Lecture 8: Pelvic contents Flashcards

1
Q

Describe pelvic tilt:

A

60 degree tilt anteriorly

  • ASIS in line with pubic tubercle
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2
Q

Describe the pelvic boundaries:

A

Ant, Post and Lat walls = bone
Floor = Pelvic diaphragm

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3
Q

What two ligaments for the greater and lesser sciatic foramen?

A

Sacrotuberous and sacrospinous ligaments

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4
Q

Whats of note when it comes to the branches of the internal iliac:

A

Large branching vessels have a consistent pattern

Small branching vessels have a huge variation

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5
Q

What are the venous drainage of the pelvis?

A

Rich venous plexuses surrounding

  • Bladder
  • Prostate
  • Rectum
  • Uterus
  • Vagina

All draining to internal iliac veins

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6
Q

What are the exceptions for venous drainage?

A

Deep dorsal vein of the penis / clitoris

Rest of perineum drains back with internal pudendal vein

DDVoP/C passes through anterior deficiency in Perineal membrane and then into Vesical/Prostatic plexuses

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7
Q

What nerves contribute to the sacral plexus? and where do the nerves it generates go?

A

L4,5 S1-4

Mostly going to innervate structures external to plevis BUT some important nerves to pelvis and perineum

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8
Q

What are the roots of the superior and inferior gluteal, what is there name based off and what do they innervate?

A

Superior gluteal (L4,L5,S1) - To gluteus medius and minimus

Inferior gluteal (L5,S1,S2) - To gluteal maximus

Pass superior and inferior to piriformis muscle respectively.

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9
Q

What contributes to the sciatic nerve? what can it be divided into and what do they pass respectively to?

A

Sciatic nerve L4-S3

Tibial part, usually leaves below piriformis

Common fibular part, may leave above, below or through piriformis (ANOTHER ANATOMICAL VARIATION)

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10
Q

What nerves contribute to the levator ani and coccygeus?

A

S3-S4

Damage/Compression here can result in relaxation of the external anal sphincter

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11
Q

What forms the pudendal nerve and whats are its functions?

A

S2-4

Perineum function and sensation (Motor and Sensory)

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12
Q

What nerves come off the pudendal n.?

A
  • Inf. rectal
  • Perineal
  • Dorsal nerve to clitoris / penis
  • Scrotal / labial
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13
Q

What is the root and action of the sciatic nerve:

A

L4-S3

Motor/sensory of the hamstrings / legs

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14
Q

What is the nerve, root, action of the post. femoral cutaneous?

A

S1-S3

Sensory: Post thigh, post leg and perineum

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15
Q

What is the nerve, root, action of the pudendal nerve?

A

S2-S4

Motor/sensory: Levator ani, ext. anal sphincter, ext. urethral sphincter, bulbospongiosus, ischiocavernosus, sensory to perineum and associated structures.

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16
Q

What is the nerve, root, action of the n. to lev ani/coccygeus:

A

S3-4

Motor: Lev ani. and coccygeus

17
Q

What are the 2 ANS plexuses of the pelvic viscera?

A
  • Superior hypogastric (Ant. body of L5 and sacral promontory)
  • Inferior hypogastric (Right and Left) - Pelvic floor

NB both ascend to supply the terminal hindgut

18
Q

What is the role of the sympathetic fibres in the ANS plexuses of the pelvis?

A
  • L1/2 fibres
  • Contract internal urethral and anal sphincters (continence)
  • Ejaculation
  • Moving secretions along epididymis
19
Q

What is the role of the parasympathetic fibres in the ANS plexuses of the pelvis?

A
  • S2-4 fibres
  • Vasodilation i.e for erections in males and females
  • Stimulate contraction of bladder
20
Q

Describe the anatomy of the sympathetic innervation of the pelvis:

A
  • L1/2 fibres mostly
  • DESCEND into plevis via superior hypogastric plexus AND directly form SACRAL SPLACHNIC NERVES
  • Plexus splits to form two big HYPOGASTRIC NERVES
21
Q

Describe the anatomy of the parasympathetic innervation of the pelvis:

A

S2-4

  • Ascend via hypogastric nerves to sup. hyposgastric plexus and into abdomen
  • Direct into inf. hypogastric plexus.
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36
Q

Whats this?

A

Saddle fracture