Pelvis

Question 0

What makes a good pelvis for childbirth?

Answer 0

straight side walls
well rounded inlet
round greater sciatic notch
supra-pubic angle >90
ischial spines not too prominent 
rounded sacrum

Question 1

What is the pelvis made up of (bones)?

Answer 1

Ilium
Ischium
Pubis
Sacrum
Coccyx

Question 2

What is the true pelvis?

Answer 2

The lesser pelvis - because this is used for childbirth

The greater pelvis mearly holds the uterus in labour

Question 3

What would you measure in clinical assessment of the pelvis?

Answer 3

antero-postero diameter 
distance between ischial spines 
distance between ischial tuberosities 
straight side walls 
the diagonal conjugate

Question 4

Why do you measure the diagonal conjugate rather than the obstetric conjugate and what is it?

Answer 4

This is because the mid pubic symphysis cannot be palpated but inferior to it can and this is where the diagonal conjugate ends
They both start at the sacal prominitory and give an estimate of pubic diameter

Question 5

what are the ligaments at the pelvic outlet?

Answer 5

Sacrospinous and sacrotuberous

Question 6

Why can the ligaments of the pelvis stretch?

Answer 6

Because progesterone makes them soft

Question 7

What is different between the male pelvis and female?

Answer 7

Not designed for childbirth, therefore it is narrower, pubic arch is narrower, the ischial spines are more prominent and the greater sciatic notch is less rounded

Question 8

What is the perineum?

Answer 8

A diamond shaped structure located in the pelvis at the pelvic outlet between the thighs

Question 9

What are the anatomical borders of the perineum?

Answer 9

bony borders..
anterior - pubic symphysis
posterior - coccyx
middle - imaginary line between ischial tuberosities
lateral - ischiopubic rami and the sacrotuberous ligament

Question 10

What can the perineum be split into?

Answer 10

Anterior and posterior triangles

Question 11

What are the surface borders of the perineum?

Answer 11

anterior - mons pubis or base of penis
posterior - intragluteal cleft
lateral - thighs

Question 12

What are the contents of the anal triangle?

Answer 12

anal spinchter
anal appeture
ischioanal fossa

Question 13

What is the function of the ischioanal fossa?

Answer 13

Contains connective tissue which expands with defecation

Question 14

What are the contents of the urogenital triangle?

Answer 14

Superior perineal pouch
Superior perineal fascia
Perineal membrane
Deep perineal pouch
Deep perineal fascia

Question 15

What is the deep perineal pouch?

Answer 15

contains bulbourethral glands of male
external urethral spinchter
urethra

Question 16

What is the deep perineal fascia?

Answer 16

Covers perineal membrane

Deep fascia

Question 17

What is the function of the superficial perineal pouch?

Answer 17

It contains the erectile tissues and the bulbospongiosum, perineal muscles and ischiocavernosus
Also bartholins glands

Question 18

What is the function of the superficial perineal fascia?

Answer 18

Continuous with abdominal fascia and also contains the mons pubis of the female and labia majora

Question 19

What is the function of the perineal membrane?

Answer 19

It acts as an attachment for muscles

Question 20

What is the perineal body?

Answer 20

A mass of connective tissue between the urogential and anal triangles
Acts as a site of attachment of the levator ani muscles, ischiocavernosus, bulbospongious, perineal muscles and urethral and anal spinchters.
In women it is significant in childbirth

Question 21

What is the nerve supply to the perineum?

Answer 21

Pudendal nerve S2-S4

Question 22

What is the arterial supply of the perineum?

Answer 22

Internal pudendal artery

Question 23

What is the function of the batholins glands?

Answer 23

they make the vagina moist

Question 24

What causes a blocked bartholins gland?

Answer 24

Staph or E. coli - skin bacteria and they can swell

Question 25

What is an epiostomy?

Answer 25

This is an incision in childbirth which avoids tearing of the perineal body and is done into the vagina mucosa and submucosa

Question 26

What is the pelvic floor?

Answer 26

This seperates the perineum and the pelvic contents | It is a diaphragm of muscle made up of levator ani muscles and coccygeus

Question 27

What are the boundaries of the pelvic floor?

Answer 27

Obtruator internus and piriformis Coccyx Pubic and Ischium

Question 28

What are the two openings into the pelvic floor?

Answer 28

Rectal hiatus | Urogenital hiatus

Question 29

What are the levator ani muscles?

Answer 29

Puborectalis Pubococcygeus Iliococcygeus .. coccygeus isnt but it does make up pelvic floor

Question 30

What are the functions of the pelvic floor?

Answer 30

Continence Resist increases in intra abdominal pressure Support the visceral organs

Question 31

What can happen to the pelvic floor?

Answer 31

Prolapse

Question 32

What increases the chances of prolapse?

Answer 32

``` Chronic cough - lung disease family history age weight number of vaginal deliveries ```

Question 33

What can you do to try and prevent pelvic floor prolapse?

Answer 33

pelvic floor exercises

Question 34

What can injury to the pelvic floor cause?

Answer 34

Prolapse pudendal nerve injury urinary incontinence anal incontinence