Exam 4: Pelvis Flashcards
Pelvic inlet/brim
pectineal line of pubis, arcuate line of ilium, and sacral promontory
Greater pelvis (false pelvis)
lower part of abdominal cavity; superior to pelvic inlet
Lesser pelvis (true pelvis)
actual pelvis, inferior to pelvic inlet & superior to pelvic outlet
Sacrospinous ligament
Sacrum to ischial spine
help prevent anteroinferior displacement of superior sacrum
Form lesser sciatic foramina
Sacrotuberous ligament
sacrum to ischial tuberosity
help prevent anteroinferior displacement of superior sacrum
Form greater sciatic foramina
Female pelvis is different than male pelvis because
Pelvic inlet is oval, pelvic canal is short with parallel walls, IT and spines are everted, greater sciatic notch is broader, pubic arch and angle is broader, relatively short and broad sacrum
Lateral pelvic wall
Obturator internus - arises within lesser pelvis, travels through lesser sciatic foramen, and attaches to femur’s greater trochanter
Obturator membrane - lines obturator internus muscle
Posterior pelvic wall
piriformis - attaches to sacrum within lesser pelvis (through greater sciatic foramen) and attaches to femur’s greater trochanter
Bed for sacral nerve plexus
Pelvic floor
pelvic diaphragm
Supports viscera and aids voluntary control of urination and fecal continence
Made of levator ani and coccygeus
Levator ani
composed of puborectalis, pubococcygeus, and iliococcygeus
Puborectalis
Levator ani
muscular sling arising from pubis; maintains fecal continence
Pubococcygeus
Levator ani
arises from pubis & tendinous arch, attaches to coccyx
Iliococcygeus
Levator ani
arises from tendinous arch & ischial spine and blends with pubococcygeus
Coccygeus
ischial spine to coccygeus/sacrum
Apex of bladder
anterosuperior aspect
Fundus of bladder
posterior wall of bladder
Body of bladder
area between apex and fundus
Neck of bladder
constriction point
Trigone of bladder
triangle between ureteric and urethral openings
Walls of bladder
primarily detrusor muscles
Female urethra
descends anterior to vagina
urine exits via external urethral orifice
glands exit adjacent to urethra
Male urethra
longer, made of 4 parts
Preprostatic - neck of bladder to prostate
Prostatic - within prostate
Intermediate/Membranous - short, through external urethral sphincter
Spongy - longest, extends through penis
Infundibulum
funnel-shaped with fimbrae of uterine tube
Ampulla
widest and longest part of uterine tube
Isthmus
part of uterine tube entering uterine horns
Ovarian ligament
ovary to uterus
Round ligament
uterus to labia majora
Broad ligament
mesentery of uterus Suspensory ligament - conveys ovarian vessels, lymphatics, and nerves Mesovarium - suspends ovary Mesosalpinx - suspends uterine tube Mesometrium - suspends most of uterus
Vagina is innervated by
somatic (deep perineal branch of pudendal) in lower 1/4 and autonomic in upper 3/4
Ductus deferentes
continuation of duct of epididymis
Ampulla - expansion of ductus deferens
Joins duct of seminal vesicle to form ejaculatory duct
Seminal vesicles
paired glands secreting thick fluid into ejaculatory ducts
Ejaculatory ducts
2 ducts formed by joining of seminal vesicle duct and ductus deferens, convergin upon the seminal colliculus of prostatic urethra
Descends through posterior prostate
Prostate
accessory gland for male reproduction
Contains prostatic urethra
Divided into lobes
Prostatic ducts
empty into prostatic sinuses on either side of seminal colliculus
Bulbourethral glands
small glands secreting during sexual arousal
Ducts open into spongy urethra in bulb of penis
Retropubic space
behind pubis, for bladder distension
Retrorectal space
behind rectum
Rectovesical pouch
in males, between bladder/prostate and rectum
Vesicouterine pouch
in females, between bladder & uterus
Rectouterine pouch
between uterus and rectum
Anterior division of Internal iliac arteries
Umbilical, obturator, inferior vesicular, middle rectal, internal pudendal, inferior gluteal, uterine
Posterior division of internal iliac arteries
Iliolumbar, lateral sacral, superior gluteal
Sacral Plexus
Sciatic, Pudendal, Superior gluteal, and Inferior gluteal nerves
Lumosacral trunk
(L4-L5)
Sciatic nerve
L4-S3 to lower limb
anterior & posterior division
exits pelvis via greater sciatic foramen
Pudendal nerve
S2-S4 to skin and muscles of perineum; main sensory nerve for external genitalia
Anterior division
Exits pelvis via greater sciatic foramen, enters perineum via lesser sciatic forament
Superior gluteal nerve
L4-S1 to gluteus medius, minimus, & tensor fascia latae
Posterior division
exits pelvis via greater sciatic foramen
Inferior gluteal
L5-S2 to gluteus maximus
Posterior division
Exits pelvis via greater sciatic foramen
Coccygeal Plexus
small plexus from ventral rami of S4-S5 and coccygeal nerves
Ganglion impar
end of sympathetic trunk - converges on anterior sacrum
Pelvic sympathetics
arise from T11-L2 spinal segments, through lumbar and sacral splanchnic nerves
Synapse in inferior mesenteric ganglion
Travel through superior hypogastric plexus, R/L hypogastric nerves, and inferior hypogastric (pelvic) plexus to target organs
Pelvic parasympathetics
From S2-S4, ascend mainly through inferior and superior hypogastric plexuses
Follow arteries to target organs & synapse in ganglia in organ plexus
Reach tragets via short postsynaptic fibers
Iliolumbar a.
branch of posterior division of internal iliac a.
Runs up toward lumbar vertebra
Lateral sacral a.
branch of posterior division of internal iliac a.
Runs across sacrum
Superior Gluteal a.
branch of posterior division of internal iliac a.
Runs between lumbosacral trunk and S1
Obturator a.
branch of anterior division of internal iliac a.
runs with obturator nerve toward obturator foramen - branches very early
Umbilical a.
branch of anterior division of internal iliac a.
Has component with blood and component without blood
Gives rise to superior vesicular a. to superior surface of bladder
Inferior Gluteal a.
branch of anterior division of internal iliac a.
Runs between S1 and S2
Internal Pudendal a.
branch of anterior division of internal iliac a.
Runs to perineum - swoops around (out of pelvis through greater sciatic foramen & back in through lesser sciatic foramen)
Gives off inferior rectal a., deep and dorsal arteries of clitoris/penis
Inferior rectal a.
branches from internal pudendal a.
Deep and dorsal arteries of clitoris/penis
Branches from internal pudendal a.
Uterine a.
in females, branch of anterior division of internal iliac a.
Runs to uterus
Gives rise to vaginal a. that runs to vagina
Superior Vesical a.
Branch of umbilical a.
runs to superior surface of bladder
Inferior vesical a.
branch of anterior division of internal iliac a.
runs to inferior surface of bladder
In males gives off a few branches to prostate gland
Middle rectal a.
branch of anterior division of internal iliac a.
Runs deep and low
Inferior epigastric a.
Branch of external iliac a.
Anastamoses with superior epigastric a.
Deep circumflex iliac a.
Branch of external iliac a.
Runs laterally along iliac crest
