Pelvic Floor and Wall Flashcards
FEATURES OF THE INNOMINATE BONE
What type of joint is that lumbosacral joint?
Secondary cartilaginous
What type of joint is the pubic symphysis?
Secondary cartilaginous
FEATURES OF THE SACRUM
What do the sacrotuberous and sacrospinous ligaments form?
- Greater sciatic foramen
- Lesser sciatic foramen
What type of joint is at the anterior sacroiliac ligament?
Synovial joints
What type of joint is at the posterior sacroiliac ligament?
Fibrous
What type of joint is at the posterior sacroiliac ligament?
Fibrous
Identify this muscle.
Iliacus
What is the origin and insertion of the iliacus?
Origin = Iliac fossa
joins psoas = iliopsoas
Insertion = lesser trochanter of femur
What is the function of the iliacus muscle?
Hip flexion
What is the innervation of the iliacus muscle?
Femoral nerve
Identify this muscle.
Psoas
What is the origin and insertion of the psoas muscle?
Origin = T12-L4 bodies and IV discs (superficial) and L1-5 (deep)
Insertion = Lesser trochanter of femur
What is the function of the psoas muscle?
- Hip flexion
- Bend trunk laterally
- Raise trunk from supine position
What is the innervation of psoas muscle?
Lumbar plexus direct branches L2-4 ant. rami
Identify this muscle.
Obturator internus
What is the origin and insertion of the obturator internus?
Origin = inner surface of obturator membrane
Insertion = medial surface of greater trochanter of femur
What is the function of the obturator internus muscle?
Lateral rotation of the hip
What is the innervation of the obturator internus?
Nerve to obturator internus direct from sacral plexus (L5,S1)
Identify this muscle.
Piriformis
What is the origin and insertion of the piriformis?
Origin = pelvic surface of sacrum
Insertion = greater trochanter of femur
What is the function of the piriformis muscle?
Lateral rotation of the hip joint
What is the innervation of the piriformis muscle?
Nerve to piriformis direct branch of sacral plexus (S1,2)
What is the function of the pelvic diaphragm?
Muscular floor to prevent prolapse
What 2 muscles make up the pelvic diaphragm?
- Levator ani
- Coccygeus
Identify this muscle.
Coccygeus
What is the origin and insertion of the coccygeus muscle?
Origin = ischial spin and sacrospinous ligament
Insertion = coccyx and inferior sacrum
What is the function of the coccygeus?
- Support pelvic viscera
- Flexion of the coccyx
What is the innervation of the coccygeus?
Direct branches from sacral plexus (S4,5)
What happens when the levator ani relaxes?
- Urination
- Defecation
What are the levator ani muscles?
- Pubococcygeus
- Iliococcygeus
What is the pubococcygeus divided into?
- Puborectalis
- Levator prostatae (males)
- Pubovaginalis (females)
Identify the coccygeus, iliococcygeus and pubococcygeus in this diagram.
Describe the pubococcygeus in males.
- Most medial fibres pass around prostate
- Insert into perineal body
(levatore prostatae)
Describe the pubococcygeus in females.
- Most medial fibres pass around vagina
- Insert into perineal body
(pubovaginalis)
What innervates the pubococcygeus?
- Motor innervation from pudendal nerve
- Nerve to levatore ani
Describe the puborectalis.
- Fibres mix wit ext. and int. anal sphincter
- “sling” around rectum to help with faecal continence
What innervates the puborectalis?
- Pudendal nerve S2-4
- Nerve to levatore ani (S4)
Where does the iliococcygeus attach? (tendinous arch of levatore ani)
- Fascia of the obturator internus
- Anococcygeal body/ligament/levator plate
What innervates the iliococcygeus?
- Pudendal nerve
- Nerve to the levator ani
What makes up the perineal body?
Fibrous connective tissue
What attaches to the perineal body?
- Levator prostatae
- Pubovaginalis
- External anal sphincter
- Perineal muscles
Where is the parietal pelvic fascia located and what does it form?
- Covers internal wall
- Thickened over obturator internus to form tendinous arch of pelvis
What does the parietal pelvic fascia form anteriorly in males?
Puboprostatic ligament
What does the parietal pelvic fascia form anteriorly in females?
Pubovesical ligament
What is the function of the visceral pelvic fascia?
- Covers organs
Where do the parietal and visceral fascia blend?
As organs pierce the pelvic floor
What is the paracolpium?
Lateral extension of visceral fascia from vagina to tendinous arch
What is the function of endopelvic fascia?
Acts as packing material around organs
What are the 2 types of endopelvic fascia?
- Loose
- Condensed
What is the function of loose endopelvic fascia?
Fills spaces in the pelvis
What is condensed endopelvic fascia?
Thickenings of the fascia
What is the primary condensation of condensed endopelvic fascia?
Hypogastric sheaths running along posterolateral walls of pelvis
