Pelvis and Pelvis Floor Flashcards

Question 1

Q

The pelvis refers to what two structures?

Answer

A

Bony pelvis: bony framework
Pelvic cabity: space inside lower part of pelvis
1. continuous with the abdominal cavity

Question 2

Q

Identify the structures indicated by number on the provided image

Question 3

Q

What is the relationship between teh peritoneum and the structures in the pelvic cavity?

Answer

A

they are beneath the peritoneum “sub-peritoneal”

Question 4

Q

Identify the bones indicated in the provided image

Question 5

Q

Identify the bones indicated in the provided image

When do we fusion of these bones?

Answer

A

Acetabulum fuses at 15 -17 years

Question 6

Q

What are the two part of the pelvis & what is the landmarks that dives them?

Answer

A

false pelvis (greater pelvis): not part of pelvic cabity, is actually part of abdominal cavity
true pelvis (lesser pelvis): it is the pelvic cavity
demarked by the pelvic inlet

Question 7

Q

How do you orient a pelvis in anatomical position?

Answer

A

ASIS & pubic tubercle in same frontal plane

Question 8

Q

Describe the path of the pelvic inlet

Answer

A

sacral promotory
along sacral ala
along the arcuate line on the ileum
along the pectinate line (continuous with arcuate line)
across the pubic symphesis & back up through the same lines on the opposite side to again reach the sacral promotory

Question 9

Q

What is the name of the lower apeture of the pelvis?

Describe its path

Answer

A

Pelvic outlet - has anterior plane & posterior plane
- bottom of public symphesis
- along ischesopubic ramus to the ishial tuberosity
- along sacrotuberous ligaments
- to the coccyx & the repeats the path on the opposite side back to the pubic symphesis

Question 10

Q

Identify the indicated structures and planes

Question 11

Q

What is the interspinous breadth?

inlet diameter?

obstetric conjugate?

diagnonal conjugate?

What are these measurements used for?

Answer

A

Used to be important in determing the risk of giving birth, but not widely used anymore

interspinous breadth
- distance between two ischial spines
transverse inlet diameter
- whereever the inlet is widest
  - femalse: usually more anterior as compared to males
o_bstetric conjugate_
- sacral promotory to the nearest point on the pubic symphesis
diagonal conjugate
- physician would stick fingers in vagina & feel for sacral promotory & mark how far in they were
- initally thought to be 2 cm longer than obstetric conjugate– not true

Question 12

Q

What are the general differences the we see between male and female pelvices?

Answer

A

Males typically have larger bones reflecting a larger body size
Females typically hae a larger pelvic cavity to accomodate parturition (birth)

pelvic inlet in females is often larger & rounder
pelvic outlet in females is much larger compared to males
subpubic angle is often more obtuse in females
greater sciatic notch is often wider in females
acetabulum is usually smaller in females
sacrum in females is shorter and less curved

Question 13

Q

What struces make up the pubic symphesis?

What type of joint is it?

What is its majore function?

Answer

A

Articulation between the symphyseal surfaces of the two pubic bones with an interpubic disc between
- Ligaments
  - superior pubic
  - inferior (arcuate) pubic
- cartilaginous symphysis
- absorbs forces from the lower (focus = stability)

Question 14

Q

Under what circumstance is it helpful for the pubic symphysis to be mobile?

How and why does this happen?

What complication can occur?

Answer

A

During birth

interpubic disc becoems more pliable due to hormones like relaxin

increases the distance between pubic bones & the transverse diameter (10-15%)

If maintained postpartum, called pubic symphysis diastasis & can cause pain

Question 15

Q

What type of joint is the sacroiliac joint?

What structures articulte here?

What movement occurs at this joint?

Answer

A

Synovial - may become fibrous with age
- tuberosity articulation forms syndesmosis joint
Articulation
- auricular surfaces of ilium & sacrum
transfers force from vertebral column to lower limb
- limited nutation (flexion) & counternutation (extension)

Question 16

Q

Identify the ligaments of the sacroiliac joint

Answer

A

Interosseus sacro-iliac ligament is the same thing they call the syndesmosis joint

Question 17

Q

25% of patients with chronic lower back pain can be explained by problems with which joint?

Answer

A

sacroiliac joint

specific mechanism is often not identifiable

Question 18

Q

What are the two lumbosacral joints?

Type of joints?

Articulations?

Movements?

Answer

A

Intervertebral
- Cartilaginous symphisis
- Articulation: L5 & S1 vertebral bodies
- contributes to vertebral column movements
  - has intervertebral disc
Facet
- synovial
- Articulation: L5 inferior articular process & S1 articular process
- contributes to vertebral column movements

Question 19

Q

Identify the ligaments of the lumbosacral joint.

Where are their attachment points?

Answer

A

Anterior logitudinal
- down entire vertebral column & ends at the sacrum
Lumbosacral
- filling in space between the facet joint
Iliolumbar
- from transverse process of L5 & L4 to iliac crest
- limits rotation of L5

Question 20

Q

Whta type of joint is the sacrococcygeal?

What are its articulations?

Movement?

Answer

A

cartilaginous symphis
Articulation
- apex of sacrum & base of the coccyx
- has intervertebral disc
Movement
- limited flexion & extension

Question 21

Q

Identify the ligaments of the sacrococcygeal joint

Attachment points?

Answer

A

Anterior sacroccygeal ligament
- criss-cross the front of the coccyx
Posterior sacroccygeal ligament
- superficial & deep part of posterior aspect of cocyx
Lateral sacrococcygeal ligament
- Transverse process of first coccygeal vertebrae & attach to the sacrum

Question 22

Q

When performing an epidural, what ligament is pierced?

Answer

A

posterior sacrococygeal ligament that fills the sacral hiatus

Question 23

Q

Identify the muscles indicated in the provided image.

Together, they from what structure?

Answer

A

the pelvic wall

Question 24

Q

Identify the muscles indicated in the provided photo.

Together, they form what structure?

Answer

A

The pelvic floor

Question 25

Q

Identify the indicated muscle

Origin & insertion?

Function?

Innervation & vascular supply?

It indicates what landmark?

Answer

A

Piriformis

Origin:
- anterior sacrum & sacrotuberous ligament
Insertion:
- superior border of greater trochanter of femur
Function
- externally rotate the thigh
Innervation
- nerve to piriformis (S1-S2)
- superior gluteal arterier
Landmark
- divides greater sciatic foramen into suprapiriform & infrapiriform foramina

Question 26

Q

Identify the indicated muscle

Origin & insertion?

Function?

Innervation & vascular supply?

Fascia covering this muscle forms what structure?

Answer

A

Obturator Internus

Origin
- ischiopubic ramus & obturator membrane
Insertion
- trochanteric fossa on femur
Function
- externally rotates thigh
Innervation & arterial supply
- nerve to obturator internus (L5-S2)
- inferior gluteal artery
covered by obturator fascia that thickens between the ischial spine & pubis to form the tendinous arch

Question 27

Q

Identify the indicated muscle

Origin & insertion?

Function?

Innervation & vascular supply?

It indicates what landmark?

Answer

A

Puborectalis

Origin & insertion
- dorsal pubic body adjacent to pubic symphysis (makes a U)
Function
- prevents defecation by pulling the distal rectum anteriorly & superiorly; aids in voluntary retention of feces
Innervation & Vascular supply
- ventral rami of S3-S4
- inferior gluteal artery
Defines the
- urogenital hiatus (a)
- anal hiatus (b)