Pelvic Girdle, Pelvic Cavity, and Neurovascular Structures of Pelvis

Question 1

gynecoid pelvis

Answer 1

normal female type

• rounded oval shape
• wide transverse diameter

Question 2

platypelloid or android pelvis

Answer 2

masculine or funnel shaped, respectively

Question 3

pelvis and forensics

Answer 3

pelvic girdle commonly used to differentiate b/w sexes

Question 4

true conjugate

Answer 4

minimum diameter of lesser pelvis - from middle of sacral promontory to the poterosuperior margin of the pubic symphysis = narrowest fixed distance through which baby’s head must go

Question 5

why can’t true conjugate be measured directly?

Answer 5

bladder in the way

Question 6

diagonal conjugate measurement

Answer 6

palpating the sacral promontory w/ the tip of the middle finger, using the other hand to mark the level of the inferior margin of the pubic symphysis on the examining hand

Question 7

how is true conjugate measured from diagonal conjugate

Answer 7

distance b/w tip of index finger and the marked level of the pubic symphysis - should be 11 cm or more

Question 8

narrowest part of the pelvic canal

Answer 8

interspinous distance - b/w ischial spines

Question 9

pelvic canal

Answer 9

passageway through the pelvic inlet, lesser pelvis, and pelvis outlet

Question 10

how is it determined if the subpubic angle is wide enough for passage of average fetal head at full term?

Answer 10

if three fingers can be inserted into vagina side by side

Question 11

what type of trauma commonly produces fractures of the pubic rami?

Answer 11

anteroposterior compression of the pelvis - during crush accidents

Question 12

what can be fractured when pelvis is compressed laterally?

Answer 12

acetabula and ilia

Question 13

fractures of the bony pelvic ring

Answer 13

almost always multiple fractures or a fracture combined with a joint dislocation

Question 14

what are the weak areas of the pelvis where fractures commonly occur?

Answer 14

• acetabula or surrounding area
• pubic rami
• region of sacro-iliac joints
• alae of the ilium

Question 15

what causes the pelvic ligaments to relax during the latter half of pregnancy?

Answer 15

• increased levels of sex hormones

- hormone relaxin

Question 16

what does relaxation of the pelvic ligaments allow for?

Answer 16

increased movement at the pelvic joints to facilitate passage of the fetus through the pelvic canal

Question 17

what does relaxation of the sacro-iliac ligaments cause?

Answer 17

• less effective interlocking mechanism of the sacro-iliac joint
• greater rotation of pelvis -> lordosis

Question 18

parturition

Answer 18

childbirth

Question 19

what may be injured during childbirth?

Answer 19

• perineum
• levator ani
• ligaments of the pelvic fascia

Question 20

what muscles are torn most often in childbirth?

Answer 20

main and most medial parts of the levator ani - pubococcygeus and puborectalis

Question 21

urinary stress incontinence

Answer 21

dribbling of urine when intra-abdominal pressure is raised during coughing and lifting - can occur due to childbirth

Question 22

prenatal training

Answer 22

attempts to train woman to learn how to relax voluntarily the muscles of the pelvic floor while simultaneously increasing intra-abdominal pressure through contraction of the diaphragm and anterolateral abdominal wall muscles

Question 23

hysterectomy

Answer 23

excision of uterus

Question 24

what may be injured during ligation of uterine artery during hysterectomy?

Answer 24

ureter

Question 25

ovariectomy

Answer 25

excision of ovary

Question 26

what may be injured during ligation of ovarian artery during ovariectomy?

Answer 26

ureter

Question 27

hemostasis

Answer 27

arrest of bleeding

Question 28

collateral pathways to the internal iliac artery

Answer 28

include these pairs of anastamoses:

• lumbar and iliolumbar
• median sacral and lateral sacral
• superior rectal and middle rectal
• inferior gluteal and profunda femoris

Question 29

what pelvic nerve is vulnerable to injury during surgery?

Answer 29

obturator nerve - injury may cause painful spasms of thigh adductors and sensory deficits in medial thigh