pelvic anatomy Flashcards
pelvic inlet boundaries
ant: symphysis pubis
post: promontory and ala of sacrum
lat: iliopectineal lines
pelvic outlet boundaries
ant: symphysis pubis
post: coccyx
anterolat: ischiopubic ramus
posterolat: sacrotuberous ligament
parts of the hip bone
ilium, pubis, ischium and acetabulum (where the three bones fuse)
parts of the pelvic girdle (posterior to anterior)
coccyx, sacrum, ilium, ischium, pubis, pubic symphysis
parts of the sacrum
sacral promontory (anterior lip of S1), anterior sacral foramen, sacral canal (entry for cauda equina), sacral hiatus
parts of the coccyx
fusion of the spinal column’s last 3-4 vertebrae
parts of the iliac fossa
anterior superior iliac spine, anterior inferior iliac spine, iliac crest, sacroiliac joint
parts of the pubis
superior rami, pubic crest, pubic tubercle, pubic symphysis, inferior rami
parts of the ischium
ischial spine, ischial tuberosity, inferior rami
male vs female pelvic bones
bones: heavier and thicker vs lighter and thinner
pelvic cavity: narrow and deep vs wide and shallow
pelvic inlet: heart shaped and small vs oval
sacrum: narrow, long and straight vs wide, short and curved
subpubic angle: acute vs large
coccyx: less flexible, curved vs flexible, straight
ischial spine: medially inverted vs everted
pelvic ligaments and their connections
sacrospinous ligament (sacrum to iliac spine)
sacrotuberous ligament (sacrum to pubic tuberosity)
obturator membrane (pubis to ischium)
foramens in the pelvis
greater sciatic foramen, lesser sciatic foramen, obturator canal
pelvic floor hiatuses
rectal/anal hiatus and urogenital hiatus
pelvic floor muscles
levator ani muscles (anterior to posterior): puborectalis, pubococcygeus, iliococcygeus
coccygeus muscle
levator ani origin and insertion
origin: ant - pubic body of hip bone, lat - tendinous arch of obturator internus, post - ischial spine
insertion: u-shaped sling inserting at pubis, coccyx, perineal body, anococcygeal ligament
coccygeus origin and insertion
origin: ischial spine
insertion: back wall of pelvis
prostate functions
produce part of seminal fluid to nourish and transport sperm in semen
prostate lobes and zones
lobes: anterior, median, posterior
zones: fibromuscular stroma, transitional zone (BPH), central zone, peripheral zone (prostate cancer)
ejaculatory duct anatomy
paired structures formed by the union of vas deferens and seminal vesicle duct, passing through the prostate and opening into the prostatic urethra
prostatic urethra parts
prostatic sinuses, urethral crest (where ejaculatory ducts open), prostatic utricle, ducts of glandular elements of prostate, ejaculatory ducts
uvula vesicae cause and treatment
uvula vesicae is a projection into the bladder caused by the middle lobe of prostate, may obstruct the passage of urine from the bladder and is surgically removed
uterus components
consists of the fundus, body and cervix, internal os between cervix and uterus and external os between cervix and vagina
anteversion and anteflexion of uterus angles
anteversion: long axis of cervix to long axis of vagina (90°)
anteflexion: long axis of uterus to long axis of cervix (170°)
where is the incision of lower segment caesarean section done?
isthmus uteri: between the internal os and upper 1/5 of the cervix
broad ligament location
extends from the sides of the uterus to the lateral walls of the pelvis, enveloping the uterine vessels, lymphatics, ovarian ligament, and vestigial remnants of mesonephric tubules
parts of the broad ligament
mesometrium: around the uterus
mesosalphinx: around the fallopian tube
mesovarium: around the ovary
fibromuscular (cardinal) ligament location
extends between the cervix and the side of the pelvic wall, uterine artery travels to the uterus through this ligament anterior to the ureter
structures playing a role in uterine support
- pelvic diaphragm
- cardinal ligament
- perineal body
- anteversion and anteflexion of uterus
- round ligament of uterus
- urogenital diaphragm
- uterosacral ligament
- pubocervical ligament
- broad ligament
fallopian tubes anatomy
transport the ova from the ovaries to the uterus, consist of the fimbriae, infundibulum, ampulla, isthmus, interstitium
where does fertilisation usually occur?
ampulla of the fallopian tubes
types of tubectomy of the fallopian tubes
banded, tied, cauterized tubectomy
types of ovarian cysts
dermoid cyst, functional cyst, endometrioma, benign cystadenoma, polycystic ovary syndrome
divisions of the internal iliac artery
anteriorly: obturator, middle rectal, superior vesical, uterine (in females), inferior vesical (/vaginal in females), inferior gluteal, internal pudendal
posteriorly: superior gluteal, iliolumbar, lateral sacral
prostatic venous vasculature
prostatic veins form a plexus around the sides and base of the prostatic gland, receiving the deep dorsal veins of the penis and draining into the internal iliac veins
uterine arterial vasculature
internal iliac arteries –> ureter at upper part of cervix –> branches to cervix + vagina + runs alongside uterus –> anastamose superiorly with ovarian artery at fallopian tubes
uterine arteries anastamose extensively with each other across the midline
fallopian tube vasculature
supply by tubal branches of the ovarian artery (directly from aorta) and uterine artery (from internal iliac artery) which anastamose below the tube between the broad ligament
uterine venous drainage
uterine veins follow the artery along the lower edge of the broad ligament to drain into the internal iliac vein
uterine innervation
inferior hypogastric plexus innervation
sympathetic: T12 + L1 to produce uterine contraction and vasoconstriction
parasympathetic: S2, S3, S4 pelvic splanchnic nerves to produce uterine inhibition and vasodilation
pelvic pain line associations
structures above or in contact with the inferior peritoneum: visceral pain is conveyed via symp splanchnic nerves
structures below the inferior peritoneum: visceral pain conveyed via parasymp pelvic splanchnic nerves
rectocele definition
rectum pushing into post vaginal wall (due to weakening of pelvic floor muscles and connective tissue bw the back wall of the vagina and rectum)
cystocele definition
bladder pushing into anterior vaginal wall (due to weakening of pelvic floor muscles and connective tissue supporting the bladder and front wall of vagina)
