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REPRODUCTION & GYNAECOLOGY > Anatomy Of The Bony Pelvis > Flashcards

Anatomy Of The Bony Pelvis Flashcards

1
Q

What are the main functions of the bony pelvis?

A
  • support of upper body when standing/sitting
  • transfer weight from spine to femurs to stand/walk
  • attachments of abdominal muscles and muscles of locomotion
  • external genitalia attachment
  • protection of pelvic organs/ vessels
  • passage for childbirth
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2
Q

What bones are included in the bony pelvis?

A
  • 2 hip bones (ilium/ischium/pubis)
  • sacrum
  • coccyx
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3
Q

What bone is part of the bony pelvis that is not included in the pelvic girdle?

A

Coccyx

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4
Q

What are the main bony landmarks of the ilium?

A
  • iliac crest
  • iliac fossa (where illiacus muscle attaches)
  • Anterior Superior and Inferior iliac spines
  • Posterior Superior and Inferior iliac spines
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5
Q

What are the main bony landmarks of the ischium?

A
  • Ischiopubic Ramus (where the two bones join)
  • Ischial tuberosity (bony bit that you are sitting on)
  • Ischial spine (attachment of hamstring muscles)
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6
Q

What bony landmarks can be found on the pubis?

A
  • ischiopubic ramus
  • pubic arch and sub pubic angle
  • superior pubic ramus
  • Pubic tubercle (where superior pubic rami join)
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7
Q

Which is more superior, the pelvic inlet or outlet?

A

Pelvic inlet

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8
Q

What bones make up the pelvic inlet and line the pelvic brim?

A
  • sacral promontory (sticks forward => prominent)
  • ilium
  • superior pubic ramus
  • pubic symphysis
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9
Q

What bones make up the pelvic outlet?

A 
Ischiopubic ramus 
Pubic symphysis
Ischial tuberosities
Sacrotuberous ligaments
Coccyx

(Imagine as an oval shape around these structures)

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10
Q

Where is the true pelvic cavity found?

A

Between the pelvic inlet and pelvic floor

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11
Q

What is considered the “false pelvis”?

A

The tops of ilium bone on each side are in the “greater/false” pelvis and not included in the “lesser/true” pelvis

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12
Q

The pelvic cavity is continuous with the abdominal cavity. TRUE/FALSE?

A

TRUE

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13
Q

What surface landmarks of the pelvis can you palpated externally?

A

Anterior:

  • Iliac crest
  • ASIS
  • Pubic tubercle
  • Pubic symphysis (on deep palpation)

Posterior:

  • iliac crest
  • Posterior superior iliac spine (PSIS)
  • Ischial tuberosity
  • Coccyx
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14
Q

Where does the inguinal ligament attach to the ilium and pubis?

A

Between ASIS and pubic tubercle

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15
Q

Name 3 joints found in the pelvis

A

Hip joint
Sacroiliac joint
Pubic symphysis

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16
Q

What type of joint is the hip joint?

A

Synovial (for movement)

17
Q

What type of joint is the pubic symphysis?

A

Secondary cartilaginous

18
Q

What type of joint is the sacroiliac joint?

A

Anterior part = synovial

Posterior part = syndemoses => fibrous

19
Q

What is the function of the large number of ligaments found in the pelvis?

A

Ligaments are stretched across a joint to aid in stabilisation

20
Q

Where does the sacrotuberous ligament attach?

A

Sacrum to Ischial tuberosity

21
Q

Where does the sacrospinous ligament attach?

A

From sacrum to Ischial spine

22
Q

What are the main functions of the sacrotuberous and sacrospinous ligaments?

A
  • Stop the inferior sacrum moving forward and superiorly when weight is suddenly transferred through the spine
  • form the greater and lesser sciatic foramen
23
Q

The pelvic ligaments are stiff during pregnancy. TRUE/FALSE?

A

FALSE - they relax during pregnancy

24
Q

What covers most of the obturator foramen?

A

Obturator membrane

- does not cover superior aspect where the obturator canal is

25
Q

What travels through the obturator canal?

A

Obturator Nerve and vessels

26
Q

How does the pelvis normally fracture?

A

In more than one place due to the ring structure

27
Q

What is the main concern after pelvic trauma which has caused a pelvic fracture?

A

Haemorrhage OR damage to pelvic organs

28
Q

What make a females pelvis different from a males pelvis?

A
  • AP and transverse diameters = larger
  • Suprapubic angle and pubic arch = wider
  • pelvic cavity is more shallow in height (to stop the baby’s head being surrounded by bone)
  • sacrum angled more vertically to allow easier passage of baby in pregnancy
29
Q

Some patients can have a persistent frontal suture. TRUE/FALSE?

A

TRUE

30
Q

Why are the fontanelles clinically relevant during childbirth?

A

Target allow moulding of the foetal skull

=> bones move over each other to make skull smaller

31
Q

What is the possible clinical relevance of fontanelles after birth?

A

Can see evidence of Raised ICP at these sites

- useful site for shunt insertion

32
Q

Moulding can cause babies to be born with misshapen heads. TRUE/FALSE?

A

TRUE

This will return to normal after a few days

33
Q

When does the anterior fontanelles typically disappear due to fusion of bones?

A

18 months -> 2 years

34
Q

What makes up the diamond shaped vertex area of a baby’s head?

A

Anterior and posterior fontanelles and parietal eminences form the outline

35
Q

Which diameter of the baby’s head should be largest?

A

Occipitofrontal diameter should be larger than biparietal diameter

36
Q

Describe the AP and transverse diameter as you move from the pelvic inlet to pelvic cavity and pelvic outlet and which way the baby’s head should be orientated in each.

A

Pelvic inlet - transverse diameter > AP diameter
=> baby’s head faces R or L

Pelvic cavity - Baby rotates and flexes it’s head towards its chin

Pelvic outlet - AP diameter is wider than transverse => baby leaves pelvis in occipitoanterior position (facing the back)

Foetal head EXTENDS during birth

37
Q

What further rotation must be carried out once a baby’s head has been delivered?

A

Rotated to align shoulders with larger AP diameter

R shoulder usually delivered first
L shoulder then delivered after

REPRODUCTION & GYNAECOLOGY (58 decks)

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