Anatomy

Question 1

How is the foetus positioned in the maternal pelvis best?

Answer 1

Goes into the pelvic inlet transverse (due to largest diameter) and then in pelvic outlet is anterior posterior

Question 2

What are the anatomical landmarks of the pelvic inlet

Answer 2

Posterior - sacral promontory
Anterior - pubic symphysis and superior pubic rami
Lateral - Arcuate line and pectineal line

Question 3

What are the anatomical landmarks of the pelvic outlet?

Answer 3

Posterior - coccyx
Anterior - pubic symphysis
Lateral - ischial tuberosities

Question 4

What are the ligaments of the sacroiliac joint?

Answer 4

• Ventral sacroiliac ligament (thickening of joint capsule)
• Dorsal sacroiliac ligament (weakest - go from crests of sacrum to PSIS and iliac crest)
• Interosseous ligament (strongest) - covered by the dorsal sacroiliac ligament

Question 5

What type of joint is the pubic symphysis

Answer 5

Fibrocartilaginous joint

Question 6

What are the abdominal muscles?

Answer 6

External and internal obliques (help in contraction in birth)
Transversus and rectus abdominis

Question 7

Discuss the path of the external obliques

Answer 7

External obliques arise from the outer surfaces of the lower eight ribs. Fibres from the lowest two ribs go vertical down towards the iliac crest, the remaining 6 pass downwards and medially towards the aponeurosis at the 9th costal cartilage

The two opposite side external obliques meet at the linea alba

Question 8

What is the linea alba formed from?

Answer 8

From fibres of all 3 muscles - the two obliques and transverses abdomens muscle

Question 9

What structures does the umbilicus transmit?

Answer 9

• Umbilical vessels
• Urachus
• Vitelline duct

Question 10

When do the structures in the umbilicus close?

Answer 10

Soon after birth

Question 11

What are the remnants of the urachus

Answer 11

Median umbilical ligament

Question 12

What is the remnant of the umbilical arteries

Answer 12

Medial umbilical ligament

Question 13

What is the remnant of the umbilical veins

Answer 13

Ligamentum teres

Question 14

Where does the ligamentum teres span through

Answer 14

umbilicus to liver

Question 15

What vessels does the lateral umbilical ligament encase?

Answer 15

Inferior epigastric vessels

Question 16

Which muscle aponeurosis forms the inguinal ligament?

Answer 16

Aponeurosis from the external oblique muscle

Question 17

Which landmarks does the internal oblique muscle arise from?

Answer 17

Lumbar fascia, lateral part of inguinal ligament and anterior aspect of iliac crest

Question 18

How to the fibres of the transverses abdomnius relate to the rectus abdomnius

Answer 18

The aponeuroses of the the upper 4/5 of the transverses abdomnius pass behind the rectus abdominus
Those from the lower part (arising from inguinal ligament and iliac crest) pass in front of the rectus abdominis

Question 19

What levels are the three transverse intersections of the recti muscles?

Answer 19

Xiphoid process, umbilicus, and midway between xiphoid and umbilicus

Question 20

What muscle aponeurosis is the rectus sheath formed from?

Answer 20

External oblique
Internal oblique
Transversus abdominis

Question 21

Which muscle lies within the rectus sheath?

Answer 21

Rectus abdominis

Question 22

How do the aponeuroses of the different abdominal muscles lie with respect to the rectus muscle?

Answer 22

External oblique app - anterior to rectus muscle
Internal oblique app - divides into two lamina - one posterior and the other anterior to rectus msucle
Transversus abdominis - posterior to rectus muscle

Question 23

At which point do all aponeuroses pass over the rectus muscles

Answer 23

The point midway between umbilicus and pubic symphysis and below

Question 24

What is the line called at which the inferior epigastric vessels gain access to the rectus sheath

Answer 24

Arcuate line

Question 25

Which vessel gives rise to the inferior epigastric vessel

Answer 25

External iliac artery

Question 26

Which vessels does the inferior epigastric artery form anastomoses with?

Answer 26

Superior epigastric artery above umbilicus Posterior intercostal arteries

Question 27

What is the landmark of the inferior epigastric vessels?

Answer 27

These vessels are lateral to the umbilical ligament

Question 28

What are the borders of the inguinal canal?

Answer 28

Anterior: external oblique aponeurosis and skin and superficial fascia Posterior: Conjoint tendon (inguinal falx) Lateral and roof: Internal oblique aponeurosis

Question 29

What are the contents of the inguinal canal?

Answer 29

The round ligament of the uterus and the ilioinguinal nerve

Question 30

Where is the deep inguinal ring situated?

Answer 30

Halfway between the ASIS and the pubic symphysis

Question 31

Where are the inferior epigastric vessels in relation to the deep inguinal ring?

Answer 31

Medially

Question 32

Where is the superficial ring situated

Answer 32

Lateral to the pubic tubercle

Question 33

At which point does the ilioinguinal nerve enter the inguinal canal?

Answer 33

At the point where it pierces the internal oblique muscle

Question 34

What areas does the ilioinguinal nerve innervate?

Answer 34

The skin of the medial thigh, the skin covering the mons pubis and labia majora It supplies fibres of internal oblique and transverses abdomens muscles

Question 35

What is the average oblique measurement of the pelvic inlet?

Answer 35

12cm (sacroiliac joint to iliopectineal eminence)

Question 36

What is the average anteroposterior measurement of the pelvic inlet?

Answer 36

11cm (sacrum to pubic symphysis)

Question 37

What is the average transverse measurement of the pelvic inlet?

Answer 37

13cm (widest points on the iliopectineal lines)

Question 38

Innervated muscles and sensory branches of iliohypogastric nerve and segments?

Answer 38

Segments (T12-L1) innervated muscles transervsus abdominis and internal oblique, sensory branches upper buttocks and mons pubis skin

Question 39

Segments, innervated muscles, sensory branches of ilioinguinal nerve

Answer 39

L1, transverses abdominis. and internal oblique, sensory branches - anterior scrotal nerves in males and anterior labial nerves in females

Question 40

Segments, innervated muscles, sensory branches of geniotfemoral nerve

Answer 40

L1,L2, cremaster muscle in males, sensory branches into femoral branch L1 and genital branch L2

Question 41

Segments, innervated muscles, sensory branches of lateral femoral cutaneous nerve

Answer 41

L2, L3, lateral femoral cutaneous nerve

Question 42

Segments, innervated muscles, sensory branches of obturators nerve

Answer 42

L2-L4 Obturator externus Adductor longus Adductor brevis Gracilis Pectineus Adductor magnus sensory branches: cutaneous branch

Question 43

Segments, innervated muscles, sensory branches of femoral nerve

Answer 43

L2-L4 Muscles: Iliopsoas Pectineus Sartorius Quadriceps femoris Sensory branches: Anterior cutaneous branches (anterior thigh) Saphenous (medial lower leg)