Bony Pelvis and Pelvic Wall Flashcards
What divides the abdomen from the pelvis?
What makes up the pelvic brim?
Pelvic Brim
arcuate line (of the ilium)
Pectin Pubis (pectineal line of the pubis)
What is the false pelvis?
what iso linger just going to refer the pelvic as?
really just still abdomen. its from the iliac crest to the pelvic brim. it’s also called the “greater” pelvis
Olinger will be saying the pelvis is from pelvic brim to pelvic diaphragm
Perineum is what?
inferior to the pelvic diaphragm, inferior to the pelvis.
are the three bones of the os coxae? (innominate)
Ilium, Ischium, pubis
what structures on the ilium do we care about?
auricular surface of the ilium
iliac crest
iliac spines
What structures do we care about on the pubis?
Body
2 branches –> a branch that sends to the ilium and one that sends to the ischium.. so we have a “superior and inferior pubic ramus”
on the body itself there’s a symphyseal surface, a pubic crest, and pubic tubercle
What’s the difference between pubic crest and pubic tubercle
there’s a ridge going inwards = crest
outside of the crest on the lateral side = tubercle
What attaches to the pubic tubercle?
Inguinal Ligament
What can we find on the superior pubic ramus? (3)
Pectin Pubis (pectineal line of the pubis)
little boney ridge called the obturator crest, and below that is the obturator groove.
What does the ischium have?
what does the 2nd structure separate?
the body of the ischium has the ischial tuberosity
Ischial Spine.
the greater and lesser sciatic notch
why is the ischiopubic ramus confusing?
it’s a little area of overlap where the inferior pubic ramus meets up with the ischial ramus and because some muscles are coming from the area between these two we come up with ischiopubic ramus.
If we were to take the arcuate line and the pectin pubis, what would we call that?
linea terminalis
Arch vs angle?
to note about women and men?
arch is the boney feature, the angle at which the arch exists…
women have bigger angles because you need to put a baby through
anterior surface of the sacrum?
4 pairs of anterior sacral foramina
little lines that used to be intervertebral discs but you have these ridges called “transverse lines”
What’s to note on the lateral surfaces of the sacrum?
Auricular surface that meets up with the auricular surface at the ilium.
Spondylolisthesis? what about in terms of this class?
L5 can do this off of S1
Separation of the vertebral arch from the vertebral body.
What are the openings of the pelvis?
superior pelvic aperture = at the pelvic brim
inferior pelvic aperture = stretching between inferior edge of the pubic symphysis and the tip of the coccyx
passage way between apertures is the pelvic canal
difference between male and female pelvises?
“which of these holes would it be easier to squash a baby through”
male: thicker, heavier, deeper greater pelvis, narrower lesser pelvis, android pelvic inlet, smaller pelvic outlet. narrower pubic arch, so smaller angle.
What’s to note about obturator foramens and acetabulum and men and women?
males have a more round obturator foramen, and a larger acetabulum
women has more oval and smaller acetabulum.
Gynecoid?
android?
Platypelloid
anthropoid
more female looking pelvic canal (much wider)
android (more narrow, you see the os coxae pointing in, the sacrum pointing in)
if you squash the pelvis from anterior to posterior direction
squash from lateral to medial
Anthropoid and Platypelloid?
female wanting to give birth but they have one of these shapes, they may not be good for vaginal childbirth.
Conjugates?
“pelvic diameters” –> important measurements obstetrically to determine the capacity of a female to bear a child.
Pelvic fractures?
we’ve made a big boney ring, it usually breaks in multiple places, including BOTH PUBIC RAMI usually
What is the only cartilage of the boney pelvis?
cartilaginous disc between the two pubic bones of the pubic symphysis called the “interpubic disc”
Lumbosacral Joint
what ligaments are there and where is it located? (3)
between L5 and the sacrum
Anterior Longitudinal Ligament –> along the anterior surface between L5 and the sacrum
Posterior Longitudinal –> out of the vertebral canal on the back of the vertebral body running down into the sacral canal… “Wallpapering the anterior part of the sacral canal”
Ligamentum Flavum –> running off the anterior surface of the vertebral lamina, wallpapering the posterior wall of the sacral canal.
What is the iliolumbar ligament? what comes from the same spot and is part of this ligament?
what kind of ligament is the 2nd one like??
it’s coming off of the transverse process of L5 and headed out to the ilium. it lends support to the lumbosacral joint.
part of the iliolumbar ligament is the lumbosacral ligament.. also coming from the transverse process of L5 headed down to the sacral ala
intertransverse ligament. (the ala of the sacrum are kind of like the transverse processes (they used to be), so this ligament going from transverse process to the sacral ala is like an inter transverse ligament.
Obturator Membrane?
what’s covering either side?
what does the little hole make?
we have an obturator foramen and block it almost completely with this membrane
then we put muscle on either side. on the outside it’s the obturator externus, on the inside is obturator internus
this is the obturator foramen after the membrane is there. it is below the obturator crest and when there’s a hole it’s the foramen. when there’s no membrane it’s the obturator groove
Inguinal ligament goes from where to where?
ASIS to the pubic tubercle.
boundary between pelvis, abdomen and lower extremity
Pubic symphysis is held together by what?
superior and inferior pubic ligaments
What makes the shallow vinegar cup a little less terrible?
the transverse acetabular L.
it goes across the big opening of the acetabulum near the obturator membrane/foramen area.
makes it a deeper socket
Sacroiliac Joint? what kind of joint is it?
a compound joint.. part is fibrous, part is synovial
of the sacroiliac joint, what is the auricular surfaces articulating with each other considered and why?
Planar synovial joint
lined with hyaline cartilage, has synovial fluid
Ilium has the iliac tuberosity and the sacrum has a sacral tuberosity.. what’s there?
considering the ligament, what does this specific junction make the joint?
the interosseous sacroiliac ligament. (in the joint space)
it makes those two tuberosities
bone, CT, bone = fibrous type joint.
Anterior and posterior sacroiliac ligaments.. explain both
the anterior = straight forward. stretches from the sacrum right across to the ilium
the posterior = has 2 long ones
also has short ligaments too.
sacrotuberous and sacrospinous ligament?
very big, touch ligaments.
they take the greater sciatic notch and turn it into the greater and lesser sciatic foramen.
the sacrospinous ligament goes from ischial spine to the sacrum.
sacrotuberous ligament goes from sacrum to ischial tuberosity
Peritoneum is what? what’s below the peritoneum (don’t include parts)? what’s below that?
Peritoneum –> Pelvic fascia –> perineal fascia
Peritoneum
dips down out of the abdomen into the pelvis, covers some of the pelvic structures and comes right back up. (Parietal peritoneum)
it leaves us with some spaces and ligamentous structures.
in the male, what are we going to see with regards to peritoneum? (3 names, technically 5 total)
Rectovesical Pouch = it’s a little dip in the peritoneum between the rectum and the bladder
on either side of the rectum are lined pouches called “pararectal fossae”
on either side of the bladder are “paravesical fossae”
in the female, what are we going to see with regards to peritoneum?
because the uterus is in there, we have additional pouches.
1) Rectouterine pouch
2) Vesicouterine pouch
3) paravesical fossae (on either side)
4) pararectal fossae (on either side)
5) Broad Ligament of the Uterus
what is the broad ligament of the uterus and what is it composed of?
the broad ligament is made of peritoneum.. we send peritoneum down into the pelvis, it covers up certain structures, including the uterus.
1) part right up against the uterus = mesometrium (double layer of peritoneum)
2) part that surrounds The ovary = mesovarium
3) part that surrounds the uterine tube = mesosalpinx
What is pelvic fascia composed of?
what is part of membranous pelvic fascia?
2 kinds: membranous Pelvic fascia and endopelvic fascia
Visceral membranous pelvic fascia + Parietal Membranous pelvic fascia
What are the structures that are lined with visceral membranous pelvic fascia?
Bladder = Vesical Fascia
Rectum = Rectal Fascia
What are the structures that are lined with parietal membranous pelvic fascia?
on the Obturator Internus muscle = Obturator Fascia
Tendinous arch of pelvic fascia
What is the tendinous arch of pelvic fascia and what is it composed of in women?
parietal membranous pelvic fascia
pubovesical L. (goes from pubis to bladder)
uterosacral L. (from uterus to sacrum)
What’s important to know about the uterosacral L?
it’s important during stretching and tearing, supporting the pelvis when childbirth takes place.
what is the tendinous arch of pelvic fascia and what is it composed of in men?
parietal membranous pelvic fascia
Puboprostatic L. from pubis to prostate gland
Rectoprostatic L from prostate to rectum
Obturator Fascia makes what canal?
what does it have?
Pudendal Canal (made of obturator fascia)
holds pudendal nerve, internal pudendal A.
What is Endopelvic fascia composed of?
loose and condensed
loose = literally just a fat filled space
condensed = tougher but not membranous.. like a dense fibrous tissue.
Condensed compartmentalizes the loose
What is the loose endopelvic fascia of women?
Retropubic space (behind the pubis)
paravesical space (on either side of the bladder)
Pelvirectal space
Retrorectal (behind the rectum)
is the paravesical space the same thing as paravesical fossae?
no
if you take this fat filled space and put peritoneum on it, you end up with the fossae.
Condensed endopelvic fascia is called what?
what are the parts of this (in women)
hypogastric sheath.
Posterior lamina goes to the rectum (Lateral Rectal L.)
anterior that goes to the bladder (Lateral L. of the bladder)
and a middle that goes and runs to the cervix of the cervix. (Transverse cervical L)
What is the transverse cervical L
this is part of the middle lamina coming from the hypogastric sheath which is the condensed endopelvic fascia
What are the parts of the loose endopelvic fascia in males?
same as females
retropubic, paravesical, pelvirectal, retrorectal
what are the parts of the condensed endopelvic fascia in males?
Posterior Lamina of hypogastric sheath (lateral rectal L)
Anterior Lamina of hypogastric sheath (Lateral L. of the bladder)
middle lamina (rectovesical septum)
What are the different triangles of the perineum?
pubic symphysis to ischial tuberosity to coccyx to ischial tuberosity = diamond
line between ischial tuberosity = two triangles
towards the pubic bone = urogenital triangle
towards sacrum = anal triangle
What is the only 2 things we really care about in the anal triangle?
Ischioanal fossa –> little space between the pelvic diaphragm and the pudendal canal lined obturator fascia.
pudendal canal
Perineal fascia creates two pouches. what are they?
what separates them?
separates the perineum into two pouches..
1) deep perineal pouch
2) superficial perineal pouch
perineal membrane
What is the perineal membrane described as being composed of?
deep perineal fascia
everything superficial to the perineal membrane is called what?
perineal fascia
What are the contents of the superficial perineal pouch in males? (7)
Bulb / Crura of the penis, superficial perineal muscles, proximal spongy urethra, branches of internal pudendal A and V., Pudendal N.
What are the contents of the superficial perineal pouch in females? (7)
Crura of the clitoris, bulbs of the vestibule, superficial perineal muscles, greater vestibular glands, branches of the internal pudendal A, V, and N.
What are the contents of the deep perineal pouch in males? (3)
Membranous urethra, muscles of the urogenital diaphragm, bulbourethral glands
What are the contents of the deep perineal pouch in females? (1)
muscles of the urogenital diaphragm
