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ORG-SYS 3rd Shift > pelvic wall > Flashcards

pelvic wall Flashcards

1
Q

pelvis function & loc

A
  • connects trunk to lower ex
  • beneath/below abd. region
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1
Q

root word of pelvis

A

“basin” (bowl-shaped structure)

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2
Q

pelvic orientation

mnemonic: Upper Box sa harap (sys) Din tai Fung sa likod (sac)

A
  • tilted forward
  • symph pub & ASIS same vertical plane
  • symph pub UB
  • sacrum (ant. surface) DF

mnemonic: Upper Box sa harap Din tai Fung sa likod

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3
Q

pelvis function

A
  • transmits weight of body downwards (vertebral column > femurs)
  • support/protect pelvic viscera & lower parts of GI tract (keeps them inside)
  • contains nerves, vessels, lymphatics
  • attaches trunk to LE (muscles)
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4
Q

pelvic wall boundaries (anterior & posterior walls)

A

front/anterior:
symphysis pubis

back/posterior:
sacrum/coccyx
(sacroiliac joint = ilium attaches to each side of sacrum)

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5
Q

pelvic wall articulation (posterior & lateral walls)

A

posterior wall: sacrum/coccyx
lateral wall: hip bone (ischium, ilium, pubis)

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6
Q

(2) parts of pelvis

A

1) true pelvis
2) false pelvis

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7
Q

dividing partition of true & false pelvis

A

pelvic inlet/brim

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8
Q

pelvic inlet/brim is formed by (3) / pelvic inlet boundaries

clue: SP, IL, SYS (mnemonic: SP/ILL mo na yan SyS!)

A

1) sacral promontory
2) iliopectineal lines
3) symphysis pubis

mnemonic: SP/ILL mo na yan SyS!

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9
Q

true pelvis is located _____ of pelvic brim

above or below?

A

below

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10
Q

false pelvis is located ____ of pelvic brim

above or below?

A

above

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11
Q

false pelvis boundaries (APL)

A

anterior: abdominal muscles
posterior: LV
lateral: iliac fossa & iliacus muscle

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12
Q

false pelvis function/support

A
  • supports abdominal content
  • supports gravid uterus at 3 months of pregnancy
  • guides fetus down to the true pelvis during early stages of labor
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13
Q

True/False:

false pelvis has lesser clinical significance than true pelvis

A

true

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14
Q

True/False:

false pelvis is considered part of abdominal cavity

A

true

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15
Q

true pelvis has (3) pelvic …

clue: IOC

A

1) pelvic inlet (brim)
2) pelvic outlet
3) pelvic cavity (between inlet & outlet)

mnemonic: In and Out of Cavite

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16
Q

pelvic inlet function

A
  • divides true and false pelvis
  • serves as “entrance” going inside
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17
Q

pelvic outlet shape

A

diamond-shaped

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18
Q

pelvic outlet is best seen in this position

A

lithotomy position

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19
Q

pelvic outlet boundaries (APL)

A

anterior: pubic arch (symphysis pubis)
posterior: coccyx
lateral: ischial tuberosities

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20
Q

pelvic outlet (3) wide notches

A

1) pubic arch - anteriorly
2) greater & - lat.
3) lesser sciatic notches - lat.

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21
Q

divides greater and lesser sciatic notches

clue: (2) “s” ligaments

A

1) sacrotuberous
2) sacospinous

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22
Q

True/False:

sacrotuberous ligaments also form part of the margin of the pelvic outlet

A

true

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23
Q

between pelvic inlet and pelvic outlet

A

pelvic cavity

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24
Q

pelvic cavity contents (3)

A

1) reproductive organs (especially that of female)
2) lower portions of intestines (sigmoid & rectum)
3) urinary bladder

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25
Q

known as the shallowest wall of true pelvis

A

anterior wall

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26
Q

anterior wall of true pelvis is formed by (3)

A

1) pubic bone
2) superior & inferior ramus of pubis/pubic rami
3) symphysis pubis

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27
Q

most extensive wall of true pelvis

A

posterior wall

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28
Q

True/False:

the posterior wall of the true pelvis is covered by parietal pelvic fascia

A

true

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29
Q

posterior wall of true pelvis is formed by (3)

A

1) sacrum
2) coccyx
3) piriformis muscle

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30
Q

posterior wall of true pelvis (3) openings

A

1) anterior sacral foramina
2) greater &
3) lesser sacral foramina

divided by sacrotub & and sacrospin ligaments

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31
Q

provides an EXIT from true pelvis

A

greater sciatic foramen

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32
Q

provides an ENTRANCE from gluteal region to perineum

A

lesser sciatic foramen

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33
Q

greater sciatic foramen (4) contents

clue/mnemonic: SPINS

A

1) sciatic nerve
2) pudendal nerve
3) superior &
4) inferior gluteal nerves and vessels

mnemonic: SPINS

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34
Q

5 rudimentary vertebrae fused to form a single wedge shape bone

A

sacrum

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35
Q

sacrum boundaries (SIL)

A

superior: 5th LV
inferior: fuses with coccyx
lateral: iliac bone (SI joint)

36
Q

(4) significant sacrum parts

A
  • sacral promontory
  • sacral hiatus
  • sacral canal
  • sacroiliac joint
37
Q

important landmark when measuring the pelvis/level of S1

A

sacral promontory

38
Q

level of S5

A

sacral hiatus

39
Q

contains anterior and posterior roots of lumbar, sacral and coccygeal spinal nerves/opening where nerves passes through before they exit

A

sacral canal

40
Q

connection of sacrum to ilium

clue: joint

A

sacroiliac joint

41
Q

True/False:

sacrum is usually wider in length in female than male

A

true

42
Q

lumbosacral angle

A
  • between L5 (lower body) and S1 (upper body
  • 30 degrees
  • decreased angle > instability
43
Q

coccyx

A
  • four vertebrae fused to form small triangular bone/sometimes 3 or 5
  • also known as “tail bone”
  • articulates with S5 (base of sacrum)
44
Q

True/False:

1st coccyx attaches to S5 and has a rudimentary transverse process and cornua

A

true

45
Q

remains of pedicles and superior articular processes

A

cornua

46
Q

pelvic floor/diaphgram

A
  • forms the inferior wall of true pelvis/inferior boundary of pelvic cavity
  • divides true pelvis into main pelvic cavity (above) and perineum (below)
  • perineum > inferior wall > cavity
  • supports pelvic viscera
47
Q

significance of true pelvis of women

A

true pelvis is where the baby grows and developes

48
Q

gynecoid pelvis characteristics

(frequency, percentage, shape of inlet, subpubic arch, delivery presentations)

A
  • “classic” female pelvis/most common type of pelvis
  • 41%
  • oval at inlet
  • generous capacity/wide subpubic arch (makes delivery of baby easy)
49
Q

anthropoid pelvis characteristics

(frequency, percentage, shape of inlet, subpubic arch, delivery presentations)

A
  • 24% white, 41% black
  • oval at inlet
  • subpubic arch narrowed and has long axis “flipped gynecoid”
  • favors occiput posterior presentations/cephalic delivery
50
Q

android pelvis characteristics

(frequency, percentage, shape of inlet, subpubic arch, delivery presentations)

A
  • most common pelvis seen in males “male pelvis” “funnel-shaped pelvis”
  • 33% white, 16% black
  • triangular shape in the inlet
  • subpubic arch narrowed
  • small babies pass than larger babies
51
Q

platypelloid pelvis characteristics

(frequency, percentage, shape of inlet, subpubic arch, delivery presentations)

A
  • least common type of pelvis
  • 2 %
  • flattened at inlet
  • has a prominent sacrum/sacral promontory pushed forward
  • subpubic arch is wide but ischial spines are prominent
  • favors transverse (sideway) presentations IN BOOK

but in real life scenarios, CS delivery is opted

52
Q

most common to least common pelvis

clue: GAAP

A

gynecoid - anthropoid - android - platypelloid

53
Q

female pelvis characteristics

false pelvis
pelvic outlet
pelvic inlet
pelvic cavity
ischial spine
sacrum
pubic arch

A

false pelvis: shallower

pelvic inlet: oval shape (transversely narrower)

pelvic outlet: larger

pelvic cavity: roomier (more spacious)

ischial spine: everted

sacrum: shorter, wider & flatter

pubic arch: wider and more rounded

54
Q

formed by anterior rami of l4-l5, s1-s4

A

sacral plexus

55
Q

largest nerve in your body

A

sciatic nerve

56
Q

roots of

superior gluteal n./ n. to quadratus femoris
inferior gluteal n. /n. to obt internus
sciatic nerve
nerve to piriformis
posterior cutaneous n. of thigh
pudendal nerve

A

superior gluteal n./ n. to quadratus femoris (L4-S1)

inferior gluteal n. /n. to obt internus (L5-S2)

sciatic nerve (L4-S3)

n. to piriformis (S1-S2)

posterior cutaneous n. of the thigh (S1-S3)

pudendal nerve (S2-S4)

57
Q

true pelvis blood supply (4)

mnemonic: SOMI

A

arteries that enter the pelvic cavity:

  • internal iliac
  • superior rectal
  • ovarian
  • median sacral

mnemonic: SOMI

58
Q

artery that supplies all of the organs within the pelvis

A

internal iliac artery

59
Q

after passing over the pelvic brim, the internal iliac artery divides into (2) trunks

A

anterior & posterior trunks

60
Q

anterior trunk (internal iliac artery) branch & what they supply

umbilical*
vaginal*
middle rectal*
uterine artery*
inferior gluteal
internal pudendal
inferior vesical
obturator artery

A
  • umbilical (sup ves/upper part of bladder)*
  • vaginal (inf ves/vagina & base of bladder)*
  • middle rectal (inf ves/lower rectum)*
  • uterine artery (ovar/uterine & fallopian tube)*
  • inferior gluteal (gsc foramen/post gluteal region)
  • internal pudendal (muscles of anal canal & skin/muscle of perineum)
  • inferior vesical (base of bladder, prostrate, & seminal vesicles)
  • obturator artery (obt. n./medial compartment of thigh)
61
Q

posterior trunk (internal iliac artery) branch & what they supply

superior rectal*
ovarian*
median sacral*
iliolumbar
lateral sacral
superior gluteal

A
  • superior rectal (inf mes/rectum & upper anal canal)*
  • ovarian (abd aorta L1/ovary for female, testicles for men)*
  • median sacral (bifurcation of aorta/sacrum and coccyx anterior surface)*
  • iliolumbar (passes laterally/pelvic inlet, psoas, iliacus)
  • lateral sacral (terminates as post. gluteal/sacrum)
  • superior gluteal (gluteal region)
62
Q

(3) veins of true pelvis (from what/joins what)

A

1) external iliac
- from post. of gluteal region (legs)
- continuation of femoral vein
- receives from inferior epigastric and deep circumflex

2) internal iliac
- from pelvis
- joins external iliac v. to become common iliac

3) median sacral
- from sacrum
- joins (L) common iliac vein

63
Q

(3) lymphatics of true pelvis

A

1) external iliac nodes
2) internal iliac nodes
3) common iliac nodes

64
Q

True/False:

lymph nodes and vessels are arranged in a chain along the main blood vessels

A

true

65
Q

sacroiliac joint characteristics

A
  • synovial (glides)
  • formed by sacrum and ilium
  • supported by: post, ant, & interosseus sacroiliac ligaments
  • transmits weight of body downwards
66
Q

symphysis pubis joint characteristics

A
  • cartilaginous (minimal to no movement)
  • surrounded by ligament that extend from 1 pubic bone to the other
67
Q

sacrococcygeal joint characteristics

A
  • cartilaginous (minimal flex/ext.)
  • between body of sacrum & 1st coccyx
68
Q

surface anatomy

iliac crest
asis
psis
urinary bladder
bladder neck
uterus

A

iliac crest (L4)
- top part of ileum
- landmark used by anesthesiologist for spinal needle

ASIS (end of iliac crest)
- start of inguinal ligament
- anterior end of iliac/lateral end of fold of groin

PSIS (S2/level of middle of SI joint)
- dimple in posterior back
- lower limit of subarachnoid space

urinary bladder (posterior of symphysis pubis)
- children under 6 (abd organ)/adults (joins pelvis)

bladder neck (level of upper border of symphysis pubis)

uterus (lower anterior abdomen 2 months preg./xiphoid process 9 months)

69
Q

at the SI joint divides into external and internal iliac arteries

A

common iliac artery

70
Q

leaves false pelvis passing the inguinal ligament to become a femoral artery

A

inferior epigastric & deep circumflex artery

71
Q

levator ani (3) fibers

A

1) anterior
2) intermediate
3) posterior

72
Q

levator ani anterior fibers

A
  • form a sling around prostate/vagina (levator prostate/sphincter vaginae)
  • insertion: perineal body
  • supports prostate (male)/constricts or expands vagina (female)
  • stabilizes perineal body
73
Q

levator ani intermediate fibers (puborectalis)

A
  • form a sling around junction of rectum & anal canal
  • prevents feces to get out, relax & support release of feces
74
Q

levator ani intermediate fibers (pubococcygeous)

A

pass posteriorly to insert the anoccygeal body

75
Q

True/False:

pubococcygeus muscle pass posteriorly to insert the anococcygeal body

A

true

76
Q

levator ani posterior fibers (ileococcygeus)

A
  • insertion: anococcygeal body/coccyx
  • support pelvic viscera/sphincter to anorectal junction & vagina/helps in valsalva
77
Q

innervation of levator ani

A

s4 & pudendal n. (perineal branch)

78
Q

innervation of coccygeous

A

s4-s5

79
Q

(2) pelvic fascia

A

1) parietal - covers wall
2) visceral - covers organs

80
Q

sacral plexus motor & cutaneous innervation

A

check table

81
Q

autonomic nerves

A

check trans

82
Q

moina

A

check table

82
Q

moina

A

check table

83
Q

lateral wall

A
  • formed by hip bone
  • below pelvic inlet, obt. mem., obt. int. muscle, 2 “s” ligaments & fascia
84
Q

what nerve is L2, 3, 4

A

obturator nerve

85
Q

covered by obturator membrane for passage of obturator nerve

A

obturator foramen

86
Q

(2) groups of muscles in pelvic diaphragm

A

1) levator ani
2) coccygeus

ORG-SYS 3rd Shift (4 decks)

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