Pelvic Wall Flashcards
linea terminalis / iliopectineal line
divide pelvis into false and true pelvis
makeup linea terminalis
pubic crest
pecten
pubis arcuate line
form pelvic inlet
sacral promontory
margin of ala
linea terminalis
form pelvic outlet
pubic arch
sacrotuberous ligament
coccyx
pubic symphysis
characteristics of female pelvis
- cavity is broad and shallow
- pelvic inlet oval + outlet round
- bones are lighter thinner
- pubic angle larger ( 80 - 85°)
- coccyx more flexible straighter
- ischial tuberosities shorter more everted
characteristics of male pelvis
- cavity is narrow and deep
- smaller inlet + outlet <3 shaped
- bones heavier thicker
- pubic angle more acute (50-60°)
- coccyx less flexible more curved
- ischial tuberosities longer face more medially
pubic symphysis
- secondary cartilaginous joint (a joint made of hyaline
cartilage and fibrocartilage) - between the left and right pubic bones
- has a superior and inferior pubic ligaments
four joints of the pelvis
- lumbosacral
- sacroiliac
- sacrococcygeal
- pubic symphysis
lumbosacral joint
- symphysis (secondary cartilaginous) (immovable) joint
- between the fifth lumbar vertebra and the base of the
sacrum - action : flexion extension lateral flexion and minimal
rotation of the torso with respect to the pelvis and lower
limbs
sacroiliac joint
- synovial joint
- between the ala of sacrum and the auricular surface o
ilium - action : allows very little mobility through slight gliding
and rotation movements. In women, the ligaments of the
joint soften during pregnancy, enabling the increase of
pelvic diameter during childbirth
sacrococcygeal joint
- amphiarthrodial joint (movable and fibrous)
- between the fifth sacral and first coccygeal segments
- action : allows flexion and extension of the coccyx
pubic symphysis
- secondary cartilaginous joint
- between the medial surfaces of the pubic bones
- action : usually there are no movements of this joint
except in pregnancy when the ligaments and cartilage
soften, allowing the increase of pelvic diameters during
labor
content and boundary of greater pelvis
- abdominal viscera
- bounded by abdominal wall anteriorly
iliac fossa posteriolaterally
L5, S1 vertebrae posteriorly
content and boundary of lesser pelvis
- pelvic viscera
- bounded by the pelvic surfaces of the hip bones sacrum
coccyx inferiorly by the pelvic diaphragm
posterior lateral pelvic wall is formed by
sacrum coccyx parts of ilia the sacroiliac joints and piriform muscle
form pelvic floor
pelvic diaphragm consists of levator and and coccyges muscle and their fasciae
parts of levator ani
consists of three parts pubococcygeus puborectalis iliococcyegeus
origin of levator ani
body of pubis fascia of obturator internus and spine of ischium
insertion of levator ani
perineal body
anoccoccygeal body
wall of prostate vagina rectum and anal canal
innervation of levator ani
fourth sacral nerve and pudendal nerve
action of levator ani
supports pelvic viscera sphincter to anorectal junction and vagina raise the pelvic floor and assist the abdominal muscles in forced expiration activities
perineal body
(or central tendon of perineum) is a pyramidal fibromuscular mass in the middle line of the perineum at the junction between the urogenital triangle and the anal triangle it is found in both males and females
origin of piriformis
front of sacrum
insertion of piriformis
greater trochanter of femur
innervation of pririformis
sacral plexuses
action of piriformis
lateral rotator of femur at hip
origin of obturator internus
obturator membrane and adjoining part of hip bone
insertion of obturator internus
greater trochanter of femur
nerve supply of obturator internus
nerve to obturator internus from sacral plexus
function of obturator internus
lateral rotation of femur at hip joint
origin of coccyges
spine of ischium
insertion of coccyges
lower end of sacrum and coccyx
innervation of coccyges
fourth and fifth sacral nerve
action of coccyges
assists levator ani to support pelvic viscera flexes coccyx
where does the aorta terminate
at L4 where it divides into left and right common iliac arteries
direct branches of the abdominal aorta
external iliac artery internal iliac artery superior rectal artery median sacral artery ovarian artery
branches of the external iliac artery
inferior epigastric artery
deep circumflex artery
branches of the internal iliac artery posterior division
- iliolumbar artery
- superior gluteal artery
- lateral sacral arteries
branches of the internal iliac artery anterior division
- obturator artery
- umbilical artery
- vaginal/uterine artery
- inferior vesical artery
- middle rectal artery
- internal pudendal artery
- inferior gluteal artery
- inferior rectal artery
veinous drainage of pelvis
- inferior vena cava (L5)
- common iliac veins
- internal iliac veins
- external iliac veins (femoral vein)
- testicular or ovarian veins (left or right)
superior rectal artery supplies
the whole of the rectum and the upper part of the anal canal up to the dentate line
middle rectal artery supplies
rectum seminal vesicle vagina
inferior rectal artery supplies
the lower part of the anal canal and the rectum and its supply may extend up to the peritoneal reflection of the rectum
middle rectal artery supplies
the lumbar and sacral vertebra coccyx anorectal junction and posterior part of the rectum
inferior epigastric artery supplies
the anterior abdominal wall muscles and skin of the anterior abdominal wall deep abdominal wall of the pubic and lower umbilical regions spermatic cord
deep circumflex artery supplies
the muscles of the anterolateral abdominal wall the iliac crest and the skin overlying the anterior superior iliac spine (ASIS)
iliolumbar artery supplies
the iliac branch of the iliolumbar artery supplies the ilium and iliacus muscle as well as contributing to anastomoses around the anterior superior iliac spine
the lumbar branch supplies the foramen between L5 and S1 it proceeds towards psoas major and quadrates lumborum which it also supplies
superior gluteal artery supplies
the gluteus maximus and overlying skin, gluteus medius, gluteus minimus, tensor fascia lata. It contributes to anastomoses at the anterior superior iliac spine and the hip joint
inferior gluteal artery supplies
the gluteus maximus, piriformis, internal obturatorius, gemellus superior and inferior and quadratus femurs muscles
inferior gluteal artery gives off a branch to the sciatic nerve
obturator artery supplies
the muscles of the pelvis and the adductors of the thigh obturator externus provides a branch that supplies the head of the femur
passes through the obturator foramen
obturator artery supplies
the muscles of the pelvis and the adductors of the thigh obturator externs provides a branch that supplies the head of the femur
passes through the obturator foramen
umbilical artery
carries deoxygenated, nutrient-depleted blood from the fetus to the placenta
ovarian artery supplies oxygenated blood to the ovary, fallopian tube, and uterus
oxygenated blood to the ovary, fallopian tube, and uterus.
vaginal/uterine artery supplies
in the myometrium the uterine artery further branches out to the arcuate artery, radial artery, spiral artery, and basal artery. The descending branch supplies blood to uterine cervix and vagina
inferior vesical artery supplies
the fundus and neck of the male urinary bladder, prostate, seminal vesicles, vas deferens, urethra and ureter in females when present, it supplies the urinary bladder
internal pudendal artery supplies
the external genitalia
