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GU > Lecture 13: Pelvic Contents > Flashcards

Lecture 13: Pelvic Contents Flashcards

1
Q

Label

A
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2
Q

Label

A
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3
Q

Label Sacrum

A

5x vertebrae fused
4x paired foramen (nerve passage)

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4
Q

Label posterior sacrum

A
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5
Q

What makes up the pelvic inlet. What is this the boundary of?

A
  • Sacral promontory
  • Alae of sacrum
  • Arcuate line
  • Pectineal line
  • Pubic tubercle
  • Pubic Crest
  • Pubic symphysis

Above this= false pelvis
Below this= true pelvis

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6
Q

Describe the ‘Pelvic Tilt’

A

~60 degree tilt anteriorly.

ASIS in line with Pubic tubercle

(sacrum also tilted)

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7
Q

What are the pelvic boundaries?

A

Ant, Post and Lat = bone

Floor = muscular (pelvic diaphragm)

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8
Q

Male/female variation of the pelvis

A
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9
Q

What forms the greater and lesser sciatic foramen?

A

Sacrospinous and sacrotuberous ligaments

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10
Q

Other ligaments of the pelvis?

A

Posterior sacroiliac ligament: fibrous (for strength)

Anterior sacroiliac ligament: synovial

Pubic symphysis

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11
Q

Muscles of the pelvic wall

A

Piriformus and Obturator Internus

OI: fills entire obturator foramen except obturator canal, has 90 degree bend

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12
Q

Draw out the vessel passages through the greater and lesser sciatic foramen.

A
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13
Q

Journey of Pudendal Nerve and vessel

A

Leave through Greater sciatic foramen, loop under and around sacrospinous ligament and re-enter below pelvic floor into perineum

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14
Q

Label nerves. Why do we need to know where these are?

A

Superior Gluteal Nerve: at risk during lateral approach to surgery

Sciatic Nerve: at risk during intramuscular injection

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15
Q

Draw the branching of the anterior division!

A

Don’t learn the pattern!!

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16
Q

Male/female differences of the anterior division of the internal iliac

A

Male: inferior vesical + middle rectal supply prostatem seminal vesicles and ductus deferens.
Testicular arteries from abdo aorta @L2

Female: uterine artery gives off vaginal artery (supplies femal genitalia)

17
Q

Draw branches of the posterior division

A

To superior gluteal → GSF above piriformis

18
Q

Venous drainage of the pelvis (EASY)

A

ALL draining to the Internal Iliac Veins

Exception: Deep dorsal vein of the penis/clitoris, drsins through deficiency in perineal membrane → vesical/prostatic plexuses

19
Q

The sacral plexus

A

S1-4 is joined by L4-5 (lumbrosacral trunk), although it’s mostly going to structures external of the pelvis, some are important!

  • Gluteal Nerves
  • Sciatic Nerves
  • Nerves to Levator Ani and Coccygeus
  • Pudendal Nerves
20
Q

Gluteal Nerves

A

Superior Gluteal (L4,L5,S1): to gluteus medius and minimus

Inferior Gluteal (L5,S1,S2): to gluteus maximus

Passing above and below piriformis

21
Q

Sciatic Nerves

A

L4-S3

Tibial always leaves below piriformis

Common peroneal can be above, below or thorugh

22
Q

Nerves to Levator Ani (direct S3-4) and Coccygeus

A
  • Direct branches of sacral plexus
  • Lie atop muscle → risk of damage → risk of prolapse
23
Q

Pudendal Nerve

A

“S2,3,4 keeps the penis off the floor

  • Supplies everything in perineum (M and S)
24
Q

Branches of the Pudendal Nerve

A
  • Inferior rectal
  • Perineal
  • DOrsal nere to clitoris/penis
  • Scrotal/labial
25
Q

2 Plexuses of the ANS to the pelvic Viscera

A
  1. Superior Hypogastric : Sits on anterior body of L5 and sacral
  2. Inferior Hypogastric: on pelvic Floor (compression risk!)
26
Q

Sympathetic supply to pelvic viscera

A

L1/2 fibres descends into pelvis via Sup. hypogastric and sacral splanchnic. Splits to form two big right and left hypogastric nerves

  • Contract int urethral and anal sphincters (continence)
  • Ejaculation
  • Moves secretions along epididymis
27
Q

Parasympathetic supply via pelvic viscera

A

S2-4, ascend via HG nerves → sup. hypogastric plexus → abdomen

Direct into Inf. HG

  • Vasodilation (for erection)
  • Bladder contraction

GU (28 decks)

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