Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Sita GenitoUrinary System > Lecture 14: Pelvis: Contents, Vessels and Nerves > Flashcards

Lecture 14: Pelvis: Contents, Vessels and Nerves Flashcards

1
Q

Fusion of pelvic bones to other structures

A

Fuse to sacrum posteriorly
Fuse together anteriorly (16/18 years old)
Ischial tuberosity = “sit bones”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bones of the sacrum

A

Ala: wings of S1 vertebrae
Sacral body
Sacral (untervertebral) foreamen (Anterior): 4x paired. anterior rami/ cauda equina
Coccyx: separate bone w. own joint to the sacrum
Sacral canal: spinal cord nerves run through
Sacral foreamen (Posterior): 4x paired. posterior rami- back muscles
Sacral hiatus: little fusion. is covered by little membrane.
Cornu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical relevance of Sacral hiatus

A

Cordal nerve blocks
Can insert needles into sacral hiatus as contain spaghetti nerves, which are easily pushed out of the way when you insert a needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

True vs False Pelvis

A

Above the pelvic inlet: Abdominal cavity/ False Pelvis
Below pelvic inlet: Pelvic cavity/ True Pelvis
- good judgement point during trauma to see if pelvic contents have shifted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Components of the Pelvic inlet

A

Distinguishes b/w False and True Pelvis
Sacral promontory –> Margin of Ala –> Arcuate line –> Pectineal line –> Pubic tubercle, crest and symphysis (Linea Terminalis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Linea Terminalis

A

Pubic Tubercle, Crest and Symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pelvic Tilt

A
  1. Pelvis ~60 degrees Anteriorly –> ASIS inline with Pubic Tubercle
  2. Sacrum is also tilted ~40 degrees Posteriorly and Inferiorly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pelvic Boundaries

A

Bone: Anterior (Pubic bones), Posterior (sacrum, coccyx, piriformis) and Lateral (illium, ishcium and pubis) walls
Muscular: Floor (pelvic Diaphragm)
- Below is Perineum
Roof: None. Peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Female Gender differences b/w pelvis

A

Pelvis: most sexually dimorphic bone in the body
Female Pelvis:
1. Illia spread wider
2. Sub-pubic angle generally greater than 90 degrees.
3. Larger and more circular pelvic inlet.
4. Ischial spine more attached to the side.
5. Sacrum Tilted backwards
6. Big Pelvic Outlet (Larger and less obstructed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Male Gender difference b/w pelvis

A

Male Pelvis:

  1. Illia spread wider
  2. Sub-pubic angle generally greater than 90 degrees.
  3. Larger and more circular pelvic inlet.
  4. Ischial spine more attached to the side.
  5. Sacrum Tilted backwards
  6. Big Pelvic Outlet (Larger and less obstructed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sacral ligaments location and function

A
  1. Sacrospinous ligament
  2. Sacrotuberous ligament
    - -> Form Greater and Lesser Sciatic formation
  3. Anterior Sacro-Illiac Ligament –> allows flexion/mechanical transfer of forces when walking
  4. Posterior Sacro-Illiac Ligament –> stronger and larger fibrous ligament
    - > strong INTEROSSEOUS ligaments
    - visible when remove iliac blades
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pubic Symphysis

A

Fibrocartilage

Relaxes during childbirth –> relaxes/opens up pelvic bones/cavity for child birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Muscles of the Pelvic Wall

A
  1. Piriformis: Travels through greater sciatic foreamen
  2. Obturator Internus:
    - covers majority of obturator foreamen (obturator canal deficet)
    - Leaves lesser sciatic foreamen –> 90 degree flip backwards –> heads towards hip –> functions as a lateral rotator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pelvic Vessel passages

A
  1. Greater sciatic foreaman Superior to Piriformis:
    Superior gluteal vessels and nerves
  2. Greater sciatic foreamen Inferior to Piriformis:
    Sciatic n., Inferior gluteal, Posterior femoral cutaneous, quadratus femoris nerves + vessels
  3. Lesser Sciatic foreamen: Pudendal nerves + Internal Pudendal nerves and vessels to Obturator internus
  4. Obturator Canal : Obturator nerves and vessels (supply adductors and medial thigh)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pudendal nerves

A

Most posterior medial

hooks around and back in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which nerves associated with the sciatic foreamen is at greatest risk during surgery?

A
  1. Superior Gluteal nerve: Laterally and superior approaches hip –> Risk of cutting during surgery
  2. Sciatic nerve: innervates hamstrings and all the muscles below the knee. Risk of hitting during intramuscular injection
    Therefore: operate on ventromedial side (Not upper quad)
17
Q

Sciatic nerve

A

Largest pelvis nerve
Runs down and innervates hamstring and all the muscles below the knee
At risk of hitting during Intramuscular injection

18
Q

What are the arterial divisions off the common illiacs?

A

Common illiac –>

  1. External Illiac –> Leg
  2. Internal Illiac (pelivs and gluteal) –>
    a) Anterior b) Posterior
19
Q

What are the arterial divisions of the Anterior Internal Iliac?

A
  1. Superior Vesicular (2-3) (VE) –> Umbilical (VE)
  2. Obturator Internus (P)
  3. Inferior Vesicular (VE)/Uterine (VI) –> Vaginal/Prostatic (VI)
  4. Middle Rectal (VI)
    –>
    a) Internal Pudendal (P) –> Inferior Rectal
    b) Inferior Gluteal (P)
    (3x Vesicular, 3x Visceral, 3x parietal)
20
Q

Branches of Anterior Division Male specific

A

Prostate, Seminal vesicles + Ductus deferens: supplied by Inferior vesicular a. and middle rectal a.
Note: Inferior vesicular (bladder and structures below (prostate, seminal vesicles, ductus deferens)
Note: Superior vesicular supplies majority of bladder
TESTICULAR artery comes from ABDOMINAL AORTA (different system)

21
Q

Gonadal artery in comparison to other pelvic arterial supply

A

General Pelvic arterial supply: Anterior division of Internal Iliac
Males: Testes: Testicular artery from ABDOMINAL AORTA L2 (Different division)
Females: Ovaries: Ovarian artery from ABDOMINAL AORTA as well

22
Q

Branches of Anterior Division Female specific

A

Uterine artery –> Vaginal artery –> supplies female genitalia
OVARIAN artery comes from ABDOMINAL AORTA L2(different system)

23
Q

Pelvic venous drainage

A

Bladder, Prostate, rectum, Uterus, Vagina = Perineum = all drain through a rich venous plexus –> Internal Pudendal vein –> Internal Iliac vein
Exception: Deep dorsal vein fo the penis/clitoris –> through Anterior deficiency in perineal membrane –> Vesical/Prostatic Plexus –>
Same end source but different pathway

24
Q

Sacral plexus

A

Anterior sacral Foramina S1-4
- Lumbosacral trunk joins at L4-5
Internal pelvis is mainly Autonomic innervation –> Sacral plexus innervates structures that are External to pelvis
Some important nerves to pelvis and peritoneum
1. Gluteal nerves
2.

25
Q

Gluteal nerves

A
  1. Superior Gluteal nerves (L5-S1) –> Gluteus Medius and Minimus
  2. Inferior Gluteal nerves (L5-S2) –> Gluteus maximus
26
Q

Sciatic nerves

A
  1. Tibial nerve –> leaves Below piriformis

2. Common peroneal –> may leave below, through or above piriformis

27
Q

Levator Ani + Coccygeus nerves

A

S3-4
Direct branches from sacral plexus
Variable account of root value
Important as it sits ONTOP of the pelvis floor muscles –> at risk of compression

28
Q

Clinical relevance of Levator Ani innvervation from sacral plexus

A

Levator ani nerve sits superior/ontop of the pelvis floor –> at risk of compression
Pregnancy –> increased pressure on pelvis from abdomen –> compression/impingement of levator ani nerve –> Lost innervation of levator ani/pelvic floor muscles –> Predisposition of abdominal viscera prolapse –> decreased ability to contain pelvic/fecal contents within cavity/continence

29
Q

Pudendal Nerve

A 
Motor and sensory: 
1. Levator Ani: Innervates some of the pelvic floor from BELOW (runs under piriformis, and then hooks back under pelvic floor into peroneal region)
2. External and Internal Anal Sphincter
3. Sphincter urethrae
4. Bulbospongiosus
5. Ischiocavernosus
6. Transverse Perineals
7. Dorsal nerve to clitoris/Penis
8. Scrotal/Labia
Sensory: 
Perineum and associated structures
30
Q

Pudendal nerve s2-4 in males

A
  1. Inferior Rectal
  2. Perineal nerve
  3. Dorsal nerve of penis/clitoris
  4. Scrotal/labial branches
31
Q

Nerve table

A

Know bold

32
Q

Autonomic innervation to pelvic viscera

A

Sympathetic chain output: T1-L2

Parasympathetic: cranial gut = C3,7,9,10 + Pelvic splanchnic (hind gut)

Sita GenitoUrinary System (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions