Bony Pelvis and Pelvic Wall

Question 1

Pelvis versus Perineum

Answer 1

• Pelvis-region of trunk inferoposterior to abdomen, between pelvic brim and pelvic diaphragm
• Perineum-area of trunk between thighs and buttocks, from coccyx to pubis, inferior to the pelvic diaphragm

Question 2

• What are the parts of the bony pelvis?

Answer 2

• Paired coxal bones, sacrum, coccyx

Question 3

• What are the components of the pelvic girdle?

Answer 3

• Paired coxal bones, joined anteriorly at the pubic symphysis

Question 4

The sacral canal transmits the _

Answer 4

• Caudate equina

Question 5

• Spondylolysis

Answer 5

• Separation of vertebral arch from vertebral body

Question 6

• Spondylolisthesis

Answer 6

• Abnormal anteriorly directed separation of L5 vertebral segment from the sacrum

Question 7

• What forms the superior pelvic aperture?

Answer 7

• Located at pelvic brim
• Formed by:
  
  • Sacral promentory
  • Superior edge of sacral ala
  • Arcuate line of the ilium
  • Pectin pubis
  • Posterior edge of pubic crest
  • Superior edge of pubic symphysis

Question 8

• What forms the inferior pelvic aperture?

Answer 8

• Inferior edge of pubic symphysis
• Inferior pubic and ischial rami
• Ischial tuberosities
• Sacrotuberous Ls
• Coccyx

Question 9

_ is the passage between the superior and inferior pelvic aperture

Answer 9

• Pelvic canal

Question 10

• Sexual differences in pelves

Answer 10

• Males
  
  • Thicker heavier pelvis
  • Deeper greater pelvis
  • Narrower and deeper lesser pelvis
  • Android Pelvic inlet
  • Small pelvic outlet
  • Narrow pubic arch
  • Round obturator foramen
  • Large acetabulum
• Females
  
  • Thinner lighter pelvis
  • Shallow greater pelvis
  • Shallow and wide lesser [elvis
  • Gynecoid pelvic inlet
  • Large pelvic outlet
  • Wide Pubic Arch
  • Oval shaped obturator foramen
  • Small acetabulum

Question 11

• Android is the _ pelvis
• Gynecoid is the _ pelvis
• Anthroploid is _ pelvis
• Platypelloid is _ pelvis

Answer 11

• Male
• Female
• Elongated anterior to posterior
• Elongated laterally

Question 12

• Pelvic _ are important measues obstetrically to determine the capacity of the female to bear a child

Answer 12

• Diameters

Question 13

• Pelvic fractures

Answer 13

• Almost always involve multiple fractures given that the pelvis is a bony ring and difficult to break in omnly one place
• Superior and inferior pubic rami are often broken on both sides as a result of pelvic fractures

Question 14

• Interpubic disc

Answer 14

• Fibrocartilagenous disc between right and left pubic symphyseal surface

Question 15

• What ligaments that are normally present in the vertebrae are absent in L5-sacrum junction

Answer 15

• Interspinous L
• Intertransverse L
• Supraspinous L
  *

Question 16

• Sacroiliac joint

Answer 16

• Compound joint
  
  • Planar Synovial
    
    • Anteriorly between articular surface of sacrum and articular surface of the ilium
    • Fibrous syndesmosis
      
      • Posteriorly between sacral and ischial tuberosities

Question 17

• The _ and _ produce the greater sciatic foramen and lesser sciatic foamen from the greater sciatic notch and lesser sciatic notch

Answer 17

• Sacrotuberous L and Sacrospinous L

Question 18

• Peritoneum
  
  • Male
  • Female

Answer 18

• Male
  
  • Paravesicle fossae
  • Pararectal fossae
  • Rectovesicle pouch (depressed area lined with peritoneum between the rectum and urinary bladder)
• Female
  
  • Paravesicle fossae
  • Broad Ligament of the Uterus
    
    • Double Layer of Peritoneum (Mesentary)
    • 3 Parts
      
      • Mesometrium-supports the uterus and surrounds ligament of the ovary and round ligament of the uterus
      • Mesosalpinx-part of the broad ligament that supports the uterine tubes
      • Mesovarium-part of the broad L of the uterus that supports the ovaries
  • Suspensory ligament of the ovary
    
    • Enclosing ovarian vessels
  • Pararectal fossae
  • Vesicouterine pouch
  • Rectouterine pouch

Question 19

• Pelvic fascia has what two components?

Answer 19

• Membranous component
• Endopelvic component

Question 20

• Membranous component of pelvic fascia has what two components?

Answer 20

• Parietal membranous pelvic fascia
• Visceral membranous pelvic fascia

Question 21

• Parietal pelvic fascia

Answer 21

• Lines muscular walls of the pelvis

Question 22

• Obturator fascia is a component of what type of pelvic fascia

Answer 22

• Membranous parietal pelvic fascia
  
  • Lines pelvic side of obturator internus m.
  • Continuous superiorly w/ transversalis fascia
  • Forms walls of pudendal canal
  • Forms tendinous arch of levator ani ms.

Question 23

Tendinous arch of pelvic fascia makes up what component of pelvic fascia?

What ligaments does it create

Answer 23

• Membranous parietal pelvic fascia
  
  • Puboprostatic ligament (anterior part in males)
  • Pubovesicle ligament (anterior part in females)
  • Sacrogenital L (posterior part)
    
    • Retroprostatic L (males)
    • Uterosacral L (females)

Question 24

• Visceral pelvic fascia is a component of what type of pelvic fascia?
• What does it line?

Answer 24

• Membranous pelvic fascia
• Lines pelvic viscera EXCEPT where the pelvic viscera penetrates the pelvic diaphragm (where parietal and visceral layers come together and form the tendinous arch of pelvic fascia)

Question 25

* What are the two types of endopelvic fascia

Answer 25

* Loose (fat filled potential spaces) * Condensed (increased density of collagen and elastic fibers responsible for compartmentalizing the loose endopelvic fascia)

Question 26

* Loose endopelvic fascia makes up what spaces

Answer 26

* Retropubic space * Paravesical space * Pelvirectal space * Retrorectal space

Question 27

* The hypogastric sheath is made of what type of pelvic fascia * What ligaments does it create

Answer 27

* Condensed endopelvic fascia * Lateral L of the bladder * Middle lamina of hypogastric sheath * Rectovesical septum * Transverse cervical L * Lateral rectal L

Question 28

* Perineum=quadrangular space * What are the four points that make up the quadrangular space of the perineum? * What two spaces is the perineum divided into?

Answer 28

* Two ischial tuberosities (lateral) * Pubic symphysis (anteriorly) * Coccyx (posteriorly) * Divisions * Anteriorly-urogenital triangle * Posteriorly-rectal triangle

Question 29

* Components of the anal triangle

Answer 29

* **Ischioanal fossa** * Fat and loose CT, allows for expansion of anal canal during defecation * **Pudendal canal** * Space in obturator fascia * Transmits internal pudendal a.,v, and pudendal n.

Question 30

* Components of the urogenital triangle-female

Answer 30

* **Perineal membrane** * **​**Extends between the two sides of the pubic arch * Covers anterior portion of inferior pelvic aperture * **Superficial perineal fascia** * **​**Continuous with superficial fascia of abdomen (has fatty and membranous component) * Fatty=labia majora and mons pubis * **Deep perineal fascia** * **Superficial perinal pouch** * **Deep perineal pouch**

Question 31

* Components of the urogenital triangle-male

Answer 31

* Perineal membrane * Superficial perineal fascia * Deep perineal fascia * Superficial perineal pouch * Deep perineal pouch