Anatomy: Pelvis Flashcards
At what angle does the sacrum sit relative to the vertebral column?
60* angle anteriorly
What does the sacrospinus ligament form?
Greater sciatic foramen
What does the sacrotuberous ligament form?
Lesser sciatic foramen
Where is the sacrospinous ligament relative to the sacrotuberous ligament?
Sacrospinous ligament is deeper
What is the origin and insertion of the sacrospinous ligament?
Sacrum to ischial spine
What is the origin and insertion of the sacrotuberous ligament?
Sacrum to ischial tuberosity
What is the false pelvis?
Greater pelvis - above the pelvic brim
What is the true pelvis?
Lesser pelvis - below the pelvic brim
What are the four differences between the male and female pelvis?
Female pubic arch is > 80*
Females have larger interspinous distances
Females have greater distances between ASIS
Females have a round pelvic inlet, males have a heart shaped pelvic inlet
What is the pelvic diaphragm?
Floor of the pelvic basin
What two muscles make up the pelvic diaphragm/floor?
Coccygeus
Levator ani
What are the three muscles of the levator ani?
Iliococcygeus
Pubococcygeus
Puborectalis
What is the origin, insertion and function of the coccygeus?
Ischial spine to coccyx
Supports viserca
Supports and elevates pelvic floor
What is the function of the levator ani muscle?
Supports viscera
Helps defecation
What is the origin and insertion of the iliococcygeus?
Pudendal canal to coccyx
What is the origin and insertion of the pubococcygeus?
Pubis to coccyx
What is the origin and insertion of the puborectalis?
Pubis to sling around rectum
What is the origin and insertion of the performis muscle?
Sacrum to greater trochanter
What seperates the pelvic basin from the perineum?
Pelvic floor
What are the roots for the pudendal nerve?
S2-3
What is the pathway of the pudendal nerve?
Exits through the greater sciatic foramen
Enters the pelvis through the lesser sciatic foramen
Runs through the pudendal canal anteriorly
What ligament does the pudendal nerve cross over?
Sacrospinous ligament
What makes up the pudendal canal?
Junction of the obturator interns and levator ani (iliococcygeus)
What are the three branches of the pudenal nerve?
Inferior rectal nerve
Perineal branches
Dorsal nerve
Where is the inferior rectal nerve located?
Ischiorectal fossa
What does the inferior rectal nerve innervate?
Rectum
External anal sphincter
What does the perineal branches innervate in males?
Sensory to scrotum
Motor to superficial and middle perineum
What does the perineal branches innervate in females?
Sensory to labia majora
Motor to superficial and middle perineum
What does the dorsal nerve innervate in males?
Sensory to penis
What does the dorsal nerve innervate in females?
Clitoris
Where is an epidural delivered?
L3-4
What is an example of a spinal block?
Epidural
What nerve is targeted in a regional block?
Pudendal nerve
What is the landmark for a regional block?
Ischial spine
What are the two layers of the perineum?
Urogenital triangle
Anal triangle
What are the superficial muscles of the urogenitial triangle?
Bullbospongiosus
Ischiocavernosus
Superficial transverse perineal
What makes up the middle layer of the urogenital triangle?
Urogential diaphragm: perineal membrane, muscle (deep transverse perineal), memrbane
Urethral sphincter
What makes up the deep layer of the anal triangle?
Levator ani
What does the bulbospongiosus muscle cover in the male?
Bulb of penis
What does the ischiocavernosus muscle cover in the male?
Crux of penis and erectile tissue
What is the origin and insertion of the superficial transverse perineal muscle?
Ischial tuberosity to perineal body
What is the difference in the deep transverse perineal muscle in males and females?
Joined together in males
What does the bulbospongiosus muscle surround in females?
Surrounds vaginal opening
What does the ischiocavernosis muscle cover in females?
Covers erectile tissue
Leans up against clitoris
What is the function of the superficial transverse perineal muscles?
Functions during sexual intercourse and voiding of urine
Where is the perineal body relative to the bulbospongiosus?
Base
Where is the perineal body relative to the ischiocavernosus?
Base
Where is the perineal body relative to the superficial transverse perineal muscles?
Center
What does the cervix have to dilate to during childbirth?
10 cm
What is a episiotomy?
Incision in perineum through the bulbospongiosus muscle from vagina to anus to widen space.
What is the performs a landmark for?
Superior gluteal artery and nerve
Inferior gluteal artery and nerve
- Along superior aspect of periforms
What nerve supplies sensory to the skin around the perineum?
Ilioinguinal and lateral femoral cutaneous
What are the borders of the perineum?
Public symphysis Inferior pubic rami Ischial tuberosity Sacrotuberous ligament Coccyx
What are the two types of internal iliac artery branches?
Visceral (organs)
Parietal (muscular)
What are the 6 direct branches of the internal iliac artery?
Iliolumbar Lateral sacral Gluteal Internal pudendal Middle rectal Superior vesicular
What type of artery is the iliolumbar?
Partietal
What type of artery is the lateral sacral?
Parietal
What type of artery is the gluteal?
Parietal
What type of artery is the internal pudendal?
Visceral
What type of artery is the middle rectal?
Visceral
What type of artery is the superior vesicular?
Visceral
Where does the obturator artery come from?
Inferior gluteal artery
Where does the inferior vesicular artery come from in males?
Internal pudendal
What is the homologous structure to the inferior vesicular artery in females?
Vaginal artery
Where does the vaginal artery come from?
Uterine artery
Where does the uterine artery come from?
Superior vesicular
What is the motor innervation to the deep perineal layer?
Nerve to levator ani
Nerve to coccygeus
What is the function of the male reproductive system?
Produce spermatozoa and testosterone
When does the development of the male reproductive system begin?
Week 5 of gestation
When can you tell the difference in gender in developing fetus?
What is used to tell?
Week 10-12
Testes start secreting testosterone
What is the function of the scrotum?
Protects testes
Maintains testes at below body temperature
What is the ejaculatory duct made of?
Seminal vesicle
Ampulla of vas defernes
What is the first division of the male urethra?
Prostatic urethra
Where does the prostatic urethra pass through?
Prostate gland
What is the second division of the male urethra?
Membranous urethra
Where does the membranous urethra pass through?
Urogenitial membrane
What is the third division of the male urethra?
Penile/spongy urethra
Where does the penile/spongy urethra pass through?
Bulb of penis
Which of the urethra sphincters do you have somatic control over?
External urethral sphincter
What nerve innervates the external urethral sphincter?
Pudendal nerve
Why is the internal urethral sphincter important in males?
Closes off bladder so urine cannot be released during an erection
What is the innervation to the cremaster muscle?
Genitofemoral
What is the innervation of the dartos muscle?
Pudendal nerve
What is the vas deferns?
Muscular tube for transport to the ejaculatory duct
How long can sperm be stored in the vas deferns in the scrotum?
2 months
What is secreted through the seminal vesicles?
Alkaline fluid of fructose, prostaglandins and coagulated proteins
Where are the bulbourethral glands located?
Near perineal membrane underneath the prostate gland
What do the bulbourethral glands secrete?
Mucus like substance before sperm are released to give the sperm a pathway as they leave the urethra
Where is the prostate gland found?
Inferior to bladder
What is the function of smooth muscle within the postate gland?
Divides lobules of gland
Empties contents
What does the prostate gland secrete?
Milky secretion that assists sperm motility as liquefying agent
Alkaline that protects sperm against acidic vagina
Where do the prostate secretions drain into?
Ejaculatory duct
How does the prostate drain into the ejaculatory duct?
Colliculus sinus
How much % of the semen is secreted by seminal vesicles?
60-70%
What is a test to check for prostate cancer?
Elevated levels of PSA
Physical palpation through rectum
What is the parasympathetic innervation for pelvic organs?
Pelvic splanchnics (S2-4)
What is the sympathetic innervation for pelvic organs?
Inferior mesenteric ganglion through hypogastric plexus
What part of the penis is continuous with the bulb of the penis and erectile, and surrounds the urethra?
Corpus spongiosum
What part of the penis is continuous with the crux of the penis?
Corpus cavernosum
What part of the penis is covered by foreskin?
Corpus spongiosum
Where is the crus of the penis relative to the bulb?
Superior
What is the suspensory ligament of the penis connected to?
Pubis symphysis to corpus cavernosum
What runs with the suspensory ligament in males?
Dorsal vein, artery and nerve
When are the ova produced?
Prenatally
How many ova are present at birth?
Over 2 million
How many eggs will mature?
400 000
How many eggs will differentiate?
400-500
Why does cyclic ovulation occur?
In response to hormonal concentations
What are the organs of the female reproductive system?
Ovaries Uterine tube Uterus Vagina Mammary glands
What do the ovaries produce?
Ova
Estrogens
Progesterone
What part of the ovary contains developing follicles?
Cortex
Which part of the ovary contains blood vessels and supportive tissue?
Medulla
What is the opening of the uterus with the vaginal canal?
External os
What is the normal position of the uterus?
Anteverted and anteflexed
How many degrees of retroversion can the uterus have?
3
What is the problem with a retroverted uterus?
Uterus can prolapse and part of the uterus can enter the vaginal canal
What is a hysterectomy?
Removal of uterus and cervix.
If the ovaries are removed in a hysterectomy, what does the woman need to do following surgery?
Take hormone replacement therapy
How are the ovaries attached to the uterus?
Ovarian ligament
What anchors the ovaries to the side of the uterus?
Mesovarium
How are the ovaries attached to the pelvic brim?
Suspensory ligament
What are the three parts of the broad ligament?
Mesosalpinx
Mesovarium
Mesometrium
What are the only area of the female reproductive tract that are not covered by partioneum?
Fimbrae
How do you externally measure the growth of a developing fetus?
Fundus of uterus to pubic bone
What is a tubal ligation?
Uterine tubes are tied/cut
What are the three layers of the uterus? (outside to inside)
Perimetrium
Myometrium
Endometrium
What layer of the uterus is discarded during menustration?
Endometrium
What is an ectopic pregnancy?
Fetus developing in uterine tube therefore a placenta cannot be formed
Where does the ovarian artery run?
In suspensory ligament
What does the hormone relaxin do during pregnancy?
Loosens joints
Can cause back pain
What type of back disorder is a pregnant woman at risk of?
Sciatica
What type of circulatory disorder is a pregnant women at risk of when laying on her back?
Crushing IVC and aorta
What is diastasis recti?
Stretching of the linea alba
What remodelling of the heart do pregnant women undergo?
Increased ventricular cavity (not wall thickness)
Drop in vagal done
Increased heart rate
Increased SV
Where is the posterior fornix in close proximity to?
Rectouterine pouch
What are the two pouches formed by the parietal peritoneum in females?
Rectouterine
Uterovesicular
What is the pouch formed by the parietal peritoneum in males?
Retrovesicular
