Pelvis

Question 1

name the 3 fused bones of the hip

Answer 1

ilium, ischium and pubis

Question 2

where do the hamstrings attach

Answer 2

ischial tuberosity

Question 3

describe the scaral bones

Answer 3

2 alas superiorly (one on each side), promontory, lateral mass (fusion of transverse processes) & coccyx

Question 4

what demarcates the true from false pelvis

Answer 4

iliopectineal line

Question 5

describe the margins of the pelvic inlet

Answer 5

pubic crest, pecten pubis, arcuate line, margin of ala, promontory (then back in reverse order to complete the loop)

Question 6

name the main pelvic shapes

Answer 6

female: gynacoid.
Male: anthropoid or android

Question 7

describe diff b/w male and female pelvis

Answer 7

male is thicker and heavier, heart shaped

Question 8

describe the dif in greater scaitic notch

Answer 8

male: narrow inverted. Female 90 degrees

Question 9

dif b/w sexes in subpubic arch, obturator foramen and acetabulum

Answer 9

male: acute, round larger.
Female: obtuse, oval, smaller

Question 10

describe dif in acetabulum/pubic symph measurements

Answer 10

in females the distance from acetabulum to pubic symphysis is greater than width of acetabulum, in males its the same

Question 11

what is the plane of least dimensions?

Answer 11

passes from s4 through ischial spine to base of pubic bone

Question 12

describe the sacro-iliac joint

Answer 12

3 ligaments: anterior, posterior and interosseous.

described as auricular

Question 13

accessory ligaments of SIJ (3)?. What is their role

Answer 13

iliolumbar, sacrospinous, sacrotuberous. ligaments prevent the sacrum rotating (nutation)

Question 14

describe pubic symphysis joint and reinforcements

Answer 14

2nd cartilaginous fibrous joint (hyaline, fibrocartilage, hyaline). 2 ligaments (superior and inferior arcuate). reinforced by abdo obliques, rectus sheath and adductor longus

Question 15

name the muscles of the pelvis from a superior view.

Answer 15

obturator internus on lateral wall. piriformis on posterior wall. Pubococcygeus (including pubovaginalis/prostalis and puborectalis) coming from pubis bone. iliococcygeus underlapping and then ischicoccygeus

Question 16

origins and insertions of obturator internus and piriformis? how do they leave pelvis

Answer 16

OI: origin is obturator membrane, insertiion is greater trochanter of femur. leaves through LSF
P: origin is 3 middle sacral bodies, insertion is also greater trochanter. leaves through GSF

Question 17

describe components of pubococcygeus

Answer 17

Medial to lateral as well as Anterior to Posterior.
puboprostaticus (male) & pubovaginalis (female) sling around respective viscera.
puborectalis (needs to relax in order to shi) s
Posteriorly: remainder of pubococcygeus (inserts into ano-coccyx raphe)

Question 18

angle of puborectalis?

Answer 18

80 degrees

Question 19

parts and function of levator ani?

Answer 19

pubo and iliococcygeous lift. ischio not functional

Question 20

describe which kind of fascia will go where with respect to pelivs?

Answer 20

loose will overly structures that need to move (eg. pubococcygeous, bladder). Whereas dense will be over structures that do not.

Question 21

where does the sacral plexus sit?

Answer 21

on piriformis

Question 22

describe the peritoneum with respect to the viscera

Answer 22

drapes over viscera and invests them with a serous coat. in b/w viscera (eg bladder and rectum) it forms a pouch.

Question 23

main artery of pelvis?

Answer 23

internal iliac

Question 24

what is the ureter crossed by in males and females respectively

Answer 24

vas deferens and uterine artery

Question 25

muscle of bladder

Answer 25

detruser

Question 26

in males which ligament surround neck of baldder

Answer 26

pubo-prostatic

Question 27

what is the base of bladder called

Answer 27

trigone

Question 28

3 accessory glands of male pelvic viscera

Answer 28

prostate, seminal vesicle, bulbourethral gland

Question 29

function of bulbourethral gland

Answer 29

secretes mucus to act as lubricant. also buffer

Question 30

function of seminal vescile

Answer 30

alkaline fluid with nutrients

Question 31

describe anatomical position of seminal vesicals

Answer 31

pair sitting on posterior-inferior surface of bladder. merge with vas deferens to pierce prostate and form ejaculatory duct

Question 32

which lobe of the prostate is of clinical significance?

Answer 32

medial lobe is enlarged in BPH and can obstruct urethra. can palpate on exam

Question 33

normal position of uterus? potential consequences of opposite?

Answer 33

anteverted on vagina. | Retroverted can possibly cause back pain and dysmenorrhea

Question 34

parts of fallopian tube (prox to dist)

Answer 34

intramural, isthmus, ampulla, infundibulum (with fimbriae)

Question 35

what is the cervix

Answer 35

bottom part of uterus that feeds into vagina

Question 36

major supportive ligaments of uterus?

Answer 36

lateral cervical, utero-sacral and pubo-cervical

Question 37

describe relationship of peritoneum with uterus

Answer 37

double folded is broad ligament, also covers tubes

Question 38

where are the ovaries positioned?

Answer 38

on side wall of pelvis where common iliac bifurcates

Question 39

which wall of the vagina is longer?

Answer 39

posterior

Question 40

what are the vaginal fornices? where?

Answer 40

recess in deepest part of vagina. there is an anterior and posterior to cervix

Question 41

what is significant about the superior rectal and ovarian artery

Answer 41

not from internal iliac. they enter the pelvis from above. Ovarian off abdominal aorta and superior rectal off IMA

Question 42

describe the nerves of pelvic viscer

Answer 42

inferior hypogastric plexus supplies viscera. one on each side of pelvis .has both para(from S2-4) and symp (thoraco lumbar) fibres. comes from superior hypogastric plexus.

Question 43

describe the boundaries of the diamond in the perinuem

Answer 43

pubic symph > ischial tuberosity (via ischiopubo ramus) > coccyx (via sacrotubular ligament) > ischial tuberosity. Line b/w tuberosities divides urogenital triangle above from anal below/.

Question 44

layers of perineum from skin

Answer 44

skin > superficial perineal pouch > perineum > deep perineal pouch

Question 45

3 key features that attach to perineal body

Answer 45

superficial and deep transverse perineal muscle. external anal sphincter

Question 46

what is the ischianal fossa?

Answer 46

the fat-filled space located lateral to the anal canal and inferior to the pelvic floor.

Question 47

what is inside the pudendal canal? where is it? eponymous name?

Answer 47

Alcock's canal contains the internal pudendal artery and vein, the pudendal nerve and the dorsal nerve of penis (clitoris). It is enclosed by fascia of obturator internus on lateral pelvic wall

Question 48

muscles of the sphincter?

Answer 48

subcutaneous, superficial and deep

Question 49

where are the anterior and posterior parts of the superficial anal sphincter fixed?

Answer 49

perineal body and coccyx

Question 50

the deep anal sphincter muscle blends with what?

Answer 50

pubo-rectalis

Question 51

to what do the external genitalia attach?

Answer 51

perineal membrane

Question 52

describe the anatomy of penis

Answer 52

corpus spongiousum converges with the 2 roots of corpus cavanosa to form the body (spongiosum in inferior). Glans at end

Question 53

describe the anatomy of clitoris

Answer 53

two roots of corpus cavanosa form body with glans at tip

Question 54

main nerve of the perineum?

Answer 54

pudejdal

Question 55

path of pudendal nerve

Answer 55

branch of sacral plexus. starts in pelvis> | exits via GSF with piriformis > winds back round ischial spine> goes back through LSF > enters perineum

Question 56

3 branches of pudendal

Answer 56

perineal, dorsal clitoris (penis) and inferior rectal