

Via the Lesser Sciatic Foramen

Question 45

What actions does the Obturator Internus M. perform?

Answer 45

Laterally rotates thigh

Question 46

What innervates the Obturator Internus M.?

Answer 46

N. to Obturator Internus (L5-S1)

Question 47

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.

Answer 47

Pelvic Diaphragm

Question 48

The Pelvic Diaphragm is perforated by what?

Answer 48

Urethra Anal Canal ***Also Vagina in females

Question 49

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.

Answer 49

Levator Ani

Question 50

What are the parts of the Levator Ani M.?

Answer 50

Puborectalis Pubococcygeus Iliococcygeus

Question 51

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.

Answer 51

Puborectalis

Question 52

The Levator Ani has dual innervation, which is...

Answer 52

S3-S4 on its pelvic (superior) surface Inferior Rectal N. (S2-S4) on its perineal (inferior) surface

Question 53

What actions does the Levator Ani perform?

Answer 53

Supports pelvic viscera Resists inferior thrust Raises pelvic floor as in forced exhalation, coughing, vomiting, urination, and lifting heavy objects.

Question 54

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

Answer 54

Puborectalis

Question 55

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.

Answer 55

Coccygeus M.

Question 56

What innervates the Coccygeus M.?

Answer 56

S4-S5

Question 57

What actions does the Coccygeus M. perform?

Answer 57

Supports and pulls forward Coccyx after childbirth or defecation.

Question 58

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

Answer 58

Pelvic Fascia

Question 59

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

Answer 59

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

Question 60

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.

Answer 60

Retropubic Space

Question 61

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

Answer 61

Rectovesical

Question 62

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.

Answer 62

Loose CT

Question 63

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.

Answer 63

Pubococcygeus | Puborectalis

Question 64

What are the types of urinary incontinence?

Answer 64

Overflow Stress Urge

Question 65

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

Answer 65

Overflow

Question 66

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

Answer 66

Stress

Question 67

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

Answer 67

Urge