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MD3002 Reproductive > Pelvis > Flashcards

Pelvis Flashcards

1
Q

differentiate between the abdomen, pelvic cavity and perineum

A
  • abdominal cavity superior until it meets the iliac crests
  • then pelvic cavity: greater and lesser pelvis separated by the pelvic brim
  • then perineum
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2
Q

What bones form the pelvis?

A
  • hip bones (ischium, ilium, pubis)
  • sacrum
  • coccyx
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3
Q

What are the joints of the pelvis?

A
  • pubic symphysis (secondary cartilaginous)
  • sacroiliac joint (bilateral and posterior - synovial)
  • hip joint (ball and socket joint - synovial)
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4
Q

What forms the pelvic inlet?

A
  • pubic symphysis
  • pubic crest
  • pectineal line
  • arcuate line of ilum
  • sacral ala and sacral promontory
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5
Q

What are the ligaments of the pelvis?

A
  • sacrotuberous ligament: from posterior-inferior iliac spine, sacram and coccyx to ischial tuberosity
  • sacrospinous ligament: from sacrum, cocyx and sacrotuberous ligament to ischial spine
  • both form greater and lesser sciatic foramina
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6
Q

What forms the pelvic outlet?

A
  • pubic symphysis
  • ischiopubic ramus
  • ischial tuberosity
  • sacrotuberous ligament
  • coccyx
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7
Q

Describe some differences between the male and female pelvis

A

Females:

  • thin and light
  • shallow greater pelvis
  • wide and shallow lesser pelvis
  • inlet is oval and rounded and wide
  • outlet is large
  • wide pubic arch

Males:

  • thick and heavy
  • deep greater pelvis
  • narrow and deep lesser pelvis
  • inlet is heart shaped and narrow
  • outlet is small
  • narrow pubic arch
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8
Q

What forms the different pelvic walls

A

Antero-inferior:

  • pubic symphysis
  • body and rami of pubis

Postero-superior:

  • sacrum
  • piriformis (divides the greater sciatic foramen)

Lateral:
- obturator internus with fascia

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9
Q

Where is the perineum found?

A

inferior to the pelvic floor and divided into 2 compartments (superficial and deep) anteriorly by perineal membrane

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10
Q

What muscles form the pelvic diaphragm?

A
  • levator ani (pubococcygeus, puboredctalis, iliococcygeus)

- coccygeus

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11
Q

What are the origins and innervations of the levator ani muscles?

A
  • pubis
  • ischial spine
  • tendinous arch (formed from thickening of internal membrane of obturator internus)
  • innervated by S3-4
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12
Q

Describe the anatomy and role of puborectalis

A
  • originates from one side of pubis, slings round to attach to other side of pubis
  • extends muscle fibres medially around anus region
  • important in faecal continence
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13
Q

What are the divisions of pubococcygeus?

A
  • puborectalis
  • puboperineal
  • pubovaginalis (female) or puboprostaticus (male)
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14
Q

What is the functions of the pelvic diaphragm (levator ani)?

A
  • supports pelvic organs
  • makes anorectal angle more acute and augments external anal sphincter for faecal continence
  • augments urethral sphincter for urinary continence
  • forms vaginal sphincter
  • actively contracted coughing/sneezing/forced expiration
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15
Q

Where are the pelvic diaphragm muscles anchored?

A
  • all meet in midline to form anococcygeal body (raphe of ligament) and perineal body (central tendon of perineum)
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16
Q

What is the lowest point in the pelvic cavity?

A
  • rectouterine/rectovesical pouch
17
Q

Describe the prevertebral plexuses

A
  • prevertebral plexuses are formed around abdominal aorta by:
  • sympathetics (T1-L2/3)
  • parasympathetics (vagus or S2-4)
  • condense around origins of branches of abdo aorta to form:
  • coeliac plexus
  • renal plexus
  • superior and inferior mesenteric plexus
  • superior hypogastric plexus
18
Q

Describe the pelvic autonomic nerves

A
  • sacral sympathetic trunks (motor and sensory, 4 pairs sympathetic ganglia, lumbar and sacral splanchnic nerves)
  • parasympathetic fibres from S2-4 (nervi erigentes, motor and sensory)
  • hypogastric plexuses (superior and inferior hypogastric plexuses)
  • periarterial plexuses (postsynaptic, sympathetic, vasomotor fibres to arteries - superior rectal/ovarian/internal iliac)
19
Q

Where is the superior and inferior hypogastric plexuses found?

A
  • superior: lies in front of inferior part of abdo aorta and its bifurcation
  • inferior: lies on each side of rectum, in base of bladder and vagina
20
Q

What is the superior hypogastric plexus formed as?

A
  • continuation of aortic plexus
  • sympathetic fibres from L3 and L4 sympathetic ganglia
  • parasympathetic fibres from pelvic splanchnic nerves
21
Q

What is the inferior hypogastric plexus formed as?

A
  • sympathetic fibres from hypogastric nerves (from superior hyogastric)
  • parasympathetics from pelvic splanchnic nerves
22
Q

Describe what different visceral afferents travel with

A
  • visceral afferents conducting unconscious sensation travel with parasympathetic fibres
  • visceral afferents conducting pain travel with: * sympathetics T11-12 (if organ touches peritoneum) - suprapubic pain
  • parasympathetics S2-4 (any organ below peritoneum) - perineum pain
23
Q

Where is the pelvic pain line?

A
  • inferior limit of peritoneum

- middle of sigmoid colon

24
Q

Where does the pudendal nerve originate and travel?

A
  • originates S2-4
  • travels through greater sciatic foramen
  • curves posterior to ischial spine and sacro-spinous ligament
  • runs forwards into perineum inferior to levator ani
25
Q

Describe the arterial supply of the pelvis

A
  • common iliac artery => internal iliac artery opposie sacroiliac joint at level T5 disc
  • internal iliac divides into anterior and posterior trunks
  • supplies buttock, medial thigh, posterior pelvic and abdo walls, pelvic viscera and perineum
26
Q

Describe the venous drainage of the pelvis

A
  • venous plexuses of pelvic viscera that drain into internal iliac or internal pudendal vein
  • internal iliac drains to the artery
  • joins external iliac vein to form common iliac vein
27
Q

Describe the lymphatic drainage of the pelvis

A
  • parallel with venous drainage
  • common, external, internal iliac and sacral lymph nodes
  • interconnected

MD3002 Reproductive (35 decks)

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