Anatomy of the Pelvis

Question 1

describe the anatomical differences between female and male pelvis

Answer 1

n.b. the pubic angle/pubic arch is the angle between the inferior pubic rami

pubic angle in females; is nearly 90 degrees or above
females have a short/broad sacrum
females have straight coccyx
females have broad ilium
=4 CHILDBIRTH

pubic angle to males; less than 90 degrees
males have a long/narrow sacrum
males have inward coccyx
males have shallow ilium (shallower hips)

Question 2

what organs sit in the true pelvis (below pelvic inlet line) whereas in the false pelvis (below pelvic inlet)

Answer 2

TRUE PELVIS :terminal end of GI tract; rectus,bladder, uterus, ovaries, prostate, internal genitalia

FALSE PELVIS; most of the small bowel (i.e. duodenum, jejunum, ileum), parts of the colon, and the common iliac vessels

Question 3

what anatomical feature do you put your hands on when you put your hands on your hips

Answer 3

anterior superior iliac spine/iliac crest

Question 4

what is the STRONGEST ligament of pelvis

Answer 4

The iliofemoral ligament is the strongest ligament in the body and attaches the anterior inferior iliac spine (AIIS) to the intertrochanteric crest of the femur.

Question 5

what ligament protects the synovial planar sacroiliac joint

Answer 5

the sacroiliac ligament (one of the strongest ligaments in body) protects the sacroiliac joint (synovial planar)

sacroiliac joint is the articulation between the sacrum (part of vertebral column) and the inonimate bone/ilium of hipbone

Question 6

what does the sacrospinous ligament connect to and from

what does the sacrotuberous ligament connect to and from

Answer 6

sacrospinous ligament= from sacrum to ischial spine

sacrotuberous ligament= is a thick fibrous band that extends from the posterior ilium, lateral sacrum and coccyx to the** ischial tuberosity**

Question 7

what structures are found in the greater vs lesser sciatic foramen and note well the ones that run through both

Answer 7

greater sciatic foramen:
-superior gluteal neurovascular bundle
-inferior gluteal neurovascular bundle
-internal pudendal artery + vein
-pudendal nerve
-sciatic nerve

lesser sciatic foramen:
-internal pudendal artery + vein
-pudendal nerve
-obturator internus muscle

Question 8

where does the inguinal ligament run to and from and what is the clinical significance of it?

Answer 8

inguinal ligament runs from ASIS (anterior superior iliac spine) to the pubic tubercle

clinical significance: inguinal ligament is an important diagnostic and surgical landmark. This structure helps differentiate groin hernia types. Herniation above the ligament indicates an inguinal hernia, while protrusion below the ligament signifies a femoral hernia

Question 9

what is contained in the female inguinal canal vs male inguinal canal

Answer 9

female inguinal canal;
-round ligament of uterus (ground uterus to the mons pubis)
-genital branch of genitofemoral nerve
-ilioinguinal nerve

male inguinal canal;
-ductus deferens
-testicular artery
-pampiniform plexus
-genital branch of gentiofemoral nerve
-ilioinguinal nerve
-muscles of the spermatic cord
-artery and veins of ductus deferens

Question 10

what muscle of the pelvic floor is responsible for faecal continence

Answer 10

puborectalis muscle provides the constrictor function to the anal canal, vagina and urethra

Question 11

What is the lithotomy position?

Answer 11

The lithotomy position is often used during childbirth and surgery in the pelvic area (legs spread up)

Question 12

where is the male membranous urethra found

Answer 12

the male membranous urethra is found in the deep peroneal pouch

Question 13

most arteries to the pelvis derive from []

Answer 13

most arteries to the pelvis derive from internal iliac artery which is a branch of the common iliac artery (which is a bifurcation of abdominal aorta; L4)

Question 14

what nerve supplies
*gluteus medius
*gluteus minimus
*gluteus maximus

Answer 14

superior gluteal nerve (L4, L5, S1) passes through the sciatic notch above the piriformis muscle. It supplies the gluteus medius and minimus and tensor fasciae latae muscles

. The inferior gluteal nerve (L5, S1, S2) supplies the gluteus maximus

Question 15

what nerve + its roots innervates
* external genitalia of both sexes, skin around anus, anal canal + perineum
* sensory supply to upper anterior thigh, skin of scrotum (males) and mons pubis (females)

Answer 15

• external genitalia of both sexes, skin around anus, anal canal + perineum= innervated by pudendal nerve (S2-S4)
• sensory supply to upper anterior thigh, skin of scrotum (males) and mons pubis (females)= genitofemoral nerve (L1,L2)

Question 16

the inferior vesical artery exists only in the male, the female has in its place the []

Answer 16

the inferior vesical artery exists only in the male, the female has in its place the vaginal/uterine artery

Question 17

what is the function of the cremaster muscle in the testes

Answer 17

its responsible for elevating the testes to maintain the temperature of sperm= cremaster muscle

when its too hot; relaxation of the cremaster muscle lowers the testicle away from the body core, thus decreasing the testicular temperature

Question 18

what nerve provides parasympathetic innervation to pelvis (pelvic viscera)

Answer 18

pelvic splanchnic nerves (parasympathetic roots S2-S4)

Question 19

What nerve provides sympathetic innervation to pelvic viscera

Answer 19

sacral splanchnic nerves (sympathetic root ganglia T10-L2 sacral)

Question 20

what is the pelvic inlet

Answer 20

The pelvic inlet (aka pelvic brim) divides the abdominal cavity from pelvic cavity.

The borders of the pelvic inlet include:

1. Sacral promontory and ala (ala of ilium refers to the upper, fan-shaped portion of the ilium; aka posterior border)
2. Lines terminals (a combination of the arcuate line on inner surface of ilium and pectineal line on superior pubic ramus) (lateral border)
3. Pubic symphysis (anterior border)

Question 21

Which ligament runs from the sacrum to the ischial tuberosity?

Answer 21

Sacrotuberous ligament runs from the sacrum to the ischial tuberosity

Question 22

Which ligament runs from the sacrum to the ischial spine?

Answer 22

The sacrospinous ligament runs from the sacrum to the ischial spine.

Question 23

Which structures pass through the greater sciatic foramen?

Answer 23

• inferior gluteal nerve
• internal pudendal nerves
• piriformis
• pudendal nerve
• sciatic nerve
  *superior gluteal nerve

Question 24

Gluteus medius and minimus receive oxygenated blood from which vessel?

Answer 24

Gluteus medius and minimus receive oxygenated blood from the superior gluteal artery

Question 25

The rectum receives blood supply from three separate arteries;
what is the origin of the following
-superior rectal artery
-middle rectal artery
-inferior rectal artery

Answer 25

Superior rectal artery - inferior mesenteric artery

Middle rectal artery - internal iliac artery

Inferior rectal artery - internal pudendal artery

Question 26

What bony landmark can be used to locate the pudendal nerve?

Answer 26

ischial spine is the bony landmark used to locate the pudendal nerve

Question 27

Where does the ovarian/testicular arterial supply originte from?

Answer 27

abdominal aorta (which begins at T12 and bifurcates at L4)

Question 28

what 3 muscles make up the levator ani

Answer 28

The levator ani group is made up of three muscles:

1. Iliococcygeus
2. Pubococcygeus
3. Puborectalis

Question 29

The posterior wall of the vagina is longer than the anterior wall; true or false

Answer 29

true; the posterior wall of the vagina is longer than the anterior wall

Question 30

The urethra and vagina both open into the vestibule of the vagina; true or false?

Answer 30

true; The vestibule of the vagina is enclosed by the labia minora. Within this region are the external orifices of both the urethra and vagina.

Question 31

In which part of the Fallopian tube does fertilisation most commonly occur?

Answer 31

ampulla of fallopian tube is usually where fertilisation occurs

Question 32

which arteries supply the fallopian tube?

Answer 32

Both the ovarian and uterine arteries provide blood supply to the Fallopian tube.

Question 33

How is the normal position of the uterus described?

Answer 33

The normal position of the uterus is described as anteverted and anteflexed.

Question 34

implantation usually occurs in the uterus in a normal pregnancy. Where does implantation occur in ectopic pregnancy?

Answer 34

Usually implantation occurs in the uterus. If implantation occurs (outside uterus/womb) in any other location (such as the Fallopian tube, ovary or cervix) this is refer to as an ectopic pregnancy