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ANAT 214 > Intro to Pelvis and Pelvic Viscera > Flashcards

Intro to Pelvis and Pelvic Viscera Flashcards

1
Q

Describe the pelvis

A

Bowl shaped region made by pelvic bones, ligaments and muscles

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2
Q

What is pelvis divided into

A

2 regions = false and true pelvis

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3
Q

Describe false pelvis

A

Greater
Superior to pelvic inlet
Part of abd cavity
Contains abdominal viscera, larger, rectum and sigmoid colon
Funnels into true pelvis
Bladder and ureters can extend into false pelvis - protrude into abd region

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4
Q

Describe true pelvis

A

Inferior to pelvic inlet
Continuous with abd cavity
Contains pelvic viscera
Has inlet and outlet - bony framework

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5
Q

Describe inlet of true pelvis

A

Comepletly surrounded by bones and joints
Defines upper border of true pelvis

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6
Q

Describe outlet of true pelvis

A

Closed by fibromuscular pelvic floor - pelvic floor seals outlet, maintains pressure of abdominal cavity, muscular pressure
Separates pelvic cavity to perineum below

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7
Q

Describe tilt of pelvis

A

Titled forwards, asis and psi’s in same plane as pubic tubercle

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8
Q

What is the hip bone

A

Pelvic bone, composed of 3 parts, 2 bones initially

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9
Q

Describe ilium

A

Articulates with sacrum - sacroiliac joint
Hand on waist, iliac crest

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10
Q

Describe pubis

A

Pubic tubercle -
Formed by 2 rami - superior and inferior form pubic symphysis and obturator foramen

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11
Q

Describe ischium

A

Forms the sit bone

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12
Q

Describe pubic tubercle

A

In front of pubic symphysis

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13
Q

When do all 3 parts of pelvis bone get fused

A

Fuse at 18 yo
Fused around acetabulum - hip joint, at 16-18 yo
Neonates and teens = not fused fully, takes time to make full bone

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14
Q

Name the easily palpable pelvic bone features

A

Iliac wing and crest

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15
Q

Describe iliac wing

A

Concave anterioly
Forms iliac fossa, where caecum and iliacus muscle are

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16
Q

Describe iliac crest

A

Superior edge of iliac wing, connects =
ASIS (ant sup iliac spine, ant end iliac crest) and PSIS (post sup iliac spine, post end iliac crest)

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17
Q

Describe pelvic inlet - brim

A

Bisects ilium and pubic regions respectively
Medial aspect pelvic, Seprates true and false pelvis

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18
Q

Describe ischial spine

A

Posterior bony projection
Separates above and below
= greater and lesser sciatic notches
Important insertion fo ligaments, very delicate, divides posterior pelvis into 2 notche

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19
Q

Describe ischial tuberosity

A

Sit bone
Large swelling postero inferiorly

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20
Q

Describe obturator foramen

A

Between pubic rami - closed by obturator membrane
At jucntion of ischial tuberosity and pubic bone, have big opening, O shaped
Faces medial thigh, n/v to medial thigh

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21
Q

Describe sacrum

A

Appearance of inverted triangle
Formed by fusion of 5 sacral vertebrae
Between each fused vertebrae = sacral foramina

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22
Q

What is function of sacrum

A

Keystone = push into sacrum and distribute weight - mechanical force on 2 sides of pelvis, pushes and distributes wight on the 2 pelvic bones, help maintain shape too

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23
Q

Describe joints of sacrum

A

Base articulates with l5
Apex articulates with Coccyx
Lateral surfaces articulate with pelvic bone via sacroiliac joints - 2 joints, wedges in here, synovial = forms pelvic girdle

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24
Q

Describe coccyx

A

Small terminal part of vertebral column
Formed by fusion 4 vertebrae

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25
Q

Describe joints of coccyx

A

Base articulates with sacrum

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26
Q

Describe pelvic girdle

A

Ring like bony frame formed by pelvic bones and sacrum
Sex speciic features different

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27
Q

Describe Afab pelvic girdle

A

Gynaecoid
Subpubic angle = angle between index and thumb = 90-100 degrees
Pelvic inlet more circular - larger pelvic outlet - wider, between inferior pubic rami
Overall is wide and shallow = allow for birth

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28
Q

Describe amab pelvic girdle

A

Subpubic angle = between index and middle finger = 70 degrees
Pelvic inlet more heart shaped - can tilt more
Overall is narrow and deep

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29
Q

Describe ligaments of pelvis - gen

A

Major compeonts of lateral wall
Need to keep pelvis upwards = ligaments to support, need solid framework, reinforced by anchors = keep upwards so prevent falling into false pelvis

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30
Q

Name ligaments of pelvis

A

Sacrospinous ligament
Sacrotuberous ligament

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31
Q

What is role of pelvic ligaments

A

Stabilize sacrum on pelvic bone - resisting tilting off sacrum
Close sciatic notches into sciatic foramina - closes notches
Openings for pelvic viscera

32
Q

Where is greater sciatic foramen in relation to ligaments

A

Superior to sacrospinous ligamnent

33
Q

Where is lesser sciatic foramen in relation to ligaments

A

Inferior to sacrospinous ligament and anterior to sacrotuberous ligament

34
Q

Describe pelvic wall muscles generally

A

2 muscles contribute to pelvic wall
Muscles are originating in pelvic cavity but attach to femur

35
Q

Describe obturator internus

A

From deep surface obturator foramen and membrane
Contributes to anterolateral pelvic wall
Leaves pelvic cavity throug lesser sciatic foramen - inserts on bony edge of opening
Covers obturator foramen
Reaches femur proximally

36
Q

Describe piriformis

A

Post lat wall pelvic, pigeon pose,
From anterior surface of sacrum
Contributes to posterior pelvic wall
Leaves pelvic cavity through greater sciatic foramen
Divides greater sciatic foramen into 2 = above and below muscle
Also reaches hip joint, external rotation, int and ext rotation, depends on hip joint flexion, close to big sciatic nerve too

37
Q

Describe pelvis gateways

A

Pelvic wall muscles sealing off almost the whole pelvis - forms like a bowl
Except for a few openings through pelvic wall

38
Q

Describe obturator canal

A

Opening in obturator membrane covering obturator foramen

39
Q

Describe greater sciatic foramen

A

Greater sciatic notch closed by sacrotuberous ligament and is divided into 2 by piriformis muscles = sup - superior gluteal region and inf = inferior gluteal region

40
Q

Describe lesser sciatic foramen

A

Lesser sciatic notch closed by sacrospinous and sacrotuberous ligaments

41
Q

Describe pelvic outlet - gateways

A

Inferior opening of true pelvis, closed by pelvic floor
Anterior = inferior bony border or pubis to ischial tuberosity
Posterior = sacrotuberous ligament, strong

42
Q

What is pelvic floor formed by

A

Pelvic diaphragm muscles
Perineal membrane and deep perineal pouch

43
Q

Describe pelvic diaphragm

A

Muscular part of pelvic floor consists of 2 muscles = levator ani and coccygeus
Seals outlet

44
Q

Describe Levator ani

A

One on each side
Support viscera and maintain closure of rectum and vagina
Originate from pelvic wall, forming 3 units

45
Q

Describe puborectalis - levator ani

A

Pubic bone and slinging behin rectum
Connects to contralateral side, slings behin rectum, prevents pubic incontinence

46
Q

Describe pubococcygeus - levator ani

A

Pubic bone to coccyx

47
Q

Describe iliococcygeus - levator ani

A

Tending us arch over obturator internus and ischial spine to coccyx
Muscle inserting on top of other muscle
Reinforces fascia of obturator internus - induce mechanical force, now thicker

48
Q

Describe how levator ani connects - on sides

A

Each side of joint posterior to vagina and around anal aperture
Anterior u shaped opening = urogenital hiatus,urethra and vagina

49
Q

Describe coccygeus

A

One on each side, overlies sacrospinous ligament
Originates from coccyx bone and distal end sacrum —> ischial spine
Inserts on base coccyx = wing tail, muscle
Outside = ligament, inside = muscle

50
Q

Describe perineal memebrane

A

Seals the 2 bones = pubic and ischial tuberosity, outside levator ani, tough, fibrotic membrane, tight perineal region
Thick triangular fascial structure attached to pubic bones
Overarching urogenital hiatus
Posterior edge is free, inserts on midline to perineal body
Provides attachement for ext genitalia - so not weighing on muscles

51
Q

Describe deep perineal pouch

A

Space between perineal membrane and pelvic diaphragm (levator ani)
contains thin muscular sheet = sphincters for urethra

52
Q

Perineal body

A

Central tendon of perineum
Ct structure into which muscles of pelvic floor and perinuem attach
Junction between levator ani and perineal membrane, anchors the 2

53
Q

Describe pelvic organs - overview

A

Contained within true pelvis, between opening s
Space contained between pelvic inlet and outlet

54
Q

Describe pelvic organs - cavity

A

Inlet = pelvic brain
Outlet = bony border of pubis to ischial tuberosity, sacrotuberous lig
Contains = urinary, gi and repro systems
most ant = bladder, most post = rectum

55
Q

Describe pelvic organs - afab

A

Uterus and vagina betwene bladder and anus

56
Q

Describe pelvic organs - amab

A

Glands associated with repro system between bladder and rectum

57
Q

Describe rectum

A

Most posterior element of pelvic viscera
Follows concave contour of sacrum

58
Q

Describe anorectal junction

A

Pulled forward by levator ani - puborectalis sling, slinging of muscle induces kink
Forms 90 degree angle closing anal canal
Moves Anal canal into posterior direction as it passes through pelvic flor
Allows to hold feces in rectal ampulla

59
Q

Describe defecation

A

Intra abd pressure increases
Puborectalis relaxes = anorectal jucntion straightens - 140 degrees
Relaxation of internal - involuntary - and external - voluntary - anal spinchters
Much weight of feces, int and ext sphincters cannot hold on own

60
Q

When is anorectal angle straighter

A

When squatting during delectation

61
Q

Describe bladder

A

On top of pubic bone, 1st organ
Most anterior element of pelvic viscera

62
Q

Describe bladder when full vs empty

A

Full = expands into abd cavity, over pelvic brim inlet
Empty = entirely contained in pelvic cavity

63
Q

What is bladder shaped like

A

3 sides pyramid tipped over one side

64
Q

Describe apex of bladder

A

Directed towards pubic symphysis
Median umbilical lig suspends it to ant abd wall

65
Q

Describe median umbilical ligament

A

To avoid unneeded weight and presssure on urinary sphincters, = suspend badder, so only weight of urine pushing on sphincter

66
Q

Describe base of bladder

A

Inverted triangle
2 ureters enter bladder to each posterosuperior corners
Urethra drains from Lowe corner at neck of bladder

67
Q

Describe trigone of bladder

A

Betwene openings = mucosa smooth, forms trigone, smooth structure
No detrusor since cannot pull on urethra or ureters = fixed in space, trigone connects them and urine flows easy, smooth funnel

68
Q

What is muscle inside bladder

A

Except for trigone = detrusor muscle

69
Q

Describe how ureters enter pelvis

A

Crossing the bifurcation of common iliac artery

70
Q

Describe where pelvic portion uterers located

A

Located posterior - behind gonadal vessels, - water under the bridge, most posterior structure

71
Q

Where do ureters enter bladder

A

To each posterosuperior corners

72
Q

Describe inside the bladder - ureters

A

Inter uteri’s ridge connects the 2 urethral orifices = forms superior border of trigone

73
Q

Name the orifices of bladder

A

Ureteral orifices - opening, kidney stones can be lodged
For urethra

74
Q

Describe Sacrospinous ligament

A

From ischial spine to sacrum and Coccyx

75
Q

Describe Sacrotuberous ligament

A

More superficial
Post post iliac spine, post surface sacrum and coccyx to ischial tuberosity

ANAT 214 (34 decks)

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