Pelvic Wall and Floors Flashcards
Arrangement of bones in the pelvis
An inominate bone on either side and a sacral bone in the middle
what covers the obturator foramen
Fascia and muscle layer
what attaches to the ischial tuberosity
Small lateral rotators of the hip and the hamstrings
What is normally attaches to the greater and lesser sciatic notch
Ligaments
what does the attachment of ligaments to the sciatic notches form
foramen
what type of joints are the lumbrosacral joint and the pubic symphysis
Secondary cartilaginous
what is the pubic symphysis
the joint between the two inominate bones and acts as a shock absorber
Where does the rectus femoris muscle attach
the anterior inferio riliac spine
what is the sacrum formed from
fused vertebrae
what do the foramen within the sacrum allow
for the nerve roots to pass out
what are the anterior and posterior walls of the pelvis
bony
what is the floor of the pelvis
A muscular sheet called the pelvic diaphragm
what are the ligaments within the pelvis
sacrotuberous, sacrospinous and the inguinal ligament
what ligaments form the greater and lesser sciatic foramen
sacrotuberous and sacrospinous
where does the inguinal ligament run from/to
anterior superior iliac spine to the pubic tubercle
what are the ligaments within the sacrum
anterior and posterior sacroiliac ligaments
what does the anterior sacroiliac ligament form
a synovial joint between the bones
what does the posterior sacroiliac ligament form
a fibrous joint that provides support
What does the ligament at the pubic symphysis form
a fibrocartilaginous joint
pubic arch in males and females
sacrum is more curved in males
pubic arch is more acute in females due to the angle of the hips
Normal shapes for pubic arch in females and males
females - gynecoid
males - anthropoid
Iliacus
Iliac fossa -> join psoas to form iliopsoas and inserts into the lesser trochanter of the femur
Flexes the hip
Femoral nerve innervation
Psoas attachment
T12-L4 vertebral bodies and IV discs - superficial
L1-L5 vertebral bodies and IV discs - deep
insertion of psoas
Joins iliacus to form iliopsoas and inserts into the lesser trochanter of the femur
Function of psoas
hip flexion
one - bend trunk laterally
both - raise trunk from supine position
innervation of psoas
L1-3 anterior rami
Gluteal muscles
Gluteus maximus, medius and minimus
Attach to pelvis bones
Act on hip joint
Obturator externus attach/insert
outer surface of obturator membrane -> trochanteric fossa of femur
where is obturator externus and what does it do
underneath the femoral triangle and involved in movement of the femur
obturator internus attach/insert
inner surface of obturator membrane -> medial surface of greater trochanter of femur
obturator internus function
lateral rotation of the hip
innervation of obturator internus
Nerve to obturator internus (L5,S1)
piriformis attach/insert
pelvic surface of the sacrum -> greater trochanter of the femur
piriformis innervation
nerve to piriformis (S1,S2)
function of peliv diaphragm
to prevent prolapse
What makes up the pelvic diaphragm
Levator ani and coccygeus
what is the muscular roof of the anal triangle
levator ani
coccygeus attach/insert
ischial spine and sacrospinous ligament -> coccyx and inferior sacrum
function coccygeus
support the pelvic visera and flexion of coccyx
coccygeus innervation
direct branches from sacral plexus (S4,S5)
different parts of levator ani
pubococcygeous and iliococcygeus
pubococcygeus
most medial fibres
attaches to and supports vagina/prostate gland and rectum
iliococcygeus
ore lateral fibres
anterior to coccygeus
divisions of pubococcygeus
puborectalis, levator prostatae and pubovaginalis
what supports the pelvic viscera
levator ani
what must relax to allow defecation and urination
levator ani
innervation of pubococcygeous
motor innervation from pudendal and nerve to levator ani
puborectalis function
maintain faecal continence
what fibres does puborectalis joint with
external anal sphincter
when is puborectalis especially important
immediately after the rectum has filled
innervation of puborectalis
pudendal nerve and nerve to levator ani
attachment of iliococcygeus
fascia of obturator internus and the annococcygeal body/ligament/levator plate
what is the area of attachment of iliococcygeus to the fascia of the obturator internus known as
The tendinous arch of levator ani
innervation of iliococcygeus
pudendal nerve and nerve to levator ani
what is the perineal body composed of
Fibrous connective tissue
what muscles attach to the perineal body
levator prostatae, pubovaginalis, external anal sphincter and perineal muscles
pouches in the perineum
female - vesico-uterine and recto-uterine
male - vesico-rectal
what covers the internal wall
parietal pelvic fascia
where is the parietal pelvic fascia thickened
over obturator internus
what does the fascia anteriorly form
puboprostatic ligament - males
pubovesical ligament - females
what covers the organs
Visceral pelvic fascia
what is the paracolpium
the lateral extension of visceral fascia from the vagina to the tendinous arch
what acts as packing material around the organs
endopelvic fascia
two types of endopelvic fascia
loose and condensed
function of loose endopelvic fascia
fills spaces in the pelvis e.g. rectopubic space
what are condensed endopelvic fascia
thickening of the fascia
primary condensation
the hypogastric sheaths running along the posterolateral walls of the pelvis
