Introduction to Repro Anat Flashcards
What is the true pelvis and false pelvis
Pelvis minor and pelvis major
What type of joint is the sacroiliac joint
Synovial
What type of joint is the pubic symphysis
Secondary cartilaginous
Male vs female pelvis: Pelvis major
Male: Narrower
Female: Wider
Male vs female pelvis: Pelvis minor
Male: Narrower and deeper
Female: Wider and shallower
Male vs female pelvis: Pelvic inlet (shape)
Male: Heart shape
Female: Oval
Male vs female pelvis: Pelvic outlet
Male: Narrow
Female: Wide
Male vs female pelvis: Subpubic angle
Male: Acute
Female: Obtuse
Male vs female pelvis: Obturator foramen
Male: Round
Female: Oval
Male vs female pelvis: Acetabulum
Male: Larger
Female: Smaller
Narrowest diameter of the pelvic inlet
Obstetric conjugate
Widest diameter of pelvic inlet
Diagonal conjugate
What muscle forms the posterior wall of the pelvis?
Piriformis
What nerve network lies on the piriformis?
Sacral Plexus
What is the perineal body?
A fibromuscular node found in the midline of the perineum
What is the anococcygeal body?
Layered musculotendinous intersection of the two haves of levator ani muscles.
Functions of the pelvic floor (2)
- Support the abdomino-pelvic organs
2. Resist intra-abdominal pressure
What 2 muscles make up the pelvic floor
- Coccygeus
2. Levator ani: pubococcygeus, iliococcygeus, puborectalis
Innervation of the pelvic floor and what origin
Pudendal. S2-S4
What is a 1) cystocele and 2) rectocele
1) anterior vaginal prolapse where bladder has prolapsed
2) posterior vaginal prolapse where rectum has prolapsed
What are the consequences of pelvic floor injury?
Urinary or bowel incontinence, pelvic organ prolapse, sexual dysfunction, pelvic pain
Why perform an episiotomy?
To minimise extensive tears to the vagina
Why mediolateral episiotomy instead of midline?
To prevent damage to the perineal body, which can cause urinary and faecal incontinence
What structures can be palpated on DRE? Male and female
Male: prostate, rectal walls
Female: cervix, rectal walls
Acronym for branches of internal iliac artery
I Love Going Places in My Very Own Underwear
What are the branches of the internal iliac artery?
Iliolumbar artery Lumbar sacral artery Gluteal - superior and inferior artery Internal pudendal artery Inferior vesicular artery - males Middle rectal artery Vaginal artery - female Obturator artery Uterine/umbilical artery - for females
Which parts of rectum drain into portal circulation?
Superior
Which parts of the rectum drain into systemic circulation?
Low and middle
Why might haemorrhoids be associated with cirrhosis of liver?
Venous blood from scarred liver backed up in portal circulation and into rectum.
Which venous plexus does the prostatic venous plexus communicate with posteriorly? What is the clinical significance?
Vertebral. Prostate cancer can metastasise to the spine.
Ilioinguinal nerve: Origin, entry, innervation.
Origin: L1
Entry: Superficial inguinal ring
Innervation: labial folds, skin of root of penis
Genitofemoral nerve: Origin, entry, innervation.
Origin: L1-L2
Entry: Deep inguinal ring
Innervation: Anterior scrotal skin, cremasteric muscle
Bony landmarks for pudendal nerve blocks (2)
1) Ischial spine 2) Sacrospinous ligament
What is the sympathetic nerve supply to the pelvis?
Inferior hypogastric.
Origins of sympathetic fibres to the pelvis? Innervation in male and females?
L1 and L2
Male: Epididymis, vas deferens, seminal vesicles, prostate
Female: Ovaries, fallopian tube, uterus, vagina
Parasympathetic fibres to pelvis name, origin and innervation
Pelvic splachnic nerve
S2-S4
Male and female: all internal pelvic organs and erectile tissue
4 primary lymph node groups of pelvis
sacral, external iliac, internal iliac, common iliac
What do the external iliac nodes drain?
Inguinal lymph nodes
What do the internal iliac nodes drain?
Gluteal region, deep perineum, inferior pelvic viscera
What do the sacral nodes drain?
Rectum and posterior wall of pelvis
What do the common iliac nodes drain?
They receive drainage from external iliac, internal iliac and sacral lymph nodes.
