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Anatomy Block 4 > Bony Pelvis, Pelvic Diaphragm, and Anal Region > Flashcards

Bony Pelvis, Pelvic Diaphragm, and Anal Region Flashcards

1
Q

What forms the pelvic skeleton

A

2 hip bones anteriorly and laterally

saccrum and coccyx posteriorly

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2
Q

What makes up the hip bone

A

ilium
ischim
pubis

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3
Q

What is the largest foramen in the body and what forms it

A

obturator

pubic and ischial elements of hip bone

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4
Q

What nearly closes the obturator foramen

A

obturator membrane

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5
Q

Where do all 3 parts of the hip bone meet

A

acetabulum

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6
Q

what is the acetabulum

A

deep fossa for head of femur

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7
Q

What are the joints of the pelvis (3)`

A

Lumbosacral
sacroiliac
pubic symphysis

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8
Q

What do the iliolumbar ligaments unite

A

vertebra L5 to iliac crest and sacrum

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9
Q

What do the the iliolumbar ligaments do

A

limit axial rotation of L5 on the sacrum

help stabilize the lumbasacral joint

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10
Q

What is the what type of joint are the sacroiliac joints and what is their role

A

synovial

responsible for transmitting the weight of the hipbones

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11
Q

What holds together the sacral and illiac bones

A

anterior sacrolilac ligaments
interosseous sacrolilac ligaments
posterior sacrolilac ligaments

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12
Q

what are the acessory ligaments of sacroiliac articulation

A

sacrotuberous and sacrospinous ligaments

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13
Q

What does the sacrotuberous ligament do

A

anchor the sacrum and coccyx to the ischial tuberosity

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14
Q

What does the sacrospinous ligament do

A

anchor the sacrum and coccyx to the ischial spine

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15
Q

what conversion is caused by the location of the sacrotuberous and sacrospinous ligaments

A

makes greatter and lesser sciatic notches into greatter and lesser sciatic foramina

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16
Q

What does the pubic symphysis have at its articulation

A

interpubic disc of fibrocartlialge

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17
Q

what is the difference of the pubic symphysis between males and females

A

females have a broader fibrocartilage disc

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18
Q

What connects the pubic bones at the pubic symphysis

A

superior and inferior arcuate pubic ligaments

connect pubic bones

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19
Q

What is located at the sacrococcygeal symphysis

A

THIN interveterbral disc

Sacrococcygeal ligaments which reinforce it

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20
Q

How is the pelvis oriented in anatomical position

A

Anterior superior illiac spines and pubic tubercles in the same vertical plane

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21
Q

What are the features of the articulated pelvis (5)

A 
pelvic brim
greater pelvis
lesser pelvis
pelvic inlet
pelvic outlet
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22
Q

What is the role of the pelvic brim

A

divides pelvis into greater and lesser pelves

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23
Q

What makes up the pelvic brim (4)

A

promontory (vertebrae) and alae (wings) of the sacrum

Arcuate line of the ilium

pectineal line of the pubis

pubic crest

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24
Q

What is the greater pelvis also known as

A

false pelvis

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25
Q

What is superior and inferior to the pelvic brim

A

superior: greater (false) pelvis
Inferior: lesser (true) pelvis

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26
Q

What does the greater pelvis form

A

inferior part of the abdominal cavity

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27
Q

What bounds the greater pelvis (ant, lat, post)

A

Anteriorly: abdominal wall

Laterally: iliac fossae

Posteriorly: L5 and S1 vertebrae

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28
Q

Which section of the pelvis contains the pelvic viscera

A

lesser pelvis

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29
Q

What bounds the lesser pelvis (ant, lat, post)

A

Anteriorly: pubis

Laterally: ilium and ischium

Posteriorly: sacrum and coccyx

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30
Q

What foramina are contained within the lesser pelvis

A

obturator
greater sciatic
lesser sciatic

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31
Q

What is another name for the pelvic inlet

A

superior pelvic aperture

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32
Q

What bounds the pelvic inlet opening

A

pelvic brim

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33
Q

When would the pelvic inlet be measured

A

for obstetric reasons during pelvic examination

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34
Q

What is another name for the pelvic outlet

A

inferior pelvic aperture

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35
Q

what forms the opening of the pelvic outlet (5)

A 
pubic symphysis
ischiopubic rami
ischial tuberosities 
sacrotuberous ligaments
coccyx
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36
Q

What 3 pieces of the pelvis are different from male to female

A

sacrum
ischial tuberosities
pubic arch

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37
Q

What is the difference in the sacrum from male to female

A

Female sacrum broader and less curved

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38
Q

What is the difference in the ischial tuberosities from male to female

A

Female ischial tuberosities everted

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39
Q

What is the difference in the pubic arch from male to female

A

Female pubic arch angle is greater

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40
Q

What is the overall effect of the pelvic skelton changes from male to female

A

female pelvis wider (larger aperatures)

female pelvis shallower

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41
Q

What muscles make up the pelvic wall

A

Obterator internus

piriformis

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42
Q

Which muscles make up the pelvic diagphragm

A

Levator Ani: pubococcygeus, puborectalis, iliococcygeus

Coccygeus

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43
Q

What muscles make up levator ani

A

ALL PAIRED
pubococcygeus
puborectalis
iliococcygeus

44
Q

Where does the obturator internus muscle orignate travel and insert

A

Originates: obturator membrane
internal margin of obturator foramen

tendon passes through lesser sciatic foramen

Inserts:Greater trochanter of the femur

45
Q

What innervates the obterator internus muscle

A

nerve to obturator internus and superior gemellus (L5 S1,2)

46
Q

What is the role of obterator internus

A

lateral rotator of the thigh

47
Q

What is the tendious arch (of levator ani)

A

thickening of the parietal fascia of obturator internus between the ischial spine and superior pubic ramus

48
Q

What does the tendinous arch give origin to

A

iliococcygeus part of pelvic diaphragm

49
Q

Where does the piriformis originate travel and insert

A

Originate: anterior surface of sacrum

leaves pelvic cavity through greater sciatic foramen

Insert: greater trochanter

50
Q

What innervates piriformis

A

nerve to piriformis (S1,2)

51
Q

What is the role of piriformis

A

lateral rotator of thigh

52
Q

What forms a muscular bed for the sacral plexus

A

piriformis

53
Q

What closses the pelvic outlet and forms the floor of the pelvic cavity

A

Pelvic diahragm

54
Q

what shape is the pelvic diaphragm

A

funnel shaped

55
Q

What do the urethra and vagina pass through in the pelvic diaphragm

A

fascial gap called urogenital haitus

56
Q

What is the origin and insertion of pubococcygeus

A

runs posteriorly from the pubis and inserts onto the coccyx

57
Q

What is the origin and insertion / path of puborectalis

A

passes posteriorly from the pubis and fuses with its companion of the
other side behind the anorectal junction,

forms a U-shaped rectal sling

58
Q

What is the thinnest part of levator ani

A

iliococcygeous

59
Q

what is the origin and insertion of iliococcygeous

A

originates: from the tendinous arch and ischial spine
inserts: onto the coccyx

60
Q

What innervates the levator ani muscles

A

nerve to levator ani and coccygeus (S3,4)

61
Q

What are the roles of the levator ani

A

support pelvic viscera

raise the pelvic floor
assist in compression of abdominal and and pelvic contents during vomiting urnination etc

62
Q

What are the specific and important roles of the puborectalis

A

holds anorectal junction anteriorly
supports most of fecal mass

(this relieves external anal sphinter from fecal pressure)

63
Q

What is the origin and insetion of the coccygeus

A

origin: ischial spine

Insert: sacrum and coccyx

64
Q

What innervates the coccygeus

A

nerve to levator ani and coccygeus

S3,4

65
Q

What is the role of the coccygeus

A

pulls coccyx anteriorly (thus raising pelvic floor)

66
Q

What is the perineum bounded by (4)

A

pubic symphysis
ishciopubic rami
sarcotuberous ligament
coccx

67
Q

What is the perineum divided into (2) and wher would the line be that divides them

A

anal triangle
urogenital triangle

line between ischial tuberosities

68
Q

What is the best way to view the perineum

A

lithotomy position (supine hips and knees flexed)

69
Q

What bounds the anal triangle

A

Posteriorly: coccyx (apex of triangle)

posterolaterally: sacrotuberous ligment
overlying: gluteus maximus

70
Q

What main things are contained in the anal fossa (4)

A

anus
external anal sphincter
anal canal
Ischioanal fossae

71
Q

What is the name for the opening for the anal canal and where is it located

A

anus

centrally in anal triangle

72
Q

What surrounds the anus

A

subcutaneous part of external anal sphincter

73
Q

Is the external anal sphincter voluntary or involuntary

A

voluntary

74
Q

What portion of the anal canal does the external anal sphincter surround

A

inferior 2/3rds

75
Q

How is the external anal sphincter divided

A

into
subcutaneous
superficial
and deep parts

76
Q

What innervates the external anal sphincter

A

inferior rectal branches of the pudendal nerve (S2-S4)

77
Q

What is the anal canal

A

distal 2 inches of the gi tract

78
Q

Where does the anal canal begin

A

at the level of the U-shaped sling formed by the puborectalis

79
Q

which direction is the anal canal and how is it oriented with respect to the rectum

A

directed posteroinferiorly

longitudinal axis right angle to rectum

80
Q

Where is the internal anal sphincter

A

Superior part of the canal

81
Q

Is the internal anal sphincter involuntary or voluntary

A

involuntary

82
Q

What is the relation of the internal to external anal sphincter

A

internal deep to external

external overlaps internal

83
Q

What are the anal columns and where are they

A

longitudinal ridges of MUCOSA in the superior part of the anal canal

84
Q

What joins the lower end of the anal columns

A

anal valves

85
Q

What is located at the inferior limit of the anal valves

A

pectinate line

86
Q

What does the pectinate line indicate

A

junction of endodermal hindgut and ectodermal proctodeum

And as such (due to dual embro origin)

Approx site of seperation for vascular lymphatic and neural supply of the anal canal

87
Q

What supplies the blood superior to the pectinate line

A

superior rectal vessels of inferior mesenteric

88
Q

What supplies the lymphatics superior to the pectinate line

A

lymphatic tributaries of internal iliac nodes

89
Q

What is the innervation superior to the pectinate line

A

autonomic innervation (GVA and GVE)

90
Q

What supplies the blood inferior to the pectinate line

A

inferior rectal (hemorrhoidal) vessels of internal illiac

91
Q

What supplies the lymphatics inferior to the pectinate line

A

lymphatic tributaries of superficial inguinal nodes

92
Q

What is the innervation inferior to the pectinate line

A

somatic innervation (GSA and GSE) from pudendal nerve

93
Q

What do the middle rectal arteries and veins anastomose with and where do they come from

A

Middle: from internal illiac
Anastomose with
Inferior rectal: internal pudendal
Superior rectal: Inferior messenteric

94
Q

What is the the superior part of the anal canal sensitive to and why

A

stretching

differences in innervation

95
Q

What is the the inferior part of the anal canal sensitive to and why

A

pain
touch
and temperature

differences in innervation

96
Q

Where is the ischioanal fossa

A

wedge shaped spaces on either side of anal canal

97
Q

what forms the base of the ischioanal fossa

A

skin of the anal region

98
Q

What forms the vertical lateral wall of the ischioanal fossa

A

obturator internus and ischial tuberosity

99
Q

What forms the superomedial wall of the ischioanal fossa

A

levator ani and anal canal

100
Q

What restricts the ischioanal fossa anteriorly

A

deep fascia of the urogenital triangle

101
Q

What is found extensively in the ischioanal fossa and what is its purpose

A

fat

supports anal canal but is readily displaced to allow feces to pass

102
Q

What bounds the ischioanal fossa

A

lateral: obturator internus and ischial tuberosity

Superomedial: levator ani and anal canal

Anterior: deep fascia of the urogenital triangle

Base: skin of the anal region

103
Q

What nerves and vessels will the ischioanal fossa contain

A

internal pudendal vessels and pudendal nerve

104
Q

Where do the nerves and vessels in the ischioanal fossa run

A

on the lateral wall in a fibrous sheath (pudendal canal)

105
Q

What do the Pudendal nerves and vessels run in and what is it derived from

A

Pudendal canal (sheath/ alcocks canal)

derived from fascia of obturator internus

106
Q

What do the internal pudendal vessels and nerves give off in the ischioanal fossa and what do they supply

A 
inferior rectal vessels and nerves
cross the fossa and supply
external anal sphincter
inferior part of anal canal
perianal skin

Anatomy Block 4 (16 decks)

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