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Gross anatomy > Pelvis and Pelvic floor > Flashcards

Pelvis and Pelvic floor Flashcards

1
Q

What is the pelvic inlet?

A

Rostral opening of the pelvis

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2
Q

What are the borders of the pelvic inlet?

A

Posterior: sacral promontory (the superior portion of the sacrum) and sacral wings

Lateral: arcuate line on the inner surface of the ilium, and the pectineal line of the superior pubic ramus.

Anterior: pubic symphysis.

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3
Q

What does the sacrotuberous ligament attach?

A

Sacrum to ischial tuberosities

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4
Q

What does the sacrospinous ligament attach?

A

Sacrum and coccyx to ischial spine

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5
Q

What spaces to the sacrotuberous and sacrospinous ligaments form?

A

The greater and lesser sciatic foramina

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6
Q

How does the pudenal nerve pass through the pelvis?

A

Passes through the greater sciatic foramen and gains access to the perineal muscles inferior to the pelvic floor by passing through the lesser sciatic foramen.

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7
Q

Which nerve passes through both the lesser and greater sciatic foramen?

A

Pudenal

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8
Q

What is the pelvic outlet?

A

Caudal opening of the pelvis

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9
Q

What are the borders of the pelvic outlet?

A

Posterior: The tip of the coccyx

Lateral: The ischial tuberosities and the inferior margin of the sacrotuberous ligament

Anterior: The pubic arch

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10
Q

What is the angle between the pubic arch known as and how does it vary between men and women?

A

Sub-pubic angle

Greater in women

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11
Q

The female sub-pubic angle is greater than __ degrees?

A

80

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12
Q

Where do the muscles of the pelvic floor all partly attach?

A

The fascia covering the obturator internus

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13
Q

Where does the perineum lie in relation to the pelvic floor?

A

Beneath

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14
Q

What two features make up the perineum?

A

The perineal body and the perineal membrane

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15
Q

What is the perineal body?

A

The perineal body is a ‘node’ or ‘knot’ of fibrous tissue

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16
Q

Where does the perineal body lie in relation to the pelvis bones?

A

Midline between the two ischial tuberosities

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17
Q

What is the perineal body and important site of attachment for?

A

Levator ani muscles and muscles of the perineum

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18
Q

What muscle forms the muscular pelvic floor?

A

Skeletal muscle (somatic)

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19
Q

What is the role of the pelvic floor?

A

Supports and maintains the position of pelvic viscera and has an important role in anal continence and defecation.

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20
Q

What muscles make up the pelvic floor?

A

Left and right levator ani (composed of pubococcygeus, puborectalis and iliococcygeus)

Right and left coccygeus muscles

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21
Q

What does the levator ani attach to?

A

The posterior surface of the body of the pubis

The fascia covering obturator internus

The spine of the ischium.

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22
Q

What are the three fibres of the levator ani?

A 
Anterior fibres 
Intermediate fibres (puborectalis and pubococcygeus)
Posterior fibres (iliococcygeus)
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23
Q

What do the anterior fibres attach to/form a sling around?

A

Form a sling around the prostate/vagina and are attached to the perineal body.

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24
Q

What does the puborectalis of the intermediate fibres form a sling around and where does the pubococcygeus attach?

A

Puborectalis fibres form a sling around the junction between the rectum and anal canal.

Pubococcygeus passes to the coccyx

25
Q

Where does the posterior fibres/iliococcygeus attach?

A

Coccyx

26
Q

What are the attachments of the coccygeus muscle?

A

Attached from the ischial spine to the junction of the sacrum and the coccyx.

27
Q

What is the role of coccygeus muscle

A

Coccygeus assists levator ani in supporting the pelvic viscera.

Muscles and ligaments provide support, normally preventing the pelvic viscera from passing through the pelvic outlet (prolapse).

28
Q

What is the perineum divided into?

A

A urogenital triangle and an anal triangle

29
Q

What divides the anal and urogenital triangles?

A

The line joining the two ishcial tuberosities

30
Q

What does the peritoneal membrane consist of?

A

Strong connective tissue

31
Q

In the urogenital triangle what lies deep to the peritoneal membrane?

A

Striated muscle, the sphincter urethrae, external urethral sphincter

32
Q

What perforates the tissues of the urogenital triangle in both males and females?

A

Urethra

33
Q

What perforates the tissues of the urogenital triangle in females only?

A

Urethra and vagina

34
Q

What is the superficial perineal pouch?

A

Anatomical space that lies below the perineal membrane and above the perineal fascia

35
Q

What are the perineum pouches in the anal triangle called and where are they located?

A

Ischioanal fossae, one each side of the anal canal

36
Q

Where is the perineal body located in males?

A

Lies in the midline between the deep and superficial perineal spaces anteriorly and the anal canal posteriorly.

37
Q

Where is the perineal body located in the female?

A

Lies in the midline, between the lower end of the vagina and the anal canal.

38
Q

In females where is the deep perineal pouch?

A

Deep perineal space lies inferior to the pelvic floor but superior to the muscles of the deep pouch and the perineal membrane

39
Q

What does the deep perineal pouch contain in women?

A

External urethral sphincter / sphincter urethrae muscle

Compressor urethrae muscle (CU)

Deep transverse perineal muscles

40
Q

In women, what lies in the superficial perineal space?

A

Lower end of the vagina, and on either side, the bulb of vestibule (erectile tissue)

41
Q

What muscles make up the superficial perineum in women?

A

Small superficial transverse perineal muscle, the ischiocavernosus muscle and the bulbospongiosus muscle.

42
Q

In males where is the deep perineal pouch?

A

Lies inferior to the pelvic floor but superior to the muscles of the deep pouch and the perineal membrane.

43
Q

What muscles does the male deep perineal pouch contain?

A

External urethral sphincter and the deep transverse perineal muscles.

44
Q

In males what muscles make up the superficial perineum?

A

Ischiocavernosus

Bulbospongiosus

Superficial transverse perineal muscles

45
Q

What shape is the female and male obturator foramen?

A

Male, oval

Female, triangular

46
Q

What forms the posterior part of the floor?

A

Coccygeus

47
Q

What lies anterior to the sacrospinous ligament?

A

Coccygeus

48
Q

What is the anococcygeal raphe?

A

A musculotendinous structure passing between the anterior coccyx and the posterior anus

49
Q

What are the key arteries of the pelvis/ branches of the internal iliac?

A

Internal iliac, superior gluteal, inferior gluteal, obturator, internal pudendal

50
Q

Internal iliac supplies?

A

Pelvic walls viscera, external genitalia, perineum, buttock, medial thigh

51
Q

Superior gluteal supplies?

A

Gluteus medius, gluteus minimus, tensor fasciae latae

52
Q

Inferior gluteal supplies?

A

Gluteus maximus, piriformis, quadrator femoris

53
Q

Obturator artery supplies?

A

Obturator externus, adductor compartment, femur

54
Q

Internal pudendal artery supplies?

A

External genitalia, perineum

55
Q

How does the pudendal nerve travel?

A

Exit pelvis through greater sciatic foramen and enters perineum via lesser sciatic foramen

Innervates perineum

56
Q

Coccygeal plexus roots

A

S4-S5

57
Q

What are the pelvic plexuses (inferior hypogastric plexuses)?

A

Autonomic and give both sympathetic and parasympathetic

58
Q

What contributes to the pelvic plexi?

A

Superior hypogastric (symp) sacral splanchnic (symp) and pelvic splanchnic (para)

Gross anatomy (17 decks)

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