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ENDO I exam 2 > ketchum, structure compartmentalization pelvis, perineum > Flashcards

ketchum, structure compartmentalization pelvis, perineum Flashcards

1
Q

What 3 bones fuse and form bony pelvis. what other bone attaches

A

ilium, ischium and pubis

sacrum

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2
Q

What bone makes up upper 2/5th of acetabulum

A

ilium

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3
Q

which bone forms posteroinferior 2/5th of acetabulum

A

ischium

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4
Q

which bone forms anterior 1/5 acetabulum

A

pubis

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5
Q

What type of disc is the pubic symphysis

A

fibrocartilaginous

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6
Q

What are the articulations of the sacroiliac joint

A

synovial between sacrum and ilium

fibrocartilaginous at lumbosacral joint

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7
Q

what are the ligaments of the sacroiliac joint

A

sacroiliac (ant and post)
sacrotuberous (sacrum to ischial tuberosity)
sacrospinous (sacrum/coccyx to ischial spine)

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8
Q

What are the ligaments of the lumbosacral joint

A

iliolumbar ligament (transverse process LV5 to iliac crest)

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9
Q

What ligaments resist rotary motion

A

interosseous sacroiliac and sacrotuberous

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10
Q

What runs through the obturator foramen

A

obturator internus

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11
Q

What does the terminal line split the pelvis into

A

major (false) pelvis above line

minor (true) pelvis below line

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12
Q

What demarcates pelvic inlet

A

terminal line

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13
Q

What demarcates pelvic outlet

A

inferior aperture

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14
Q

What is the normal position of pelvis when erect position

A

50-60 degrees from horizontal

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15
Q

The ASIS and what other structure lie in same vertical plane

A

pubic symphysis

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16
Q

what is higher in the erect position the base of sacrum or pubic symphysis

A

base of sacrum is higher

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17
Q

In what ways is the female pelvis different than the male

A 
shallower major pelvis
anterior iliac crests tend to evert
shallower minor pelvis with greater diameters
broad, less concavity
pelvic inlet is wider and more oval
the subpubic angle is greater
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18
Q

What are the 4 types of pelvis

A

Android
Anthropoid
Gynecoid
Platypelloid

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19
Q

What is the most common male pelvis and describe it

A

android, heart shaped pelvic inlet

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20
Q

What is the most common pelvis in women and describe it

A

gynecoid and slightly oval shaped pelvic inlet

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21
Q

What is the 2nd most common male pelvis

A

Anthropoid, exaggerated anterior and posterior inlet

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22
Q

What is the 2nd most common female pelvis

A

android

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23
Q

What is the least common pelvis

A

platypelloid, exaggerated transverse inlet diameter

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24
Q

In which practice do pelvic diameters play a role

A

obstetrics, if canal is too narrow, hard for normal delivery

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25
Q

What is the true conjugate pelvic diameter

A

from sacrovertebral angle to superior margin of symphysis

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26
Q

What is the diagonal conjugate pelvic diameter

A

sacrovertebral angle to inferior margin of symphysis

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27
Q

What is the transverse diameter of the superior aperture of pelvis

A

the largest one, used in imaging, greatest width of superior aperture

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28
Q

Were is the oblique diameter of the pelvis

A

sacroiliac articulation to iliopectineal eminence contralaterally

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29
Q

Where is the transverse diameter of the inferior aperture

A

between inner surfaces of ischial tuberosity

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30
Q

Where is the anterior sagittal diameter of inferior aperture

A

from transverse diameter to symphysis

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31
Q

Where is the posterior sagittal diameter of inferior aperture

A

transverse diameter to sacrococcygeal junction

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32
Q

What mm line the inner walls of the minor pelvis

A

obturator internus and piriformis

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33
Q

What is the origin, insertion of obturator internus

A

o: obturator membrane (over canal) to rim of obturator foramen
i: greater trochanter of femur

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34
Q

What is the inn and action of obturator internus

A

inn by n to obturator internus

action is external rotation of the hip

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35
Q

Which notch does the tendon of obturator internus exit the pelvis

A

lesser sciatic notch

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36
Q

What is the origin and insertion of piriformis m

A

o: sacrum
i: greater trochanter of femur

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37
Q

What inn anc action of piriformis

A

inn by ventral rami of S1S2

external rotation of thigh and ABduction of thigh

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38
Q

Where does piriformis exit the pelvis

A

greater sciatic foramen

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39
Q

What is the function of the pelvic diaphragm

A

support pelvic viscera

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40
Q

why is the pelvid diaphragm incomplete

A

allow passage of urethra and vagina (genital hiatus)

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41
Q

Where is the urogenital diaphragm and what is its role

A

in perineum

suppors midline structures like urethra, vagina and prostate

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42
Q

What are the 3 parts of the pelvic diaphragm

A

pubococcygeus m
ileococcygeus m
puborectalis m

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43
Q

What is the origin and insertion of pubococcygeus

A

o: pubis
i: coccyx and anococcygeal lig

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44
Q

What is the inn and action of pubococcygeus

A

inn by perineal branches S3S4

supports pelvic viscera

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45
Q

The urethra passes through an opening made by what part of pelvic diaphragm

A

the separation of the pubococcygeous anterior to the rectum

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46
Q

what is the origin and insertion of iliococcygeus m

A

o: arcus tenidenus
i: coccyx and anococcygeal lig

47
Q

What is the inn and action of iliococcygeus m

A

perineal branches of S3S4

supports pelvic viscera

48
Q

What is the origin and insertion of puborectalis

A

o: pubis
i: puborectalis on contralateral side posterior to rectum

49
Q

what is the inn and action of puborectalis

A

inn perineal branches S3S4

action is support pelvic viscera, maintain anorectal junction(sphincter like)

50
Q

What is the origin and insertion of coccygeus m

A

o: ischial spin, sacrotuberous lig
i: coccyx and lower part os sacrum

51
Q

What is the inn and action of coccygeus

A

inn by ventral rami S4S5

support pelvic viscera

52
Q

What is the most posterior m of the pelvic diaphragm

A

coccygeus

53
Q

What system has the most anteriorly placed structure in pelvis

A

the urinary system

pelvic portion of bladder and urinary bladder

54
Q

Where are the GI structures located in pelvis and what are they

A

posteriorly

rectum and anal canal

55
Q

What are the repro organs in the middle of pelvis in men and women

A

men: pelvic portion of vas deferens, seminal vesicles, prostate gland
women: vagina, uterus, uterine tubes, ovaries

56
Q

What lines the pelvic wall and floor

A

endopelvic fascia that is membranous with loose CT

57
Q

Where is the pelvic peritoneum located

A

NOT in contact with floor and walls

draped over superior part of structures and forms folds and pouches

58
Q

What is the peritoneal pouch in the male between rectum and bladder

A

rectovesical pouch

59
Q

What divides the pouches in the female pelvis

A

the uterus

60
Q

What are the pouches of the female pelvis

A

rectouterine (between rectum and uterus)

vesicouterine (between superior aspect of urinary bladder and uterus)

61
Q

Where is the broad ligament and what is if derived from

A

laterally across pelvis and folds over uterus

formed from paramesonephric ducts

62
Q

Where is the perineum located

A

between coccyx and pubis

63
Q

clinically the perineum refers to what in females

A

central tendon (perineal body)

64
Q

What are the boundaries of perineum

A

anterior- pubis
lateral- ischiopubic rami and ischial tuberosities
posterior- coccyx and caudal sacrum
posterior-lateral- sacrotuberous ligaments
superior- separated from pelvic cavity by pelvic diaphragm

65
Q

What two rami does the UG diaphragm stretch between

A

ischiopubic rami

66
Q

What are the borders of the anal triangle

A

anterior- posterior edge of UG diaphragm
posterior- boundaries of perineum
lateral- ischiopubic rami and obturator internus m (below arcs tendineus)
superior- inferior aspect of pelvic diaphragm
inferior- skin and superficial fascia of perineum

67
Q

What are the borders of the ischioanal fossa

A

superior- levator ani and pelvic diaphragm
inferior- skin of perineum
posterior- right and left ischioanal fossa communicate
anterior- external anal sphincter and UG diaphragm fuse

68
Q

Where is the anterior recess in the ischioanal fossa

A

extends anteriorly between levator ani and UG diaphragm

69
Q

What structures are in the anal triangle

A

external anal sphincter, internal pudendal vessels, pudendal n and perineal branch of S4 n

70
Q

What are the components of the external anal sphincter

A

superficial, subcutaneous and deep

71
Q

What part of external anal sphincter is main component

A

the deep component

72
Q

What do the internal pudendals branch from

A

internal iliac a

73
Q

where do the internal pudendals aa leave pelvis

A

greater sciatic foramen

74
Q

What is the Pudendal canal of Alcocks

A

fascial canal from splitting of obturator fascia

75
Q

What are the branches off internal pudendal a

A

inferior rectal a, perineal aa, deep and dorsal aa of the penis/clitoris

76
Q

What is supplied by inferior rectal aa

A

sphincter, anal canal and skin of anus

77
Q

What branches from perineal aa

A

transverse perineal and posterior scrotal (labial) aa

78
Q

What are the terminal branches of internal pudendal a

A

deep a of penis, dorsal a of penis(clitoris)

79
Q

What nerves runs with internal pudendal aa

A

the pudendal from S2-S4

80
Q

what are the main branches of pudendal n

A

inferior rectal n
perineal n
dorsal n of penis

81
Q

What supplies cutaneous inn to skin of posterior anal triangle

A

perineal branch of S4

82
Q

what does the perineal branch of S4 inn

A

skin post anal triangle
external sphincter
lateral aspect of anal and UG regions on medial thigh

83
Q

What are the borders of of the UG traingle in male

A

anterior-pubis
lateral- ischiopubic rami
posterior- dorsal edge of UG diaphragm
superior- pubo-coccygeal portion of leavator ani m

84
Q

Is the UG diaphragm voluntary or no

A

voluntary mm

85
Q

Where does the UG diaphragm run from

A

pubis to ischial tuberosities

86
Q

What mm form the UG diaphragm

A

anterior is sphincter urethrae(urethrovaginalis in women)
posterior is the deep transverse perineal m
compressor urethrae extends laterally

87
Q

What is between UG diaphragm and pubis

A

an anterior gap of transverse perineal ligament, deep dorsal v of penis enters here

88
Q

What covers the UG diaphragm

A

inferior and superior fascial sheaths that fuse at muscle borders
superior from transversalis fascia
inferior from perineal membrane

89
Q

Describe the superficial perineal fascia

A

Colle’s(scarpa in peritoneum)
forms Dartos (superficial fascia of scrotum)
have erectile bodies, musculature, vessels and nn

90
Q

Describe deep perineal fascia

A

between inf and superior fascia
forms deep penile fascia (Bucks)
contains mm of UG diaphragm, vessels and nerves

91
Q

What mm form penis

A

corpus spongiosum

two corpora cavernosa

92
Q

What muscle of penis is adherent to inferior fascia of UG diaphragm

A

corpus spongiosum

93
Q

Why is the corpus spongiosum enlarged at distal end

A

forms glans penis

94
Q

What forms the crura of penis

A

2 corpora cavernosa

95
Q

what surrounds each layer of erectile tissue

A

tunica albuginae

96
Q

Where does the tunica albunginae fuse

A

along midline to form septum of penis

97
Q

What are the ligaments that support the penis

A

fundiform and suspensory

98
Q

What forms fundiform

A

thickending of scarpas fascia and adheres to colles fascia of penis

99
Q

What forms suspensory ligament of penis

A

lower end linea alba, inserts to deep fascia of penis

triangular band of CT

100
Q

What mm run in suspensory lig

A 
bulbospongiosus m (compressor urethrae)
ischiocavernosus m (erector)
101
Q

What is the last mm of the UG diaphragm that originates on ischiopubic rami and isnerts to central tendon of perineum

A

superficial transverse perineal mm

102
Q

What is the cetnral tendon of perineal body an insertion point for

A

superficial and deep transverse perineal mm
bulbospongiosus m
external anal sphincter

103
Q

What are the erectile tissue components of femal genitalia

A 
vestibular bulbs (corpus spongiosum in male)
corpora cavernosa (form clitoris)
104
Q

where are the vestibular bulbs of vagina

A

base of labia majora

cover the bulbourethral glands

105
Q

What does the clitoris attach to

A

suspensory ligament of clitoris

106
Q

What are the mm of erectile tissue in females

A

bulbospongiosus (wrap around labia minus)

ischiocavernosus (isciopubic rami to pubic arch forming crura of clitoris)

107
Q

What is the mons pubis

A

fat pad overlaying pubic symphysis

108
Q

what is the labia majora

A

homolog to scrotal folds
form boundaries of pudendal cleft
contain round ligament of uterus

109
Q

What is the round ligament of the uterus a remnant of

A

gubernaculum in fetus

110
Q

what does the labia minor create

A

vestibule surrounding vagina and urethral opening
antero-lateral portion unite to form prepuce of clitoris
medial portions unite to form frenulum at glans of clitoris

111
Q

What are the branches of the perineal branch off internal pudendal a

A

transverse perineal and posterior scrotal/labial

112
Q

What are main branches off internal pudendal a

A 
artery of bulb, 
urethral a
aa to mm of deep perineal space
deep artery of penis/clitoris
dorsal a of penis/clitoris
113
Q

what is the main vein of the penis/clitoris

A

deep dorsal v

114
Q

What are the nn off perineal n of pudendal n

A

posterior scrotal/labial
deep branches
dorsal n of penis/clitoris

ENDO I exam 2 (11 decks)

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