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Anatomy > Pelvis > Flashcards

Pelvis Flashcards

1
Q

Inferior hypogastric plexus

A

Recieves pre-ganglionic parasympathetic fibres from
S2 - S4

Inferior hypogastric plexus form on posterior abdominal wall as extensions of abdominal pre-vertebral plexus

Post-ganglionic fibres penetrate pelvic floor –>
Innervate erectile tissue in males and females

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2
Q

Sacrum

A

Five sacral vertebrae fused

Has 4 anterior sacral foramina

Has 4 posterior sacral foramina

Sacral canal posteriorly which is a continuation of vertebral canal

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3
Q

Zygapophysial joints

A

Joints between adjacent inferior and superior articular processes of L5 and S1

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4
Q

Ligaments of the sacro-iliac joints

A

Anterior sacro-iliac ligaments
-thickening of the fibrous memrbane of the joint capsule

Interosseous sacro-iliac ligament

  • largest, strongest
  • posteriosuperior to joint and attach on roughended areas on ilium and sacrum

Posterior sacro-iliac ligament
-covers the interossesous sacro-iliac ligament

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5
Q

Ligaments between L5 –> ilium/sacrum

A

Lumbosacral ligament
-Transverse process L5 –> sacrum

Ileolumbar ligament
-Iliac crest –> transverse process of L5

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6
Q

Ligaments of pubic symphysis joint

A

Superior pubic ligament
-located above the joint

Inferior pubic ligament
-located below joint

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7
Q

Female vs male pelvis

A

Female pelvis

  • circular inlet
  • pubic arch 80-85
  • ischial spines don’t project

Male pelvis

  • heart-shaped inley
  • pubic arch 50-60
  • pojecting ischial spines + prominent sacral promonotory
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8
Q

Sacrospinous ligament

A

Smaller of the two ligaments

Triangular, apex attached to ischial spine

Base attached to margins of sacrum and coccyx

More anterior vs sacrotuberous ligament

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9
Q

Sacrotuberous ligament

A

Larger of the two, sits posterior to sacrospinous

Triangular

Base has broad attachment that extends from posterior superior iliac spine –> coccyx

Attaches to medial margin of ischial tuberosity

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10
Q

Innervation of obturator internus

A

Innervated by nerve to obturator internus
L5 S1

O: deep surface of obturator membrane and surrounding bone

I: Medial surface of greater trochanter of femur
-tendon leaves pelvic cavity through lesser sciatic foramen, makes a 90 bend around ischium –> posterior to hip –> greater trochanter

F: Lateral rotation of extended hip
Abduction of flexed hip

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11
Q

Innervation of piriformis

A

Innervated by branches from (L5) S1 + S2

O: Anterior surface of sacrum between the four anterior sacral foramina

I: Medial side of superior border of greater trochanter of femur

F: Lateral rotation of extended hip
Abduction of flexed hip

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12
Q

Obturator canal

A

Supeior defect in obturator membrane

Borders:

  • Superior pubic ramus
  • Obturator internus, externus, and membrane

Contants

  • Obturator nerve
  • Obturator vessels
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13
Q

Greater sciatic foramen

A

Borders:

  • greater sciatic notch
  • sacrspinous ligament (posterior)
  • sacrotuberous ligament (inferior)
  • spine of ischium

Piriformis divides into two compartments

Superior to piriformis

  • Superior gluteal nerve
  • Superior gluteal vessels

Inferior to piriformis

  • Inferior gluteal nerve
  • Inferior gluteal vessels
  • Internal pudendal vessels
  • posterior femoral cutaenous nerve
  • nevre to obturator internus
  • nerve to quadrate femoris
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14
Q

Innervation of levator ani

A

Innervated by:

  • inferior rectal branch of internal pudendal nerve
  • direct branches from ventral ramus of S4

O: line around pelvic wall

  • ischial spine
  • tendinous arch
  • obturator internus
  • pubic bone

I:

  • anterior: superior surface of perineal mambrane
  • posterior: meets partner on perineal body, around anal canal and along anococcygeal ligament

F: reinforces pelvic floor, reinforces sphincters

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15
Q

Innervation of coccyges

A

Innervated by direct branches from ventral rami of S3 and S4

O: ischial spine and pelvic surface of sacrospinous ligament

I: lateral margin of coccyx and related border of sacrum

F: contributes to formation of pelvic floor which support viscera and pulls coccyx forward after defecation

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16
Q

Anococcygeal ligament

A

Posterior to the anal aperture the two sides of levator ani form raphe = anococcygeal ligament

This forms structural connection with external anal sphincter and coccyx

17
Q

Parts of levator ani

A

Pubococcygeus

  • originates body of pubis
  • -> midline as far back as coccyx

Puborectalis

  • Originates form pubis
  • -> forms sling around inferior anal aperture

Iliococcygeus

  • Originates from fascia surrounding obturator internus
  • -> forms anococcygeal ligament / raphe
18
Q

Perineal membrane

A

Thick facial triangular structure

  • attached to bony framework of pub arch
  • free posterior border

Anterior gap: between inferior pubic ligament and fascia

Covers deep perineal pouch

Hiatus for urethra and vagina

19
Q

Deep perineal pouch

A

Covered by perineal membrane

Skeletal muscle tha functions as a sphincter

Anteriorly: external urethral sphincter

+/-spinchter urethrovaginalis (surrounds urethra and vagina)
+/- compressor urethrae pm each side: originate from ischiopubic rami and meet anterior to urethra

20
Q

Deep transverse perineal muscle

A

Two muscles that parallel free edge of perineal membrane
-joins with partner in midline

Act to stabilise position of perineal body

21
Q

Structures connecting to perineal body

A

Positioned on posterior border of perineal membrane

Structures connecting to it:

  • posterior end of urogenital hiatus in levator ani
  • deep transverse perineal muscles meet at it
  • females: urethrovaginalis
  • external anal sphincter
  • superficial transverse perineal muscles
  • bulbospongiosus muscles of perineum
22
Q

Innervation of external urethral sphincter

A

Innervated by perineal branches of pudendal nerve S2 - S4

O: inferior ramus of pubis and adjacent walls of deep perineal pouch

I: surrounds membranous part of urethra

F: compresses membranousus urethra

23
Q

Innervation of deep transverse perineal muscle

A

Innervated by perineal branches of pudendal nerve S2 - S4

O: medial aspect of ischial ramus

I: perineal body

F: stabilises position of perineal body

24
Q

Level of start of retcum

A

S3

25
Q

Perineal flexure

A

Anorectal junction is pulled forwards bu puborectalis of levator ani

=perineal flexure

Anatomy (22 decks)

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