Anatomical Clinical Correlations of the Pelvis

Question 1

What is pelvimetry? What 6 measurements are involved?

Answer 1

1. Used in obstetrics to assess the dimensions of the pelvis for management of labor.
2. Diameters of the pelvic inlet
   a. True (obstetric) conjugate – sacral promontory to mid-level of pubic symphysis; narrowest fixed distance which infant’s head must pass during vaginal delivery.
   b. Diagonal conjugate – sacral promontory to inferior margin of symphysis
   c. Oblique –sacroiliac articulation to iliopectineal eminence.
   d. Transverse – greatest width of the pelvic inlet; arcuate line to arcuate line.
3. Diameters of the pelvic outlet
   a. Transverse diameter – from ishial tuberosity to ischial tuberosity.
   b. Anteroposterior diameter – from pubic symphysis to coccyx.

Question 2

What is the effect of relaxin?

Answer 2

Pregnancy and Pelvic Articulations

a. The sacroiliac and pubic symphysis joints are sensitive to pregnancy-related hormones; primarily relaxin which is produced by the placenta.
b. Relaxation of these joints can increase the diameters of the pelvis by 10-15%.

Question 3

What can create urinary and/or fecal incontinence in women?

Answer 3

During vaginal deliveries, the muscles and fasciaes of the pelvic floor can be torn and damaged. This can lead to urinary and fecal incontinence in some women.

Question 4

Do anastomotic connections exist in the pelvis? Why?

Answer 4

Anastomotic connections exist amongst pelvic arteries providing important collateral circulation in cases of blockage or severing of the internal iliac a.

Question 5

How are the veins of the pelvis linked to the circulation? Why is this clinically relevant?

Answer 5

Anastomotic connections (lateral sacral veins) link the venous plexuses of the pelvic viscera to the internal vertebral venous plexuses, creating potential routes of transmission for infections and metastatic tumor cells.

Question 6

How can pelvic cancers spread so easily?

Answer 6

The high degree of interconnections between pelvic lymphatic channels makes it fairly easy for pelvic cancers to spread to other organs

Question 7

What is a clinical correlation for pelvic lymph channels?

Answer 7

The high degree of interconnections between pelvic lymphatic channels makes it fairly easy for pelvic cancers to spread to other organs.

Seriously, the third or 4th time this topic was mentioned. Should probably know for exam.