Female Pelvis & Perineum

Question 1

The Hip bone is also known as the _________ bone

Answer 1

Innominate

Question 2

What are the 3 bones that make up the hip

Answer 2

Illium (crests)
Ischium
Pubis

Question 3

Attachments for the Inguinal Ligament

Answer 3

Anterior Superior Iliac Spine–> Pubic Tubercle

Question 4

The Pubis has 2 rami (True or False)

Answer 4

True (superior and inferior)

Question 5

Angle inbetween the inferior rami of the pubis bones as they approach the symphysis; is wider in females to facilitate childbirth

Answer 5

Pubic Arch

Question 6

The LATERAL attachment for the Inguinal Ligament

Answer 6

Anterior Superior Iliac Spine

Question 7

The MEDIAL attachment for the Inguinal Ligament

Answer 7

Pubic Tubercle

Question 8

Pointed triangular eminence pointing behind the Ischium; separates the Greater and Lesser Sciatic notches; IMPORTANT landmark for Pudendal nerve blocks

Answer 8

Ischial Spine

Question 9

Pelvic structure that serves as important landmark when performing Pudendal nerve blocks

Answer 9

Ischial Spine

Question 10

The Ischial Spine separates what two structures

Answer 10

The Greater and Lesser Sciatic Notches

Question 11

Tuberosity located on the posteroinferior aspect of the hip; serves as attachment for the hamstring muscles

Answer 11

Ischial Tuberosity

Question 12

Bony connection between the Ischium and the Inferior Ramus of the Pubis; site of attachment for erectile tissues of the genitalia

Answer 12

Ischiopubic Ramus

Question 13

Opening at the inferior end of the Sacrum

Answer 13

Sacral Hiatus

Question 14

Main differences between the Male and Female Pelvis

Answer 14

Male: taller, narrower with smaller Pubic arch
Female: larger, broader and wider Pubic arch

Question 15

Muscular lining that defines the floor of the Pelvic cavity

Answer 15

Pelvic Diaphragm

Question 16

The Pelvic Inlet is also known as…

Answer 16

the Pelvic Brim

Question 17

What divides the Pelvis into the “true” and “false” pelvis

Answer 17

Pelvic Inlet (or Brim)

Question 18

Strong synovial joints between the sacrum and the Hip bones (ilium)

Answer 18

Sacroiliac joints

Question 19

Strong cartilaginous joint at the anterior midline that joins the Pubic bones

Answer 19

Pubic Symphysis

Question 20

What hormone, during pregnancy, relaxes the hip ligaments (Sacroiliac, Pubic Symphysis, etc.) to facilitate childbirth

Answer 20

Relaxin

Question 21

What two posterior ligaments help to further stabilize the Sacrum to the hip bones

Answer 21

Sacrospinous ligament (sacrum to ischial spine)
Sacrotuberous ligament (sacrum to ischial tuberosity)

Question 22

What foramina are present in the Hip (3 total)

Answer 22

Greater Sciatic foramen
Lesser Sciatic foramen
Obturator foramen

Question 23

The Pelvic (wall/floor) muscles eventually exit the pelvic cavity and attach to the femur to move the hip joint

Answer 23

Wall

Question 24

The Pelvic (wall/floor) muscles support the overlying pelvic organs

Answer 24

Floor

Question 25

Examples of Pelvic Wall muscles (2 total)

Answer 25

Piriformis | Obturator Internus

Question 26

Pelvic Wall muscle; forms the posterior wall of pelvis and passes through the Greater Sciatic Foramen and attaches to femur

Answer 26

Piriformis

Question 27

Pelvic Wall muscle; forms the lateral wall of the pelvis and passes through the Lesser Sciatic Foramen and attaches to femur

Answer 27

Obturator Internus

Question 28

The Piriformis exits through the (Greater/Lesser) Sciatic Foramen

Answer 28

Greater

Question 29

The Obturator Internus exits through the (Greater/Lesser) Sciatic Foramen

Answer 29

Lesser

Question 30

Thickening of the Obturator Fascia (which covers obturator internus); forms a line from the Pubis to the Ischial Spine; site of attachment for pelvic floor muscles

Answer 30

Arcus Tendineus

Question 31

What are the muscles that form the Pelvic Diaphragm (2 total)

Answer 31

Levator Ani* Coccygeus *largest

Question 32

Which of the Pelvic Floor muscles, the Levator Ani or the Coccygeus, is the largest

Answer 32

Levator Ani

Question 33

The Levator Ani is made of what 3 muscles

Answer 33

Pubococcygeus (middle) Iliococcygeus (posterior) Puborectalis (anorectal)

Question 34

Opening in the Levator Ani pelvic floor muscle; allows passage of the Urethra, Vagina and Rectum

Answer 34

Levator Hiatus

Question 35

The Levator Hiatus allows the passage of what structures

Answer 35

Urethra Vagina Rectum

Question 36

Pelvic floor muscle that plays a huge role in Urinary and Fecal continence

Answer 36

pelvic diaphragm (especially Levator Ani b/c it's the largest and has puborectalis that surrounds the levator hiatus)

Question 37

Fibromuscular mass (central tendon of perineum) at the base of the pelvic diaphragm; site were several muscles of the Perineum converge; essential for the integrity of the Pelvic floor, and if ruptured during vaginal birth --> causes organ prolapse

Answer 37

Perineal body

Question 38

Strongest of the Levator Ani pelvic floor muscles; tears (during childbirth) can result in cystocele (bladder incontinence) and rectocele (defecatory dysfunction)

Answer 38

Pubococcygeus

Question 39

Prolapse of the bladder through the Pelvic diaphragm

Answer 39

Cystocele

Question 40

Prolapse of the rectum through the Pelvic diaphragm

Answer 40

Rectocele

Question 41

Peritoneal recess between the Bladder and Uterus

Answer 41

Vesicouterine Pouch

Question 42

Peritoneal recess between the Uterus and the Rectum

Answer 42

Rectouterine Pouch

Question 43

The Rectouterine Pouch is also known as...

Answer 43

the Pouch of Douglas

Question 44

The most inferior recess of the FEMALE Peritoneal cavity

Answer 44

Rectouterine Pouch

Question 45

Peritoneal recess between the Bladder and Rectum (only in Males)

Answer 45

Rectovesical Pouch

Question 46

Which Peritoneal recess is ONLY seen in Males

Answer 46

Rectovesical pouch (because females have the uterus between the bladder and rectum instead)

Question 47

The most inferior recess of the MALE Peritoneal cavity

Answer 47

Rectovesical Pouch

Question 48

Subperitoneal space between the Pubic Symphysis and the Bladder

Answer 48

Retropubic space

Question 49

Subperitoneal space between the Rectum and Sacrum

Answer 49

Retrorectal space

Question 50

fibrous fascia/septum between the Rectum and Vagina

Answer 50

Rectovaginal septum/fascia

Question 51

The pelvic viscera are vascularized by the (external/internal) Iliac artery

Answer 51

Internal

Question 52

The Aorta divides into the Right and Left Common Iliac arteries at what vertebral level

Answer 52

L4

Question 53

The Internal Iliac artery descends into the Pelvic cavity and further divides into what?

Answer 53

Anterior and Posterior division

Question 54

The Posterior division of the Internal Iliac artery has what branches?

Answer 54

Iliolumbar Lateral Sacral Superior Gluteal (Mnemonic: I Like Spaghetti)

Question 55

The (Anterior/Posterior) division of the Internal Iliac Artery provides the main supply for the Pelvic Viscera

Answer 55

Anterior

Question 56

Branch of the Anterior division of the Internal Iliac artery; traverses OVER the ureter to supply the Uterus

Answer 56

Uterine artery

Question 57

The Ureter goes (over/under) the Uterine artery

Answer 57

Under

Question 58

Branch of the Anterior division of the Internal Iliac artery; supplies the Perineum

Answer 58

Internal Pudendal artery

Question 59

Which branch of the Anterior division of the Internal Iliac actually EXITS the Pelvis through the Greater Sciatic Foramen, traverses AROUND the ischial spine, and RE-ENTERS the Lesser Sciatic Foramen

Answer 59

Internal Pudendal Artery

Question 60

What are the 3 main branches of the Internal Pudendal artery

Answer 60

``` Inferior Rectal artery (external anal sphincter) Perineal artery Dorsal Clitoral (or dorsal penile) artery ```

Question 61

What are the 2 divisions of the ventral ramus of the L1 nerve

Answer 61

Iliohypogastric nerve | Ilioinguinal nerve

Question 62

Division of the L1 ventral ramus; supplies sensation to the hypogastric region

Answer 62

Iliohypogastric nerve

Question 63

Division of the L1 ventral ramus; passes through the inguinal canal and supplies sensation to the scrotum and labia majora

Answer 63

Ilioinguinal nerve

Question 64

Nerve from L1 and L2; provides sensation for the medial groin and labia/scrotum

Answer 64

Genitofemoral nerve

Question 65

The main source of SOMATIC innervation for the Perineum is what?

Answer 65

Pudendal nerve

Question 66

What are the 3 divisions of the Pudendal nerve

Answer 66

Inferior Rectal nerve (anus) Perineal nerve (scrotum/labia) Dorsal penile/clitoral nerve *same divisions as the artery

Question 67

Inferior Hypogastric Plexus is aka

Answer 67

Pelvic Plexus

Question 68

Inferior Hypogastric Plexus is divided into what smaller plexuses

Answer 68

1. Vesical plexus 2. Uterovaginal plexus 3. Rectal Plexus

Question 69

A smaller plexus of Inferior Hypogastric Plexus that provides autonomic innervation to the bladder

Answer 69

Vesical plexus

Question 70

A smaller plexus of Inferior Hypogastric Plexus that provides autonomic innervation to the uterus and vagina

Answer 70

Uterovaginal plexus

Question 71

Sympathetic splanchnic nerves arise from

Answer 71

T10-L2

Question 72

Parasympathetic splanchnic nerves arise from

Answer 72

S2-4

Question 73

Parasympathetic splanchnic nerves is aka

Answer 73

pelvic splanchnic nerves

Question 74

Pain sensations from the fundus and body of uterus are conveyed via visceral sensory nerves that retrograde with the

Answer 74

Sympathetic splanchnic nerves (T10-L2)

Question 75

Pain sensations from the cervix and upper vagina are conveyed via visceral sensory nerves that retrograde with the

Answer 75

pelvic (parasympathetic) splanchnic nerves (S2-S4)

Question 76

Creates an imaginary line within the pelvis for pain

Answer 76

pelvic pain line

Question 77

When structures above or in contact with the peritoneum convey visceral pain sensations via the sympathetic splanchnic nerves is referred to as

Answer 77

above the pelvic pain line

Question 78

When structures below the peritoneum convey visceral pain sensations via the pelvic splanchnic nerves is referred to as

Answer 78

below the pelvic pain line

Question 79

Pelvic diaphragm/Levator ani is innervated by what nerves?

Answer 79

Sacral nerves (S2-S4) and pudendal nerve

Question 80

What skeletal muscles are strengthened by kegel exercises?

Answer 80

Pelvic diaphragm/pelvic floor muscles (levator ani majorly) - Pubococcygeus (middle) - Iliococcygeus (posterior) - Puborectalis (anorectal)

Question 81

Weakening of pelvic diaphragm can result in prolapse of

Answer 81

uterus, bladder, and rectum

Question 82

spaces filled with a loose connective tissue called endopelvic fascia

Answer 82

subperitoneal recesses * starts with "RETRO-"

Question 83

What nerves traverse alongside the ischial spine?

Answer 83

1. pudendal nerve | 2. Sacral plexus (S2-S4)