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Repro Final > Bony Pelvis and Pelvic Wall > Flashcards

Bony Pelvis and Pelvic Wall Flashcards

1
Q

How can you tell if the sacrum is in anatomical position?

A

ASIS and anterior pubis are in the same vertical plane

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2
Q

When do the ilium, ischium, and pubis fuse?

A

puberty

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3
Q

Who gets pelvic fractures more: children or adults?

A

adults

pelvic bones fuse at puberty, so the 3 bones are more flexible until they fuse

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4
Q

What are the anatomical landmarks of the ilium?

A
  • iliac crest
  • iliac fossa
  • anterior superior iliac spine
  • anterior inferior iliac spine
  • arcuate line
  • iliac tuberosity
  • posterior superior iliac spine
  • anterior gluteal line
  • posterior gluteal line
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5
Q

What are the anatomical landmarks of the ischium?

A
  • ischial spine
  • ischial body
  • ischial tuberosity
  • ischial ramus
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6
Q

What are the anatomical landmarks of the pubis?

A
  • superior pubic ramus
  • pectineal line
  • pubic tubercle
  • pubis, body
  • symphyseal surface
  • inferior pubic ramus
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7
Q

What ligament(s) are between the sacrum and ilium?

A

anterior sacroiliac L

posterior sacroiliac L

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8
Q

What are the functions of the sacrospinous L and sacrotuberous L?

A

prevent rotation of sacrum and coccyx

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9
Q

What is the other name for the greater pelvis?

A

false pelvis

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10
Q

What is the other name for the lesser pelvis?

A

true pelvis

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11
Q

What type of compression fracture causes multiple breaks?

A

anterior posterior compression - car accident

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12
Q

What type of fracture causes fracture of acetabulum?

A

lateral compression

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13
Q

What are the weak points of the pelvis?

A
  • pubic rami
  • acetabulum
  • sacroiliac joints
  • iliac ala
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14
Q

What is the male pelvis called?

A

android pelvis

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15
Q

What is the female pelvis called?

A

gynecoid pelvis

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16
Q

Desccribe the android pelvis

  • general
  • greater pelvis
  • lesser pelvis
  • pelvic inlet
  • pelvic outlet
  • pubic arch/angle
  • obturator foramen
  • acetabulum
  • greater sciatic notch
A
  • general: thick and heavy
  • greater pelvis: deeper
  • lesser pelvis: narrow and deep
  • pelvic inlet: heart shaped
  • pelvic outlet: smaller
  • pubic arch/angle: <70 degrees
  • obturator foramen: round
  • acetabulum: large
  • greater sciatic notch: narrow ~70 degrees
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17
Q

Decribe the gynecoid pelvis

  • general
  • greater pelvis
  • lesser pelvis
  • pelvic inlet
  • pelvic outlet
  • pubic arch/angle
  • obturator foramen
  • acetabulum
  • greater sciatic notch
A
  • general: thin and light
  • greater pelvis: shallow
  • lesser pelvis: wide and shallow
  • pelvic inlet: oval, cylindrical, wide
  • pelvic outlet: larger (wider)
  • pubic arch/angle: wide > 80 degree
  • obturator foramen: oval
  • acetabulum: small
  • greater sciatic notch: large ~90 degrees
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18
Q

What does the greater pelvis contain?

A

abdominal viscera

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19
Q

What contains the lesser pelvis?

A

pelvic bones

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20
Q

What is the other name for the pelvic inlet?

A

superior aperture

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21
Q

What is the other name for the pelvic outlet?

A

inferior aperture

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22
Q

What are the main pelvic wall muscles?

A
  • piriformis
  • obturator internus
  • coccygeus
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23
Q

What muscles work together to laterally rotate the thigh?

A

obturator internus and piriformis

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24
Q

Where does the obturator internus attach?

A

greater trochanter

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25
Q

Where does the piriformis attach?

A

greater trochanter

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26
Q

What is the action of the piriformis?

A

laterally rotate the thigh

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27
Q

What is the action of the obturator internus?

A

laterally rotate the thigh

28
Q

What is the function of the coccygeus m?

A

supports pelvic viscera and flexes coccyx

29
Q

The pelvic floor is also the ____

A

roof of the peritoneum

30
Q

What are the pelvic floor muscles?

A

coccygeus
iliococcygeus
pubococcygeus
puborectalis

31
Q

What are the levator ani function?

A

elevate the anal canal

32
Q

What is the tendinous arch of levator ani?

A

thickening of obturator internus fascia between ischial spine and pubic body

33
Q

What does the tendinous arch of the levator ani divide?

A

obturator internus m into superior pelvic region and inferior perineal portion

34
Q

What is the anorectal angle created by?

A

puborectalis m

35
Q

What is the function of the anorectal angle created by the puborectalis m?

A

helps maintain fecal continence

  • will relax during urination and defecation
  • works independently from sphincters
36
Q

What are the levator hiatus?

A

openings created by pelvic floor muscles - anterior gap in levator ani muscles

  • passageway for the urethra, rectum, and vagina
  • anteromedial fibers of pubococcygeus and puborectalis
37
Q

What is the order of the levator ani from medial to lateral?

A

puborectalis
pubococcygeus
iliococcygeus

38
Q

What are the most susceptible muscle to tear during childbirth?

A

puborectalis m

pubococcygeus m

39
Q

What is the ischiorectal fossa filled with?

A

fat, neurovasculature

40
Q

What is the function of the ischio-anal fossae?

A

allows movement of pelvic diaphragm and expansion of anal canal

41
Q

What are the triangles of the ischial-anal fossae?

A

urogenital triangle and anal triangle (front and back)

42
Q

What are the two flexures?

A
  • sacral flexure/dorsal bend

- anorectal flexure/ventral bend/perineal flexure

43
Q

What is the dorsal bend due to?

A

concave form of sacrum

44
Q

What is the ventral bend due to?

A

encirclement of the rectum by the levator ani (puborectal sling)
-point where rectum transitions to anal canal

45
Q

What are the parts of the anal canal?

A
  • anal columns
  • anal valves
  • anal sinuses
  • external anal sphincter
  • internal anal sphincter
  • pectinate line
46
Q

What are anal columns?

A

longitudinal ridges

47
Q

What are anal valves?

A

folds at the base of the columns

48
Q

What are anal sinuses?

A

adjacent to valves

-secrete mucus to facilitate defication

49
Q

What are the parts of the external anal sphincter?

A
  • subcutaneous
  • superficial
  • deep
50
Q

What percent of anal tone is the external anal sphincter doing?

A

15-30%

51
Q

What percent of anal tone is the internal anal sphincter doing?

A

55-85%

52
Q

What type of muscle is the external anal sphincter?

A

skeletal

53
Q

Is the external anal sphincter voluntary or involuntary?

A

voluntary

54
Q

What type of muscle is the internal anal sphincter?

A

circular smooth m

55
Q

Is the internal anal sphincter voluntary or involuntary?

A

involuntary

56
Q

What is the function of the internal anal sphincter?

A

tonic contraction except when feces fill rectum

57
Q

What does the pectinate line divide?

A

upper 2/3 anal canal from lower 1/3 anal canal

58
Q

Above pectinate line

-embryological origin

A

endoderm

59
Q

below pectinate line

-embryological origin

A

ectoderm

60
Q

above pectinate line

  • nerves
  • veins
  • hemorrhoid classification
  • destination of lymph
A
  • nerves: inferior hypogastric plexus (visceral - mixed symp and para)
  • veins: superior rectal v (portal)
  • hemorrhoid classification: internal (not painful)
  • destination of lymph: internal iliac lymph nodes, inferior mesenteric
61
Q

below pectinate line

  • nerves
  • veins
  • hemorrhoid classification
  • destination of lymph
A
  • nerves: inferior rectal N (somatic)
  • veins: inferior rectal v (systemic)
  • hemorrhoid classification: external (painful)
  • destination of lymph: superficial inguinal lymph nodes
62
Q

describe internal hemorrhoid

A
  • above pectinate line
  • bright red blood
  • not painful
  • prolapsed rectal mucosa due to weakened muscularis mucosa and abundant arteriovenous anastamosis
63
Q

describe external hemorrhoids

A
  • below pectinate line
  • painful: hurts when wiping
  • external venous plexus covered with epidermis
64
Q

What are hemorrhoids a consequence of?

A

portal hypertension

65
Q

describe the lymph drainage

-superior rectum

A

superior rectum –> pararectal lymph nodes –> sacral lymph nodes –> inferior mesenteric lymph nodes

66
Q

describe lymph drainage

-inferior rectum

A

inferior rectum –> internal iliac lymph nodes

67
Q

describe lymph drainage

-anal canal (below pectinate line)

A

anal canal–> superficial lymph nodes

Repro Final (9 decks)

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