Olinger's Clinical Notes (Exam 2) Flashcards
the bony pelvis includes these bones:
the pelvic girdle includes these bones:
the bony pelvis includes these bones: paired coxal bones, sacrum, coccyx
the pelvic girdle includes these bones: paired coxal bones, joined anteriorly at the pubic symphysis
- degenerative joint dz which involves calcification of edges of the vertebral body
- can cause localized pain and stiffness
- condition is characterized by separation of the vertebra arch from the vertebral body
spondylolysis
- degenerative joint dz which involves calcification of edges of the vertebral body
- can cause localized pain and stiffness
- condition is characterized by the anterior displacement of the vertebral body on the inferior vertebral segment
spondylolisthesis
- exists at the pelvic brim, between the greater and lesser pelvises
- formed by the sacral promentory, superior edge of the sacral ala, arcuate line of the ileum, pectin pubis, posterior edge of the pubic crest, and superior edge of the pubic symphysis
superior pelvic aperature
(pelvic inlet)
- bound by the inferior edge of the pubic symphysis, inferior pubic and ischial rami, ischial tuberosities, sacrotuberous ls., and coccyx
- pelvic canal exists between the superior aperature and this structure
inferior pelvic aperature
(pelvic outlet)
What are the sexual differences within pelves?
- males have thicker, heavier pelves, deeper greater pelvis, narrower and deeper lesser pelvis, android pelvic inlet, small pelvic outlet, narrow pubic arch, round obturator foramen, and larger acetabulum
- females have thinner, lighter pelves, a shallow greater pelvis, wide and shallow lesser pelvis, gynecoid pelvic inlet, large pelvic outlet, wide pubic arch, oval-shaped obturatory foramen, and small acetabulum
What are the 4 different types of pelvic shapes?
- android (classically male)
- gynecoid (classically female)
- anthropoid (elongated anterior to posterior)
- platypelloid (elongated laterally)
What part of the pelvis is important to measure for childbirth?
pelvic diameter (conjugates) are important measurements obstetrically to determine the capacity of a female to bear a child
- type of fracture that almost always involve multiple fractures given that the articulated pelvis is a bony ring and therefore difficult to break in any one place
- superior and inferior pubic rami are often broken on both sides as a result of this type of injury
pelvic fracture or crush fracture
What are the ligaments that produce the ligamentous borders to produce greater sciatic foramen and lesser sciatic foramen from the greater sciatic notch and lesser sciatic notch?
- sacrotuberous l.
- sacrospinous l.
the perineum is a quadrangular space when viewed from the inferior aspect, what are the 4 points of the quadrangle?
- pubic symphysis (anteriorly)
- coccyx (posteriorly)
- 2 ischial tuberosities (laterally)
(if a line is drawn between the ischial tuberosities, the quadrangle is divided into 2 triangular spaces, the urogenital triangle (anteriorly), and the anal triangle (posteriorly))
- irregular fibromuscular mass in the midline between anal canal and perineal membrane
- contains collagenous and elastic fibers
- is the attachment for bulbospongiosus m., external anal sphincter m., superficial transverse perineal m., and deep transverse perineal m.
- sometimes classified as a central tendon of the pelvic and urogenital diaphragms
perineal body
- muscle in the female reproductive tract that is described as being smooth muscular mass along the posterior edge of the perineal membrane
deep transverse perineal m.
- composed of 4 muscles: the 3 levator ani ms. (puborectalis, pubococcygeus, iliococcygeus) and the coccygeus m.
- the superficial fascia of this structure also contains small slips of muscle that insert on the urinary bladder, those muscles are the pubovesicalis m. from the pubis to the urinary bladder and the rectovesicalis m. from the rectum to the urinary bladder
pelvic diaphragm
- muscle that produces several small slips of muscle that extend to nearby structures, all sharing similar actions and innervation as the parent muscle
- these muscles include: levator prostate m. (males), pubovaginalis m. (females), and puboperinealis m., and puboanalis m. (in both)
pubococcygeus m.
How do uterine proportions change throughout female lifetime?
- after child birth, female infant uterus has adult proportions (2/3 body to 1/3 cervix) due to maternal hormonal influence
- postpartum into adolescence, uterus reduces to a 1:1 ratio due to lack of hormonal influence
- during puberty and into adulthood, uterus has a 2:1 ratio
- if female is multiparous, uterus develops a 3:1 ratio
- after menopause, uterus returns to a 1:1 ratio
What are the different types of hysterectomies?
- partial: only uterus removed
- total: uterus and cervix removed
- radical: uterus, cervix, fallopian tubes, ovaries, and top portion of vaginal canal removed
- procedure done either abdominally or laparoscopically through the umbillicus
- involves ligating uterine tubes so oocytes never reach uterine cavity
- types: banded, cauterized, tied/cut
ligation of the uterine tubes
- ligation and/or excision of ductus deferens through an incision made in the superior scrotum
- renders resultant ejaculant devoid of spermatozoa
deferentectomy or vasectomy
- occurs w/ increasing male age and can impinge on the prostatic urethra, impeding urination
- this and prostatic cancer can both be determined by digital rectal exam
prostate gland enlargement
What is the difference between internal and external hemorrhoids?
- internal hemorrhoids (“piles”) are the prolapse of the mucosa containing the internal rectal venous plexus, which impede blood flow
- external hemorrhoids: are produced by bloot clots in the external rectal venous plexus, which bulge out the mucosa and overlying skin; usually are very painful
