Introduction to Pelvis and Perineum

Question 1

Which part of the pelvis is termed as the true pelvis

Answer 1

Inferiorly

Question 2

Which part of the pelvis is termed as the false pelvis

Answer 2

Superiorly

Question 3

What type of joint is the sacroiliac joint

Answer 3

Synovial

Question 4

What type of joint is the pubic symphysis

Answer 4

Secondary cartilaginous (a joint made of hyaline cartilage and fibrocartilage)

Question 5

Describe the male and female greater pelvis

Answer 5

Female-shallow

Male-deep

Question 6

Describe the male and female lesser pelvis

Answer 6

Female-Wide and shallow

Male- narrow and deep

Question 7

Describe the male and female pelvic inlet

Answer 7

Male-oval and round

Female-heart shaped

Question 8

Describe the male and female pelvic outlet

Answer 8

Male-small

Female- large

Question 9

Describe the obturator foramen in male and female

Answer 9

Female-oval

Male-Round

Question 10

What is the narrowest diameter of the pelvic inlet

Answer 10

13cm

Question 11

What is the narrowest diameter of the pelvic outlet

Answer 11

11cm

Question 12

What muscle is present in the posterior wall of the pelvis

Answer 12

Piriforms

Question 13

Which nerve network lies on the muesli forming the posterior wall of the pelvis

Answer 13

Sacral plexus

Question 14

Where does the Perineal body lie?

Answer 14

Midline of the perineum anterior to rectum and anal canal

Question 15

Where does the anococcygeal body lie?

Answer 15

Midline between coccyx and posterior part of rectum

Question 16

Name the muscles that make up the majority of the pelvic floor

Answer 16

Levator Ani

Coccygeus

Question 17

Name 2 functions of the pelvic diaphragm/floor

Answer 17

Helps support pelvic viscera

Resists increases in intra-abdominal pressure

Question 18

What is the innervation of the pelvic diaphragm

Answer 18

Branches of S4
Inferior anal (rectal) nerve
Coccygeal plexus

Question 19

What is Cyctocele

Answer 19

Prolapsed bladder

Question 20

What is Rectocele

Answer 20

Herniation of the front wall of the rectum into the back wall of the vagina

Question 21

Injury to pelvic floor during childbirth is common and potentially damaging.
Why?

Answer 21

During childbirth the pelvic floor supports the foetal head while the cervix of the uterus is dilating to permit delivery of the foetus

Question 22

Why may an episiotomy minimise long term damage?

Answer 22

It can help prevent severe spontaneous tears

Question 23

Whys is a mediolateral episiotomy preferable to a midline episiotomy

Answer 23

Risk of anal tear is much lower

Question 24

List the 3 main urinary pelvic organs

Answer 24

Bladder
Ureter
Urethra

Question 25

List the main male reproductive pelvic organs

Answer 25

``` Testes Epididymis Prostate Ductus deferens Seminal glands Ejaculatory ducts Bulbourethral glands ```

Question 26

List the main female reproductive pelvic organs

Answer 26

Vagia Uterus Uterine Tubes Ovaries

Question 27

What structures can be palpated when performing a DRE

Answer 27

Prostate | Uterus and Cervix

Question 28

What arteries supply the bladder, seminal gland and prostate in males

Answer 28

Superior and inferior vesical artery

Question 29

What arteries supply the pelvic part of the ureter, uterus, ligament of uterus, uterine tube and vagina

Answer 29

Uterine artery

Question 30

What arteries supply the abdominal artery from the pelvis

Answer 30

Gonadal (testicular or ovarian)

Question 31

What artery ripples the Gluteal muscles and tensor fasciae latae

Answer 31

Superior rectal artery

Question 32

What artery supplies the seminal gland, prostate and rectum

Answer 32

Middle and inferior rectal artery

Question 33

What artery supples the Vagina and branches to inferior part of urinary bladder

Answer 33

Vaginal artery

Question 34

What artery supplies the perineum

Answer 34

Internal pudendal artery

Question 35

What artery supples the pelvic muscles

Answer 35

Obturator artery

Question 36

Which part(s) of the rectum drain(s) into the portal circulation?

Answer 36

Superior rectal veins

Question 37

Which part(s) of the rectum drain(s) into the systemic circulation?

Answer 37

Middle and Inferior rectal veins

Question 38

What is the significance of understanding the venous drainage of the rectum?

Answer 38

The venous drainage of the rectum mirrors the arterial supply

Question 39

Why might haemorrhoids be associated with cirrhosis of the liver?

Answer 39

The upper and middle thirds of the rectum drain primarily into the superior rectal vein and finally empty into the liver via the inferior mesenteric vein and portal vein

Question 40

With which venous plexus does the prostatic venous plexus communicate with on its posterior side?

Answer 40

Internal vertebral venous plexus

Question 41

Where does the ilioguinal nerve originate from and what does it supply

Answer 41

L1 | Skin at root of penis in male and labia in female

Question 42

Where does the genitofemoral nerve originate from

Answer 42

L1 and L2 and enters deep inguinal ring

Question 43

Which segmental level does the pudendal nerve arise from

Answer 43

S2-S4

Question 44

What bony landmarks are used when performing a pudendal nerve block during labour

Answer 44

The sacrospinous ligament to the ischial spine

Question 45

Where does the autonomic nerve supply to the pelvis originate

Answer 45

Pelvic Plexus

Question 46

Where do the sympathetic fibres originate

Answer 46

L1 and L2 via the hypogastric nerve and terminal aspect of the sympathetic trunk

Question 47

Where do the parasympathetic fibres in the pelvis originate from

Answer 47

Pelvic splanchnic nerves (S2 to S4)

Question 48

What are 4 primary lymph node groups in the pelvis

Answer 48

External iliac Internal iliac Sacral Common iliac