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Anatomy- Pelvis and Perineum > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Pelvic girdle

A

Hip Bones
- Ilium
- Ischium
-Pubis
Sacrum
Coccyx

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2
Q

Main joints of the pelvic Bones

A

Anterior: pubic symphysis
Posterior: sacroiliac

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3
Q

Pelvic Inlet Boundaries

A
  • Pubic symphysis and posterior border of pubic crest
  • Pecten pubis
  • Arcuate line of the ilium
  • Anterior border of ala of sacrum
  • Sacral promontory
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4
Q

Pelvic outlet (pelvic diaphragm) Boundaries

A
  • Inferior margin of the pubic symphysis
  • Inferior rami of pubis and ischial bone
  • Sacrotuberous ligaments
  • Tip of the coccyx
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5
Q

Subpubic angle

A

Runs in the inferior border of the symphysis pubis

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6
Q

False (greater pelvis)

A

-Superior to the pelvic inlet

Boundaries:

  • Anterior: abdominal wall
  • Posterolateral: iliac fossae
  • Posterior: L5-S1 vertebrae
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7
Q

Content of the greater (false) pelvis

A

Ileum and Sigmoid colon

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8
Q

True (lesser) pelvis

A

-Inferior to the pelvic inlet

Boundaries:

  • Anterior: pubic symphysis
  • Posterior: coccyx
  • Inferior: pelvic outlet (pelvic diaphragm)
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9
Q

Contents of the true (lesser) pelvis

A

-Rectum, Urinary bladder, Reproductive Organs

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10
Q

Main Joints of Pelvis

A
  1. Lumbosacral Joints (L5-S1)
  2. Sacrococcygeal joint
  3. Sacroiliac joints
  4. Pubic symphysis
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11
Q

Lumbosacral joints (L5-S1) of the pelvis

A
  • Determined by the intervertebral disk
  • Iliolumbar ligament to the ilia and L5
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12
Q

Sacrococcygeal joint of the Pelvis

A
  • Has both anterior and posterior ligaments
  • Lateral ligaments at the posterior surface of the coccyx
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13
Q

Sacroliac joint of the Pelvis

A
  • Presents several intraarticular joints between the articular surface of the ilium and sacrum
  • Interosseous ligaments
  • Sacroiliac ligaments (anterior and posterioror)
  • Sacrotuberous ligaments (greater sciatic foramen)
  • Sacrospinous ligaments (creates the lesser sciatic foramen)
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14
Q

Pubic symphysis of the Pelvis

A
  • Presents a disk of cartilage that joins both pubic bones
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15
Q

Anterior pelvic wall

A
  • Made up of pubic bones and the pubic symphysis
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16
Q

Lateral pelvic wall

A
  • Hip bones (Ischium, Pubic, and part of ilum)
  • Obturator canal (the connection between the lesser pelvis and the anteromedial surface of the thigh)
  • Obturator internus muscle (tendon runs out of the greater sciatic foramen to the posterior thigh)
  • obturator nerves and vessels (apart of the lumbar plexus)
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17
Q

Posterior pelvic wall

A
  • Sacrum and coccyx
  • Piriformis muscle
  • Sacroiliac joint
  • Sacral plexus
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18
Q

Pelvic floor (pelvic diaphragm)

A
  1. Levator ani muscle
    - Puborectalis (runs from the posterior surface of the pubis and surround the rectum)
    - Puboccygeus (runs from the posterior pubis and insert at the level of the tip of the coccyx)
    - Iliococcygeus
  2. Coccygeus muscle: part of the diaphragm of the pelvis
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19
Q

Pelvic Nerves (Plexus)

A
  • Sacral (largest) and coccygeal nerves
  • Autonomic nervous system (composed from sympathetic and parasympathetic nerves that came from the vertebrae bone)
  • Piriformis and coccygeus: bed of the neurovascular structure of the pelvis
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20
Q

Pudendal Nerve; S2-S4 (Sacral plexus)

A
  • ONLY nerve that runs from the lesser pelvis, exits out of the superior border of the sacrospinous ligament (greater sciatic foramen), makes a loop, and reenters the perineum via the lesser sciatic foramen
  • MAIN INNERVATION OF THE PERINEUM IN BOTH MALES AND FEMALES!
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21
Q

Sciatic Nerve (L4-S3) ; Sacral Plexus

A
  • The largest nerve of the body
  • Runs in the posterior aspect of the leg after it exits the pelvis via the greater sciatic foramen
22
Q

Quadratus femoris and inferior gemellus nerve; L4-S1 (Sacral plexus)

A
  • Innervated the quadratus femoris and inferior gemellus muscles
23
Q

Posterior femoral cutaneous nerve; S2-S3 (Sacral Plexus)

A
  • Sensorial nerve to the posterior aspect of the thigh
  • Runs through the inferior border of the gluteus maximus
24
Q

Superior gluteal nerve; L4-S1 (Sacral Plexus)

A
  • Corresponds to the posterior aspect of the sacral plexus
  • Exits the pelvis via the greater sciatic foramen
  • Innervates: Gluteus medius, Gluteus minimus and tensor fascia lata
  • Posterior divisions
25
Q

Inferior gluteal nerve; L4-S2(Sacral plexus)

A
  • Exits pelvis via the greater sciatic foramen
  • Innervates the gluteus meximus muscle
  • Posterior divisions
26
Q

Pelvic Nerves (Sacral Plexus)

A
  • Nerve to piriformis muscle (S1-S2)
  • Nerve to obturator internus and superior gemellus muscles (L5-S2)
  • Levator ani / coccygeus nerve (S3-S4)
  • Perineal branch nerve (cutaneous to the perineal region)
  • Perforating cutaneous nerve (additional cutaneous nerves of the perineum)
27
Q

Coccygeal plexus

A
  • Ventral rami S4-S5 and the coccygeal nerve
  • Anococcygeal nerve
  • Innervation to: Coccygeaus muscle, Part of the Levator ani, and Sacrococcygeal joint
28
Q

Autonomic System

A
  • Responsible for the autonomic functions of the pelvis, inferior limb, and part of the external genitalia
29
Q

Sacral sympathetic trunk

A
  • Runs in two chains parallel to the backbone and at the end of the pelvis it presents 4 sympathetic ganglia
  • Coccygeal ganglion (anterior to coccyx)
  • Gives fibers to the Sacral Nerve, Coccygeal Nerve, Median Sacral Artery, and inferior hypogastric plexus
  • Gives Postsynaptic fibers to the sacral plexus for sympathetic innervation of lower limbs (vasomotor, pilomotor, and sudomotor)
30
Q

Hypogastric Plexus

A

Superior

  • Inferior to bifurcation of aorta
  • Receives L3-L4 splanchnic nerves (sympathetic chain)
  • Descends to the pelvis as the left and right hypogastric nerves

Inferior (pelvic plexus)

  • To prostate gland, seminal vesicles, bladder, cervix, and lateral fornices of the vagina
31
Q

Parasympathetic Component of the pelvic Nerves

A
  • S2-S4 (Nervi erigentes: gives innervation for the parasympathetic component)
  • Nervi erigentes nerves are inferior to the hypogastric plexus
  • Gives multiple branches to the Subplexus
  • Subplexus surrounds the rectal, visceral, and uterovaginal structures
32
Q

Arteries entering the pelvis

A
  • Internal iliac artery (MAIN ARTERY OF THE PELVIS)
  • Ovarian artery (orginates from the aorta)
  • Medial sacral artery
  • Superior rectal artery
33
Q

Internal iliac artery (L5-S1)

A
  • Close to the areas of the ureter
  • Ends at the superior border of the greater sciatic foramen
34
Q

Umbilical Artery (Anterior Division of the Internal Iliac Artery)

A
  • In adults, the umbilical artery is called the Superior Vesical artery
  • It continues as the medial peritoneal ligament
35
Q

Obturator Artery (Anterior Division of the internal Iliac Artery)

A
  • Travels in the obturator canal at the lateral wall of the pelvis
  • Ends at the anterior medial aspect of the thigh
36
Q

Inferior Vesical Artery (Anterior Division of the Internal iliac Artery

A
  • ONLY IN MALES
  • Supplies the prostate, bladder, seminal vesicles, ureter (distal)
  • Branches: vas deferens and prostatic artery
37
Q

Middle Rectal Artery (Anterior Division of the Internal Iliac Artery)

A
  • Supplies the mid portion of the rectum, vagina (proximal), prostate gland, and seminal vesicles
38
Q

Uterine Artery (Anterior Division of the Internal Iliac Artery)

A
  • ONLY in females
  • Runs in the root of the broad ligament
  • Travels up to the lateral margin of the uterus
  • Branch: vaginal artery (male= Inf. Vesical)
  • Anterior and superior to the ureter (during hysterectomy physicians has to be aware of the uterine artery when you have to occlude the artery)
  • Anastomose with ovarian artery
39
Q

Internal pudendal artery (Anterior Division of the Internal iliac artery

A
  • Exits via the greater sciatic foramen
  • Goes through the ischioanal fossa via the lesser sciatic foramen
  • Supplies the Perineum
40
Q

Inferior Gluteal Artery (Anterior Division of the Internal iliac artery)

A
  • Larger artery
  • Exits via the greater sciatic foramen
  • Located inferior to the piriformis muscle
  • Will supply the inferior aspect of the gluteal region
41
Q

Superior Gluteal Artery (Posterior Division)

A
  • Exits via the greater sciatic foramen
  • Located superior to the piriformis muscle
  • Supplies the superior aspect of the thigh
42
Q

Iliolumbar Artery (Posterior Division of the Internal Iliac Artery)

A
  • Branches: Iliac and lumbar branches
  • Supplies the iliac muscle and the ilium
  • Also supplies the psoas major and the quadratus lumborum
43
Q

Lateral sacral artery (Posterior Division of the Internal Iliac Artery)

A
  • The main artery to the spinal meninges located inside of the vertebral canal
  • Erector spinae and skin and supplied by the lateral sacral artery
44
Q

Median Sacral Artery (Pelvic Vessels)

A
  • Posterior surfaces of the abdominal aorta
  • Anterior to the bodies of L4-L5, sacrum, and coccyx

Braches:

  • 5th lumbar arteries
  • Lateral sacral arteries
  • Rectal arteries (posterior)
45
Q

Superior Rectal Artery (Pelvis Vessels)

A
  • the terminal branch of the inferior mesenteric artery
46
Q

Ovarian Artery (Pelvis Vessels)

A
  • Branches directly from the abdominal aorta
47
Q

Pelvic Veins

A

All veins runs parallel at the level of the arteries

48
Q

Superior gluteal veins

A
  • Greater tributary of the internal iliac, except in pregnancy (uterine vein)
49
Q

Internal iliac veins

A

Joins with the external iliac vein and from the common iliac veins

50
Q

Common iliac veins

A

Iliolumbar veins

Anatomy- Pelvis and Perineum (6 decks)

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