Bony Pelvis And Pelvis Wall Flashcards

1
Q

Name bony feature of the ilium, ischium, pubis, and pelvic brim

A

Ilium: crest, ASIS, AIIS, PSIS, gluteal lines, iliac fossa, arcuate line (border between greater and lesser pelvis)

Ischium: body, ramus, spine, tuberosity

Pubis: symphysis, tubercle, body, superior and inferior pubic rami, pectineal line

Pectineal and arcuate line demarcate pelvic brim

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2
Q

When is the pelvic bone in anatomical position?

A

When the ASIS and anterior pubis is in the same vertical plane

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3
Q

Strong extensive ligaments connecting the sacrum and ilium and separates the hip bones?

What ligaments prevent rotation of the sacrum/coccyx and create the greater and lesser sciatic foramina?

A

Sacroiliac L (anterior/posterior)

Sacrotuberous and sacrospinous L

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4
Q

Pelvic injuries:

Anteroposterior compression causes fractures of ____.

Lateral forces squeeze ____ and ____ together breaking both.

Weak areas?

A

Pelvic rami

Acetabulum and ilia

Pubic rami, acetabulum, sacroiliac joints, and ala

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5
Q

Define the area of the lesser/true pelvis

Define the area of the greater (false) pelvis

What bone bears most the abdominal weight?

A

Superiorly by pelvic brim (pelvic inlet), inferiorly by muscular pelvic diaphragm, laterally and anteriorly by lower half of hip bones, posteriorly by sacrum and coccyx

Superior to pelvic brim, occupied by abdominal viscera

Pubic bone

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6
Q

What is the normal male pelvis?

Female pelvis?

A

Android pelvis: thick and heavy, deep greater pelvis, narrow and deep lesser pelvis, heart shaped pelvic inlet, small pelvic outlet, narrow pubic arch and subpubic angle, round obturator foramen, narrow greater sciatic notch

Gynecoid pelvis: thin and light, shallow greater pelvis, wide and shallow lesser pelvis, oval pelvic inlet, large pelvic outlet, wide pubic arch and subpubic angle, oval obturator foramen, wider 90 degree greater sciatic notch

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7
Q

Obturator internus M:

Origin
Insertion
Innervation
Action

A

Ilium/ischium surface (inside surface); obturator membrane

Greater trochanter

Obturator N

Rotates thigh laterally

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8
Q

Piriformis M:

Origin
Insertion
Innervation
Action

A

S2-4 surface, superior margin of greater sciatic notch; sacrotuberous L

Greater trochanter

S1-S2

Rotates thigh laterally

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9
Q

Coccygeus M

Origin
Insertion
Innervation
Action

A

Ischial spine

Inferior end of sacrum and coccyx

S4-S5

Support pelvic viscera, flex coccyx

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10
Q

Four muscle of the pelvic diaphragm with origin

What is the action of the last three and what are they called?

A

Coccygeus M: ischial spine

  • Iliococcygeus M: tendinous arch
  • Pubococcygeus M: pubis
  • Puborectalis M: pubis
  • Elevate the anal canal; levator ani
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11
Q

What is the function of the levator ani and what muscles does it contain?

What is the tendinous arch of the levator ani?

A

Elevates the anal canal

Iliococcygeus, pubococcygeus, puborectalis

Tendinous arch of levator ani is a thickening of obturator (part of endopelvic) fascia between ischial spine and body of pubis

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12
Q

What makes up the anorectal angle?

What is its function?

A

Puborectalis M

Maintain fecal continence (with sphincters)

Relaxes during both urination and defecation

Distinct from external and internal anal sphincter

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13
Q

What is the urogenital (levator) hiatus and how does it form?

What muscles are susceptible to tearing during birth?

A

Passageway for rectum, urethra, and vagina; formed by anterior gap between levator ani muscle

Pubococcygeus and puborectalis most susceptible to tearing during birth being most medial and large part of levator ani

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14
Q

Where is the ischiorectal fossae?

What is it filled with?

How is it divided?

Where is the perineal membrane?

A

Inferior to pelvic floor

Filled with fat

Diamond shaped and divided into two triangles (urogenital, anal)

Perineal membrane spans between rami; layer of fat is superior to membrane and external genitalia is inferior to membrane

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15
Q

Describe the ischiorectal fossae

Location?
Action?
Contents?

A

Fat-filled space around anorectum

Fossa extends anteriorly above perineal membrane

Allows moment of pelvic diaphragm and expansion of anal canal

Contains neurovasculature to anal canal and some perineum

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16
Q

Where is the anal canal?

What are anal columns?

Anal valves?

Anal sinuses?

A

Begins at the level when the rectum perforates the levator ani

Longitudinal rides

Folds at the base of columns

Small recess adjacent valves, exude mucus facilitating defecation

17
Q

Describe the internal anal sphincter

External anal sphincter

A

Inner circular smooth M. (Involuntary), keeps tonic contraction except when feces fill the rectum, 55-85% of resting anal tone

Skeletal M. (Voluntary), 15-30% of resting anal tone; 3 parts: subcutaneous, superficial, deep (puborectalis)

18
Q

Enlarged and collapsed varicosity of normal venous anatomy

Clinical consequence of _____.

What causes internal and its bright red blood?

External?

A

Hemorrhoids

Portal hypertension

Prolapse of rectal mucosa; due to weakened muscularis mucosa (bright red due to abundant arteriovenous anastomoses within internal rectal venous plexus)

External venous plexus covered with epidermis (painful)

19
Q

What is above the pectinate line?

Nerves, veins, hemorrhoids classification, destination of lymph, embryological origin

A

Nerves: inferior hypogastric plexus (visceral)

Veins: primarily superior rectal V.

Hemorrhoids classification: internal hemorrhoids (not painful)

Destination of lymph drainage: internal iliac lymph nodes, inferior mesenteric

Embryological epithelial origin: endoderm

20
Q

What is below the pectinate line?

Nerves, veins, hemorrhoids classification, destination of lymph, embryological origin

A

Nerves: inferior rectal nerves (somatic)

Veins: primarily inferior rectal veins

Hemorrhoids classification: external hemorrhoids (painful)

Destination of lymph drainage: superficial inguinal lymph nodes

Embryological epithelial origin: ectoderm