Osteo Flashcards
Where is the arcuate line, and what is its importance?
Medial aspect of ilium
One of three components of pelvic brim
One of two components of linea terminalis
What does the auricular surface of the ilium articulate with?
Auricular surface of sacrum
On the iliac crest, what projects superiorly? What is on the medial aspect?
Iliac tubercle
Iliac tuberosity
Where is the superior attachment for the inguinal ligament?
Anterior superior iliac spine
What does the pubic symphyseal surface articulate with?
Contralateral coxal bone to form pubic symphysis
What is on the lateral aspect of the pubic crest?
Pubic tubercle
What is the pectin pubis (pectineal line) continuous with, and what does it form?
Continuous with arcuate line of ilium
Forms linea terminalis and coxal part of pelvic brim
Where is the iliac fossa, and what does it contain?
Medial aspect of the ilium
Iliacus m.
What is the obturator crest?
Ridge on lateral aspect of superior pubic ramus
Where is the obturator groove?
Inferior to obturator crest
What is the obturator groove continuous with?
Obturator foramen
What does the obturator groove transmit?
Obturator nerve
Obturator artery
Obturator vein
The ___ projects towards the acetabulum, while the ___ projects toward the ischial ramus
Superior pubic ramus
Inferior pubic ramus
Describe the location of the body of the ischium
Posterior to obturator foramen
Anterior to ischial spine
Where does the ischial spine project?
Posteriorly between greater and lesser sciatic notches
Describe the ischial tuberosity
Posteroinferiorly directed roughened area
Describe greater sciatic notch
Posterior edge of ischium
Inferior to iliac ala
Superior to ischial spine
Describe lesser sciatic notch
Posterior edge of ischium
Between ischial spine and ischial tuberosity
Ischial ramus projects toward ___
Inferior pubic ramus
What is the inferior gap in the acetabular rim called?
Acetabular notch
What is the depression in the central acetabulum called?
Acetabular fossa
What is the smooth surface around the acetabular fossa called?
Lunate surface
What forms the obturator foramen?
Superior and inferior pubic rami
Ischial ramus
Body of ischium
Iliopubic eminence projects anteriorly at the ___
Iliopubic junction
The area of overlap between the ischial ramus and inferior pubic ramus is called ___
Ischiopubic ramus
What is composed of the arcuate line of the ilium and pecten pubis and is the coxal contribution to the pelvic brim?
Linea terminalis
What is the bony arch between right and left inferior pubic and ischial rami?
Pubic arch
The apex of the pubic arch is at the ___
Pubic symphysis
The angle immediately inferior to pubic symphysis is the ___
Subpubic angle
The bony pelvis includes…
Paired coxal bones, sacrum, coccyx
Pelvic girdle describes….
Paired coxal bones joined anteriorly at pubic symphysis
Superior articulating process projects superiorly and articulates with ____
Inferior articulating process of L5
Sacral promentory is the ___ and is the sacral contribution to the ___
Anteriorly projecting edge of vertebral body of S1
Pelvic brim
Vertebral body of S1 articulates with ___
Vertebral body of L5
Sacral ala project ___ and contribute to pelvic brim
Laterally
Auricular surface of sacrum articulates with ___
Auricular surface of ilium
Median sacral crest is made from ___
Fused spinous processes
Medial (intermediate) sacral crest is made up from
Fused articulating processes
Lateral sacral crest is made from ___
Fused transverse processes
Sacral tuberosity is located ___ and forms ___
Lateral to lateral sacral crest
Fibrous articulation with iliac tuberosity
Posterior (dorsal) sacral foramina are __ than anterior sacral foramina
Smaller
What do the posterior (dorsal) sacral foramina transmit?
Dorsal ramus of sacral spinal nerves
What is the resultant gap left by absence of lamina and spinous process of S5?
Sacral hiatus
What projects inferiorly and are inferior articulating processes of S5?
Sacral cornua
How many transverse lines are on the ventral surface of the sacrum? What do they represent?
4
Fusion of sacral vertebrae
What do the anterior (ventral) sacral foramina transmit?
Ventral ramus of sacral spinal nerves
What is the continuation of the vertebral foramina?
Sacral canal
What does the sacral canal transmit?
Cauda equina
What is spondylolysis?
When the vertebral arch of L5 separates from the vertebral body
What is spondylolisthesis?
Abnormal anteriorly directed separation of L5 vertebral segment from the sacrum
What is the superior pelvic aperture? Where is it? What forms it?
Pelvic inlet/brim
Between greater and lesser pelves
Sacral promentory, superior edge of sacral ala, arcuate line of ilium, pectin pubis, posterior edge of pubic crest, and superior edge of pubic symphysis
What is the inferior pelvic aperture? What is it bound by?
Pelvic outlet
Inferior edge of pubic symphysis, inferior pubic and ischial rami, ischial tuberosities, sacrotuberous ligaments, and coccyx
What is the passage between superior and inferior pelvic aperture?
Pelvic canal
Describe the coccyx
3-5 fused vertebrae
Embryological remnant
Coccygeal cornua articulates with ____
Sacral cornua
Transverse process on coccyx is present ___
Only on superior most coccygeal segment
Describe male pelves compared to female.
Males have thicker, heavier pelves Deeper greater pelvis Narrower and deeper lesser pelvisf Android pelvic inlet Small pelvic outlet Narrow pubic arch Round obturator foramen Large acetabulum
Compare female pelves to male
Females have thinner, lighter pelves Shallow greater pelvis Wide and shallow lesser pelvis Gynecoid pelvic inlet Large pelvic outlet Wide pubic arch Oval-shapped obturator foramen Small acetabulum
Describe pelvic shapes
Android (classically male)
Gynecoid (classically female)
Anthropoid (elongated anterior to posterior)
Platypelloid (elongated laterally)
What are often broken on both sides as a result of pelvic fractures or crush fractures? Why?
Superior and inferior pubic rami
Articulated pelvis is a bony ring and therefore difficult to break in only one place
Describe the interpubic disc
Fibrocartilaginous disc between right and left pubic symphyseal surfaces
Where does the anterior longitudinal ligament travel?
On ventral surface of vertebral bodies
Onto ventral surface of sacrum
Where does the posterior longitudinal ligament travel?
On dorsal surface of vertebral bodies
Onto anterior wall of sacral canal
What is the ligamentum flavum?
Pale yellow fibers which travel on ventral surfaces of vertebral laminae
Onto posterior wall of sacral canal
What ligaments are absent on L5 vertebral segment and sacrum?
Interspinous ligament
Intertransverse ligament
Supraspinous ligament
Where does the iliolumbar ligament travel?
From L5 transverse processes
To iliac crest
Where does the lumbosacral ligament travel?
From L5 transverse process and body
To sacral ala
What is the annulus fibrosis of the intervertebral disc?
Tough fibrous outer region
What is the nucleus pulposus of the intervertebral disc?
Soft gelatinous inner portion
Obturator membrane is located where?
Stretched across obturator foramen
Where does the inguinal ligament travel?
From pubic tubercle of pubic
To anterior superior iliac spine of ilium
What is the union between the symphyseal surfaces of right and left pubic bones, which are separated by fibrocartilaginous disk?
Pubic symphysis
What does the pubic symphysis consist of?
Superior pubic ligament
Inferior pubic ligament (arcuate pubic ligament)
Interpubic disk
What stretches across the acetabular notch?
Transverse acetabular ligament
What are the joints at L5 and sacrum?
Lumbosacral joint
Intervertebral joint: symphysis
Zygopophyseal joint: planar synovial
Describe the joints between the coxal bone and the sacrum?
Sacroiliac: compound joint
Anteriorly between auricular surface of sacrum and articular surface of ilium: planar synovial
Posteriorly between sacral and ischial tuberosities: fibrous syndesmosis
Where does the sacrospinous ligament travel?
From ventral sacrum
to ischial spine
Where does the sacrotuberous ligament travel?
From ventral sacrum
To ischial tuberosity
Describe the long posterior sacroiliac ligament
Two bands that originate from the posterior superior iliac spine and median sacral crest (S3,4)
Then blend inferiorly with sacrotuberous ligament
Describe the short posterior sacroiliac ligament
Originates from median sacral crest (S1, 2)
Inserting on to posterior surface of iliac crest and iliac tuberosity
The interosseous sacroiliac ligament is deep to what ligament?
Posterior sacroiliac ligament
Describe the joint of the sacrum and coccyx, and what are the ligaments associated?
Sacrococcygeal: symphysis
Anterior sacrococcygeal ligament
Posterior sacrococcygeal ligament
What produce the ligamentous borders which produce greater sciatic foramen and lesser sciatic foramen from the greater sciatic notch and lesser sciatic notch?
Sacrotuberous ligament
Sacrospinous ligament
Describe the layering of the fascia of the pelvis and perineum
Peritoneum
Pelvic fascia
Membranous pelvic fascia (visceral and parietal) & Endopelvic fascia (loose and condensed)
Perineal fascia
Describe the peritoneum
Dips down out of abdomen into pelvis to cover, but not surround the pelvic viscera
What does the male peritoneum cover?
Superior and lateral aspects of urinary bladder and rectum
What is the paravesicle fossae?
Depressed areas lined with peritoneum on either side of the bladder
What is the pararectal fossae?
Depressed areas lined with peritoneum on either side of rectum
What is the rectovesicle pouch?
Depressed area lined with peritoneum between rectum and urinary bladder
In male only
Describe the female peritoneum
Covers superior and lateral aspects of urinary bladder, uterus, uterine tubes, ovaries, and rectum
What is the broad ligament of the uterus?
Double layer of peritoneum (mesentery) that extends from lateral pelvic walls to uterus
What does the broad ligament enclose?
Uterus, uterine tubes, round ligament of the uterus, ligament of the ovary
What makes up the broad ligament?
Considered to have 3 parts: mesometrium, mesosalpinx, mesovarium
But also includes suspensory ligament of ovary
What is the mesometrium?
part of broad l. That supports the uterus
Also surrounds ligament of ovary and round l. Of uterus
What is the mesosalpinx?
Part of the broad l. That supports the uterine tubes
What is the mesovarium?
Part of the broad l. That supports the ovaries
What is the suspensory ligament of the ovary?
Prolonged lateral extension from the ovary enclosing ovarian vessels
What is the vesicouterine pouch?
Depressed area lined with peritoneum between urinary bladder and uterus
What is the rectouterine pouch?
Cul-de-sac of Douglas
Depressed area lined with peritoneum between uterus and rectum
What is pelvic fascia and spaces a continuation of? What are the components?
Endoabdominal fascia into pelvis
Has a membranous component and endopelvic component
What does the parietal pelvic fascia line?
Muscular wall of the pelvis: Obturator internus m. Piriformis m. Levator ani ms. Coccygeus m.
What lines the muscular walls of the pelvis (obturator internus m., piriformis m., levator ani ms., coccygeus m)?
Parietal pelvic fascia
What does the obturator fascia line?
Lines the pelvic side of the obturator internus m.
What lines the pelvic side of the obturator internus m?
Obturator fascia
What is the obturator fascia continuous with?
Continuous superiorly with transversalis fascia
What does the obturator fascia form?
Walls of the pudendal canal
Tendinous arch of the levator ani ms.
What forms the walls of the pudendal canal and the tendinous arch of the levator ani ms.?
Obturator fascia
What does the visceral pelvic fascia surround?
Pelvic viscera, except where pelvic viscera penetrates pelvic diaphragm where parietal and visceral layers come together to form the tendinous arch of pelvic fascia
What are part of the tendinous arch of pelvic fascia?
Male: puboprostatic ligament (anterior), rectoprostatic ligament (posterior)
Female: pubovesicle ligament (anterior), uterosacral ligament (posterior)
Rectoprostatic and uterosacral ls. Are also known as sacrogenital l.
What do the puboprostatic/pubovesicle ls. And rectoprostatic/uterosacral ls. Form?
Tendinous arch of pelvic fascia
What is loose endopelvic fascia? What are the associated spaces?
Fat-filled potential spaces
Retropubic (prevesical) space, paravesical space, pelvierctal space, retrorectal (presacral) space
Retropubic (prevesical) space, paravesical space, pelvirectal space, and retrorectal (presacral) space are considered as what?
Loose endopelvic fascia
Where is the retropubic (prevesical) space?
Between pubis and urinary bladder
What is the retropubic (prevesical space) continous with?
Continous posterolaterally with paravesical space
What space is between the pubis and urinary bladder?
Retropubic (prevesical) space
Where is the paravesical space?
Between obturator fascia and anterior part of hypogastric sheath
What space is between the obturator fascia and anterior part of hypogastric sheath?
Paravesical space
What separates the paravesical space from the pelvirectal space?
Hypogastric sheath
What spaces does the hypogastric sheath separate?
Paravesical and pelvirectal spaces
What does the pelvirectal space surround?
Rectum
What is the rectum surrounded by?
Pelvirectal space
What separates the pelvirectal space into anterior and posterior parts?
Lateral rectal ligament
What does the lateral rectal ligament separate into anterior and posterior parts?
Pelvirectal space
Where is the retrorectal (presacral) space?
Between sacrum and rectum
What space is between the sacrum and rectum?
Retrorectal (presacral) space
What is the retrorectal (presacral) space continuous with?
Continuous anterolaterally with pelvirectal space
Describe the condensed endopelvic fascia
Increased density of collagen and elastic fibes
Compartmentalizes loose endopelvic fascia
What consists of increased density of collagen and elastic fibers and is responsible for compartmentalizing loose endopelvic fascia?
Condensed endopelvic fascia
Describe the hypogastric sheath
Thick band of condensed fascia that serves as a conduit for nerves and vessels going form lateral pelvic wall to pelvic viscera (including ureters and ductus deferens (male)). It is divided into anterior, middle, and posterior lamina
What is the thick band of condensed fascia that serves as a conduit for nerves and vessels going from lateral pelvic wall to pelvic viscera, including ureters and ductus deferens (male)?
Hypogastric sheath
What is the lateral ligament of the bladder an extension of?
Hypogastric Sheath to the urinary bladder
What is the extension of the hypogastric sheath to the urinary bladder?
Lateral ligament of the bladder
What are the middle lamina of the hypogastric sheath?
Male: rectovesical septum
Female: transverse cervical ligament
The rectovesical septum and the transverse cervical ligament are what part of the hypogastric sheath?
Middle lamina
Where is the rectovesical septum?
In males, between the rectum and the urinary bladder
In males, what is between the rectum and urinary bladder?
Rectovesical septum
What is the transverse cervical ligament an extension of?
Extension of the hypogastric sheath to the uterus
What is the extension of the hypogastric sheath to the uterus?
Transverse cervical ligament
What is the lateral rectal ligament an extension of?
Extension of the hypogastric sheath to the posterior aspect of the recturm
What is the extension of the hypogastric sheath to the rectum?
Lateral rectal ligament
The perineum is a quadrangular space, what makes up the four points?
Pubic symphasis (anteriorly), coccyx (posteriorly), and the two ischial tuberosities (laterally)
If a line is drawn between the ichial tuberosities of the quadrangular space, what is anterior, and what is posterior?
Anteriorly: the urogenital triangle
Posteriorly: the anal triangle
Where is the ischioanal fossa?
Around the wall of the anal canal
Inferior to the pelvic diaphragm
What is around the anal canal and inferior to the pelvic diaphragm?
The ischioanal fossa
Describe the ischioanal fossa:
It is narrow superiorly, wide inferiorly
Filled with fat and loose connective tissue that allows for expansion of the anal canal during defecation
What is filled with fat and loose connective tissue and allows for expansion of the anal canal during defecation?
Ischioanal fossa
What is the pudendal canal and what does it transmit?
Space inside obturator fascia
Transmits internal pudendal a. And v. And pudendal n.
What transmits the internal pudendal a. And v. And pudendal n.?
Pudendal canal
What does the anal triangle consist of?
Ischioanal fossa and pudendal canal
What does the urogenital triangle consist of?
Perineal membrane Superficial perineal fascia Deep perineal fascia Superficial perineal pouch Deep perineal pouch
Where does the perineal membrane extend?
Extends between the two sides of the pubic arch
What extends between the two sides of the pubic arch?
Perineal membrane
What does the perineal membrane cover?
Anterior portion of the inferior pelvic aperture
What covers the anterior portion of the inferior pelvic aperture?
Perineal membrane
What is the superficial fascia continuous with?
Superficial fascia of the abdomen
What are the components of the superficial perineal fascia?
Fatty (superficial) superficial perineal fascia
Membranous (deep) superficial perineal fascia
What does the fatty (superficial) superficial perineal fascia form in the female and the male?
Female: fatty layers of the labia majora and the mons pubis
Male: penis and scrotum
The fatty layers of the labia majora and the mons pubis in females, and penis and scrotum in males are formed by what?
The fatty (superficial) superficial perineal fascia
What does the membranous (deep) superficial perineal fascia form?
The Dartos Fascia of the penis and scrotum
What forms the Dartos Fascia of the penis and scrotum?
Membranous (deep) superficial perineal fascia
What is the deep perineal fascia in the male vs. female?
Male makes up deep fascia of the penis and perineal membrane
Female exists primarily as perineal membrane
Where is the superficial perineal pouch?
Between membranous superficial perineal fascia and the perineal membrane
What is between the membranous superficial perineal fascia and the perineal membrane?
Superficial perineal pouch
In the male, what are the contents of the superficial perineal pouch?
Bulb and crura of the penis,
Superficial perineal muscles,
Proximal spongy urethra,
Branches of the internal pudendal a. And v., and of the pudendal n.
In the female, what are the contents of the superficial perineal pouch?
Crura of the clitoris Bulbs of the vestibule Superficial perineal muscles Greater vestibular glands Branches of the internal pudendal a. And v. And of the pudendal n.
Describe the deep perineal pouch:
Open superiorly
Lies inferoanteriorly to the urinary bladder
In the male, what are the contents of the deep perineal pouch?
Membranous urethra
Muscles of the urogenital diaphragm
Bulbourethral glands
In the female, what are the contents of the deep perineal pouch?
Muscles of the urogenital diaphragm
