pelvic wall and floor Flashcards
Name two secondary cartilagenous joints in the pelvic region?
lumbrosacral and pubic tubercle
Pelvic boundaries
Posterior wall…..
sacrum, coccyx, piriformis
Pelvic boundaries Floor….
floor= muscular pelvic diaphragm
Pelvic boundaries Anterior wall …..
Pubic bodies, pubic rami and pubic symphysis
which two ligaments form the greater and lesser sciatic foramen?
Sacrotuberous and sacrospinous
what is the inguinal ligament?
The inguinal ligament is a band running from pubic tubercle to anterior superior spine. It forms base of inguinal canal through which an indirect inguinal hernia may develop
which sacroiliac ligament is fibrous?
Posterior
Which sacroiliac ligament is synovial?
Anterior
Name the two male hip shapes
Gynecoid and Android
Name the two female hip shapes
Anthropoid and Platypelliod
Wall muscles - iliacus
> Iliac fossa to join psoas as iliopsoas and insert into lesser trochanter of femur
hip flexion
Femoral nerve
Wall muscles - psoas
> T12- L4 bodies and intervertebral discs (superficial) and L1-L5 (deep) to join iliacus as iliopsoas - lesser trochanter of femur
> hip flexion, bend trunk laterally (one), raise trunk from supine position (both)
> Lumber plexus direct branches L2-4 anterior ramii
Name the three gluteal muscles
Gluteus maximus, medius and minimus
Where do the gluteal muscles attach ?
They attach to pelvic bones but not within pelvic cavity
*more in lower limb lectures
Wall muscles - obturator externus
> outer surface of obturator membrane to trochanteric fossa of femur
Wall muscles - obturator internus
> inner surface of obturator membrane to medial surface of greater trochanter of femur
> Lateral rotation of hip
> Nerve to obturator internus direct from sacral plexus (L5,S1)
Wall muscles - piriformis
> Pelvic surface of sacrum to greater trochanter of the femur
Lateral rotataion of hip
Nerve to piriformis direct branch of sacral plexus (S1, S2)
What is the function of the pelvic diaphragm?
Muscular floor to prevent prolapse
What muscles make up the pelvic diaphragm?
Levator ani and coccygeus
What muscle is the muscular roof of the anal triangle?
Levator ani
Coccygeus
> Ischial spine and sacrospinous ligament to the coccyc and inferior sacrum
> support pelvic viscera, flexion of coccyx
> Direct branch from sacrall plexus (S4,5)
Levator ani is made up of two main muscles called…
Pubococcygeus and Iliococcygeus
Pubococcygeus
most medial fibres, attach to and support vagina/prostate gland and rectum
Iliococcygeus
more lateral fibres of levator ani, anterior ro coccygeus
What is pubococcygeus split into?
Puborectalis, levator prostatae and pubovaginalis
Function of levator ani
Supports the pelvic viscera - contract during forced expiration, coughing etc
Must relax to allow urination and defecation
Pubococcygeus gets motor innervation from …
pudendal nerve and nerve to levator ani
Levator prostatae
Males= most medial fibres pass around the prostate and insert into the perineal body
Pubovaginalis
Females= most medial fibres pass around vagina and insert into perineal body
Puborectalis
Both sexes
Fibres mix with those from external anal sphincter, modified as a sling around the rectum to help maintain faecal continence
Important after rectum has filled (internal anal sphincter open)
Nerve innervation of Puborectalis
Pudendal nerve (S2-4) and nerve to levator ani (S4)
3 angles of puborectalis
Tonic, Contract , Relax
Iliococcygeus
Attaches to fascia of obturator internus and the anococcygeal body/ligament /levator plate
More fibrous than pubococcygeus
What is described as the tendinous arch of levator ani
Iliococcygeus
Nerve innervation of Iliococcygeus
Pudendal nerve and nerve to levator ani
What is the perineal body composed of and what attaches here?
Perineal body is composed of fibrous connective tissue
Levator prostatae, pubo vaginalis, external anal sphincter and perineal muscles attach here
Parietal pelvic fascia
covers internal wall
thickened over obturator internus to form tendinous arch of pelvis
Anterior> puboprostatic ligament (male) pubovesical liamenr (female)
Visceral pelvic fascia
Covers organs , parietal and visceral blend as organs pierce the pelvic floor
What is the lateral extension of vicera; fascia from vagina to tendinous arch called?
Paracolpium
Endopelvic fascia
Acts as a packaging material around the organs,
2 basic types of endopelvic fascia
Loose and Condensed
Loose endopelvic fascia
Fills spaces in the pelvis …e.g the retropubic (pre-vesical) space
Condensed endopelvic fascia
Thickenings of fascia …eg the primary condensation is the hypogastric sheaths running along the posterolateral walls of the pelvis
