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GI- Week 3 > Ach: Lower Abdominal Cavity I > Flashcards

Ach: Lower Abdominal Cavity I Flashcards

1
Q

What forms the pelvic brim?

A
  1. sacral promontory and ala
  2. pectineal line
  3. symphysis pubis
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2
Q

What forms the false pelvis?

A

part of the abdominal cavity that supports abdominal organs

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3
Q

What forms the true pelvis?

A
  1. Pelvic inlet
  2. pelvic outlet (coccyx, ischial tuberosities, pubic arch)
  3. pelvic cavity (space between inlet and outlet)
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4
Q

What forms the sacrococcygeal joint?

A

cartilagenous intervertebral joint (S5-C1)

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5
Q

What forms the symphysis pubis?

A

fibrocartilagenous joint between bodies of two pubic bones

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6
Q

What forms the lumbosacral joint?

A

typical cartilagenous intervertebral joint between L5-S1

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7
Q

What forms the sacroiliac joint?

A

synovial joint between articular surfaces of ilium and sacrum

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8
Q

What is the interosseous sacroiliac ligament?

A

Suspends sacrum between two iliac bones

transfers weight from axial to appendicular skeleton

Resists forward rotation of the upper sacrum

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9
Q

What is the difference between the posterior and anterior sacroiliac ligaments?

A

Anterior = thin, not well defined

posterior= 2 parts, very strong

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10
Q

What forms the sacrotuberous ligament?

A

from the ischial tuberosity to lower sacrum and coccyx

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11
Q

What does hte sacrotuberous ligament do?

A

resists backward rotation of the lower sacrum

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12
Q

Where is the sacrospinous ligament?

A

It extends from the ischial spine to the lower sacrum and coccyx

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13
Q

What does the sacrospinous ligament do?

A

resists backward rotation of the lower sacrum

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14
Q

What is the difference between the pelvises of males and females?

A

M- heavy, thick, more prominent bone markings,

F- wider, shallower, larger superior and inferior pelvic apertures, ROUNDER and WIDER pubic arch

pelvic inlet is heart shaped in M but OVAL in F

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15
Q

Antrhopoid pelvis

A

ape like 23%

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16
Q

platypelloid pelvis

A

flat 2%

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17
Q

android pelvis

A

M 32%

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18
Q

gynecoid pelvis

A

F 43%

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19
Q

What can cause dystocia (difficult labor)?

A

deformities of the pelvis

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20
Q

What is the true conjugate diameter?

A

Sacral promontory to point just below the superior margin of the pubic symphysis (11 cm)

The shortest diameter through which the head must pass (radiographic films)

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21
Q

What is the diagonal conjugate?

A

sacral promontory to lower border of pubic symphysis (11.5 cm) (easily measured and assessed)

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22
Q

What is the obstetric conjugate?

A

sacral promontory to thickest part of pubic bone (10 cm)

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23
Q

What forms the pelvic walls?

A
  1. obturator internus

2. piriformis

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24
Q

What forms the pelvic floor? What does it support?

A

The pelvic diaphgram

supports the pelvic viscera

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25
Q

Where is the pelvic diaphragm located?

A

Stretches across the pelvis like a hammock

Suspended from the iliacus fascia

Divides the cavity into the pelvis above and the perineum below

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26
Q

What are the two divisions of the pelvic diaphgragm?

A
  1. levator ani (anterior)

2. coccygeus (posterior)

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27
Q

What are the actions of the pelvic diaphragm

A

Support pelvic floor and organs that pierce it

Resists outward thrust accompanying increases in intra-abdominal pressure (forced expiration and coughing)

Assists in defecation

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28
Q

The female pelvis contains what internal reproductive organs?

A

ovaries
uterine tubes
uterus
vagina

29
Q

Where are the vagina and uterus located?

A

midsagittally

30
Q

Where are the bladder and rectum located?

A

midline structures (both sexes)

31
Q

What is the endopelvic fascia?

A

in the pelvis covers and supports the pelvic viscera, fills in spaces, and transmits neurovasculature to the organs; it is continuous with the fascia transversalis in the abdomen;

32
Q

What are the two components of the endopelvic fascia?

A
  1. parietal pelvic fascia (forms sheath over pelvic muscles)

2. visceral pelvic fascia (forms fascial coverings over pelvic viscera)

33
Q

What fascia is important for the repair of prolapsed structures (more than muscles)?

A

endopelvic fascia

34
Q

The visceral pelvic fascia is thickened to form what ligaments?

A

Cardinal ligaments

sacrouterine ligaments

35
Q

In a mid-saggital section how is the peritoneum traced?

A

anterior abdominal wall

superior surface of urinary bladder

vesicouterine pouch (uterovesical)
				anterior and posterior uterus
				upper portion of vagina and rectouterine pouch (of Douglas)
				anterior surface of rectum
				continuous with sigmoid mesocolon
36
Q

What separates the anterior surface of the uterus from the urinary bladder?

A

vesicouterine pouch

37
Q

What separates the posterior surface from the rectum?

A

rectourterine pouch

38
Q

What is the broad ligament of the uterus?

A

2 layered fold of peritoneum that extends across the pelvic cavity from the uterus to the lateral pelvic walls

39
Q

What are the parts of the broad ligaments?

A
  1. Mesovarium
  2. Suspensory ligament
  3. Mesosalpinx
  4. Mesometrium
40
Q

What does the mesovarium do?

A

Attaches the ovary to the posterior layer of the broad ligament

41
Q

What does hte suspensory ligament do?

A

transmits the ovarian vessels, lymphatics and nerves that the ovary dragged in its descent from the abdomen

lies lateral to the attachment of the mesovarium

42
Q

Each uterine tube occupies the free superior margin of the broad ligament in the…

A

mesosalpinx

43
Q

What is the mesometrium?

A

portion of the broad ligament below the mesosalpinx and mesovarium

44
Q

What is the round ligament of the ovary?

A

Upper remnant of the gubernaculum

Extends from the ovary to the uterus where the uterine tube connects

45
Q

What is the round ligament of the uterus?

A

Passes from the uterus to the deep inguinal ring and through the inguinal canal (lower remnant of the gubernaculum)

46
Q

What causes prolapse of the uterus?

A

laxity or atonia of the muscles of the fascia nad pelvic floor

47
Q

What causes prolapse of the uterus?

A

Obstetrical trauma

Damage to pelvic floor:
laceration of the perineum
separation of the levator ani muscle

48
Q

What causes bladder prolapse?

A

Repeated obstetrical trauma can cause the inferior portion of the bladder to sag below the openings of the urethra d/t a weakened or torn pelvic diaphragm to form a cystocele

49
Q

What causes prolapse of the rectum?

A

incompetent pelvic diaphragm (anterior wall of rectum bulges into the vagina)

50
Q

What reproductive organs does the male pelvis contain?

A 
ductus deferens
seminal vesicles
ejaculatory ducts
prostate gland
urethra
51
Q

What is the only pouch in males?

A

rectovesical pouch

52
Q

What types of nerves does the sacral plexus contain?

A

somatic nerves

53
Q

What contributes to the sacral plexus?

A
  1. lumbosacral trunk (half of L4, L5)

2. Ventral rami of S1-S4

54
Q

All the branches of the sacral plexus pass through the greater sciatic foramen except which nerve which exits below the piriformis muscle?

A

Superior gluteal nerve

55
Q

Sciatic nerve

A

L4, 5, S1-3

56
Q

Superior gluteal nerve (nerve to the quadratus femoris)

A

L4, 5, S1

57
Q

Inferior gluteal nerve (nerve to the obturator internus)

A

L5, S1-2

58
Q

posterior femoral cutaneous nerve

A

S1,2,3

59
Q

pudendal nerve

A

S2,3,4

60
Q

What branches supply the piriformis?

A

S1,2

61
Q

What branches of the sacral plexus supply the levator ani?

A

S3,4

62
Q

What supplies autonomic innervation to ALL of the pelvic organs EXCEPT the gonads?

A

inferior hypogastric plexus

Superior hypogastric plexus > right and left hypogastric nerves (1-4) which descend on the sacrum via the inferior hypogastric plexus

63
Q

Where is the inferior hypogastric plexus located?

A

extraperitoneal tissues of the pararectal fossae

64
Q

Describe the sympathetic component of the inferior hypogastric plexus.

A

Preganglionic neurons (lower thoracic and upper lumbar levels of the spinal cord)>

  1. lumbar splanchnics–> synapse on small clusters of POSTgang neurons in the inferior hypogastric plexus
  2. sacral splanchnics–> descend in the lumbar and sacral sympathetic trunk WITHOUT synapsing and enter the inferior hypogastric plexus to synapse on clusters of postgang neurons
65
Q

What does the sympathetic component of the inferior hypogastric plexus do?

A

inhibits contraction of the wall of the rectum and bladder

66
Q

What does the parasympathetic component of the inferior hypogastric plexus do?

A

contracts the bladder and rectum

relaxes the internal sphincters of the rectum and bladder

67
Q

Describe the parasympathetic component of the inferior hypogastric plexus.

A

Pregang neurons to the IHP have nerve cell bodies in S2,3,4>
leave as pelvic splanchnic nerves>
enter IHP but DONT synapse>
terminate on post gang neurons in the walls of the organs innervated

68
Q

Visceral afferent fibers in the IHP sense…

A

pain and distension

69
Q

What subsidary plexuses does the IHP give rise to?

A

rectal
prostatic
uterovaginal
vesical

all follow branches of hte internal iliac artery

GI- Week 3 (15 decks)

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