HD anatomy Flashcards
Obturator formane bones
Pubis and ischium
Iliac crest
ASIS –> PSIS
Attachment point for gluteal and iliacus muscles
Sacrospinous ligament
Separates greater and lesser sciatic foramen
Greater sciatic foramen
Formed by sacrospinous and sacrotuberous ligaments
Sciatic nerve
Piriformis
Pudendal nerve (exiting pelvis)
Superior and inferior gluteal vessels and nerves
Lesser sciatic foramen
Formed by sacrospinous and sacrotuberous ligaments Obturator internus Pudendal nerve (re-entering pelvis)
Male vs female pelvis
Female larger and broader, males narrower and taller
Iliac crests more flared in females
Pubic arch narrower in males
Female = large oval pelvic inlet and males rounder
Coccyx more posterior in females to give larger pelvic outlet
Pelvic floor functions
Supports pelvic viscera
Resists intrapelvic pressure
Maintains continence
Levator ani divisions
Levator prostate/sphincter vaginae
Puborectalis
Pubococcygeus
Iliococcygeus
Internal iliac brnaches
Superior gluteal
Inferior gluteal
Pudendal
Lumbar plexus
L1-L4 Behind psoas major Femoral (L2-4) - anterior thigh Obturator (L2-4) - medial thigh Genitofemoral (L1-2) - scrotum, cremaaster, labia majora
Sacral plexus
L4-S4 Sciatic (L4-S3) Superior gluteal (L4-S1) Inferior gluteal (L5-S2) Pudendal (S2-4)
Pudendal nerve course
Out through greater sciatic foramen
Back in through lesser sciatic foramen
Piriformis
Sacrum –> greater trochanter
External rotation and abduction
Obturator internus
Ischiopubic ramus –> greater trochanter
External rotation and abduction
Perineum boundaries
Pubic symphesis Inferior pubic rami Ischial tuberosites Sacrotuberous ligament Coccyx
Broad ligament
Fold of peritoneum draped over the uterus containing the round ligament, ovarian ligament and suspensory ligament of the uterus
Round ligament
Uterus –> labia majora via inguinal canal
Ovarian ligament
Ovary –> uterus
Uterus position
Anteverted with respect to the vagina
Anteflexed with respect to the cervix
Fallopian tube parts
Uterine
Isthmus
Ampulla
Infundibulum
Uterus blood supply
Uterine and vesicular arteries from the internal iliac
Ovary blood supply and venous drainage
Ovarian arteries from abdominal aorta
Drain via ovarian veins to IVC on the right and and renal vein on the left
Ureter course
Arise from kidneys and descend retroperitoneally
Cross pelvic prim at sacroiliac joint and cross common iliac bifurcation point
Run down lateral pelvic walls
Turn anteromedial direction at ischial spines and head towards bladder
Pass close to the uterine artery at the side of the cervix
Pass close to the ovarian artery at the pelvic brim
Perineal body
Levator ani, bulbospongiosus, superficial and deep transverse perineal muscles, external anal sphincter
Vas deferens course
Up from epididymis through inguinal canal
Down lateral pelvic wall
Turns medially and passes between bladder and urethra
Joins duct from seminal vesicle to form the ejaculatory duct within the prostate
Inguinal canal contents
Female = round ligament of the uterus and ilioinguinal nerve Male = vas deferens, testicular vessels and ilioinguinal nerve
Deep inguinal ring
Opening in transversalis fascia at the midpoint of the inguinal ligament
Superficial inguinal ring
Opening in external oblique aponeurosis above the pubic tubercle
Male urethra parts
Prostatic
Membranous
Spongey
Penis blood supply
Internal pudendal artery from internal iliac
Scrotum nerve supply
Genitofemoral
Anterior and posterior scrotal
Posterior femoral cutaneous
Female peritoneal pouches
Vesicouterine - between bladder and uterus
Rectouterine (Douglas) - between uterus and rectum
Female deep perineal pouch contents
Proximal urethra
External urinary sphincter
Deep transverse perineal muscle
Vagina
Female superficial perineal pouch
Clitoris and ischiocavernosus
Bulbs of vestibule and bulbospongiosus
Greater vebstivualr glands
Superficial transverse perineal muscle
Male deep perineal pouch contents
Membranous urethra
External urinary sphincter
Deep transverse perineal muscle
Bulbourethral gland
Male superficial perineal pouch contents
Crura of penis and ischiocavernosus
Bulb of penis and bulbospongiosus
Superficial transverse perineal muscle
Pampiniform plexus
Network of veins that drains the testes
Heat exchanger system that cool arterial blood before it supplies the testes
Suspensory ligament contents
Ovarian artery
Ovarian vein
Pudendal nerve terminal branches
Inferior rectal
Dorsal nerve of penis/clitoris
Perineal
