Module 10 Pelvis and Perineum Flashcards
What is the “line” that divides the pelvis?
Iliopectineal line (AKA pelvic brim)
What is the region above the iliopectineal line referred to as?
Pelvic major (false pelvis)
What is the region below the iliopectineal line referred to as?
Pelvic minor (true pelvis)
What are you sitting on right now?
Ischial tuberosity
What does the iliopectineal line transform into in the pubis?
pectineal line
What are the boundaries of the superior pelvic aperture-pelvic inlet (brim)
Poster-Promontor and ant border of ala
Lat-Iliopectineal line
Anter-Pubic symph, pectin puis, pubic crest
What are the boundaries of the inferior pelvic aperture-pelvic outlet?
Post-sacrum and coccyx
Lat-ischial tuberosities, sacrotuberous ligaments
Ant-pubic symp, arcuate ligament, rami of pubis and ischium
So the superior pelvic outlet is looking from the ________ to the _______
top to the bottom
The inferior pelvic outlet is looking from the ______ to the _____
bottom to the top
What are the boundaries of the major pelvis (false pelvis)
above the pelvic brim
and wall, iliac fossa, and L5-S1
What is contained in the major (false) pelvis?
Abdominal viscera (ileum of SI and sigmoid colon)
What are the boundaries of the minor (true) pelvis?
Below the pelvic brim
Above the pelvic outlet (floor)
Pelvic surfaces of hip bones, sacrum and coccyx
What is contained in the minor (true) pelvis?
Mostly reproductive organs
What forms the acetabulum?
Junction of 3 hip bones (hip socket)
Acetabular notch
lunate
margin
What forms the obturator foramen?
Rami of pubis and ischium
So the obturator foramen is different than the obturator canal how?
The foramen in the small hole in the ligamentous material contained in the foramen. The canal is where the obturator nerve comes through.
M/F? Larger bones?
Male
M/F? Shallower false pelvis?
Female
M/F? Oval shaped pelvic inlet?
Female
What shape is the males pelvic inlet?
heart shaped
What shape is the female obturator foramen?
Oval or triangular
What shape is the male obturator foramen?
round
What two ligaments maintain stability between Left and R pelvic bone?
Superior pubic ligament and Inferior pubic ligament
Where is most of the support in regards to the vertebropelvic ligaments?
Posterior region
Attachments-Iliolumbar ligament
L4/5-iliac crest
Attachments-Sacrotuberous ligament
Lateral sacrum/coccyx-Ischial tuberosity
Attachments-sacrospinous ligament
Caudal border of sacrum to ischial spine
What forms the anterior pelvic wall?
Pubic symphysis
Obturator internus
Body and rami of pubic bones
What forms the lateral pelvic wall?
Obturator internus
Attachm-obturator internus
Pelvic surface of ilium and ischium and obturator membrane—>Greater trochanter of femur
Innervation -obturator internus?
Obturator nerve
What forms the lateral pelvic wall?
Sacrum and portion of the ilium
SI joints and their ligaments
Piriformis muscle
Attach: Piriformis m.
sacral pelvis numb. 2 and 4, superior margin of sciatic notch, and sacrotuberous ligament–>Greater trochanter of femur
So both the muscles of the lateral and anterior pelvic wall attach up top and run down to where?
The Greater trochanter of the femur
What muscles make up the floor of the pelvis?
Puborectalis
Pubococcygeus
Iliococcygeus
Ischicoccygeus
What muscles are considered Levator Ani?
Pubrectalis
Pubococcygeus
Iliococcygeus
What does Levator Ani do?
resists intraabdominal pressure
Which is the U shaped muscle that is a “lasso” around the anorectal junction?
Puborectalis
Where does the Levator Ani attach?
Body of pubis, obturator membrane, and ischial spine—->Coccyx, walls of prostate or vagina, rectum and anal canal
Where does the common iliac artery bifurcate?
L4
Which artery passes through the false pelvis only?
External iliac artery
Which vessel in the pelvis becomes the femoral artery?
External iliac artery
Posterior division of internal iliac provides blood to _____?
The organs
Anterior division of the internal iliac artery provides blood to ______?
Outside wall of the pelvis
Where does the Ilioinguinal nerve go?
passes inferolateral and anterior to quadratus lumborum
What does the ilioinguinal nerve supply?
skin-suprapubic and inguinal
motor-abdominals
Where does the femoral nerve go?
Lateral to blood vessel as it enters thigh deep to inguinal ligament
What does the femoral nerve supply?
Posterior divisions
Hip flexors
Extensors of knee
What does the obturator nerve supply?
Anterior diviisons, adductors of the thigh
Sacral plexus divides into _____ and ______
Posterior division (common peroneal) and Anterior division (tibial nerve)
Where is the urinary bladder located?
in the true pelvis (below the brim)
What is the name of the part of the posterior wall that is made of specialized smooth muscle of the bladder wall?
Trigone
What is the smooth muscle that lines the walls of the bladder called?
detrusor
What is the skeletal muscle that forms a sphincter around the urethra as it passes through the urogenital diaphragm?
External urethral sphincter
What is the smooth muscle that forms a sphincter at the junction the bladder and urethra?
Internal urethral sphincter
Where is sperm produced?
Seminiferous tubules
How do the testes develop?
Retroperitoneally and descend into the scrotum
What are the three parts of the epididymis?
Head, body tail
What are the functions of the epididymis?
Storage and maturation of sperm
Propulsion of sperm into ductus deferns
Where does the ductus deferens begin?
Epididymus tail
Where does the ductus deferens enter the pelvis?
Deep inguinal ring
Where does the ductus deferens end?
At the ampulla of the ductus deferent where it merges with the semnal vesicle and becomes the ejaculatory duct
What does epididymis contain that is good for sperm?
fructose (nutrition)
What is Florence’s test?
Test to determine if fructose and choline (which is not produced anywhere in the body except the seminal vesicles) is present on sexual assault victims.
What does the prostate produce?
Fluid that combines with sperm and fluid of bulbourethral gland and seminal vesicle to produce semen (seminal fluid)
Which lobe of the prostate is MC to hypertrophy?
Posterior lobe
Which lobe of the prostates is MC to develop BPH?
Middle lobe
What doe bulbourethral glands secrete?
(Cowper’s Gland)-Muscus like secretion
T/F scrotum is a cutaneous pouch that contains fat as well as reproductive organs?
F-No fat in the scrot!
What is contained in the Scrotum?
Testes and epididymis
What are the layers of the scrotum consistent with?
Layers of the abdominal wall.
What is the cremaster muscle a continuation of?
Internal oblique muscle
What part of the penis fills with 90% of the blood?
Cavernosa
What forms the body of the penis
Corpus spongiosum
Corpus cavernosa
The root of the penis contains what?
Crura
bulb
The head of the penis is formed by what?
Terminal corpus spongiosum
Where does the urethra pass through?
corpus spongiosum
What are the 3 divisions of the male urethra?
Prostatic
Membranous (peroneum)
Spongy (cavernous)
What do the ovaries secrete?
estrogen
progesterone
Where is the uterus located?
between the rectum and the bladder
What are the 3 layers of the wall of the uterus?
Perimetrium (outer)
Myometrium (middle)
endometrium (inner)
What is the MC gynecological malignancy?
Cervical cancer
Front to back order of openings external landmarks of the vagina?
Clitoris Vestibule Vestibule contains: Urethra vaginal opening
Define the perineum
Diamond shaped space that is part of the pelvic outlet
What are the boundaries of the perineum?
Ant- Pubic symphisis Ant/Lat-Ischiopubic rami Lat- Ischial tubero Post/Lat-Sacrotuberous lig Post-Coccyx
What are the 2 subdivisions of the perineal triangle?
Urogenital triangle
anal triangle
What are the subdivisions of the urogenital triangle?
Superficial perineal space
Deep perineal space
What are the muscles of the superficial perineal space?
Ischiocavernosus m.
Bulbospongiousus m.
Superficial transverse perineal m.
What is the space located between the superficial perineal fascia (collets fascia) and inferior fascia of urogenital diaphragm called?
Superficial perineal space
What is the space located between inferior fascia of origin diaphragm and superior fascia of urogenital diaphragm called?
Deep perineal space
What are the muscles of the anal triangle?
Obturator internus
Levator ani
Sphincter ani externus
coccygeus