Lecture 6: Pelvis I Flashcards
anasthetic for vaginal delivery and surgery, injection made where pudendal n. crosses ischial spine, transvaginal or transcutaneous
pudendal block
passes behind ischial spines, from ventral rami of S2, S3, S4, nerve supply of pelvic floor
pudendal nerve
subpubic angle <90, heart shaped inlet, small outlet, ischial spines point inward
male pelvis
subpubic angle >90, round inlet, large outlet
female pelvis
when pelvic joints and ligaments relax from sex hormones and relaxin
pregnancy
ligaments among the strongest in the body, cause of back pain
sacroiliac ligaments
support pelvic viscera, create 90 degrees between rectum and anal canal (for continence), raises to increase intra-abdominal pressure
pelvic floor muscles (levator ani, pelvic diaphragm)
specific muscle that creates 90 degrees between rectum and anal canal (for continence)
pubo rectalis muscle
when weak pelvic floor muscles alter the position of the neck of the bladder or urethra
urinary stress incontinence
below pelvic floor, diamond shaped area
perineum
anterior, posterior, and lateral borders of perineum
pubic symphysis, sacrum, ischial tuberosities
2 triangles of perineum
anal, urogenital
deep to superficial perineum
superior fascia of UG diaphragm, UG diaphragm muscle, inferior fascia of UG diaphragm, roots of external genitalia, superficial fascia, skin
roots of external genitalia
2 crura (ischiocavernosus), bulb (bulbospongeosus)
muscle across perineal space, anterior to anus
superficial transverse perineal muscle
between vagina and anal canal, connective tissue where 8 muscles converge
perineal body
incision to perineal body to prevent tearing during childbirth
episiotomy
UG diaphragm, membranous urethra, bulbourethral glands
male deep perineal pouch
erectile structures that form penis, urethra
male superficial perineal pouch
UG diaphragm, urethra, vagina
female deep perineal pouch
erectile structures of clitoris, bartholin’s glands
female superficial perineal pouch
mother artery of the pelvis
internal iliac artery
arteries of posterior division of internal iliac artery
iliolumbar, lateral sacral, superior gluteal (large)
arteries of anterior division of internal iliac artery (8)
umbilical, superior vesicle, inferior vesicle (vagina), middle rectal, obturator, internal pudendal, inferior gluteal, uterine
path of lymph from superficial inguinal nodes
superficial inguinal nodes, deep inguinal nodes, external iliac nodes, common iliac nodes, aortic nodes
ventral rami that form sacral plexus
L4-S4
end nerves of sacral plexus
sciatic, posterior femoral cutaneous, pudendal
