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Gross Anatomy > pelvis > Flashcards

pelvis Flashcards

1
Q

types and names of joints at pelvis

A

lumbosacral - 2o cartilaginous
sacroiliac joints - synovial (anterior) and fibrous (posterior)
pubic symphysis - 2o cartilaginous

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2
Q

ligament separating the greater and lesser sciatic foramen

A

sacrospinous

*sacrotuberous crosses both

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3
Q

borders of pelvic cavity

A

posterior - sacrum, coccygeus and piriformis
floor - pelvic diaphragm
anterior - pubic rami, pubic body and pubic symphysis

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4
Q

pubic symphysis: type of joint and composition

A

2o cartilaginous and fibrocartilage

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5
Q

ligament with attachments at ASIS -> pubic tubercle

A

inguinal ligament

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6
Q

muscles making up wall of pelvis

A 
iliacus
psoas
gluteal
obturator externus
obturator internus
piriformis
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7
Q

attachments for psoas

A

T12-L4 (superficial) and L1-L5 (deep) to join iliacus as iliopsoas and insert onto the lesser trochanter of the femur
*iliacus from the iliac fossa

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8
Q

muscles that cause hip flexion

A

psoas and iliacus

*psoas also bends trunk laterally and raises from supine position

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9
Q 
nerve supply for pelvic wall muscles:
psoas
iliacus
obturator internus
piriformis
A

nerve to psoas direct from lumbar plexus (L2-L4)
femoral nerve (L2-L4)
nerve to obturator internus direct from sacral plexus (L5-S1)
nerve to piriformis direct from sacral plexus (S1-S2)

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10
Q

obturator internus attachments

A

inner surface of obturator membrane to medial surface of greater trochanter of femur

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11
Q

muscles that cause lateral rotation of the hip

A

obturator internus and piriformis

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12
Q

attachments of piriformis

A

pelvic surface of sacrum to the greater trochanter of femur

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13
Q

what originates at the outer membrane of the obturator foramen and inserts on the trochanteric fossa of the femur

A

obturator externus

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14
Q

muscles making up the pelvic diaphragm

A

coccygeus and levator ani

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15
Q

coccygeus attachments

A

ischial spine and sacrospinous ligament -> inferior sacrum and coccyx

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16
Q

muscles making up levator ani

A

pubococcygeus (divided into puborectalis and levator prostate/pubovaginalis)
iliococcygeus

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17
Q

puboccocygeus (levator prostate/pubovaginalis) attachments

A

around prostate/vagina and insertion on perineal body

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18
Q

innervation of coccygeus and levator ani

A

coccygeus - sacral plexus (S4-S5)

levator ani - pudendal nerve (S2-S4) + levator ani direct from sacral plexus (S4)

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19
Q

composition of perineal body

A

fibrous connective tissue

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20
Q 
role of pelvic diaphragm:
coccygeus
levator ani
-pubococcygeus
 -puborectalis
A

general - muscular floor to stop prolapse
support and flex coccyx
contract (cough) relax (urination)
support vagina/prostate
mix with external anal sphincter - sling around rectum

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21
Q

what is the tendinous arch of the levator ani and what attaches here

A

thickened fascia of obturator internus membrane

iliococcygeus attaches here (as well as anococcygeal body)

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22
Q

covers internal wall of pelvis

A

parietal pelvic fascia

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23
Q

parietal pelvic fascia forms which ligament posteriorly in males/females

A

puboprostatic ligament/pubovesical ligament

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24
Q

covers the organs of the pelvis

A

visceral pelvic fascia

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25
Q

name of lateral extension of visceral fascia from vagina to tendinous arch

A

paracolpium

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26
Q

what acts as a packing around pelvic organs

A

endopelvic fascia (loose - fills spaces; primary condensations e.g. sheaths)

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27
Q

cardinal ligament found

A

from ischial spine to superior bladder on both sides

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28
Q

ligaments in pelvic cavity (4)

A

tendinous arch of levator ani
tendinous arch of pelvic fascia
paracoplium
cardinal (transverse cervical) ligament

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29
Q

peritoneum (pouches) in females then males

A

female - vesico-uterine pouch and recto-uterine pouch

male - vesico-rectal pouch

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30
Q

bladder lining

A

transitional epithelium and rugae

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31
Q

bladder positioning

A

partial covering of peritoneum stuck to pubic bones- when full rises into suprapubic region
apex is posterior to pubic symphysis

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32
Q

what is the triangular area at the base of the bladder with an internal smooth mucous membrane and what is found here

A

trigone

ureters enter and urethra exits

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33
Q

features of bladder

A

smooth muscle - detrusor

neck - circular sphincter vesicae

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34
Q

what allows the neck of the bladder to be held in place

A

incomplete circular vesicae held in place by puboprostatic/pubovesical ligaments

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35
Q

artery, vein and nerve supply to the bladder

A

superior vesicle artery x2
inferior vesical artery x2 (females = vaginal artery)
vescial venous plexus drains to internal iliac
ANS inferior hypogastric plexus

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36
Q

lymphatic drainage (nodes) of ureter (in order of descent towards bladder)

A

lumbar
common iliac
external iliac
internal iliac

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37
Q 
lymphatic drainage (nodes) of urethra
*sometimes differs in male and female
A

internal iliac
spongy urethra - deep inguinal
females - sacral

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38
Q 
lymphatic drainage (nodes) of bladder
*differs superiorly and at neck
A

internal iliac
superior - external iliac
neck - sacral

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39
Q

covering and attachment of rectum

A

upper 1/3 - visceral peritoneum
middle 1/3 - peritoneum on anterior surface
lower 1/3 - infraperitoneal
attach: 3rd sacral vertebrae to tip of coccyx

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40
Q

transitions of rectum

A

sigmoid colon - 1st transverse fold - rectal ampulla - 2nd fold - 3rd fold - anorectal junction

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41
Q

arteries, veins and nerves of rectum

A

superior rectal artery (inferior mesenteric)
middle rectal artery (internal iliac)
inferior rectal artery (internal pudendal)
superior rectal vein (portal)
middle rectal vein (internal iliac)
inferior rectal vein (internal pudendal)
nerve = inferior hypogastric plexus

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42
Q 
lymphatic drainage (nodes) of rectum:
superior rectum
inferior rectum
above pectinate line
below pectinate line
A

superior rectum - aortic nodes @L3 (inferior mesenteric)
inferior rectum - internal iliac nodes
above pectinate line - internal iliac
below pectinate line - superficial inguinal nodes

43
Q

mesentery of:
ovaries
uterus
fallopian tubes

A

mesovarium
mesometrium
mesosalpinx

44
Q

features of the uterus

A 
fimbriae
fallopian tubes
fundus
body
cervix
vagina
45
Q

sections of the fallopian tube

A

intramural - isthmus - ampulla - infundibulum

46
Q

ligaments of the uterus and their function

A

round ligament - potential lymph pathway

broad ligament - vessels nerves and lymphatics

47
Q

what ligaments of the cervix support the uterus

A

sacrocervical (uterosacral), transverse cervical, pubocervical

48
Q

name for when long axis of uterus is bent forward along the axis of the vagina (90o)

A

anteversion

49
Q

name for when the uterus is bent forward at internal os with the long axis of the vagina (170o)

A

anteflexion

50
Q

function of the ovaries

A

ova and hormone production

51
Q

attachment of the ovaries

A

mesovarium by the broad ligament

52
Q

artery, vein and nerve supply to the ovaries

A 
ovarian artery (@L2)
ovarian vein (IVC right, left renal)
aortic plexus
53
Q

ovarian ligaments

A

mesovarium
ligament of ovary
suspensory ligament of ovary

54
Q

blood supply to the uterus and where this originates

A

uterine artery

a branch of the anterior division of the internal iliac

55
Q 
lymphatic drainage of:
fallopian tubes
ovarian vessels 
body of uterus
cervix
vagina
A

aortic nodes @L2
superficial inguinal nodes
external iliac nodes (via broad ligament)
internal iliac nodes - some to sacral
internal iliac nodes -> superficial inguinal

56
Q

what is the vas deferens

A

muscular tube

57
Q

where does the vas deferens pass

A

through the inguinal canal via spermatic cord
join ampulla duct from seminal vesicle to form ejaculatory duct
through the prostate to join urethra

58
Q

what do the seminal vesicles secrete

A

liquid component of semen - fructose

59
Q

blood supply of seminal vesicles

A

inferior vesicle artery

60
Q

location of the prostate gland

A

inferior to bladder

61
Q

production of the prostate gland

A

proteolytic enzymes and acid phosphatase

62
Q

blood supply and drainage of the prostate gland

A

internal pudendal artery
middle rectal artery
inferior vesicle artery
deep and dorsal veins of penis which drain to prostatic plexus and internal iliac

63
Q

what structures support the prostate gland

A

puboprostatic ligament
perineal body
levator prostate

64
Q

common malformation of prostate

A

prostatic enlargement - may be benign or malignant

65
Q 
lymphatic drainage of:
vas deferens
seminal vesicle
prostate gland
phallus
head 
testis
skin + wall of scrotum
A 
external iliac nodes
external and internal iliac nodes
internal iliac nodes and some sacral
internal iliac nodes
deep inguinal and iliac nodes
aortic nodes at root of testicular artery (@L2)
superficial inguinal nodes
66
Q

anal triangle:
wall
roof
floor

A

ischial tuberosity, rectum, anal canal
levator ani
skin

67
Q

contents of anal triangle (ischioanal fossa)

A

internal pudendal vessels (arteries, veins and nerves)
adipose tissue
inferior rectal vessels (arteries, veins and nerves)

68
Q

anal canal transitions

A 
rectum
anal columns
pectinate line
anal canal
anocutaneous line - transition to skin
internal anal sphincter (covers canal)
external anal sphincter (covers internal)
69
Q

what vessels terminate at the anal columns

A

superior rectal vessels

70
Q

features on internal anal sphincter

A

smooth muscle

involuntary

71
Q

features of external anal sphincter

A

skeletal muscle
voluntary
has deep superficial and subcutaneous part

72
Q

attachment of external anal sphincter

A

perineal body to anococcygeal ligament

73
Q

function of external anal sphincter

A

closes anus aided by puborectalis

74
Q

innervation of external anal sphincter

A

pudendal nerve (S2-S4)

75
Q

venous drainage of anal canal:
drains wall
drains surrounding muscle
run along either side of canal

A

superior rectal vein
inferior rectal vein
internal and external venous plexuses

76
Q

what makes up the fascia of the urogenital triangle

A

membranous - scarpa’s fascia transitions to colle’s fascia which is attached to the posterior border
fatty - camper’s fascia transitions to ischiorectal fascia

77
Q

What 3 layers make up the urogenital diaphragm and what inclose it

A 
perineal membrane
superficial perineal pouch
superior layer
deep perineal pouch
inferior layer

anteriorly fuse and leave gap at pubic symphysis, posteriorly fuse with membranous superficial fascia and perineal body

78
Q

deep perineal pouch contents

*there are difference dependant on male or female

A

urethra
sphincter urethrae
deep transverse perineal muscles
innervated by dorsal nerve of clitoris from pudendal

internal pudendal vessels (arteries, veins and nerve)

female - vagina and dorsal nerves of clitoris
male - dorsal nerves of penis, bulbourethral glands and penile arteries

79
Q

superficial perineal pouch contents

A 
muscles:
ischiocavernous
bulbospongiosus glands
superficial transverse perineal
innervated by muscular branches of pudendal

urethra
vagina
clitoris
penis

erectile tissue:
crura
bulb of vestibule
bulb of penis

nerves and vessels

80
Q

attachments of perineal body

A

external anal sphincter
bulbospongiosus
superficial transverse perineal muscles

81
Q

features of the penis

A

bulb
corpus spongiosum
corpus cavernosum
glans

82
Q

vessels supplying the penis

A

internal pudendal artery -> transverse perineal artery, the artery of the bulb, deep and dorsal penile arteries
pudendal nerve -> dorsal nerve of penis and perineal nerve which has scrotal branches

83
Q

4 sections of the male urethra

A

pre-prostatic
prostatic
membranous
spongy

84
Q

root of the pudendal nerve and internal pudendal vessels

A

through greater sciatic notch -> behind sacrospinous ligament -> through the lesser sciatic foramen

then branches to form inf rectal
perineal nerve -> scrotal branches
dorsal and deep nerves of penis

85
Q

features of clitoris

A

glans
body
crus

86
Q

innervation of clitoris

A

dorsal nerve of clitoris

87
Q

sciatic nerve root value

A

L4-S3

88
Q

superior gluteal root value

A

L4-S1

89
Q

inferior gluteal root value

A

L5-S2

90
Q

nerve to obturator internus root value

A

L5-S1

91
Q

nerve to piriformis root value

A

S1-S2

92
Q

pudendal nerve root value

A

S2-S4

93
Q

what does pudendal nerve innervate

A 
levator ani
external anal sphincter
external urethral sphincter
bulbospogiosus
ischiocavernosus
94
Q 
sympathetic effect on:
rectum
internal anal + urethral sphincter
bladder detrusor
ductus deferens 
seminal vesicles
uterus
arteries
A 
decrease movement
contract
relax
contract
contract
relax
vasoconstriction

ejaculation

95
Q

parasympathetic is from where

A

pelvic splanchnic nerves (S2-S4)

96
Q 
parasympathetic effect on:
rectum
anal canal
internal anal sphincter
bladder detrusor
arteries
A 
increase motility
increase motility
relax
contract
vasodilation = erection

*no effect on; seminal vesicles, ductus deferens, uterus

97
Q

nerves of penis

A

dorsal nerve of penis from pudendal nerve (somatic sensory + sympathetic)
cavernous nerve from prostatic plexus (parasympathetic)

98
Q

nerves of scrotum

A

anterior scrotal from ilioinguinal and genitofemoral
posterior scrotal from perineal branch of pudendal
(somatic)

99
Q

nerves of anterior perineum (female)

A

anterior labial from ilioinguinal and genitofemoral

100
Q

nerves of posterior perineum (female)

A

posterior labial from pudendal

101
Q

nerve to labia

A

posterior labial from pudendal

102
Q

nerve to orifice of vagina

A

deep branch of pudendal

103
Q

nerve to bulb of clitoris

A

cavernous nerve from the utero-vaginall process

Gross Anatomy (6 decks)

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