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SUGER > Anatomy 26 > Flashcards

Anatomy 26 Flashcards

1
Q

What are some functions of the bony pelvis?

A

Supporting the spine, torso and upper body
Locomotion
Housing and protecting the pelvic viscera

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2
Q

What 3 bones make up the bony pelvis?

A

Sacrum
Left and Right Hip (innominate) bones

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3
Q

What 3 bones is the hip bone composed of?

A

Ilium
Ischium
Pubis

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4
Q

How many articulations does the bony pelvis have?

A

5

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5
Q

What are the 5 articulations of the bony pelvis?

A

Hip joint
Sacroiliac joint
Pubic symphysis
Lumbosacral joint
Sacrococcygeal joint

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6
Q

What is the hip joint?

A

Between the head of the femur and the acetabulum (socket) of the pelvis

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7
Q

What bones fuse at the acetabulum?

A

Ilium, ischium and pubis of the hip bone

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8
Q

Where is the sacroiliac joint located?

A

Between the sacrum and the ilium of the hip bone

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9
Q

Where is the pubic symphysis located?

A

Between the 2 pubic bones

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10
Q

What movement occurs at the pubic symphysis?

A

Almost no movement

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11
Q

Where is the lumbosacral joint located?

A

Between the 5th lumbar vertebrae and the sacrum

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12
Q

What lies between the 5th lumbar vertebrae and the sacrum?

A

An intervertebral disc

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13
Q

Where is the sacrococcygeal joint?

A

Between the sacrum and coccyx

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14
Q

What does the intercristal line mark?

A

Level of the L4/L5 disc space

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15
Q

What is the clinical relevance of the intercristal line?

A

It’s the position where a lumbar puncture can be performed or an epidural injection given

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16
Q

What is the Anterior superior iliac spine (ASIS)?

A

Most anterior point of the ilium and is palpable in most people

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17
Q

What is the iliac tubercle?

A

The most lateral point of the ilium

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18
Q

What does the intertubercular line mark?

A

Marks the division of the lower third of the abdomen from the middle third, thereby delineating the suprapubic region from the umbilical, and the iliac fossae from the flanks

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19
Q

What is the pubic tubercle?

A

Most medial point of the pubic bone

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20
Q

Where is the inguinal ligament located?

A

Runs from the anterior superior iliac spine to the pubic tubercle

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21
Q

What is the mid-inguinal point?

A

The mid-point of a line drawn from the anterior superior iliac spine to the pubic symphysis

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22
Q

Which artery is palpable at the mid-inguinal point?

A

Femoral artery

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23
Q

What is McBurney’s point?

A

Marks the approximate location of the base of the appendix

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24
Q

What are features of a females pelvic inlet?

A

Wider
Circular

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25
Q

What are features of a males pelvic inlet?

A

Narrower
Heart shaped

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26
Q

What angle is formed by the inferior pubic rami in females?

A

Obtuse (>90˚) angle

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27
Q

What angle is formed by the inferior pubic rami in males?

A

Acute angle (<90˚)

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28
Q

What feature does the sacrum in females have?

A

Wider and shorter sacrum

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29
Q

What feature does the sacrum in males have?

A

Narrower, longer sacrum

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30
Q

What organs does the pelvis contain in females?

A
  • Organs of the gastrointestinal and genitourinary systems, including the rectum and bladder
  • The uterus, ovaries and vagina
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31
Q

What organs does the pelvis contain in males?

A
  • Organs of the gastrointestinal and genitourinary systems, including the rectum and bladder
  • The prostate and seminal vesicles
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32
Q

What arteries supply the pelvis?

A

Left and right internal iliac arteries

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33
Q

What do the internal iliac arteries give rise to?

A

Several branches in the pelvis that supply the pelvic viscera

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34
Q

What do some branches of the internal iliac arteries exit the pelvis to supply?

A

The perineum and gluteal region

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35
Q

What are some key branches of the internal iliac arteries?

A

Vesical arteries
Uterine and vaginal arteries
Middle rectal artery
Internal pudendal artery
Superior and inferior gluteal arteries

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36
Q

What do the vesical arteries supply?

A

Supply the bladder in both sexes, and the prostate and seminal vesicles in males

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37
Q

What does the middle rectal artery supply?

A

Rectum

38
Q

What does the internal pudendal artery supply?

A

Exits the pelvis to supply the perineum

39
Q

What do the superior and inferior gluteal arteries supply?

A

Exit the pelvis to supply the gluteal (buttock) region

40
Q

What do the venous plexuses in the pelvis unite and drain into?

A

Internal iliac vein

41
Q

What types of nerves supply the structures of the pelvis?

A

Somatic, parasympathetic and sympathetic nerves

42
Q

What nerves arise from the sacral plexus?

A

Sciatic nerve
Pudendal nerve
Superior and inferior gluteal nerves
Pelvic splanchnic nerve

43
Q

What is the sciatic nerve formed by?

A

Lower lumbar and sacral spinal nerves L4-S3

44
Q

What does the sciatic nerve supply?

A

Lower limbs

45
Q

What nerves is the pudendal nerve derived from?

A

Spinal nerves S2-S4

46
Q

What region is the pudendal nerve a major nerve of?

A

Perineum

47
Q

What does the superior and inferior gluteal nerves supply?

A

Exit the pelvis and innervate the gluteal region

48
Q

What does the pelvic splanchnic nerve carry?

A

Parasympathetic fibres from the S2-S4 spinal cord segments to the pelvic viscera

49
Q

Where are sympathetic fibres that innervate the pelvic viscera derived from?

A

Lumbar splanchnic nerve

50
Q

What is the pelvic floor?

A

Collective name for several muscles that support the pelvic organs from below

51
Q

What are the 3 primary functions of the pelvic floor?

A
  1. Prevent herniation of the pelvic organs inferiorly, out of the pelvis
  2. Control continence of urine and faeces by providing a sphincter action on the urethra and rectum respectively
  3. Aid in increasing intra-abdominal pressure
52
Q

What 2 muscles make up the pelvic floor?

A

Levator ani and coccygeus

53
Q

What 3 paired muscles make up the levator ani?

A

Puborectalis
Pubococcygeus
Iliococcygeus

54
Q

What is the puborectalis?

A

U-shaped muscle attaches to the pubic bones anteriorly and forms a sling around the rectum

55
Q

How does the puborectalis prevent defecation?

A

It pulls on the rectum so that a sharp angle is formed between the rectum and anal canal

56
Q

What does the puborectalis contribute to?

A

Control of micturition

57
Q

Which is the most anterior levator ani muscle?

A

Puborectalis

58
Q

Where is the pubococcygeus located in relevance to the puborectalis?

A

Posterior and lateral to it

59
Q

What is the pubococcygeus attached to?

A

Pubic bone anteriorly, and the coccyx and sacrum posteriorly

60
Q

Where is the iliococcygeus located in relevance to the pubococcygeus?

A

Lateral to it

61
Q

What does the iliococcygeus attach to?

A

Spines of the ischium

62
Q

What is the levator ani innervated by?

A

Branch of the S4 nerve and by some branches of the pudendal nerve (from S2-S4)

63
Q

What can pelvic floor weakness lead to?

A
  • Incontinence of urine or faeces
  • It can also lead to pelvic organ prolapse where the uterus prolapses into the vagina, or the rectum prolapses out of the anus, because they are no longer supported
64
Q

What structure is found superficial and inferior to the pelvic floor?

A

Perineum

65
Q

What is the perineum?

A

The superficial region between the pubic symphysis and the coccyx, and between the medial surfaces of the thighs

66
Q

What can the perineum be split into?

A

2 triangles
Anal triangle (posteriorly)
Urogenital triangle (anteriorly)

67
Q

What does the anal triangle contain?

A

Contains the opening of the anus and the external anal sphincter

68
Q

What are the layers of the urogenital triangle?

A

Skin
Perineal fascia
Superficial perineal pouch
Perineal membrane
Deep perineal pouch

69
Q

What is the skin in the urogenital triangle?

A

The urethra and vagina open out through the skin

70
Q

What is the perineal fascia in the urogenital triangle?

A

A continuation of the fascia overlying the abdominal wall muscles

71
Q

What is the superficial perineal pouch in the urogenital triangle?

A

A potential space that contains the erectile tissues of the penis or clitoris and also 3 muscles

72
Q

What 3 muscles are found in the superficial perineal pouch?

A

Ischiocavernosus, bulbospongiosus and the superficial transverse perineal muscles

73
Q

What is the perineal membrane?

A

A strong fibrous membrane that provides support for the attachment of ischiocavernosus and bulbospongiosus.
- It has specific holes in it for the urethra and vagina

74
Q

What is the deep perineal pouch?

A

A potential space between the perineal membrane and the pelvic floor muscles

75
Q

What does the deep perineal pouch contain?

A

Parts of the vagina, urethra and the external urethral sphincter

76
Q

Where does the perineal body sit?

A

Between the two triangles of the perineum

77
Q

What is the function of the perineal body?

A

Acts as an attachment for almost all the perineal and pelvic floor muscles, including levator ani, the external anal sphincter, the external urethral sphincter, the superficial and deep transverse perineal muscles and bulbospongiosus

78
Q

What are the parts of the corpora cavernosa that are attached to the ischial ramus known as?

A

‘Crura’ (singular: crus), which means ‘legs’, so ‘crura of the clitoris’ and ‘crura of the penis’ refer to the parts of the corpora cavernosa that are attached to the ischial rami

79
Q

What is the bulb of the penis?

A

Expanded part of the corpus spongiosum which rests on the perineal membrane

80
Q

In females what does the corpus spongiosum split into?

A

2 parts that flank the vaginal opening and they also rest on the perineal membrane, either side of the vaginal opening, these are the bulb of the vestibule (or bulb of the clitoris)

81
Q

What is the corpora cavernosa covered by?

A

Ischiocavernosus muscles

82
Q

What is the corpus spongiosum covered by?

A

Bulbospongiosus muscle

83
Q

What is the function of the ischiocavernosus?

A

Helps stabilise the erect penis and clitoris

84
Q

What does the bulbospongiosus in males assist in?

A

Maintaining erection by compressing the veins that drain erectile tissues and it contracts to squeeze any
remaining urine or semen from the urethra

85
Q

What does the bulbospongiosus in females assist it?

A

Helps maintain clitoral erection and constricts around the vaginal orifice which can help expression of fluid from the greater vestibular glands

86
Q

What is the arterial supply to the perineum?

A

Via the internal pudendal artery

87
Q

What is the internal pudendal artery a branch of?

A

The internal iliac artery

88
Q

What is the main nerve that innervates muscles in the perineum and skin of the external genitalia?

A

Pudendal nerve (S2-S4)

89
Q

How do the internal pudendal artery and pudendal nerve arise in the pelvis?

A

They travel through the greater and lesser sciatic foramina of the pelvis

90
Q

What type of nerves innervate the perineal structures in addition to the pudendal nerve?

A

Autonomic nerves

91
Q

What is a episiotomy?

A

Pre-emptive incision during labour made just lateral to the perineal body

92
Q

What is the clinical importance of an episiotomy?

A

Avoids injury to the perineal body or an uncontrolled tear through the anal sphincter

SUGER (5 decks)

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