Pelvis Flashcards
pelvis is enclosed by _____
pelvic girdle
the pelvis is closed off inferiorly by …
pelvic and urogenital diaphragms
perineum
area of surface of trunk between thighs and buttocks and the shallow compartment lying deep to this area and inferior to the pelvic diaphragm
includes anus and external genitalia
mons pubis
rounded mass of fatty tissue overlying pubic bones
bony pelvic girdle
two coxal (hip) bones (fused ilium,pubis, ischium - join in acetabulum) + sacrum + coccyx
pelvic inlet
open
sacral promontory to superior margin of pubic symphysis
joints of the pelvis loosen under the action of _______ during pregnancy
joints of the pelvis loosen under the action of relaxin during pregnancy
greater pelvis
false pelvis, pelvis major
- inferior pt of abd cavity
- holds some abd viscera
lesser pelvis
true pelvis, pelvis minor
- between pelvic inlet and outlet
- holds pelvic viscera
pelvic axis shape? what does it join?
curved
joins center points of pelvic inlet and outlet
pelvic outlet
closed
inferior margin of pubic symphysis to tip of coccyx
female differences in pelvis
female measurements longer
bones thinner, lighter
inlet oval, rounded, wider
outlet larger
pubic arch larger and angle wider
iliac wing more flared
ischial tuberosity more apart (everted)
true conjugate
obstetrical conjugate
narrowest fixed diameter through which head of baby passes
- measure radiographically
- approximate from diagonal conjugate
pelvic floor
pelvic diaphragm
urogenital diaphragm
bears weight of abdpelvic viscera
maintains continence
walls of pelvic cavity
ant: pubis bone/pubic symphysis
lat: obturator internus m.
inf: pelvic floor m. (pelvic diaphragm)
post: piriformis m.
levator ani
puborectalis
pubococcygeus
illococcygeus
supportive m. for midline pelvis organs
weakness –> incontinence
pelvic diaphragm
levator ani + coccygeus m.
puborectalis
forms puborectal sling
m. possibly torn during childbirth
surgical tx to widen birth canal?
bulbospongiosus m., levator ani (especially pubococcygeus)
episiotomy
the most inferior extent of peritoneum in the male
rectovesical pouch
recto-prostatic fascia of denonvilliers
separates the rectum (posterior) from the genito-urinary tract (anterior)
prostate cancer can spread to rectum
internal sphincter of urinary bladder (male)
smooth muscle of neck of bladder
external sphincter of unrinary bladder (male)
sphincter urethrae m. (skeletal)
Benign prostatic hyperplasia
enlarged prostate
obstructs urethral orifice, usually due to middle lobe enlargement
leads to nocturia, dysuria and urgency
seminal vesicles
pair of glands posteroinferior to the bladder
secrete fluid that becomes semen
excretory ducts open into vas deferens as it enters the prostate gland and become the ejaculatory ducts
the most inferior extent of peritoneum in the female
recto-uterine pouch
aka DOUGLAS’ POUCH
where peritoneum reflects from vagina onto rectum
fluid can pool here
female pelvic organs
rectum
anal canal
distal ureters
urinary bladder
urethra
ovaries
oviducts
uterus
vagina
rectovaginal fascia of Otto
separates vagina and rectum
cervical cancer can spread to rectum from here
female homologue of prostate gland
parauretheral glands (Skene’s duct) –> G-spot?
hyster- refers to
uterus
salphingo- refers to
oviduct
oophoro- refers to
ovary
The normal position of the uterus is _________ and ________ and lies almost in the ____________ position
The normal position of the uterus is ANTEFLEXED and ANTEVERTED and lies almost in the HORIZONTAL position
flexion is defined by angle between
w/ regard to female pelvis
angle between axes of body of uterus and the cervix
verision is defined by angle between
w/ regard to female pelvis
angle between axis of cervix against vagina
broad ligament of the uterus
double layer of peritoneum, is draped over oviducts and forms “sleeves” on either side of uterus
holds uterus in place
uterine artery is ______ to ureter
uterine artery is superior to ureter
rim around cervix
vaginal fornix
ectopic pregnancy
outside uterus
frequently in Fallopian tube
endometriosis
benign disorder
mass of endometrial tissue occurs aberrantly in various locations (uterine wall, ovaries, or other extraendometrial sites)
frequently forms cysts containing altered blood
leiomyoma/fibroid
most common benign neoplasm of the female genital tract derived from smooth muscle
occurs in the wall of the uterus
large fibroid can cause bleeding, pressure and pain in the pelvis, heavy menstrual periods and infertility
cervix is held in place by which ligaments?
- cardinal ligament (transverse cervical) ligament AKA Mackenrodt’s
- uterosacral ligament
- round ligament of uterus
relaxation of Macenrodt’s ligament can lead to…
uterine prolapse
Mackenrodt’s ligament=cardinal (transverse cervical) ligament
transformation zone and cervical cancer
Columnar cells constantly changing into squamous cells in an area of the cervix
Most common place on the cervix for abnormal cells to develop
pelvic innervation
sacral plexus (sciatic and pudendal)
nerves to pelvic diaphragm (n. to levator ani and coccygeus)
pelvic plexus
sciatic n.
L4-S3
pudendal n.
S2-S4
n. to pelvic diaphragm
n. to levator ani
n. to coccygeus
S3-S4
pelvic plexus
pelvic splanchnic n. (S2-S4) parasympathetic and visceral afferent
hypogastric plexuses (mixed)
most of the autonomic nerves to the pelvic viscera arise in the ______________
paired inferior hypogastric plexuses
describe referred pain above pelvic pain line
visceral afferent fibers conducting pain from abdominal pelvic viscera follow SYMPATHETIC fibers
ascend through hypogastric/aortic plexus, abdominopelvic splanchnic n., lumbar sympathetic trunks, and white rami communicates to reach cell bodies in inferior thoracic/upper lumbar spinal ganglia
describe referred pain below pelvic pain line
visceral afferent fibers conducting pain from viscera follow PARASYMPATHETIC fibers
go through pelvic and inferior hypogastric plexus and pelvic splanchnic n. to reach cell bodies in spinal sensory ganglia S2-S4
anesthesia for childbirth
spinal block via lumbar puncture
caudal epidural block
pudendal n. block
Only the lower portion of the vagina is ________ ________
Only the lower portion of the vagina is somatic efferent
Main blood supply of male pelvis
ant. division of internal iliac a.
- internal pudendal
- inferior vesical
- obliterated umbilical a.
- superior vesical
- middle rectal
aorta –> common iliac –> internal iliac
Batson’s plexus
veins draining pelvic viscera
valveless, prostate cancer can spread thru
graining veins unite to form internal iliac veins of each side, which unite with the corresponding external iliac veins to form the common iliac veins to the IVC
Main blood supply of female pelvis
ant. division of internal iliac a.
- internal pudendal
- middle rectal
- vaginal, w/ br. to bladder
- uterine
- obliterated umbilical a.
- superior visceral
aorta –> common iliac –> internal iliac
lymphatic drainage of testes and ovaries
lumbar (caval/aortic nodes)
