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Reproduction > Lec1 - Defining the Pelvic Region > Flashcards

Lec1 - Defining the Pelvic Region Flashcards

1
Q

How many bones (including ligaments) make up the pelvis?

A 
Four:
Ilium
Ischium and pubis
Sacrum
Coccyx
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2
Q

What is the latin for pelvis?

A

Os coxa

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3
Q

Name the four ligaments of the pelvis

A

Sacroiliac - between the sacrum and ilium (with anterior and posterior component)
Sacrococcygeal - sacrum to coccyx
Sacrospinous - sacrum/coccyx to ischial spine
Sacrotuberous - posterior to the sacrospinous, between the lateral aspect of the sacrum margin of the ischial tuberosity

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4
Q

What is the perineum?

A

Refers to the space located at the pelvic outlet and inferior to the pelvic diaphragm - i.e. muscle of the pelvic floor

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5
Q

Describe the borders/limits of the perineum

A

Diamond shaped surface extending from the mons pubis (in females) to the medial surface of the thighs (laterally) and posteriorly to the gluteal folds

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6
Q

What are the names of the two triangles that the perineum can be divided into and what is the line of division?

A

A transverse line from the two ischial tuberosities splits the perineum into 2 triangles:
Urogenital triangle
Anal triangle

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7
Q

What does the midpoint of the transverse line joining the two ischial tuberosities define?

A

The perineal body

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8
Q

What is the significance of the perineal body?

A

The perineal body sees the convergence of several sphincter and perineal pouch muscles
This area can also get damaged during childbirth

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9
Q

What does the deep perineal pouch enclose?

A

Urethra
Vagina in females
Glands e.g. bulbourethral (Cowper glands in males)
Perineal muscles that act as sphincters - Compressor urethrae or urethrovaginal sphincter in females

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10
Q

What does the superficial perineal pouch enclose?

A 
Urethra
Vagina in females 
Root of penis in males 
Glands e.g. bartholin in females 
Perineal muscles that provide support to the external genitalia e.g. bulbospongiosus or ischiocavernous muscles
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11
Q

What are the bones of the articulated pelvis?

A

Sacrum
Ileum, pubis, ischium
Ischial tuberosity
Ischial spine

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12
Q

What are the joints of the articulated pelvis?

A

Sacroiliac
Sacrococcygeal
Pubic symphysis

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13
Q

What are the ligaments of the articulated pelvis?

A

Sacrospinous
Sacrococcygeal
Sacrotuberous
Sacroiliac

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14
Q

The pelvic brim/pelvic inlet is formed by the:

A

Premontory and ala of the sacrum
Arcuate line
Pectineal line

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15
Q

What is the function of the pelvic brim/inlet?

A

Separates the true pelvis from the greater pelvis

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16
Q

What are the borders of the true pelvic cavity?

A 
Sacrum/coccyx - posterior
Pubic symphysis - anterior
Pelvic diaphragm - inferior 
Pelvic brim - superior 
Obturator internus muscle - lateral
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17
Q

What are the contents of the true pelvic cavity?

A

Reproductive organs and tracts
Bladder
Rectum

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18
Q

Name the pelvic musculature that line the wall of the pelvis:

A

Piriformis

Obturator internus

19
Q

Name the pelvic musculature that line the pelvic floor

A

Coccygeus

Levator ani

20
Q

Which muscles make up the Levator ani?

A

Iliococcygeus
Pubococcygeus
Puborectalis

21
Q

Origin and insertion of the piriformis?

A

Origin: Anterior surface of the sacrum
goes through the greater sciatic foramen i.e. over the ischial spine
Inserts onto the greater trochanter of the femur

22
Q

Origin & insertion of the Obturator internus

A

Origin: internal surface of the obturator membrane
Through the lesser sciatic foramen (below ischial spine)
Inserts on to the greater trochanter of the femur

23
Q

Origin and insertion of the coccygeal

A

Origin: ischial spine
Insertion: inferior end of the sacrum and coccyx

24
Q

Iliococcygeus

A

Origin: tendinous arch

Insertion Anococcygeal body

25
Q

What is the tendinous arch?

A

A line extending from the ischial spine to the posterior aspect of the pubic bone

26
Q

Pubococcygeus

A

Origin: posterior aspect of the pubic bone
Insertion: Lateral fibres insert to the coccyx
Medial fibres insert onto the contralateral fibres of the pubococcygeus itself

27
Q

Puborectalis:

A

Continuous muscle that
Origin: Posterior aspect of the pubic bone
Slings behind the rectum

28
Q

What is the blood supply to the pelvis?

A

Anterior division of the iliac (uterine, vesicular and internal pudenal arteries)
Gonadal arteries supply the gonads

29
Q

Where do the gonadal arteries come off the abdominal aorta and why?

A

Just below the level of the renal arteries

because during development the gonads develop very close to the kidneys

30
Q

Veins draining the pelvis?

A

Internal iliac vein - to the common iliac veins

Gonadal veins - draining to the IVC or L renal vein

31
Q

What are the somatic plexuses of nervous control of the pelvis?

A

Lumbosacral (L4-S4 joined by lumbar L4/L5)

Coccygeal (S4 -Co)

32
Q

What are the nerves supplying the pelvic region?

A

Sciatic nerve
Superior gluteal
Inferior gluteal
Pudendal nerve

33
Q

What are the visceral plexuses in this region?

A

Paravertebral/prevertebral
Sympathetic/parasympathetic/visceral fibres
e.g. for erection/ejaculation
e.g. inferior hypogastric plexus

34
Q

Which foramen does the obturator nerve go through?

A

Obturator foramen

35
Q

What are the nerve roots of the superior gluteal nerve?

A

L4, L5, S1

36
Q

What are the nerve roots of the inferior gluteal nerve?

A

L5, S1, S2

37
Q

What are the nerve roots of the sciatic nerve?

A

L4, L5, S1, S2

38
Q

What are the nerve roots of the pudendal nerve?

A

S2, S3, S4

39
Q

What type of innervation are the pelvic splanchnic nerves?

A

Parasympathetic

40
Q

What time of innervation are the sacral sympathetic trunk, superior and inferior hypogastric plexuses?

A

Sympathetic

41
Q

What nerve goes out through the greater sciatic foramen and inferior to the piriformis, around the ischial spine and back in through the inferior sciatic foramen

A

Pudendeal nerve

42
Q

What area does the pudendal block numb?

A

The areas supplied by the pudendal nerve

43
Q

How do you find the pudendal nerve and administer the pudendal block

A

Because the pudendal nerve wraps around the ischial spine, you palpate for ischial spine and administers the anaesthetic to this area to block the whole pudendal region

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