Anatomy of pregnancy Flashcards
What bones does the pelvis consist of?
Ileum, Ischium and Pubis- all of which fuse and contribute a part to the acetabulum.
Which two ligaments help to form the floors of the lesser and greater sciatic foramen?
sacrotuberous ligament- floor of the lesser
sacrospinous ligament- floor of the greater
What apertures are present in the pelvis and what neurovascular structures are conducted by them?
Greater sciatic foramen- divided by into a superior and inferior aperture by the piriformis muscle- Superior gluteal nerves and vessels pass through the superior aperture.
Inferior gluteal nerves and vessels,the sciatic nerve, posterior femoral cutaneous nerves, and the nerves to the obturator interns and the quadratus femoris pass through the inferior aperture.
Lesser sciatic foramen- conducts the pudendal nerve and internal pudendal vessels after they pass through the greater sciatic foramen and loop around the ischial spine.
Obturator canal- conducts the obturator nerve and vessels and and lies most anteriorly.
What structures form the pelvic floor?
pelvic diaphragm, in anterior midline the perineal membrane.
What muscles form part of the levator ani?
iliococcygeus, pubococcygeus and puborectalis
What muscles form part of the pelvic diaphragm?
levator ani and coccygeus muscles
What functions does pelvic diaphragm perform?
supports the pelvic viscera, maintains an angle between rectum and anal canal, reinforces the external anal sphincter and in women functions as a vaginal sphincter.
What is the innervation of the levator ani?
branches direct from the ventral ramus of S4 and by the inferior rectal branch of the pudendal nerve.
What structures are contained within the deep perineal pouch?
external urethral sphincter, deep transverse perineal muscles
women also have- sphincter urethrovaginalis and the compressor urethrae
bulbourethral glands
What attaches to the perineal body and where is it located? Why is it significant?
It is found in the midline at posterior border of the perineal membrane.
Point of crossing over for the legator ani musclesIt is a point of attachment for the superficial transverse perineal muscles, the sphincter urethrovaginalis, the external anal sphincter, the bulbospongiosus muscles. It is a commonly damaged component on childbirth and can be avoided using well executed episiotomy. It can have drastic consequences for continence of bowels and bladder.
What ligaments stabilise the uterus?
transverse cervical ligament or cardinal ligament, pubocervical ligament, sacrouterine/uterosacral ligament, round ligament of uterus. These are assisted by the levator ani muscles, the perineal body and the perineal membrane
What peritoneal reflections are present in the male and female pelvic cavity?
female- rectouterine and uterovesical pouches
male-rectovesical pouche. The rectouterine pouch (of douglas) is an important area as it is the lowest point in the pelvis when the woman is in a supine position- infection and fluids typically collect here.
What is the broad ligament and what is it formed from?
it is a condensation of reflected peritoneum over the uterus and fallopian tubes. The mesovarium, mesosalpinx and mesometrium are the main condensations. the round ligament is also contained within the broad ligament.
How are the ureters and uterine artery associated to the broad ligament?
The uterine artery passes in the widest part of the broad ligament in the mesometrium, it crosses the ureters which pass just inferior to the broad ligament and can help to supply the distal ends of the ureters.
what are the medial umbilical ligaments derived from?
The umbilical arteries which uses to take deoxygenated blood away from the foetus to the placenta.
