Pelvic contents

Question 1

What is the greater and lesser sciatic notch?

Answer 1

In terms of an ‘os conxa’ bend posteriorly between the ilium and the ischium

lesser sciatic notch: between ischial spine and ishcial tuberosity

Question 2

What are parts of the sacrum?

Answer 2

Wings or ala superiorly on each side
4 ant./post. sacral foramen either side
sacral canal
inferiorly and post is sacral hiatus for caudal nerve blocks

Question 3

What forms the pelvic inlet? (true vs false pelvis)

Answer 3

sacral promontory, sacral alae, arcuate line, pectineal line, pubic crest, pubic tubercles, PS

True is below this line

Question 4

What is the pelvic tilt? (NB sacrum has 40 degree backwards tilt)

Answer 4

The 60degree anterior tilt the pelvis has, such that the ASIS is is line with the pubic tubercles/symphysis

Question 5

What are the pelvic boundaries?

Answer 5

pelvic inlet
posteriorly bony (sacrum, coccyx, piriformis)
anteriorly: pubic boines
floor: muscular diaphragm

Question 6

What is the difference between a male and female pelvis?

Answer 6

Male: sub pubic angle < 90 degrees; heart shaped inlet; small pelvic oulet
female: sub pubic angle > 90 degrees; circular inlet and outlet

Question 7

What two pelvic ligaments must we know

Answer 7

sacrotuberous (sacrum to ischial tuberosity)
Sacrospinous ( sacrum tio ischial spine)

Form greater and lesser sciatic foramen

Question 8

Muscles of the pelvic wall and where do they travel

Answer 8

Obturator internus (LSF) and piriformis (through greater sciatic foramen)

Question 9

What are the vessel pasages?
GSF: (above or below piriormis)
LSF: (

Answer 9

GSF:
-above piriformis: superior gluteal n. and a
-below piriformis: inferior gluteal n. and a. ; sciatic nerve (L4-S3) ; post. cutaneous nerve of the thigh (S1-3);
everythang

LSF: these have left the greater sciatic foramen and come back into the pelvis

• internal pudendal a. and pudendal nerve (S2-S4)
• n. to obturator internus

Question 10

What are the branches of the internal iliac artery?

Answer 10

Ant and posterior divisions
Anterior:
vesicular: Umbilical (fibrous), superior vesical 2/3 branches (bladder) and inferior vesical to prostatic (uterine in F to vaginal)
Visceral: Uterine, vaginal, middle rectal
Parietal: Obturator, internal pudendal, inferior gluteal

Posterior: superior gluteal

Question 11

What is the venous drainage?

Answer 11

All veins drain to the internal iliac vein

EXCEPT deep dorsal vein of penis/ clitoris;
-drains into prostatic/ vesicular plexi through ant. deficiency in perineal membrane.
Note that rest of perineum drains drains back with internal pudendal vein

Question 12

Lumbosacral plexus nerve roots

Answer 12

L4-S4

out of ant. sciatic foramina

Question 13

Gluteal nevres

Answer 13

Sup. Gluteal: L4-S1 Gl. medius and minimus

Inf. Gluteal: L5-S2

Question 14

Sciatic nerve

Answer 14

L4-S3

tibial nerve always below piriformis, CP changes

Question 15

Nerve to levator ani and coccygeus

Answer 15

S3-4.

At risk of being compressed by things in pelvis

Question 16

Pudendal nerve and branches

Answer 16

S2-4
perineal muscles. Motor and sensory of perineal region
Branches: inf. rectal; perineal; dorsal nerve to clitoris/ penis; scrotal/labia

Question 17

What are the two ANS nerve plexi involved

Answer 17

Superior hypogastric: on sacral promontory

Inferior hypogastric: pelvic floor

Question 18

Pelvic sympathetic supply roots, pathway and functions

note supplies hindgut

Answer 18

L1-2
Contraction of internal urethral and anal sphincters, ejeaculation and moving epididymis stuff
Fibres DESCND from sup. hypogastric plexus and from sacral splachnic. Two hypogastric nerves

Question 19

Pelvic parasympathetic supply pathway and functions

note supplies hindgut

Answer 19

vasodilation and bladder contraction

ASCEND via hypogastric nerves to abdomen or direct into inf hypogastric plexus