Pelvis Flashcards by Kamaal Jones

Name the components of the Ilium.

Iliac fossa
Iliac crest
Anterior superior iliac spine
Posterior superior iliac spine
Anterior inferior iliac spine
Posterior inferior iliac spine

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Name the components of the Ischium.

Ischial tuberosity
Lesser sciatic notch
Ischiadic (Ischial) Spine
Greater Sciatic notch

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Name the components of the Pubis.

Superior ramus
Inferior ramus
Body
Pubic Crest
Pubic tubercle
Pectineal line
Obturator foramen and membrane

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“False Pelvis”

Pelvis Major

Lowermost part of the abdominal cavity lying between the iliac fossae.

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“True Pelvis”

Pelvis Minor

Inferior to the superior pelvic aperture. Contains pelvic viscera.

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Main contents of the Pelvis

(1) Rectum
(2) Bladder
(3) Uterus/vagina in females; prostate gland in males

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Ligaments of the Pelvis

PUBIC SYMPHYSIS: Joins the two pubic bones

SACROILIAC LIGAMENTS: From iliac to sacral tuberosities

ILIOLUMBAR LIGAMENTS: L5 transverse process to iliac crest

SACROTUBEROUS LIGAMENT: From lateral sacrum and coccyx to the medial side of the ischial tuberosity

SACROSPINOUS LIGAMENT: From lateral sacrum and coccyx to ischial spine

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Muscles of the Pelvis

(1) Obturator Internus
(2) Piriformis M.
(3) Pelvic Diaphragm
(4) Urogenital Diaphragm

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Obturator Internus and Externus Muscles

INTERNUS:

Laterally rotates and stabilizes hip
Innervation: Nerve to obturator internus
Inserts into Greater Trochanter

OBTURATOR EXTERNUS has same insertion except outside of obturator membrane. It serves to rotate and adduct the hip.

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Pectinate line

Pain sensory above the line

None below

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Anal blood supply

Superior Rectal Br. of Mesenteric A. (Upper 2/3rds)

Middle Rectal A [from internal iliac A.] (lower 1/3rd muscular layer)

Inferior Rectal A. [from internal pudendal A.] (anastomoses with superior rectal in anal columns)

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How is the Trigone of bladder different from the rest of the bladder?

Of mesodermal origin, whereas everything else is endodermal.

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Pirformis Fossa Muscle

Inserts into greater trochanter
Laterally rotates and abducts thigh
Innervation: Anterior primary rami S1, S2

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What structures forms the pelvic diaphragm?

Levator Ani Muscles
Coccygeus Muscle
Fascia

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Muscles of Levator Ani

Iliococcygeus
Pubococcygeus
Puborectalis
Pubovaginalis/puboprostaticus

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Coccygeus Innervation

Anterior Primary Rami

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Arcus Tendinous

Whitish tendonous band that is part of the pelvic fascia and marks the line of attachment of the special fascia associated with the pelvic viscera.

External iliac artery later become the…

Femoral artery

Main divisions of the Internal Iliac

The Anterior and Posterior divisions of the Internal Iliac

The branches off external iliac artery

Inferior epigastric

- Deep circumflex iliac

All of the posterior division arteries of the internal iliac artery go to…

Muscles

Branches of Posterior Division of Internal Iliac

(a) Ilioblumbar
(b) Lateral Sacral
(c) Superior gluteal

Branches of Anterior Division of Internal Iliac

(a) umbilical
(b) superior vesical
(c) obturator
(d) inferior vesical
(e) middle rectal
(f) inferior gluteal
(g) internal pudendal

Main important vein in pelvis

Uterine/Vaginal (ut/iv)

Where does the sacral plexus rest?

On the piriformis muscle, where it gives branches to the pelvis and the perineum and then splits to give anterior and posterior divisions

Sacral Plexus branches to the Pelvis/Perineum

(1) N. to piriforis (2) perforating cutaneous (3) pelvic splanchnics (autonomics) (4) PUDENDAL N. (5) Perineal branch of S4

Anterior Division Nerves of Sacral Plexus

- tibeal art of sciatic - nerve to quadratus femoris and inferior gemellus - nerve to obturator internus and to superior gemellus - medial part of posterior femoral cutaneous n. - PUDENDAL N.

Posterior Division Nerves of Sacral Plexus

- superior gluteal n. - inferior gluteal n. - common peroneal part of sciatic (fibial) - lateral part of posterior femoral cutaneous n. - n. to piriformis - perforating cutaneous n's

Ganglion Impar

Small ganglion at the front of the coccyx where the sympathetic trunks converge after descending from the abdomen along the sacrum.

What notable muscle does the obturator nerve NOT innovate?

Obturator internus. This is innervated by the nerve to the Obturator internus. The obturator nerve DOES HOWEVER, innervate the external obturator, among other muscles.

Functional of Pudendal nerve

- Main nerve of the perineum. - Carries sensation from the external genitalia of both sexes and the skin around the anus/perineum - Motor supply to various pelvic muscles including external urethral sphincter and external anal sphincter DAMAGE TO THIS NERVE (often during childbirth) MAY CAUSE SENSORY LOSS OR FETAL INCONTINENCE

Sympathetic innervation of the pelvis

SUPERIOR HYPOGASTRIC PLEXUS. Receives contributions from the lumbar splancnics n's. The branches of the SHP spill into the pelvis as the R and L HYPOGASTRIC N's. -They mix with the pelvic splanchnics to form the INFERIOR HYPOGASTRIC PLEXUS

Parasympathetics of the Pelvis

PELVIC SPLANCHNICS (S2-4) Combine with the sympathetic branches to form the INFERIOR HYPOGASTRIC PLEXUS on the walls of the pelvis

What defines the rectum?

It is continuous structurally with the colon but is called the rectum once the mesentery is lost

When you here this word, think "bladder"

Vesical

Muscular component of bladder walls

Detrusor Muscle

The prostate is perforated (pierced) by the...

Urethra

Large ligament surrounding uterus

Broad ligament

What holds up the ovaries?

Sensory ligaments

Relationship between uterine artery and ureter.

"Water under the bridge" The ureter crosses UNDER the uterine aretery

Blood supply of Ovaries

Ovarian Artery