Pelvis Flashcards
Hip bone (os coxae) is made up of which 3 bones?
- ilium (superior portion)
- ischium (lower posterior portion)
- pubic (lower anterior portion)
the two os coxae meet anteriorly at….
posteriorly at….
- pubic symphysis joint (allows for movemnent when pregnant up to 9 mm)
- sacroiliac joint
the deep pockets of the hip joint are termed….
acetabula, accepts head of femur
sacrum
5 fused vertebrae
coccyx
4 fused cartilaginous bones
sacrospinous ligament
- extends from lateral border of sacrum and coccyx to ischial spine
- prevents posterior rotation of ilium with respect to sacrum
- fixation site for pelvic organ prolapse
sacrotuberous ligament
- with sacrospinous ligament closes off greater sciatic notch to form greater sciatic foramen
- closes of lesser sciatic notch to form lesser sciatic forament
pelvis boundaries
posterior-upper border of sacral promontory
lateral-ileopectineal line
anterior-upper border of pubis
gynaecoid pelvis
- ideal shape for vaginal delivery
- side walls straight w/blunt ischial spines
- wide sacro-sciatic notch
- subpubic angle is 90-100
anthropoid pelvis
- long anteroposterior diameters
- short transverse diameters
- long and narrow sacrum
- wide sacro-sciatic notch
- subpubic angle is less than 90
- ape like
android pelvis
- common male type
- projecting ischial spines
- narrow sacro-sciatic notch
- subpubic angle is less than 90
platypelloid pelvis
- flat female type
- short anteroposterior diamater
- long transverse diameter
- sacro-sciatic notch narrow
- sub pubic angle is wide
pelvic cavity contains….
- urinary bladder
- ureters
- pelvic genital organs
- retum
- blood vessels
- lymphatics
- nerves
sacral promontory
most superior portion of sacrum
sacroiliac joint is made up of….
- anterior sacroiliac
- interosseus sacroiliac
- posterior sacroiliac
- sacrotuberous
sacro-coccygeal joint is made up of….
- anterior sacrococcygeal
- posterior sacrococcygeal
- lateral sacrococcygeal
- intercornual sacrococcygeal
problems with the hip ligaments leads to….
osteoarthritic changes in femur/acetabulum
for every pound overweight you are putting….
3 extra pounds of pressure on the hip
pelvic inlet
superior aperture
pelvic outlet
inferior aperture
greater pelvis
- aka false pelvis
- abdominal wall anteriorly
- iliac fossa posteriolaterally
- L5 S1 vertebrae posteriorly
lesser pelvis
- aka true pelvis
- location of pelvic viscera (bladder and reproductive organs such as uterus and ovaries)
- bounded by hip bones, coccyx, sacrum
- inferiorly by muscular fascial pelvic diaphragm
anterior pelvic wall formed by
-body and rami of pubic bones and pubic symphysis
lateral pelvic wall formed by
- hip bone and obturator internus muscle
- below pelvic inlet
- made up of sacrotuberous and sacrospinous ligaments
posterior pelvic wall formed by
- sacrum and coccyx
- piriformus muscle covers (wallets cause pain in this area referred to as piriformus syndrome)
pelvic floor formed by
- funnel shaped pelvic diaphragm
- consists of levator ani and coccygeus muscles an their fascia
- stretches between pubis anteriorly and coccyx posteriorly from one lateral pelvic wall to the other
lavator ani is made up of
- pubococcygeus
- iliococcygeus
- puborectalis
in women the pelvic floor consists of….
-muscles, ligaments, connective tissues, and nerves that support the bladder, uterus, vagina, and rectum
in men the pelvic floor consists of…
-muscles, tissues, and nerves that support the bladder, rectum, and other pelvic organs
levator ani is innervated by
-S4 and inferior anal (rectal) nerve from S2-S4 and the coccygeal plexus
Coccygeus muscle: origin
- insertion
- innervation
- ischial spine
- inferior end of sacrum
- branches of S4/S5
Pelvic diaphragm
- separates pelvic cavity above and perineal region below
- muscular partition formed by levator ani and coccygei muscles
3 possible areas of constriction in ureters?
- ureteropelvic junction
- pelvic inlet
- entrance to bladder
bladder trigone is….
and is formed by…..
- smooth triangular region of urinary bladder sensitive to stretch/expansion
- 2 ureteric orifice and urethral orifice
detrusor muscle
smooth muscle found in wall of urinary bladder
- parasympathetic to contraction of muscle (detrusor) S2/S4
- sympathetic to contraction of internal sphincter
male bladder problems
male-benign hyperstatic hypertrophy from prostate limiting urine output
female-
bladder innervation
- sympathetic fibers from superior and inferior hypogastric plexus
- parasym from pelvic splanchnic nerves
urination is controlled by
sympathetic nervous system, (sphincter)
somatic motor control of bladder
- voluntary
- pudendal nerve maintains tonic contraction of external urethral sphincter until voluntarily inhibited
perineum
lies inferior to pelvic outlet and is separated from pelvic cavity by pelvic diaphragm
perineum bounded -anteriorly
- anterolaterally
- laterally
- posteriolaterally
- inferiorly
- pubic symphysis
- inferior pubic rami and ischial rami
- ischial tuberosity
- sacrotuberous ligament
- sacrum and coccyx
anal triangle
anus
urogenital triangle
-root of penis and scortum in males and external genitalia in females
perineal membrane
-stretches b/w 2 sides of pubic arch and covers anterior part of outlet
perineal body
The perineal body (or central tendon of perineum) is a pyramidal fibromuscular mass in the middle line of the perineum at the junction between the urogenital triangle and the anal triangle. It is found in both males and females
common iliac artery gives rise to
internal iliac
artery to head of femur
- supplies head of femur
- ligament damage around here can cause necrosis from lack of blood flow
lymphatics of pelvis
-external/internal/common iliac nodes
lymph from common iliac passes to
lateral aortic nodes
superior hypogastric plexus
- situated in front of sacral promontory continuation of aortic plexus
- branches from L3/L4
inferior hypogastric plexus
- lie on each side of rectum, base of bladder, vagina
- formed form hypogastric nerve from superior and pelvic splanchnic nerve
