Endo/Repro Anatomy Flashcards
Ilium
Upper 2/5th of acetabulum - articulates posteriorly with sacrum
Ischium
Posterior-Inferior 2/5 of acetabulum - superior and inferior rams form the obturator foramen
Pubis
Superior rams forms anterior 1/5th of acetabulum
Describe the pubic symphysis joint
Fibrocartilaginous disc linking the pubis bones, only site of movement especially during pregnancy
Describe the sacroiliac joints
Synovial joints, reinforced by anterior, posterior, and interosseous SI ligaments, additional reinforcement by sacrotuberous lig
Movement primarily gliding but can be rotary, interosseous and sacrotuberous resist rotary movement
Path of sacrotuberous ligament
From sacrum to the pubic tuberosity
Which ligaments resist rotary movement of the pelvis?
Interosseous and sacrotuberous
Describe the terminal line and what lies above/below
Runs along the iliopubic eminence (pubic and iliac bones) completed posteriorly by rounded angle btw base and pelvic surface of the sacrum
False (major) lies above the line
True (minor) lies below the line
Pelvic inlet runs in the plane of the line
Pelvic outlet is the irregular lower border
Describe the pelvis in the normal erect position
Tips 50-60 degrees from the horizontal
Base of sacrum is 4 in higher than the symphysis
ASIS and symphysis pubis lie in about the same line
Compare the female pelvis to the male pelvis
Shallower major pelvis with everted anterior crests
Shallower wider minor pelvis with greater diameter
Everted sciatic tubers
Broader sacrum with less curve
Superior aperture more oval
Subpubic angle greater (angle formed by pubic symphysis
Android
Most common male - heart shaped pelvic inlet (30% females)
Anthropoid
2nd most common male - exaggerated anterior/posterior inlet (20% female)
Gynecoid
Most common female - slightly oval inlet (47% female)
Platypelloid
Least common both sexes - transverse inlet diameter (3% female)
The usual site of pelvic constriction is where?
Superior
True conjugate
Sacrovertebral angle to superior margin of symphysis
Diagonal conjugate
Sacroverterbral angle to inferior margin of symphysis
Transverse (Superior)
Greatest width of superior aperature
Oblique
Sacroiliiac articulation of one side to iliopectineal eminence of the other side
Transverse (Inferior)
Btw inner surfaces of ischial tuberosity
Ant sagittal
Transverse diameter to symphysis
Post sagittal
Transverse diameter to sacrococcygeal junction
Obturator internus m.
O: inner surface of obturator membrane and surrounding bony rim
I: greater trochanter
A: External rotation of thigh
In: N. to obturator internus
Leaves pelvis as tendon passing around margin of lesser sciatic notch - covered by heavy obturator fascia from which levator ahi arises
Piriformis m.
O: sacrum
I: greater trochanter
A: external rotation and abduction of thigh
Leaves pelvis passing thought greater sciatic foramen
The pelvic diaphragm is made up of what 2 muscles?
Levator anim. and coccygeus m.
Levator ani - pubococcygeus m.
O: pubis I: coccyx and anococcygeal lig A: supports pelvic visera In: perineal branches of S3, S4 Anterior to rectum the right and left portions are separated - separation bridged by connective tissue, urethra of both sexes passes through this opening
Levator ani - iliococcygeus m.
O: Arcus tendineus (obt fascia btw pubis and spine)
I:coccyx and anococcygeal lig
A: supports pelvic viscera
In: perineal branches of S3, S4
Levator ani - puborectalis m.
O: pubis
I: puborectalis from opposite side on posterior side of rectum
A: supports pelvic visera, maintains anorectal junction
In: perineal branches of S3, S4
Lying along upper surface of pubococcygeus m.
Coccygeus m.
O: ischial spine, sacrotub lig I: coccyx and lower part of sacrum A: supports pelvic visera In: S4, S5 ventral rami Most posterior m. of pelvic diaphragm
Urinary tract elements
Anteriorly placed structures:
Pelvic portion of ureter
Urinary bladder
GI tract elements
Posteriorly placed structures:
Rectum
Anal canal
Reproductive organs
Lie btw urinary tract and GI elements
Male - pelvic vas deferens, seminal vesicles, prostate gland
Female - vagina, uterus, uterine tubes, ovaries
Inner walls and floor of pelvis
Consists of membranous lining and loose connective tissue surrounding pelvic contents
Fills space btw peritoneum and muscles
Peritoneum of pelvis
Does not contact floor and walls of pelvis but is draped over superior aspects of structures in pelvis, forming distinct pouches and folds
Rectovesical pouch
Male btw rectum and bladder
Rectouterine pouch
Female btw rectum and uterus
Vesicouterine pouch
Female btw superior aspect of urinary bladder and the uterus
Broad ligament
Found only in females - reaches laterally across pelvis, folded over uterus, formed during formation of uterus and vagina from paramesonephric ducts
Boundaries of the perineum
Ant: pubis
Lateal: ischiopubic rami and ischial tuberosities
Post: coccyx and caudal sacrum
Post lat: sacrotuberous lig
Sup: separated from pelvic cavity by pelvic diaphragm
Urogenital diaphragm
Stretches ant btw 2 ischiopubic rami creating urogenital and anal regions
Perineum
Anatomically area btw coccyx and pubis, often used to refer to central tendon of females
Anal triangle boundaries
Ant: post edge of urogenital diaphragm
Post: boundaries of perineum
Lat: ischippubic rami and obt int m. below the arcs tendineus
Sup: roof formed by inf aspect of pelvic diaphragm
Inf: Skin and superficial fascia of perineum
Ischioanal fossa - boundaries
Filled with adipose tissue
