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203-T2 > Defining the pelvic region > Flashcards

Defining the pelvic region Flashcards

1
Q

Consider the articulated pelvis

State the four bones that together make thee pelvis

A
  • Two innominate bones: ilium, ischium and pubis
  • Sacrum (formed by the fusion of the 5 sacral vertebrae)
  • Coccyx (formed by the fusion of the 4 coccygeal vertebrae)

** and ligaments

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2
Q

State a key anatomical landmark of the ileum

State two key anatomical landmarks of the ischium

State two key anatomical landmarks of the pubic bone

A

Iliac fossa

Ischial spine, Ischial tuberosity

Superior ramus of pubis bone, inferior ramus of pubis bone

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3
Q

What structure lies between L5 and the sacrum?

What structure lies behind this?

A

Intervertebal disc

Posterior sacral foramina

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4
Q

Describe the location of the sacroilliac joint

A

Sacroiliac joint lies in front of the sacroiliac ligament

Sacrp

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5
Q

What is the pubic symphysis

A

Interpubic disc + ligaments

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6
Q

Starting most superiorly state the ligaments of the pelvis and what they connect to

A

Sacroiliac ligament - from sacrum to ilium, has anterior and posterior components
Sacrococcygeal ligament- between the sacrum to coccyx
Sacrotuberous ligament- from lateral aspect of sacrum/coccyx onto medial aspect of ischial tuberosity
Sacrospinous ligament- from sacrum to ischial spine

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7
Q

What is the perineum

A

Space located at the pelvic outlet and inferior to the pelvic diaphragm (muscles of the pelvic floor) - THE NARROW REGION BETWEEN THE THIGHS

  • diamond shaped extending from mons pubis to posteriorly to the gluteal folds
  • lateral vertex = medial surface of thighs
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8
Q

Which anatomical structure does the transverse line of the perineum join?

Which two compartments arise from this?

What is the midpoint of this transverse line?

A

The ischial tuberosities

Splittinig the perineum inteo urogenital and anal triangles

The midpoint defines the perineal body
- it sees the convergence of several sphincter and perineal pouch muscles

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9
Q

What structures are enclosed within the deep perineal pouch?

A
  • urethra
  • vagina, in females
  • glands (e.g. bulbourethral gland in males- Cowper)
  • perineal muscles that act as sphincters such as compressor urethrae or urethrovaginal sphincter in females
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10
Q

What structures are enclosed within the superficial perineal pouch?

A
  • urethra
  • vagina, in female; root of penis in males
  • glands (Bartholin in female)
  • perineal muscles that provide support to the external genitalia, such as the bulbospongiosus or ischocavernosus muscles
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11
Q

Outline the structures that form the pelvic brim

A
  • Promontory and wing ofsacrum
  • arcuate line
  • pectineal line
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12
Q

What are the borders of the true pelvic cavity

Think

  • posteriorly
  • anteriorly
  • inferiorly
  • superiorly
  • laterally

What are the contents of the true pelvic cavity?

A
  • Posterior: sacrum/coccyx
  • Anterior: pubic symphysis
  • Inferior: pelvic floor
  • Superiorly: pelvic brim
  • Laterally: obturator internus m

Reproductive organs, tracts
Bladder
Rectum

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13
Q

Consider the pelvic musculature

Outline the origin, route and insertion of the two muscles which form the lining of the wall

A
  1. PIRIFORMIS
    - origin: anterior surface of sacrum
    - route: traverses through the greater sciatic foramen, above the ischial spine
    - insertion: the greater trochanter of the femur
  2. OBTURATOR INTERNUS
    - origin: internal surface of the obturator membrane
    - route: traverse through the lesser sciatic foramen, below the ischial spine
    - insertion: the greater trochanter of the femur
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14
Q

Starting superiorly, state the muscles that make the pelvic floor?

Where does the piriformis muscle fit into this?

A

Puborectalis muscle
Pubococcygeus muscle
Iliococcygeus muscle
Coccygeus muscle

Piriform muscle

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15
Q

State the origin and insertion of the coccygeal and iliococcygeus muscles

A

Coccygeal- from the ischial spine to the inferior end of the sacrum+coccyx

Iliococcygeus- from the tendinous arch to the annococcygeal body

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16
Q

What is the tendinous arch?

A

A line that extends from the ischial spine to the posterior aspect of the pubic bone

17
Q

State the origin and insertion of the pubococcygeus and puborectalis muscles

A

Pubococcygeus: from the posterior aspect of the pubic bone, inserting onto the coccyx (lateral fibres),or merging with the contralateral fibres of the same muscle (medial fibres)

Puborectalis: continuous muscle from the posterior aspect of pubic bone and slings behind the rectum

18
Q

State the arterial supply to the pelvic muscles

A

Anterior division of INTERNAL ILIAC, providing several branches, e.g. uterine, vesical or internal pudendal

GONADAL, from abdominal aorta - supplies gonads

19
Q

State the venous drainage to the pelvic muscles

A

Internal iliac - to common iliac veins

Gonadal- to IVC or L renal vein

20
Q

Consider the nervous control of the pelvis

Describe the somatic plexuses

A

(L4-Co) subdivided into

  • Lumbosacal: L4-S4
  • Coccygeal: S4-Co
  • function as motor or sensory e.g. sciatic nerve, sup/inf gluteal, pudendal nerve
21
Q

Consider the nervous control of the pelvis

Describe the visceral plexuses

A
  • Paravertebral/prevertebral
  • Sympathetic/ Parasympathetic/ visceral fibres
  • Erection/ejaculation e.g. inferior hypogastric plexus
22
Q

State 2 nerves that pass through the greater sciatic foramen

A
  • Pudendal nerve
  • Sciatic nerve
  • Superior gluteal nerve
  • Lumbosacral trunk
23
Q

Consider the lumbosacral trunk

State the nerve roots for the branches of the lumbosacral trunk

A

Superior gluteal: L4, L5, S1
Inferior gluteal: L5, S1, S2
Sciatic: L4, L5,S1-S3 (largest branch of plexus)
Pudendal: S2-S4

24
Q

The visceral plexuses consist of both a parasympathetic and sympathetic flow.
- Which nerves provide this

A

PARASYMPATHETIC FLOW
- Pelvic splanchnic nerves (S2-S4)

SYMPATHETIC FLOW

  • Sacral sympathetic trunk
  • Superior and inferior hypogastric plexuses
25
Q

The posterior pelvis

A
  • sciatic nerve
  • pudendal nerve
  • gluteal vessels (superior- above piriformis and inferior- below piriformis)
26
Q

Put the following structures in order, from most anterior to posterior

Pudendal n, deep perineal n, dorsal nerve of the clitoris, superior perineal n, sacrotuberious ligament

A

Dorsal nerve of the clitoris

Deep perineal n

Superior perineal n

Pudendal n

Sacrotuberous ligament

203-T2 (19 decks)

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