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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
What is the true conjugate pelvic diameter
from sacrovertebral angle to superior margin of symphysis
26
What is the diagonal conjugate pelvic diameter
sacrovertebral angle to inferior margin of symphysis
27
What is the transverse diameter of the superior aperture of pelvis
the largest one, used in imaging, greatest width of superior aperture
28
Were is the oblique diameter of the pelvis
sacroiliac articulation to iliopectineal eminence contralaterally
29
Where is the transverse diameter of the inferior aperture
between inner surfaces of ischial tuberosity
30
Where is the anterior sagittal diameter of inferior aperture
from transverse diameter to symphysis
31
Where is the posterior sagittal diameter of inferior aperture
transverse diameter to sacrococcygeal junction
32
What mm line the inner walls of the minor pelvis
obturator internus and piriformis
33
What is the origin, insertion of obturator internus
o: obturator membrane (over canal) to rim of obturator foramen i: greater trochanter of femur
34
What is the inn and action of obturator internus
inn by n to obturator internus | action is external rotation of the hip
35
Which notch does the tendon of obturator internus exit the pelvis
lesser sciatic notch
36
What is the origin and insertion of piriformis m
o: sacrum i: greater trochanter of femur
37
What inn anc action of piriformis
inn by ventral rami of S1S2 | external rotation of thigh and ABduction of thigh
38
Where does piriformis exit the pelvis
greater sciatic foramen
39
What is the function of the pelvic diaphragm
support pelvic viscera
40
why is the pelvid diaphragm incomplete
allow passage of urethra and vagina (genital hiatus)
41
Where is the urogenital diaphragm and what is its role
in perineum | suppors midline structures like urethra, vagina and prostate
42
What are the 3 parts of the pelvic diaphragm
pubococcygeus m ileococcygeus m puborectalis m
43
What is the origin and insertion of pubococcygeus
o: pubis i: coccyx and anococcygeal lig
44
What is the inn and action of pubococcygeus
inn by perineal branches S3S4 | supports pelvic viscera
45
The urethra passes through an opening made by what part of pelvic diaphragm
the separation of the pubococcygeous anterior to the rectum
46
what is the origin and insertion of iliococcygeus m
o: arcus tenidenus i: coccyx and anococcygeal lig
47
What is the inn and action of iliococcygeus m
perineal branches of S3S4 | supports pelvic viscera
48
What is the origin and insertion of puborectalis
o: pubis i: puborectalis on contralateral side posterior to rectum
49
what is the inn and action of puborectalis
inn perineal branches S3S4 | action is support pelvic viscera, maintain anorectal junction(sphincter like)
50
What is the origin and insertion of coccygeus m
o: ischial spin, sacrotuberous lig i: coccyx and lower part os sacrum
51
What is the inn and action of coccygeus
inn by ventral rami S4S5 | support pelvic viscera
52
What is the most posterior m of the pelvic diaphragm
coccygeus
53
What system has the most anteriorly placed structure in pelvis
the urinary system | pelvic portion of bladder and urinary bladder
54
Where are the GI structures located in pelvis and what are they
posteriorly | rectum and anal canal
55
What are the repro organs in the middle of pelvis in men and women
men: pelvic portion of vas deferens, seminal vesicles, prostate gland women: vagina, uterus, uterine tubes, ovaries
56
What lines the pelvic wall and floor
endopelvic fascia that is membranous with loose CT
57
Where is the pelvic peritoneum located
NOT in contact with floor and walls | draped over superior part of structures and forms folds and pouches
58
What is the peritoneal pouch in the male between rectum and bladder
rectovesical pouch
59
What divides the pouches in the female pelvis
the uterus
60
What are the pouches of the female pelvis
rectouterine (between rectum and uterus) | vesicouterine (between superior aspect of urinary bladder and uterus)
61
Where is the broad ligament and what is if derived from
laterally across pelvis and folds over uterus | formed from paramesonephric ducts
62
Where is the perineum located
between coccyx and pubis
63
clinically the perineum refers to what in females
central tendon (perineal body)
64
What are the boundaries of perineum
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
What two rami does the UG diaphragm stretch between
ischiopubic rami
66
What are the borders of the anal triangle
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
What are the borders of the ischioanal fossa
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
Where is the anterior recess in the ischioanal fossa
extends anteriorly between levator ani and UG diaphragm
69
What structures are in the anal triangle
external anal sphincter, internal pudendal vessels, pudendal n and perineal branch of S4 n
70
What are the components of the external anal sphincter
superficial, subcutaneous and deep
71
What part of external anal sphincter is main component
the deep component
72
What do the internal pudendals branch from
internal iliac a
73
where do the internal pudendals aa leave pelvis
greater sciatic foramen
74
What is the Pudendal canal of Alcocks
fascial canal from splitting of obturator fascia
75
What are the branches off internal pudendal a
inferior rectal a, perineal aa, deep and dorsal aa of the penis/clitoris
76
What is supplied by inferior rectal aa
sphincter, anal canal and skin of anus
77
What branches from perineal aa
transverse perineal and posterior scrotal (labial) aa
78
What are the terminal branches of internal pudendal a
deep a of penis, dorsal a of penis(clitoris)
79
What nerves runs with internal pudendal aa
the pudendal from S2-S4
80
what are the main branches of pudendal n
inferior rectal n perineal n dorsal n of penis
81
What supplies cutaneous inn to skin of posterior anal triangle
perineal branch of S4
82
what does the perineal branch of S4 inn
skin post anal triangle external sphincter lateral aspect of anal and UG regions on medial thigh
83
What are the borders of of the UG traingle in male
anterior-pubis lateral- ischiopubic rami posterior- dorsal edge of UG diaphragm superior- pubo-coccygeal portion of leavator ani m
84
Is the UG diaphragm voluntary or no
voluntary mm
85
Where does the UG diaphragm run from
pubis to ischial tuberosities
86
What mm form the UG diaphragm
anterior is sphincter urethrae(urethrovaginalis in women) posterior is the deep transverse perineal m compressor urethrae extends laterally
87
What is between UG diaphragm and pubis
an anterior gap of transverse perineal ligament, deep dorsal v of penis enters here
88
What covers the UG diaphragm
inferior and superior fascial sheaths that fuse at muscle borders superior from transversalis fascia inferior from perineal membrane
89
Describe the superficial perineal fascia
Colle's(scarpa in peritoneum) forms Dartos (superficial fascia of scrotum) have erectile bodies, musculature, vessels and nn
90
Describe deep perineal fascia
between inf and superior fascia forms deep penile fascia (Bucks) contains mm of UG diaphragm, vessels and nerves
91
What mm form penis
corpus spongiosum | two corpora cavernosa
92
What muscle of penis is adherent to inferior fascia of UG diaphragm
corpus spongiosum
93
Why is the corpus spongiosum enlarged at distal end
forms glans penis
94
What forms the crura of penis
2 corpora cavernosa
95
what surrounds each layer of erectile tissue
tunica albuginae
96
Where does the tunica albunginae fuse
along midline to form septum of penis
97
What are the ligaments that support the penis
fundiform and suspensory
98
What forms fundiform
thickending of scarpas fascia and adheres to colles fascia of penis
99
What forms suspensory ligament of penis
lower end linea alba, inserts to deep fascia of penis | triangular band of CT
100
What mm run in suspensory lig
``` bulbospongiosus m (compressor urethrae) ischiocavernosus m (erector) ```
101
What is the last mm of the UG diaphragm that originates on ischiopubic rami and isnerts to central tendon of perineum
superficial transverse perineal mm
102
What is the cetnral tendon of perineal body an insertion point for
superficial and deep transverse perineal mm bulbospongiosus m external anal sphincter
103
What are the erectile tissue components of femal genitalia
``` vestibular bulbs (corpus spongiosum in male) corpora cavernosa (form clitoris) ```
104
where are the vestibular bulbs of vagina
base of labia majora | cover the bulbourethral glands
105
What does the clitoris attach to
suspensory ligament of clitoris
106
What are the mm of erectile tissue in females
bulbospongiosus (wrap around labia minus) | ischiocavernosus (isciopubic rami to pubic arch forming crura of clitoris)
107
What is the mons pubis
fat pad overlaying pubic symphysis
108
what is the labia majora
homolog to scrotal folds form boundaries of pudendal cleft contain round ligament of uterus
109
What is the round ligament of the uterus a remnant of
gubernaculum in fetus
110
what does the labia minor create
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
What are the branches of the perineal branch off internal pudendal a
transverse perineal and posterior scrotal/labial
112
What are main branches off internal pudendal a
``` artery of bulb, urethral a aa to mm of deep perineal space deep artery of penis/clitoris dorsal a of penis/clitoris ```
113
what is the main vein of the penis/clitoris
deep dorsal v
114
What are the nn off perineal n of pudendal n
posterior scrotal/labial deep branches dorsal n of penis/clitoris

ENDO I exam 2 (11 decks)

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