Pelvis 1 & 2 Flashcards
What is the bony pelvis made up of (3)?
1) hip bones (os coxa)
2) sacrum
3) coccyx
What are the three hip bones?
1) ilium
2) ishium
3) pubis
Which of the three hip bones is the biggest?
ilium
Which of the three hip bones is posterior?
ischium
Which of the three hip bones is anterior?
pubis
What do all three hip bones converge to?
acetabulum
The arcuate line of ilium is continuous with ____ ____ in pubis
pectineal line
What makes the pelvic brim?
1) pectineal line of pubis
2) arcuate line of ilium
3) sacral promontory
What is the significance of pelvic brim?
boundary that separates greater and lesser pelvis
lower part of abdominal cavity; superior to pelvic inlet
greater pelvis
actual pelvis; inferior to pelvic inlet and superior to pelvic outlet
lesser pelvis
This is a synovial joint that joins the sacrum to ilium and it helps transfer weight to the lower extermety
sacroiliac joint
This is a secondary cartilaginous (fbrocartilaginous) joint with intervertebral (IV) disc and it joins the lumbar and sacral
lumbosacral joint
This is a secondary cartilaginous joint with IV disc and it joins sacral and coccyx
sacrococcygeal joint - small
This is a secondary cartilaginous joint that joins two pubis together
pubis symphysis
What is the name of the ligament that runs longitudinally over the anterior part of IV discs?
anterior longitudinal ligaments
This ligament attaches sacrum to ischial spine
sacrospinous ligament
This ligament attaches sacrum to ischial tuberosity
sacrotuberous ligament
What is the function of sacrospinous and sacrotuberous ligaments?
help prevent anterioinferior displacement of superior sacrum
Which ligament converts greater sciatic notch to greater sciatic foramen?
sacrospinous ligament
Which ligament converts lesser sciatic notch to lesser sciatic foramen?
sacrotuberous ligament
What is the shape of a female pelvic inlet?
rounded/oval
What is the shape of a male pelvic inlet?
heart-shaped
How does the pelvic canal differ between male and female?
male –> long and funnel-shaped
female –> short with parallel walls
How do ischial tuberosities and spines differ between male and female?
female –> everted
male –> not everted
How do greater sciatic notches differ between male and female?
female –> broader
male –> narrower
This pubic arch and subpubic angle is broad and has a greater than 90 degree angle, which sex might this be?
female
This pubic arch and subpubic angle is narrow and has a lesser than 70 degree angle, which sex might this be?
male
This pelvic muscle is located lateral and it arises within lesser pelvis, passes through lesser sciatic foramen and attaches to femur’s greater trochanter
obturator internus
What does the obturator membrane form medially?
tendinous arch
This pelvic muscle is located posterior and it attaches to sacrum within lesser pelvis, passes through greater sciatic foramen and attaches to femur’s greater trochanter
piriformis
What muscle creates a “bed” for sacral nerve plexus?
piriformis
What muscles make up the pelvic diaphragm (pelvic floor)?
levator ani and coccygeus
What makes up the levator ani muscles?
1) puborectalis
2) pubococcygeus
3) iliococcygeus
What is the function of the pelvic diaphragm?
1) support viscera (especially during increased intraabdominal pressure)
2) aids voluntary control of urination and fecal continence
This is a muscular sling arising from pubis; maintains fecal continence (sometimes treated as part of puboccygeus)
puborectalis
This muscle arises from pubis and tendinous arch and attaches to coccyx
pubococcygeus
This muscle arises from tendinous arch and ischial spine and blends with pubococcygeus
iliococcygeus
Which of the three levator ani muscles is the most medial?
puborectalis
Which of the three levator ani muscles is the most lateral?
iliococcygeus
This muscle is attached from ischial spine to coccygeus/sacrum
coccygeus (ishiococcygeus)
What is in the pelvic viscera?
1) urinary bladder
2) parts of ureters
3) parts of reproductive sys
4) rectum
Kidneys are considered abdominal organs, although embryogically ____
pelvic
These are retroperitoneal muscular tubes transporting urine from kidneys to posterosuperior bladder
ureters
Ureters enter bladder obliquely, forming flap valves so muscular contractions of bladder act as sphincters, what does this prevent?
urinary reflux into ureters
In females, ureters pass ____ to uterine arteries’ origins
medial
In males, _____ rest between ureters and peritoneum
vas deferens (it cris-cross with ureters)
What arteries supply ureters in the pelvic region?
females –> uterine
males –> inferior vesicular
What innervates ureters?
nearby autonomic plexuses (T11 - L2):
1) renal
2) aortic
3) superior hypogastric
4) inferior hypogastric
What functions as temporary reservoir for urine?
bladder
What are the 5 parts to bladder?
1) apex
2) fundus
3) body
4) neck
5) trigone
What part of the bladder is anterosuperior aspect?
apex
What part of the bladder is posterior wall?
fundus
What part of the bladder is between apex and fundus?
body
What part of the bladder constricts?
neck
What part of the bladder forms a triangle between ureteric and urethral openings?
trigone
What is projection of trigone called, usually seen in older men?
uvula
What muscle is in the bladder walls?
detrusor muscle
In females, muscle of bladder’s neck is continuous with what?
urethra’s muscle
In males, muscle of bladder’s neck is continuous with what?
prostate’s fibromuscular tissue
The prostate’s fibromuscular fibers form an involuntary internal urethral sphincter, what is its significance?
prevents semen from entering bladder
This is a muscular tube that transports urine from bladder to the outside world
urethra
In females, urethra descends ____ to vagina
anterior
In females, urine exits via…
external urethral orifice
How many urethral curves are present in flaccid penis?
two
How many urethral curves are present in erect penis?
just one
What are the four parts to the male urethra?
1) preprostatic
2) prostatic
3) intermediate/membranous
4) spongy
What part of the male’s urethra goes from neck of bladder to prostate?
preprostatic
What part of the male’s urethra is actually within prostate?
prostatic
What part of the male’s urethra is short, narrow, and least distensible, also passes through external urethral sphincter
intermediate/membranous
What part of the male’s urethra is the longest, ending at external urethral orifice of glans penis?
spongy
Which parts of the male’s urethra is not located in the pelvis region, but perineum?
intermediate/membranous and spongy parts
What is the median ridge within the prostatic urethra called?
urethral crest
What is rounded eminence of the prostatic urethra called?
seminal colliculus
This is part of the prostatic urethra that is a cul-de-sac remnant of uterovaginal canal in seminal colliculus
prostatic utricle
Where are openings of ejaculatory ducts located?
within the prostatic urethra - seminal colliculus (inferior to prostatic utricle)
Where are openings of prostatic ducts?
within the prostatic urethra - lateral to seminal colliculus
What are the four parts to uterine tubes?
1) infundibulum
2) ampulla
3) isthmus
4) uterine part
Which part of the uterine tubes is funnel-shaped with fimbrae?
infundibulum
Which part of the uterine tubes is the widest and longest?
ampulla
Which part of the uterine tubes enters uterine horns?
isthmus
Which part of the uterine tubes is a short segment in uterine wall?
uterine part of uterine tubes
What are the two parts to uterus?
body and cervix
Which part of the uterus makes up the upper 2/3rd?
body
What does the body of the uterus consist of?
1) fundus
2) uterine horns
3) isthmus
Which part of the uterus is superior to uterine tubes?
fundus
Which part of the uterus is the entrance of uterine tubes?
uterine horns
Which part of the uterus is constricted region superior to cervix?
isthmus
Which part of the cervix (of uterus) is the opening to uterus?
internal os
Which part of the cervix (of uterus) is the opening to vagina?
external os
What ligament connects ovary to uterus?
ovarian ligament
What ligament connects uterus to labia majora?
round ligament (ligamentum teres)
Which ligament is mesentery of uterus and has several subdivisions?
broad ligament
What are the subdivisions of broad ligament?
1) suspensory ligament
2) mesovarium
3) mesosalpinx
4) mesometrium
Which of the subdivision of broad ligament conveys ovarian vessels, lymphatics and nerves?
suspensory ligament
Which of the subdivision of broad ligament suspends ovary?
mesovarium
Which of the subdivision of broad ligament suspends uterine tube?
mesosalpinx
Which of the subdivision of broad ligament suspends most of uterus?
mesometrium
Which ligament is posteroinferior to uterotubal junction?
ovarian ligament
Which ligament is anteroinferior to uterotubal junction?
round ligament
What position is the uterus in?
typically anteverted and anteflexed
This is amusculomembranous tube that runs from cervix to vestibule
vagina
Vagina is located _____ to urethra and bladder, and _____ to rectum
posterior; anterior
What are the three positions of fornices located in the superiormost vagina that surrounds cervix?
1) anterior
2) posterior
3) lateral
What kind of innervation does the lower 1/4 of vagina have?
somatic
What kind of innervation does the upper 3/4 of vagina have?
autonomic
What structure is the continuation of duct of epididymis?
ductus defentes
What is the expansion of ductus deferens called?
ampulla
Ductus deferentes joins ducts of ____ _____ to form ejaculatory duct
seminal vesicle
Paired glands secreting thick fluid into ejaculatory ducts
seminal vesicles
What do ejaculatory ducts descend through?
posterior prostate
What are the different lobes the prostate is divided into?
1) anterior
2) posterior
3) middle
4) lateral
Where do the prostatic ducts empty into?
prostatic sinuses on either side of seminal colliculus
What small glands secret during sexual arousal?
bulbourethral glands
What are all the organs that contribute in producing semen?
1) testes
2) seminal vesicles
3) prostate
4) bulbourethral glands
Bulbourethral glands are ____ to intermediate/membranous urethra
posterolateral
Where do ducts of bulbourethral glands open into?
spongy urethra in bulb of penis
What symptom can benign prostatic hyperplasia have?
urgency to urinate
What are some potential problems to transurethral resection of the prostate (TURP)?
possible alteration of external and internal urethral sphincters –> cause reflux of sperm into bladder or incontinence as well
The pelvic fascia is a continuation of which fascia?
endoabdominal
What are the two layers of pelvic fascia?
1) parietal –> lines walls and floor
2) visceral –> lines pelvic surfaces
What does extraperitoneal or subperitoneal mean?
outside or below the peritoneal cavity (includes most pelvic viscera)
What structures of the pelvic region are primarily retroperitoneal?
1) kidneys
2) ureters
3) rectum
4) anal canal
In addition in males: prostate, seminal vesicles and vas deferens
What structures of the pelvic region are intraperitoneal?
1) uterus
2) ovaries
3) uterine tubes
What is the space behind pubis that accommodates bladder distension?
retropubic space (space of Retzius)
What space is behind rectum and accomodates rectal expansion?
retrorectal space
What space is located in males, between bladder/prostate and rectum?
rectovesical pouch
What space is located in females, between bladder and uterus?
vesicouterine pouch
What space is between uterus and rectum?
rectouterine pouch (pouch of Douglas)
What two spaces does the uterus separate?
1) vesicouterine pouch
2) rectouterine pouch
Which of the spaces can accumulate fluids or potential pathogens?
1) rectovesical pouch (males)
2) vesicouterine pouch (females)
3) rectouterine pouch (females)
Which space may be easily accessed via posterior fornix?
rectouterine pouch
What does the common iliac artery bifurcate into?
internal iliac a
external iliac a
What does the internal iliac a bifurcate into?
posterior div
anterior div
Which regional lymph nodes receive lymph from lower limbs and lowest body wall (excluding external genitalia)?
inguinal nodes
Which regional lymph nodes receive lymph from pelvis and inguinal nodes?
external and internal iliac nodes
Which regional lymph nodes receive lymph from external and internal iliac nodes?
common iliac nodes
Which regional lymph nodes receive lymph from common iliac nodes?
lumbar nodes
Which spinal levels makes up lumbosacral trunk?
L4-L5
Which spinal levels is obturator nerve?
L2-L4
Which spinal levels is accessory obturator nerve?
L3-L4 (if present)
What are the four parts to sacral plexus?
1) sciatic
2) pudendal
3) superior gluteal
4) inferior gluteal
Which spinal levels is sciatic nerve?
L4-S3
Which spinal levels is pudendal nerve?
S2-S4
Which spinal levels is superior gluteal nerve?
L4-S1
Which spinal levels is inferior gluteal nerve?
L5-S2
Which nerve of sacral plexus supplies lower limb?
sciatic
Which nerve of sacral plexus supplies skin and muscles of perineum?
pudendal
Which nerve of sacral plexus is the main sensory nerve for external genitalia?
pudendal
Which nerve of sacral plexus supplies gluteus medius, minimus, and tensor fascia latae?
superior gluteal
Which nerve of sacral plexus supplies gluteus maximus?
inferior gluteal
Where does the sacral plexus exit from the pelvis?
greater sciatic foramen
Where does pudendal n enter perineum?
lesser sciatic foramen
Coccygeal plexus is made up of ventral rami of which spinal nerves?
S4-S5 and coccygeal nerves
What marks the end of sympathetic trunk?
ganglion impar
How many ganglia are located bilaterally on anterior sacrum?
usually 4
What spinal segments do the sympathetics arise from?
T11-L2
Sympathetics travel through the nearby sympathetic chain to which nerves?
lumbar and sacral splanchnic nerves
Which ganglion do sympathetics synapse at?
inferior mesenteric ganglion
The postsynpatics travel through which plexuses?
1) superior hypogastric plexus
2) R/L hypogastric nerves
3) inferior hypogastric (pelvic) plexus
After the plexuses, sympathetic postsynaptic fibers follow what to target organs?
pelvic arteries
Which spinal segments do parasympathetics arise from?
S2-S4 (pelvic splanchnics)
The parasympathetics travels through which plexuses?
ascend mainly through inferior and superior hypogastric plexuses
Where do parasympathetics synapse?
organ/gut plexuses
