Abdomen - Pelvic Flashcards
- region of trunk lies inferior to abdomen
- transmits body weight from vertebral column to femur
pelvis
Post: lumbar vertebrae
Lateral: iliac fossa and iliacus
Ant: lower part of abdominal wall
false pelvis
pelvic inlet, pelvic outlet, pelvic cavity
true pelvis
aka pelvic brim
Boundaries:
Post: sacral promontory
Lat: iliopectineal lines
Ant: symphysis pubis
Pelvic Inlet
Boundaries:
Post: coccyx
Lat: ischial tuberosities
Ant: pubic arch
Pelvic Outlet
lies between the pelvic inlet & outlet
pelvic cavity
bones of the pelvis
Sacrum
Coccyx
Hip Bones (2)
3 bones joined at acetabulum
upper flattened part of hip bone
ilium
- Iliac fossa
- Iliac crest
- Iliac tubercle
- ASIS
- AIIS
- PSIS
ilium
bulge where ilium and pubis meets
iliopubic eminence
runs downward & forward on the inner surface of ilium; divides true and false pelvis
symphysis pubis
inferior and posterior bone
● Ischial tuberosity
● Ischial spine
ischium
● Greater sciatic notch
● Lesser sciatic notch
ischial spine
- anterior part
- pubic rami, symphysis pubis, body of pubis
pubis
● Pubic tubercle
● Pubic crest
body of pubis
superior and inferior
pubic rami
post; limited movement
Fxn: transmit weight from spine to pelvis
sacroiliac joint
ant, post and interosseous
sacroilliac ligament
strong; from lateral of sacrum, coccyx and PSIS to ischial tube
sacrotuberous ligament
triangular; base from lateral of sacrum & coccyx; apex – ischial spine
sacrospinous ligament
- ant; cartilaginous joint
- (+) fibrocartilaginous disc bet. 2 pubic bones
- fixed
symphysis pubis
Filled in by obturator membrane, a fibrous sheet, leaving only a small gap
obturator foramen
obturator nerve & vessels
oburator canal
Tendon: OI
Nerve: pudendal & n. to OI
lesser sciatric foramen
Muscle: piriformis
● Nerves:
● Sciatic
● IGN
● SGN
● Pudendal
● nerve to OI and QF
● Vessels:
● Sup & Inf gluteal a. & v.
● Internal pudendal a. & v.
greater sciatric foramen
Difference of pelvis in males & females
false pelvis: males
deep
Difference of pelvis in males & females
false pelvis: females
shallow
Difference of pelvis in males & females
pelvic inlet: females
transverse oval
Difference of pelvis in males & females
pelvic cavity: males
smaller
Difference of pelvis in males & females
pelvic cavity: females
larger
Difference of pelvis in males & females
pelvic outlet: males
smaller
Difference of pelvis in males & females
ischial tuberosity: females
everted
Difference of pelvis in males & females
ischial tuberosity: males
inverted
Difference of pelvis in males & females
sacrum: males
longer
Difference of pelvis in males & females
pubic arch: females
round
Difference of pelvis in males & females
pelvic inlet: males
heart
Difference of pelvis in males & females
pelvic outlet: females
larger
Difference of pelvis in males & females
sacrum: females
shorter
Difference of pelvis in males & females
pubic arch: males
triangular
pubic bone, pubic rami, symphysis pubis
pelvic walls: anterior
sacrum, coccyx, piriformis muscle
pelvic walls: posterior
pubic bone, ilium, sacrotuberous & sacrospinous
ligament, oburator internus ms
pelvic walls: lateral
supports pelvic viscera; divides pelvic cavity and perineum - Formed by pelvic diaphragm
pelvic walls: inferior
Obturator membrane & adjoining part of hip bone
obturator internus
Pubic body obturator fascia
levator ani
Ischial spine
coccygeus
Greater troch. (femur)
piriformis & obturator internus
Lower end of sacrum & coccyx
coccygeus
Hip ER
piriformis
Supports pelvic viscera, sphincter to vagina & anorectal jxn
levator ani
Assists levator ani,
Flexes coccyx
coccygeus
n. to piriformis
piriformis
n. to OI
obturator internus
S4, pudendal n.
levator ani
Ant: sling around prostate or vagina; inserted to
perineal body
Levator prostate - M
Sphincter vaginae- F
levator ani muscles
sling bet rectum and anal canal
puborectalis
inserts to anococcygeal body
pubococcygeus
inserts to anococcygeal body & coccyx
iliococcygeus
small triangular muscle
Coccygeus / Ischiococcygeus
Formed by connective tissue
Continuous with fascia lining abdominal wall and perinuem
2 layers: parietal & visceral
pelvic fascia
lines walls of pelvis, named accdg to muscle it overlies
parietal pelvic fascia
covers and supports the pelvic visera
visceral pelvic fascia
term used to refer to pelvic fascia in the region of the uterine cervix
parametrium
Lies on post pelvic wall
● Relations:
NERVE SUPPLY
● Ant: internal iliac vessel and their branches
● Post: piriformis
sacral plexus
sciatic nerve
(L4-S3)
superior gluteal nerve
(L4-S1 post)
inferior gluteal nerve
(L5-S2 post)
quadratus femoris
(L4-S1 ant)
obturator internus
(L5-S2 ant)
cutaneous of the thigh
(S1-S3)
piriformis
(S1-S2 post)
- ends at pelvic inlet infront of SI jt
- divides into external and internal iliac a.
common iliac artery
- follows the pelvic brim
- gives off branches: inferior epigastric & deep circumflex iliac a. - passes under inguinal ligament to become femoral a.
external iliac artery
- passes down to pelvis to upper margin of greater sciatic foramen
- divides into ant and post division
internal iliac artery
Superior vesical a. - upper part of bladder
umbilical
- base of bladder, prostate & seminal vesicles
- Artery to vas deferens
obturator
- lower rectum
middle rectal artery
muscles of anal canal, skin and muscles of perineum
internal pudendal a
takes place of inf. vesical a. in males
vaginal a
supplies gluteal region
superior gluteal a
joins (L) common iliac vein
median sacral veins
Sigmoid colon
● Rectum
pelvic cavity: posterior
Ureter
● Urinary Bladder
anterior pelvic cavity
Continuation of descending colon
10 to 15.75 in
level of 3rd sacral vertebra (continues as rectum)
Attached to post pelvic wall by sigmoid mesocolon
sigmoid colon
Arteries: sigmoid branches of inf. mesenteric a.
Veins: tributaries of inferior mesenteric vein
NERVE SUPPLY: inf. hypogastric plexus
sigmoid colon
5 inches long
* Begins: level of S3 vertebra
* Course: Goes downward, following curve of sacrum & coccyx
* Ends: tip of coccyx
* pierce pelvic diaphragm -> anal canal
rectum
dilated lower part
rectal ampulla
covers the ff:
first 1/3
middle 1/3
last 1/3
peritoneum
ant & lat surfaces
first 1/3
ant only
middle 1/3
none
last 1/3
outer longitudinal & inner circular layers of smooth muscles
muscular coat
3 permanent folds; formed by mucous membrane and circular muscle layers
transverse folds
BLOOD SUPPLY:
Arteries: superior, middle and inferior rectal a. Veins: superior, middle and inferior rectal v.
NERVE SUPPLY: inferior hypogastric plexus
rectum
● a pair of muscular tubes extending from kidney to posterior surface of bladder
● crosses pelvic inlet anterior to bifurcation of common iliac a.
CONSTRICTIONS:
● renal pelvis joins ureter in abdomen
● as it crosses the pelvic brim to enter pelvis
● where it pierces the bladder wall
ureter
found behind symphysis pubis
● stores urine (max capacity: 500 ml of urine in women and 700 ml in men)
● Empty: pyramidal-shaped; lies within pelvis
● Full: ovoid- shaped; superior wall rises to hypogastric region
urinary bladder
points anteriorly
● connected to symphysis pubis by median umbilical ligament
apex urinary bladder
posterior surface; triangular (trigone)
base urinary bladder
covered by peritoneum
superior surface: urinary bladder