clinical anatomy of the pelvic wall and pelvic mass

Question 1

what is the peritoneum?

Answer 1

your peritoneum is a membrane that lines the inside of your abdomen and pelvis (parietal layer)

Question 2

obturator bundle passes through what space?

Question 3

obturator membrane overlies which structure?

Answer 3

obturator bone

Question 4

what are the 3 outer ligaments of the lateral pelvis?

Answer 4

• sacrospinous ligament
• sacrotuberous ligament
• obturator membrane

Question 5

what are the 3 bones of the lateral pelvic wall?

Answer 5

• ischium
• ilium
• pubis

Question 6

what are the gonadal arteries?

Answer 6

testicular or ovarian arteries

Question 7

where do the gonadal arteries come from?

Answer 7

• abdominal aorta due to embryological origin
• posterior abdo wall
• arise L2 layer

Question 8

name 3 muscles of the lateral pelvic wall?

Answer 8

• piriformis
• coccygeus
• levator ani

Question 9

posterior division of internal iliac supplies

Answer 9

• body wall structures

Question 10

anterior division of internal iliac supplies

Question 11

what is medial umbilical ligament

Question 12

what is diff between superior and inferior vesical arteries in male vs females

Answer 12

• females do not have inferior vesical artery

Question 13

what artery does majority of blood supply to perineum?

Answer 13

• internal pudendal artery

Question 14

what artery do you not have in males that we do have in females in perineum?

Answer 14

• uterine artery and vaginal artery ((comes off internal iliac) but also branches off uterine artery))

Question 15

in the female pelvis where does the anastomosis’ occur?

Answer 15

• between uterine artery and ovarian artery
• between uterine artery and ovarian artery

Question 16

what does water under the bridge mean in female pelvis?

Answer 16

• ureter passes under uterine bridge
  -> important in clinical setting - hysterectomy - as you do not want to damage the ureter

Question 17

system of venous drainage is largelly same as arteries, what is diff between artery and veins in the perineum

Answer 17

• no of plexuses in veins

Question 18

most venous blood from perineum drain to where?

Answer 18

• internal iliac vein
• some will drain via sup rectal into hepatic portal system
• some will drain via lateral sacral veins into internal vertebral venous plexus

Question 19

what is the only nerve that does not branch of the sacral plexus?

Answer 19

• obturator nerve - branches of sacral part of lumbrosacral plexus
• only one that passes through obturator canal

Question 20

pudendal nerve - S2, S3, S4 keep what off the floor?

Answer 20

• pelvis

Question 21

pelvic sphlanic nerve carries what nervous supply?

Answer 21

• parasympathetic

Question 22

superior pelvic viscera lymph drains which route?

Answer 22

• external iliac nodes -> common iliac -> aortic -> thoracic duct -> venous system

Question 23

inferior pelvic viscera lymph drains which route?

Answer 23

• deep perineum -> internal iliac -> common iliac -> aortic -> thoracic duct -> venous system

Question 24

superficial perineum lymph drains which way?

Answer 24

• superficial inguinal nodes

Question 25

what is trans-peritoneal spread?

Answer 25

• disease can penetrate through peritoneal layer and disseminated into peritoneal cavity as peritoneum is only one cell thick