Pelvic Viscera Flashcards
List the Pelvic cavity boundaries
Pelvic inlet (Greater and lesser)
Pelvic outlet
Pelvic girdle
What are the pelvic divisions? (2)
Greater pelvis -> some abdominal viscera live here
Lesser pelvis -> between the pelvic inlet and outlet
What are the contents of the pelvic cavity?
Distal ureters
urinary bladder
rectum
pelvic genital organs
blood vessels
lymphatics
nerves
Abdominal viscera over flow - small intestine (ileum) and large intestine (appendix, sigmoid colon)
What is the perineum?
Between the thighs and buttocks and from the pubic symphysis to ischial tuberosities
make up of the genitalia and anus
What is the anterior triangle of the perineum called?
Urogential triangle
What is the posterior triangle of the perineum called?
Anal triangle
What bones make up the pelvis?
Pelvic girdle that includes - Ilium, Ischium, and Pubis
Sacrum
How are the bones of the pelvis put together?
The Ilium, Ischium, and pubis all come together to form the Acetabulum and form the hip joint
What muscles are included in the pelvic floor?
Coccygeus
Levator Ani - Puborectalis, Pubococcygeus, and Iliococcygeus
What are the muscles of the pelvic floor also called?
Pelvic Diaphragm
How are the muscles of the pelvic floor arranged?
Form somewhat of a funnel/hammock across the floor of the pelvis
supports the organs above it
How does the puborectalis assist with fecal continence?
it forms a sling around the anorectal junction
pulls anorectum anteriorly to prevent fecal incontinence
Describe the difference between male and female pelvic girdles
Males -> Android shape, usually for heavier builds, holds larger muscles and is more heart shaped
Females -> Gynecoid shape, rounded and more oval with a wider transverse diameter, adapted for child birth
Describe the peritoneal coverage of pelvic viscera in males
Covers from the anterior abdominal wall -> over bladder -> to the rectum
inferior 1/3rd of rectum is sub peritoneal
Describe the peritoneal coverage of pelvic viscera in females
Covers from the anterior abdominal wall -> over bladder -> over uterus -> to rectum
inferior 1/3rd of rectum is sub peritoneal
What is the Broad Ligament of the uterus?
Extraperitoneal
contains uterine tubes, ovaries & ligaments, and round ligaments of the uterus
connects it to the lateral pelvic sidewalls
makes uterus look like a butterfly
Tree map of the arterial supply and branches to the pelvis
Aorta -> Common Iliac artery -> Internal and External Iliac artery
Internal Iliac artery
-> anterior -> viscera
-> posterior
-> 1) Iliolumbar -> either a) Iliac branch (Ilium) OR b) Lumbar branch (Psoas major, QL)
-> 2) Lateral sacral arteries -> spilt into Superior/inferior which split into spinal branches of anterior (meninges of sacral roots) & posterior (erector spinae)
-> 3) Superior Gluteal (gluteal muscles)
Level of vessels from most medial to most lateral in pelvis
Arteries
Veins & lymphatics
Nerves
How do male gonadal arteries differ from other arteries entering the pelvis?
Aorta -> Gonadal (testicular) artery -> transverses inguinal cavity -> enters scrotum
Doesn’t enter the lesser pelvis
supplies abdominal ureter, testis, and epididymis
How do female gonadal arteries differ from other arteries entering the pelvis?
Aorta -> Ovarian artery (above inferior mesenteric artery but below renal arteries) -> runs along ureters -> crosses external iliac vessels & then runs medially and divides -> to Ovarian and Tubal branches
Map of venous drainage from the pelvis
Internal & External Iliac veins -> Common Iliac veins -> IVC
some drainage through superior rectal vein -> inferior mesenteric vein -> Hepatic portal vein
Map of lymph drainage from the pelvis
External Iliac nodes -> Internal Iliac nodes -> Common iliac nodes
Sacral nodes either through Internal OR common Iliac nodes
Describe the Somatic nerve supply to the pelvis
Sacral Plexus (L4-S3/4)
- Pudendal (S2-4)
serves perineum & sensory to external genitalia
Coccygeal Plexus (S4-5) & coccygeal nerves
- serves coccygeus & levator Ani muscles (pelvic
floor)