ANATOMY 4

Question 1

3 layers of pelvic floor

Answer 1

diaphragm
perineal pouch
perineal membrane

Question 2

what makes up pelvic diaphragm

Answer 2

levator ani

coccygeus

Question 3

what is the gap at front of pelvic diaphragm called and what passes through it

Answer 3

urogenital hiatus

urethra and vagina and prostate

Question 4

attachments of coccygeus

Answer 4

ischial spine to coccyx

Question 5

attachment of levator ani

Answer 5

pubic bones
ischial spines 
tendinous arch of levator ani
perineal body
coccyx

Question 6

what are the 3 parts of levator ani

Answer 6

puborectalis (most medial)
pubococcygeus (middle, biggest)
iliococcyeus (most lateral and inferior)

Question 7

levator ani is contracted/relaxed most of the time

Answer 7

contracted

Question 8

what is endo-pelvic facia

Answer 8

connective tissue, areolar tissue and fibrous tissue which gives extra support to pelvis

Question 9

what are pelvig ligaments giving extra support

Answer 9

uterosacral
transverse cervical (cardinal)
lateral ligament of bladder
lateral rectal ligaments

Question 10

what is contained in deep perineal pouch

Answer 10

part of urethra
bulbourethral glands (males)
neurovascular bundles for penis/clitoris
extension of ichioanal fat pads and muscles

Question 11

muscles in perineal pouch

Answer 11

external urethral sphincter

compressor urethrae

Question 12

what is perineal membrane

Answer 12

thin sheet of touch deep fascia

Question 13

what does vaginal prolapse present as

Answer 13

lump in vaginal wall

Question 14

how is vaginal/uterine prolapse repaired

Answer 14

sacrospinous fixation (sutures in the ligament)

Question 15

risk of sacrospinous fixation

Answer 15

injury to pudendal neurovascular bundle and sciatic nerve

Question 16

where do majority of arteries to pelvis and perineum arise from

Answer 16

internal iliac artery

Question 17

what arteries of pelvis and perineum do not arise from internal iliac

Answer 17

gonadal artery (L2 abdominal artery)
superior rectal artery (continuation of superior mesenteric)

Question 18

what does the inferior epigastric artery sit in

Answer 18

lateral umbilical fold

Question 19

where does most venous drainage go to from pelvis and perineum

Answer 19

internal iliac

Question 20

where does superior rectal vein drain

Answer 20

hepatic portal vein

Question 21

where does lateral sacral vein drain to

Answer 21

internal vertebral venous plexus

Question 22

what nodes does superior pelvic viscera drain to

Answer 22

external iliac nodes

Question 23

where does external iliac nodes then drain

Answer 23

aortic
thoracic duct
venous system

Question 24

where does inferior pelvic viscera drain to (deep perineum)

Answer 24

internal iliac nodes

Question 25

where does internal iliac nodes then drain

Answer 25

common iliac
aordtic
thoracic duct
venous system

Question 26

where does superficial perineum drain to

Answer 26

superficial inguinal nodes