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Gross Anatomy 3 > Pelvic walls and floor > Flashcards

Pelvic walls and floor Flashcards

1
Q

What are the 2 main parts of levator ani?

A

Pubococcygeus - more medially

Iliococcygeus - more laterally

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2
Q

Describe the parietal pelvic fascia of the pelvis

A

Covers the internal wall of the pelvis. Thickens over the obturator internus to form the tendinous arch of the pelvis and levator ani

Anteriorly it forms the puboprostatic ligament and the pubovesical ligament

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3
Q

Describe the endopelvic fascia

A

Acts as a packing material around the organs and there are 2 types - loose and condensed

Loose fills spaces in the pelvic e.g. the retropubic (pre-vesical) space
Condensed are thickenings of the fascia e.g. the hypogastric sheaths running along the posterolateral walls of the pelvis

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4
Q

Describe the attachments of iliacus muscle

A

Originates at the iliac fossa
Joins with the psoas muscle to create iliopsoas
Inserts into the lesser trochanter of the femur

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5
Q

What is the perineal body?

A

A small piece of fibrous tissue that lies in the pelvic floor at the edge of the urogenital diaphragm between the openings of the vagina (female), urethra (male) and the anal canal

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6
Q

Describe the visceral pelvic fascia

A

Covers the pelvic organs. The parietal and visceral fascia blend as the organs pierce the pelvic floor.

Lateral extension of the visceral fascia from the vagina to the tendinous arch forms the paracolpium

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7
Q

Describe the sacrum and its articulations

A

Formed of 5 fused sacral vertebrae

Articulates with the L5 vertebrae and the coccyx

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8
Q

What muscles attach to the perineal body?

A

Puboprostaticus
Pubovaginalis
External anal sphincter
Perineal muscles

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9
Q

What is this muscle and its functions?

A

Psoas
Hip flexion and bends trunk laterally (one)
Raise trunk from a supine position (both)

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10
Q

What muscle is highlighted?

A

Coccygeus

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11
Q

Describe the path taken by the fibres of pubococcygeus?

A

The fibres pass from the pubic bones to wrap around the prostate/vagina and the rectum
The fibres that wrap around the vagina and prostate insert into the perineal body and are named puboprostaticus and pubovaginalis
In both sexes the more posterior fibres continue to wrap around the rectum - puborectalis

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12
Q

What are the attachments of piriformis?

A

Originates on anterior/pelvic surface of the sacrum
Passes through greater sciatic foramen to cross the gluteal region
Inserts into greater trochanter of femur

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13
Q

What are some of the features that increase the internal diameter of the female pelvis?

A

Pubic angle at the pubic symphysis is wider
Ischial spines don’t protrude into the pelvic cavity as markedly
Sacrum is flatter than what is seen in a male

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14
Q

What is the innervation of the iliacus muscle?

A

Femoral nerve

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15
Q

What is the innervation of the psoas muscle?

A

Lumbar plexus - direct branches of L2-4 anterior rami

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16
Q

What joint classifications are the lumbosacral and pubic symphysis joints of the pelvis?

A

Secondary cartilagenous - allows for the cushioning of stresses passing into the pelvis from the trunk and passing around the pelvic bowl

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17
Q

What is the role of the cocygeus muscle?

A

Supports the pelvic viscera and flexion of the coccyx

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18
Q

What muscle is highlighted?

A

The puborectalis of the pubococcygeus

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19
Q

What is the classic shape of the female pelvis?

A

Gynecoid

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20
Q

What is this muscle and its function?

A

Obturator internus

Lateral rotation of the hip

21
Q

What muscle is highlighted?

A

Pubococcygeus

22
Q

What are the attachments of iliococcygeus?

A

Attaches to obturator internus fascia - the tendinous arch of levator ani
Attaches to the anococcygeal ligament also called the levator plate

23
Q

What is the role of the levator ani?

A

Supports the pelvic viscera and prevents prolapse of pelvic organs - contract during forced expiration and coughing etc.
Relaxes to allow urination and defecation

24
Q

What is this muscle and its innervation?

A

Piriformis - nerve to piriformis, a direct branch of the sacral plexus (S1, S2)

25
Q

What nerves form on the superior surface of the piriformis muscle?

A

Sciatic and pudendal nerves

26
Q

What are the attachments of obturator externus?

A

Outer surface of the obturator membrane to the trochanteric fossa of the femur

27
Q

What are the attachments of posas?

A

Originates at T12-L4 bodies and intervertebral discs (superficial) and L1-L5 (deep)
Joins with iliacus as iliopsoas
Inserts into the lesser trochanter of the femur

28
Q

What forms the inguinal ligament?

A

The aponeurosis of the external oblique as it rolls over itself to create the anterior wall and floor of the inguinal canal

29
Q

What structures does the pubococcygeus support?

A 
Supports the vagina in women and the prostate gland in men. Also supports the rectum. 
Divided into further parts;
 - Puborectalis
 - Puboprostaticus
 - Pubovaginalis
30
Q

What muscle is highlighted?

31
Q

What is the function of piriformis?

A

Lateral rotation of the hip

32
Q

What are the 2 muscle blocks that make up the pelvic diaphragm?

A 
Levator Ani (anteriorly)
Coccygeus (posteriorly)
33
Q

What is the classic shape of the male pelvis?

34
Q

What is the innervation of levator ani?

A

Nerve to levator ani and the pudendal nerve

35
Q

What forms the pelvis?

A

2 inominate bones that articulate with each other and the sacrum

36
Q

What muscle is highlighted and what is its function?

A

Iliacus - hip flexion

37
Q

What are the attachments of the coccygeus muscle?

A

Ischial spine and sacrospinous ligament

Attaches to the coccyx and inferior sacrum

38
Q

What are the 2 large ligaments of the sacrum?

A

Sacrotuberous

Sacrospinous

39
Q

What are the boundaries of the pelvis?

A

Anterior wall is bony - pubic bones, rami and symphysis
Posterior wall is bony - sacrum and coccyx
Laterally - piriformis
Floor - is the muscular pelvic diaphragm
Superior inlet is open to the abdominal cavity

40
Q

What is the innervation of obturator internus?

A

Nerve to the obturator internus direct from the sacral plexus (L5, S1)

41
Q

What are the different fascia types of the pelvis?

A

Parietal pelvic fascia
Visceral pelvic fascia
Endopelvic fascia

42
Q

Describe the sacroiliac joints

A

Combination of a synovial plane joint anteriorly, that is protected by the anterior sacroiliac joint and a fibrous joint posteriorly that is protected by the posterior sacroiliac joint

43
Q

True or False?

The pelvic contents are retroperitoneal

A

False! - the are subperitoneal

The pelvic contents are covered by a continuation of the peritoneal lining of the abdominal cavity which is what forms the pouches in males and females

44
Q

What muscle covers the external surface of the obturator foramen?

A

Obturator externus

45
Q

What muscle is highlighted?

A

Illyococcygeus

46
Q

What is the innervation of coccygeus?

A

Direct branches from the sacral plexus - S4, S5

47
Q

What are the attachments of obturator internus?

A

Inner surface of the obturator membrane to the medial surface of the greater trochanter of the femur

48
Q

Describe the attachments of the sacral ligaments

A

Sacrotuberous passes to the ischial tuberosity
Sacrospinous passes to the ischial spine

Forms the posterior boundaries of the greater and lesser sciatic foraminae

49
Q

What is the role of puborectalis?

A

Acts to maintain faecal continence by bending the rectum
There is a small amount of tonic contraction to support the pelvic organs but the muscle can further contract to increase the bend in the rectum or it can relax making it straighten, allowing faeces to pass through

Gross Anatomy 3 (14 decks)

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