Pelvis Flashcards
Greater sciatic foramen
Sciatic nerve
Sup and inf gluteal nerves and vessels
Pudendal nerve
Post femoral cutaneous nerve
Nerves to obturator internus and quadratus femorus
Lesser sciatic foramen
Tendon of obturator internus
Nerve to obturator internus (both)
Pudendal nerve (both)
Internal pudendal artery and vein
PINT
Lumbar plexus
On post psoas major
In front TPs lumbar vert
Stimulation causes quads contraction
L1-4
4 mixed and one sensory (lat cut)
Male vs female pelvis
male more thick, and deep with narrow lesser pelvis, heart shaped inlet, small outlet, arch <70 degrees, sciatic notch 70, round obturator foramen, large acetabulum
Female thin wide and shallow, oval wide inlet, oval obturator formen, >80 arch, 90 sciatic notch
greater and lesser pelvic brim
greater (brim)- S1 and iliac ala (iliem and sigmoid)
Lesser (inlet) - ala of sacrum, ileum below arcuate line, pubis
Sacrotuberous ligament
from posterior ilium, sacrum and coccyx to ischial tuberosity
Sacrospinous ligament
lateral coccyx and sacrum to ischial spine
splits sciatic foramen into greater and lesser
Muscles of the pelvic floor
Lateral - obturator internus
Post sup - piriformis
Floor - coccygeus + levator ani
Levator ani
puborectalis - faecal continence, from pubis to pubis
pubococcygeus - forms anococcygeal body
iliococcygeus - post obturator fascia to perineal body
Internal iliac
from L5/S1
Main supplier pelvis
Ends at greater sciatic foramen where splits ant and post
Other pelvic arts
sup rectal from inf mes
median sacral from bifuration aorta
gonadal from aorta
Posterior iliac artery
iliolumbar
lateral sacral
superior gluteal
Pelvic lymph drainage
bladder -> external iliac
Most others to internal iliac
Obturator nerve
L2-4
extraperitoneal lat wall pelvis
after foramen splits into ant and post
medial thigh muscles
Sacra plexus
L4 S1 - sup gluteal - exits sup to piriformis
L5 S2 - inf gluteal (inf to coccygeus)
L4 S3 - sciatic, post thigh
S1 3 - post fem cutaneous
S2 4 - pudendal - perineium
Ureters
Water under bridge (testicular or ovarian arteries)
Ureter blood and nerve
renal, common iliav, int iliac and gonadal
T10-L2
Urethra blood supply
Female - vaginal and int pudendal
Male - inf vesicular (prostatic branch), middle rectal
Male urethra
intramural - internal urethral sphincter
prostatic - prostatic and ejac ducts, widest part
intermediate membranous - narrowest, external urethral sphincter
spongy - longest, bulbourethral + urethral glands
Rectum anatomy and blood
S3 to coccyx
anorectal flexure 80 degrees through pelvic diaphragm
BLood sup IMA
med internal iliac
inf - int pudendal (sup and inf anastamose)
Epithelium ovaries
single layer cuboidal
Fallopian / uterine tubes
10cm
infundibulum by ovary
ampulla widest and longest (fertilisation)
isthmus - thick walled
uterine part
art from internal iliac
Ovarian artery
from L2
post abdominal wall
crosses ext iliac at pelvic brim and enters suspensory lig
Layers uterus
perimetrium - outer thin
myometrium - smooth muscle, vascular
endometrium - mucous, blastocyte attaches, sheds in period
Ligaments ovary and uterus
Broad - flat peritoneium from walls each side
ovarian - from ovary to uterus
suspensory - ovary to abdo wall with vasculature
round - uterine horns to labia (through inguinal canal) remnants gubernaculum
cardinal - by cervix, have uterine artery and veins
Vagina
7-9cm
art - sup uterine, inf vagina and int pudendal
nerves - somatic only lower quarter - deep perineal
Epithelium uterus
Simple columnar
Location vas deferens
Lower posterior spermatic cord
Sympathetic supply to testis
T10
Location appendix testis
Upper pole testis
Male urethra in
Corpus spongiosum
Structure superior to piriformis in sciatic foramen
Superior gluteal artery and nerve
Sympathetic innervation rectum
T12-L2 lumbar plexus
Lumbrosacral trunk
L4/5
