GYN Test 1 Flashcards
The Pelvic Muscles
- Serves as anatomical landmarks and support
- Most are paired structures; _____ symmetric
- _____ echogenic than fat and exhibit _____ internal echoes
- _____ & _____ muscles overlie the sacrum/coccyx
- Along the lateral margins of the pelvic cavity, lie the hip bones, which are covered by _____ internus muscles
- The _____ ani and _____ muscles form the lower margin of the pelvic floor/diaphragm
- The margin above the pelvic diaphragm is the _____ cavity; the smaller area below the pelvic floor is the _____. The lowest part of the peritoneal cavity is the _____ pouch (pouch of Douglas)
bilaterally less linear piriformis coccygeus obturator levator coccygeus pelvic perineum rectouterine
Abdominal Wall Muscles
Muscles of the anterior abdominal wall which are in the abd cavity but do not extend into the pelvic cavity
- _____ abdominis muscles - anterolaterally
- _____ abdominal obliques
- _____ abdominal obliques
Muscles which originate in the abd cavity and extend superiorly from _____ process to _____ pubis inferiorly
-Paired _____ abdominis muscles anteriorly
(may be seen on US in false pelvis)
transversus internal external xiphoid symphysis rectus
Muscles of the Pelvic Cavity
(Greater/False/Major & Lesser/True/Minor)
- Psoas major: Pelvic _____
- Iliacus - Pelvic _____
- Iliacus M. & Psoas M. = Iliopsoas M.
- Piriformis: _____ wall
- Obturator Internus: _____ pelvic sidewall
Levator ani: Pelvic _____ (diaphragm)
-Coccygeus: _____ pelvic floor (diaphragm)
sidewall sidewall posterolateral anterolateral floor posterior
Muscles of Greater/False/Major Pelvis
1) Psoas Major Muscles
- Originates from ________ region
2) Iliacus Muscles
- Lie inside the ________ crest in the pelvis
- Seen as large muscle @ level of mid BL (________ pelvis) on US bilaterally, the psoas muscle join with Iliacus to form the ________ muscled to support the pelvic cavity ________ and upper border of UT laterally
- Image with US in the false pelvis on TRV @ BL
Lumbar Iliac False Iliopsoas Laterally
Recurs Abdominis Muscles (Six-Pack)
- seen well on US ________ within the abdominal cavity, but not within the pelvic cavity
- Paired; forms much of the ________ wall of the abdominopelvic cavity
- Extends from the _____ rib and ________ process Caudally/inferiorly to pubic symphysis
- Wrapped in a muscular sheath; fuses with the ________ abdominis muscles to form the linea alba in the ML abdomen (the transverse abdominis muscles form the anterolateral borders of the abdominopelvic cavity)
- SONO appearance - on cross section, seen in the ________ pelvis as ovoid or lenticular shaped (lens shaped) just off ML bilaterally
Transversely Anterior 6th Xiphoid Transverse False
Muscles of the TRUE Pelvis
- ________
- ________
- ________ Ani (pubococcygeus M. + Iliococcygeus M. + Puborectalis M.)
- ________ Internus Muscles
Piriformis
Coccygeus
Levator
Obturator
1) Piriformis M.
- Makes up the ________ and ________ wall of true pelvis
SONO appearance:
- Can look ________ or ________ shaped on US
- At the same level as the ________ but ________ to ovaries
- Often confused for ________
- ________ to uterus
Posterior Lateral Triangular Oval Ovaries Posterior Ovaries Lateral
2) Coccygeus Muscle
- ________ shaped muscle (anatomically)
- makes up the ________ lateral wall of true pelvis; ________ portion of pelvic floor/diaphragm (the portion that levator ani muscle group doesn’t cover)
- lies ________/behind the levator ani
- supports the ________ and ________
SONO Appearance:
-Not easily distinguished from the ________ ani muscle group
Triangular Posterior Posterior Posterior Sacrum Coccyx Levator
Levator Ani
-made up of 3 muscles: _____ M. + _____ M. + _____ M.
Together these muscles form a “_____” like structure across the pelvic floor/diaphragm ant to post and from lateral side to lateral side, coming together as one in the very inferior portion of the pelvic cavity
Levator Ani Muscle
- “_____-like” muscle group draping the pelvic floor/diaphragm ant - post and laterally
- supports the _____, _____, and _____
- plays an important role in _____ and _____ continence by maintaining these orifices closed until needed
- helps in maintaining the position of the _____ and _____
1) Pubococcygeus Muscles - Extend from pubic bone anteriorly to _____ posteriorly, encircling _____, _____, _____
- Most medial and _____ to the pelvic diaphragm
2) Iliococcygeus Muscles - Lateral to the _____ muscles
- Drapes pelvic floor from _____ to medial, bilaterally to “mesh” with pubococcygeus muscles ML
3) Puborectalis Muscles - Attached _____ and drapes around the _____
pubococcygeus iliococcygeus puborectalis hammock hammock rectum vagina urethra rectal urinary uterus vagina coccyx vagina urethra rectum anterior pubococcygeus posteriorly rectum
4) Obturator Internus M.
- Makes up the _____-_____ wall of true pelvis
- Situated _____ to ilipsoas runs sup to inf pelvic cavity
SONO appearance:
-On trans view, seen at the anterior portion of true pelvis _____; approx @ lower level of BL
-In sagittal view, appears thin, _____ strip of muscle
antero-lateral
posterior
laterally
hypoechoic
What are the names of the area CEPHALIC to the linea terminalis?
False pelvis
Greater pelvis
Pelvis Major
What are the names of the area CAUDAL to the linea terminalis?
True Pelvis
Lesser Pelvis
Pelvis Minor
Is a serous membrane lining the walls of the abdominal cavity and clothing the abdominal viscera
Peritoneum
What does the peritoneum support?
Organs in the abdominal cavity
The potential space between the parietal and visceral peritonea
Peritoneal cavity
The portion that lines the abdominal wall but does not cover a viscus
Parietal Peritoneum
The portion that covers an organ
Visceral Peritoneum
What organs are found within the peritoneal cavity?
None
What structures are found within the pelvic cavity?
Female: Reproductive organs, bladder, uterus, ovaries, ureters, fallopian tubes
Male: Prostate, bladder, colon, muscle, vessels
Does the peritoneum cover the pelvic organs?
No
What are two bony structures palpable on the anterior pelvic cavity?
Innominate bones
The Pelvic Cavity
- is a body cavity that is bounded by the bones of the _____
- primarily contains _____ organs, the _____ bladder, the _____ colon, and the _____. The rectum is placed at the back of the pelvis, in the curve of the _____ and _____; the bladder is in front, behind the pubic _____.
- In the female, the _____ and _____ occupy the interval between these viscera. The pelvic cavity also contains major _____, _____, _____, and _____. These structures have to work together in a little crowded space. They can be affected by many different diseases and by many drugs in many different ways. One part may impact upon another, for example constipation may overload the rectum and compress the urinary bladder, or childbirth might damage the pudendal nerves and later lead to anal weakness
- _____ processes can occur within the pelvic cavity
pelvis reproductive urinary pelvic rectum sacrum coccyx symphysis uterus vagina arteries veins muscles nerves pathological
The Bony Pelvis
Consists of _____ bones
- 2 innominate (coxal) bones
- _____
- _____
Divided into 2 continuous compartments
(_____/_____ and _____/_____ pelvis) by oblique plane that passes through pelvic brim
greater
false
lesser
true
Region of transition where the trunk and the lower limbs meet, inferior portion of the trunk, contains pelvic cavity, the inferior portion of the abdominopelvic cavity, below the pelvic brim
Pelvis
Pelvic Diaphragm a.k.a. Pelvic Floor
- Is a funnel shaped fibromuscular fascia made up of ____ levator ani and ___ coccygeus muscles which closes the pelvic outlet, posteriorly
- It is open anteriorly where the _____, _____, and _____ exit.
2 2 urethra vagina anus
The Pelvic Cavity is divided into 2 distinct regions:
1) Greater (false) Pelvis or Pelvis Major
- above the _____ terminalis and _____ brim; communicates with abd cavity
- Primarily filled with loops of _____ (sigmoid colon and ileum)
- musculature included: _____, _____ Abdominis, _____ Abdominis
2) Lesser (True) Pelvis or Pelvis Minor
- below the _____ terminalis and _____ brim, formed by the bony of the pelvic bones
- bowl-shaped, contains _____ organs, the pelvic _____ which is entirely walled by bone, and the pelvic _____ which is only partially walled by bone
- enclosed inferiorly by membrane (_____) and muscles
- musculature included: _____ internus, _____, pelvic diaphragm muscles (_____, _____, _____ ani, and _____)
linea pelvic bowel iliopsoas rectus transverse linea pelvic reproductive inlet outlet peritoneum obturator piriformis pubococcygeus iliococcygeus levator coccygeus
an oblique imaginary line passing through the prominence of the sacrum and the upper margin of the symphysis pubs that divides the pelvis into the greater and the lesser pelvis
Linea Terminalis or Pelvis Brim
The linea terminalis or innominate line consists of the _____ line, the _____ line, the _____ crest, the _____ ala, and the _____ promontory. It is part of the pelvic brim, which is the edge of the pelvic _____
pectineal arcuate pubic sacral sacral inlet
External Pelvic Landmarks
- _____ pubis
- Labia _____
- Labia _____
- _____
- _____ opening
- Vestibule of _____
mons majora minora clitoris urethral vagina
The body’s organs are located within the different ____ within the body
cavities
The Entire Pelvic Cavity
- Posterior wall formed by _____ and _____
- Posterolateral wall formed by _____ and _____ muscles
- Anterolateral walls formed by _____ bones and _____ internus muscles, ischium laterally and _____ pubis anteriorly
- Lower margin of pelvic cavity, pelvic floor, formed by _____ ani and _____ muscles a.k.a. pelvic diaphragm
- most inferiorly thin layer below the pelvic floor is the _____
- Posterior Cavity: Occupied by _____, _____, _____
- Anterior Cavity: Occupied by _____, _____, _____, _____ tubes, _____, _____
sacrum coccyx piriformis coccygeus hip obturator symphysis levator coccygeus perineum rectum colon ileum bladder ureters ovaries fallopian uterus vagina
True Pelvis
- Is situated inferior to caudal portion of _____ peritoneum
- _____ Pelvis is considered the pelvic cavity
Bladder is anterior to _____
Uterus is posterior to _____
Uterus is anterior to _____ colon
Sigmoid Colon is posterior to _____
parietal true uterus bladder sigmoid uterus
A thin serous membrane made of mesothelium tissue which lines the walls of the abdominal and pelvic cavities
peritoneum
The Peritoneum
- covers the organs within these cavities:
1) _____ Peritoneum - Lines the walls of the abd and pelvic cavities
2) _____ peritoneum - covers the organs
3) _____ Cavity - Potential space between the parietal and visceral layers of peritoneum; in the males is a closed sace but in the female, there is a communication with the exterior through the uterus, fallopian tubes and the vagina
parietal
visceral
peritoneal
The _____ (omentum) are fused peritoneal folds that attach the abdominal organs with one another
omenta
2 omenta:
- the greater omental bursa, aka _____ sac (larger)
- the lesser omental bursa, aka _____ sac (smaller)
Both the _____ and _____ omentum attach to the stomach and pass to other viscera within the abdominal cavity. This article will provide you with a brief introduction to peritoneum, its formations and cavities. Then it will describe the structure, function, relations, vasculature and development of the greater and lesser omentum
The reason we care is because normally, we do not see the omenta very well on US but if fluid builds up within these 2 folds then is seen on US as an abni fluid filled area
greater
lesser
greater
lesser
