ANAT 1 Pelvic and Perineal Osteology and Arthrology Flashcards
HN: The Pelvis, or Pelvic cavity is the region of the trunk inferoposterior to the Abdomen, between the Pelvic Brim and Pelvic Diaphragm. The Pelvis is also the transition point between trunk and Lower Extremity. The Perineum is the area of the trunk between the Thighs and Buttocks, from the Coccyx to the Pubis, inferior to the Pelvic Diaphragm.
Suprapubic angle in males and females?
The bony pelvis includes? (3)
pelvic girdle describes? which are joined where?
The Bony Pelvis includes the Paired Coxal Bones, The Sacrum and the Coccyx. The Pelvic Girdle describes the paired Coxal Bone, which are joined anteriorly at the Pubic Symphysis.
Spondylolysis vs spondylolisthesis at L5
L5 Spondylolysis: Separation of the vertebral arch from the vertebral body. L5 Spondylolisthesis: Abnormal anteriorly directed separation of the L5 vertebral segment from the Sacrum.
superior and inferior pelvic aperture
exists where made up of?
The Bony Pelvis has a Superior and Inferior Pelvic Aperture. The Superior Pelvic Aperture (Pelvic Inlet) exists at the Pelvic Brim, between the Greater and Lesser Pelves, and is formed by the Sacral Promentory, Superior edge of the Sacral Ala, Arcuate Line of the Ilium, Pectin Pubis, posterior edge of the Pubic crest and superior edge of the Pubic Symphysis. The Inferior Pelvic Aperture (Pelvic Outlet) is bound by the inferior edge of the Pubic Symphysis, Inferior Pubic and Ischial Rami, Ischial Tuberosities, Sacrotuberous Ls. and the Coccyx. The Pelvic Canal is the passage between the two Apertures.
sexual differences in pelves?
Sexual Differences in Pelves: Males have thicker, heavier Pelves, a deeper greater Pelvis, narrower and deeper lesser Pelvis, Android Pelvic Inlet, small Pelvic Outlet, narrow Pubic Arch, round Obturator Foramen and large Acetabulum. Females have thinner, lighter Pelves, a shallow greater Pelvis, wide and shallow lesser Pelvis, Gynecoid Pelvic Inlet, large Pelvic Outlet, wide Pubic Arch, oval-shaped Obturator Foramen and small Acetabulum.
Pelvic shapes?
(4)
Pelvic Shapes include the Android (classically male), gynecoid (classically female), Anthropoid (elongated anterior to posterior) and Platypelloid (elongated laterally)
pelvic diameters are important why?
Pelvic Diameters (Conjugates) are important measurements obstetrically to determine the capacity of a female to bear a child.
Pelvic fractures? almost always involve? why?
often broken in this kind of injury?
Pelvic Fractures or crush fractures almost always involve multiple fractures given that the articulated Pelvis is a bony ring and therefore difficult to break in only one place. The Superior and Inferior Pubic Rami are often broken on both side as a result of this kind of injury.
which ligaments create foramen? which foramen?
from what landmarks?
The Sacrotuberous L. and Sacrospinous L. produce the ligamentous borders which produce the Greater Sciatic Foramen and Lesser Sciatic Foramen from the Greater Sciatic Notch and Lesser Sciatic Notch.
fascia of the pelvis and perineum
layers?
Peritoneum (dips down out of the Abdomen into the Pelvis to cover, but not surround the Pelvic Viscera)
Pelvic Fascia and Spaces (continuation of Endoabdominal Fascia into the Pelvis, described as having a Membranous component and an Endopelvic component)
Perineal Fascia and Spaces
Peritoneum- male
In the Male (covers the superior and lateral aspects of the Urinary Bladder and Rectum)
a. Paravesicle Fossae (depressed areas lined with Peritoneum on either side of the Urinary Bladder)
b. Pararectal Fossae (depressed areas lined with Peritoneum on either side of the Rectum)
c. Rectovesicle Pouch (depressed area lined with Peritoneum
In the Female (covers the superior and lateral aspects of the Urinary Bladder, Uterus, Uterine Tubes, Ovaries and Rectum)
a. Paravesicle Fossae (depressed areas lined with Peritoneum on either side of the Urinary Bladder)
b. Broad Ligament of the Uterus (double layer of Peritoneum (Mesentery), extends from the Lateral Pelvic Walls to the Uterus, enclosing the Uterus, Uterine Tubes, Round L. of the Uterus and Ligament of the Ovary, described as having three parts, also includes the Suspensory L. of the Ovary)
1. Mesometrium (part of the Broad L. that supports the Uterus, also surrounds the Ligament of the Ovary and the Round L. of the Uterus)
2. Mesosalpinx (part of the Broad L. that supports the Uterine Tubes)
3. Mesovarium (part of the Broad L. that supports the Ovaries)
4. Suspensory Ligament of the Ovary (prolonged lateral extension from the Ovary enclosing the Ovarian Vessels)
c. Pararectal Fossae (depressed areas lined with Peritoneum on either side of the Rectum)
d. Vesicouterine Pouch (depressed area lined with Peritoneum
between the Urinary Bladder and the Uterus)
e. Rectouterine Pouch (cul-de-sac, of Douglas; depressed area
lined with Peritoneum between the Uterus and the Rectum)
In the Female (covers the superior and lateral aspects of the Urinary Bladder, Uterus, Uterine Tubes, Ovaries and Rectum)
a. Paravesicle Fossae (depressed areas lined with Peritoneum on either side of the Urinary Bladder)
b. Broad Ligament of the Uterus (double layer of Peritoneum (Mesentery), extends from the Lateral Pelvic Walls to the Uterus, enclosing the Uterus, Uterine Tubes, Round L. of the Uterus and Ligament of the Ovary, described as having three parts, also includes the Suspensory L. of the Ovary)
1. Mesometrium (part of the Broad L. that supports the Uterus, also surrounds the Ligament of the Ovary and the Round L. of the Uterus)
2. Mesosalpinx (part of the Broad L. that supports the Uterine Tubes)
3. Mesovarium (part of the Broad L. that supports the Ovaries)
4. Suspensory Ligament of the Ovary (prolonged lateral extension from the Ovary enclosing the Ovarian Vessels)
c. Pararectal Fossae (depressed areas lined with Peritoneum on either side of the Rectum)
d. Vesicouterine Pouch (depressed area lined with Peritoneum
between the Urinary Bladder and the Uterus)
e. Rectouterine Pouch (cul-de-sac, of Douglas; depressed area
lined with Peritoneum between the Uterus and the Rectum)
In the Female (covers the superior and lateral aspects of the Urinary Bladder, Uterus, Uterine Tubes, Ovaries and Rectum)
a. Paravesicle Fossae (depressed areas lined with Peritoneum on either side of the Urinary Bladder)
b. Broad Ligament of the Uterus (double layer of Peritoneum (Mesentery), extends from the Lateral Pelvic Walls to the Uterus, enclosing the Uterus, Uterine Tubes, Round L. of the Uterus and Ligament of the Ovary, described as having three parts, also includes the Suspensory L. of the Ovary)
1. Mesometrium (part of the Broad L. that supports the Uterus, also surrounds the Ligament of the Ovary and the Round L. of the Uterus)
2. Mesosalpinx (part of the Broad L. that supports the Uterine Tubes)
3. Mesovarium (part of the Broad L. that supports the Ovaries)
4. Suspensory Ligament of the Ovary (prolonged lateral extension from the Ovary enclosing the Ovarian Vessels)
c. Pararectal Fossae (depressed areas lined with Peritoneum on either side of the Rectum)
d. Vesicouterine Pouch (depressed area lined with Peritoneum
between the Urinary Bladder and the Uterus)
e. Rectouterine Pouch (cul-de-sac, of Douglas; depressed area
lined with Peritoneum between the Uterus and the Rectum)
female
what type of fascia? this is split into?
Membranous Pelvic Fascia (possesses parietal and visceral components)
A. Parietal Pelvic Fascia (lines the muscular walls of the Pelvis: Obturator Internus M., Piriformis M., Levator Ani Ms. and Coccygeus M.)
- Obturator Fascia (lines the pelvic side of the Obturator Internus M., is continuous superiorly with Transversalis Fascia, forms the walls of the Pudendal Canal, forms the Tendinous Arch of the Levator Ani Ms.)
- Tendinous Arch of Pelvic Fascia
a. Puboprostatic L. (anterior part; ♂)
b. Pubovesicle L. (anterior part, ♀)
c. Sacrogenital L. (posterior part)
i. Rectoprostatic L. (♂)
ii. Uterosacral L. (♀)
B. Visceral Pelvic Fascia (surrounds Pelvic Viscera, except where the Pelvic viscera penetrates the Pelvic Diaphragm, where the Parietal and Visceral layers come together to form the Tendinous Arch of Pelvic Fascia)
female
what type of fascia? this is split into?
Membranous Pelvic Fascia (possesses parietal and visceral components)
A. Parietal Pelvic Fascia (lines the muscular walls of the Pelvis: Obturator Internus M., Piriformis M., Levator Ani Ms. and Coccygeus M.)
- Obturator Fascia (lines the pelvic side of the Obturator Internus M., is continuous superiorly with Transversalis Fascia, forms the walls of the Pudendal Canal, forms the Tendinous Arch of the Levator Ani Ms.)
- Tendinous Arch of Pelvic Fascia
a. Puboprostatic L. (anterior part; ♂)
b. Pubovesicle L. (anterior part, ♀)
c. Sacrogenital L. (posterior part)
i. Rectoprostatic L. (♂)
ii. Uterosacral L. (♀)
B. Visceral Pelvic Fascia (surrounds Pelvic Viscera, except where the Pelvic viscera penetrates the Pelvic Diaphragm, where the Parietal and Visceral layers come together to form the Tendinous Arch of Pelvic Fascia)
male
what type of fascia? this is split into?
Membranous Pelvic Fascia (possesses parietal and visceral components)
A. Parietal Pelvic Fascia (lines the muscular walls of the Pelvis: Obturator Internus M., Piriformis M., Levator Ani Ms. and Coccygeus M.)
- Obturator Fascia (lines the pelvic side of the Obturator Internus M., is continuous superiorly with Transversalis Fascia, forms the walls of the Pudendal Canal, forms the Tendinous Arch of the Levator Ani Ms.)
- Tendinous Arch of Pelvic Fascia
a. Puboprostatic L. (anterior part; ♂)
b. Pubovesicle L. (anterior part, ♀)
c. Sacrogenital L. (posterior part)
i. Rectoprostatic L. (♂)
ii. Uterosacral L. (♀)
B. Visceral Pelvic Fascia (surrounds Pelvic Viscera, except where the Pelvic viscera penetrates the Pelvic Diaphragm, where the Parietal and Visceral layers come together to form the Tendinous Arch of Pelvic Fascia)
male
what type of fascia? this is split into?
Membranous Pelvic Fascia (possesses parietal and visceral components)
A. Parietal Pelvic Fascia (lines the muscular walls of the Pelvis: Obturator Internus M., Piriformis M., Levator Ani Ms. and Coccygeus M.)
- Obturator Fascia (lines the pelvic side of the Obturator Internus M., is continuous superiorly with Transversalis Fascia, forms the walls of the Pudendal Canal, forms the Tendinous Arch of the Levator Ani Ms.)
- Tendinous Arch of Pelvic Fascia
a. Puboprostatic L. (anterior part; ♂)
b. Pubovesicle L. (anterior part, ♀)
c. Sacrogenital L. (posterior part)
i. Rectoprostatic L. (♂)
ii. Uterosacral L. (♀)
B. Visceral Pelvic Fascia (surrounds Pelvic Viscera, except where the Pelvic viscera penetrates the Pelvic Diaphragm, where the Parietal and Visceral layers come together to form the Tendinous Arch of Pelvic Fascia)
female
What type of fascia? this is split into?
Endopelvic Fascia (comprised of Loose and Condensed parts) a. Loose Endopelvic Fascia (fat filled potential spaces)
- Retropubic Space (Prevesical Space; between Pubis and Urinary Bladder, continuous posterolaterally with the Paravesical Space)
- Paravesical Space (between Obturator Fascia and anterior part of the Hypogastric Sheath, separated from the Pelvirectal Space by the Hypogastric Sheath)
- Pelvirectal Space (surrounding the Rectum, separated into anterior and posterior parts by the Lateral Rectal L.)
- Retrorectal Space (Presacral Space; between the Sacrum and the Rectum, continuous anterolaterally with the Pelvirectal Space)
b. Condensed Endopelvic Fascia (increased density of Collagen and Elastic Fibers, responsible for compartmentalizing the Loose Endopelvic Fascia) - Hypogastric Sheath (thick band of condensed fascia, serves as conduit for nerves and vessels going from the Lateral Pelvic Wall to Pelvic Viscera, including the Ureters and in the male the Ductus Deferens, is divided into anterior, middle and posterior Lamina)
a. Lateral L. of the Bladder (extension of the Hypogastric Sheath to the Urinary Bladder)
b. Middle Lamina of the Hypogastric Sheath
i. Retovesical Septum (♂; between the Rectum and Urinary Bladder)
ii. Transverse Cervical L. (Cardinal L.; extension of the Hypogastric Sheath to the Cervix of the Uterus)
c. Lateral Rectal L. (extension of the Hypogastric Sheath to the posterior aspect of the Rectum)
male
what type of fascia? this is split into?
Endopelvic Fascia (comprised of Loose and Condensed parts) a. Loose Endopelvic Fascia (fat filled potential spaces)
- Retropubic Space (PrevesicalSpace; between Pubis and Urinary Bladder, continuous posterolaterally with the Paravesical Space)
- Paravesical Space (between Obturator Fascia and anterior part of the Hypogastric Sheath, separated from the Pelvirectal Space by the Hypogastric Sheath)
- Pelvirectal Space (surrounding the Rectum, separated into anterior and posterior parts by the Lateral Rectal L.)
- Retrorectal Space (Presacral Space; between the Sacrum and the Rectum, continuous anterolaterally with the Pelvirectal Space)
b. Condensed Endopelvic Fascia (increased density of Collagen and Elastic Fibers, responsible for compartmentalizing the Loose Endopelvic Fascia) - Hypogastric Sheath (thick band of condensed fascia, serves as conduitfor nerves and vessels going from the Lateral Pelvic Wall to Pelvic Viscera, including the Ureters and in the male the Ductus Deferens, is divided into anterior, middle and posterior Lamina)
a. Lateral L. of the Bladder (extension of the Hypogastric Sheath to the Urinary Bladder)
b. Middle Lamina of the Hypogastric Sheath
i. RetovesicalSeptum (♂; between the Rectum and Urinary Bladder)
ii. Transverse Cervical L. (Cardinal L.; extension of the Hypogastric Sheath to the Cervix of the Uterus)
c. Lateral Rectal L. (extension of the Hypogastric Sheath to the posterior aspect of the Rectum)
perineal fascia and spaces
what is the perineum? when viewed from?
what are the points of this?
line drawn through where? this makes what?
G. Perineal Fascia and Spaces
HN: The Perineum is a Quadrangular Space when viewed from the inferior aspect. The Four points of the Quadrangle are the Pubic Symphysis (anteriorly), the Coccyx (posteriorly) and the two Ischial Tuberosities (laterally). If a line is drawn between the two Ischial Tuberosities the Quadrangle is divided into two triangular spaces, the Urogenital Triangle (anteriorly) and the Anal Triangle (posteriorly).
These structures make up?
Anal Triangle
a. Ischioanal Fossa (around the wall of the Anal Canal, inferior to the Pelvic Diaphragm, narrow superiorly, wide inferiorly, filled with fat and loose connective tissue that allows for expansion of the Anal Canal during defecation)
b. Pudendal Canal (space inside Obturator Fascia which transmits the Internal Pudendal A., V. and Pudendal N.)
what is this?
what is in it?
urogenital triangle female
parts? (5)
some things that come from other things?
Urogenital Triangle
a. Perineal Membrane (extends between the two sides of the Pubic Arch, covers the anterior portion of the Inferior Pelvic Aperture)
b. Superficial Perineal Fascia (continuous with the Superficial Fascia of the Abdomen, made up of a Fatty and Membranous component)
1. Fatty (Superficial) Superficial Perineal Fascia (in the Female forms the fatty layers of the Labia Majora and the Mons Pubis, replaced by the Penis and Scrotum in the Male)
2. Membranous (Deep) Superficial Perineal Fascia (forms the Dartos Fascia of the Penis and Scrotum)
c. Deep Perineal Fascia (in the Female exists primarily as Perineal Membrane, in the Male makes up the Deep Fascia of the Penis and Perineal Membrane)
d. Superficial Perineal Pouch (between Membranous Superficial Perineal Fascia and the Perineal Membrane)
1. Contents in the Male (Bulb and Crura of the Penis, Superficial Perineal Muscles, Proximal Spongy Urethra, branches of the Internal Pudendal A. and V., and of the Pudendal N.)
2. Contents in the Female (Crura of the Clitoris, Bulbs of the Vestibule, Superficial Perineal Muscles, Greater Vestibular Glands, branches of the Internal Pudendal A. and V., and of the Pudendal N.)
e. Deep Perineal Pouch (Open superiorly, lies inferoanteriorly to the Urinary Bladder)
1. Contents in the Male (Membranous Urethra, Muscles of the Urogenital Diaphragm, Bulbourethral Glands)
2. Contents in the Female (Muscles of the Urogenital Diaphragm) Neurology)
male urogenital triangle
what layers (5)
what comes from what?
Urogenital Triangle
a. Perineal Membrane (extends between the two sides of the Pubic Arch, covers the anterior portion of the Inferior Pelvic Aperture)
b. Superficial Perineal Fascia (continuous with the Superficial Fascia of the Abdomen, made up of a Fatty and Membranous component)
1. Fatty (Superficial) Superficial Perineal Fascia (in the Female forms the fatty layers of the Labia Majora and the Mons Pubis, replaced by the Penis and Scrotum in the Male)
2. Membranous (Deep) Superficial Perineal Fascia (forms the Dartos Fascia of the Penis and Scrotum)
c. Deep Perineal Fascia (in the Female exists primarily as Perineal Membrane, in the Male makes up the Deep Fascia of the Penis and Perineal Membrane)
d. Superficial Perineal Pouch (between Membranous Superficial Perineal Fascia and the Perineal Membrane)
1. Contents in the Male (Bulb and Crura of the Penis, Superficial Perineal Muscles, Proximal Spongy Urethra, branches of the Internal Pudendal A. and V., and of the Pudendal N.)
2. Contents in the Female (Crura of the Clitoris, Bulbs of the Vestibule, Superficial Perineal Muscles, Greater Vestibular Glands, branches of the Internal Pudendal A. and V., and of the Pudendal N.)
e. Deep Perineal Pouch (Open superiorly, lies inferoanteriorlyto the Urinary Bladder)
1. Contents in the Male (Membranous Urethra, Muscles of the Urogenital Diaphragm, Bulbourethral Glands)
2. Contents in the Female (Muscles of the Urogenital Diaphragm) Neurology)
