Pelvis

Question 1

what’s the differences between the male and female bony pelvis?

Answer 1

pelvis major and minor: F = shallow and wider, M = deep and narrower
pelvic inlet: F = oval/round, M = heart shaped
sub pubic angle: F > 90, M < 90
Acetabulum: F = smaller
Obturator foramen: F = round, M = oval

Question 2

what are the 2 joints associated with the pelvis and what type of joints are they?

Answer 2

sacroiliac joint = synovial plane

pubic symphysis = secondary cartillagenous

Question 3

what nerves lie on the piriformis?

Answer 3

sacral plexus

Question 4

what are the pelvic floor muscles?

Answer 4

puborectalis
pubococcygeus
illiococcygeus
coccygeus

Question 5

give 2 functions of the pelvic floor.

Answer 5

constrictor/continence mechanism for urethra, anus and vagina
supports abdominal viscera

Question 6

what is the innervation of the pelvic floor muscles?

Answer 6

levator ani - inferior anal nerve S4, coccygeal plexus

coccygeus - anterior rami of S4 and S5

Question 7

what is a cytocele?

Answer 7

prolapse of bladder into vagina

Question 8

what is a retrocele?

Answer 8

prolapse of rectum into vagina

Question 9

why is damage to the pelvic floor during childbirth damaging?

Answer 9

stretching or tearing of the perineal body from th perineal muscles can cause prolapse of the uterus/vagina or bladder

Question 10

what can be done in order to avoid damaging the pelvic floor muscles during childbirth if the birth canal is too narrow?

Answer 10

episiotomy

this will enlarge the vagina to minimise damage to the perineal body and perineal muscles

Question 11

what is more preferred, a midline or mediolateral episiotomy and why?

Answer 11

mediolateral episiotomy will prevent tearing of the peroneal body which is in the midline and therefore going through ligaments
because going through ligaments causes less bleeding but longer to heal compared with cutting through muscle which will heal quicker

Question 12

what is the main blood supply of the pelvic organs?

Answer 12

internal iliac arteries

Question 13

what artery supplies the testes and ovaries?

Answer 13

gonadal artery

Question 14

what is the blood supply of the bladder?

Answer 14

superior and inferior vesical arteries

Question 15

what artery supplies the vagina?

Answer 15

vaginal artery

Question 16

what is the main blood supply of the perineum?

Answer 16

internal pudendal artery

Question 17

what does the obturator artery supply?

Answer 17

muscles of the pelvic floor

nutrient artery to illium and femur

Question 18

what is the blood supply of the seminal vesical and prostate in males?

Answer 18

superior and inferior vesical

Question 19

what parts of the rectum drain into the portal and systemic circulation ?

Answer 19

superior 1/3 = portal circulation

inferior 2/3 = systemic circulation

Question 20

what is the importance of knowing the venous drainage of the rectum?

Answer 20

the superior 1/3 drains into the portal circulation os can be affected by portal hypertension

Question 21

why might haemorrhoids be associated with cirrhosis of the liver?

Answer 21

cirrhosis = portal hypertension

increased venous pressure can cause haemorrhoids

Question 22

what is the course of the pudendal nerve?

Answer 22

formed from the sacral plexus
travels through the lower part of the greater sciatic foramen and goes to supply the perineum
follows with pudendal artery

Question 23

what foramen does the pudendal nerve go through and what does it supply?

Answer 23

greater sciatic foramen

perineum

Question 24

what is the root values of the pudendal nerve?

Answer 24

S2 - S4

Question 25

what procedure is used to reduce/stop pain during childbirth and why?

Answer 25

bilateral pudendal nerve block

pudendal nerve supplies the skin and muscles of the perineum

Question 26

what bony landmark is used when performing a bilateral pudendal nerve block?

Answer 26

ischial spine

Question 27

what does the pudendal nerve innervate?

Answer 27

muscles and skin of the perineum

Question 28

what pelvic area does the external iliac lymph nodes drain?

Answer 28

superior parts of anterior organs

Question 29

what pelvic area does the internal iliac lymph nodes drain?

Answer 29

gluteal region, deep perineum, inferior pelvic viscera

Question 30

what pelvic area does the sacral lymph nodes drain?

Answer 30

posterior inferior pelvic viscera

Question 31

where does the 3 lymph node groups in the pelvis drain?

Answer 31

drain to the common iliac lymph nodes

Question 32

what are the 3 main lymph groups in the pelvis?

Answer 32

internal iliac
external iliac
sacral

Question 33

what is the innervation of the coccygeus muscle?

Answer 33

anterior rami S4 and S5