Pelvis and Perineum Flashcards

1
Q

What bony landmarks make up the pelvic brim/ inlet?

A

Sacral promontory
Arcuate line of the ilium
Pubic crest
Pubic symphysis
Pubic tubercle
Ala of the sacrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the bony features and ligaments which make up the pelvic outlet?

A

Inferior rami of pubis
Tip of coccyx
Inferior margin of pubic symphysis
Sacro-tuberous ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What part of the pelvis are termed the true and false pelvis?

A

True - inferior
False - superior
Pelvic inlet is the junction between true and false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of joint is the sacroiliac joint?

A

Synovial plane joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What type of joint is the pubic symphysis?

A

Secondary cartilaginous joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the features of the female pelvis when compared to male?

A

Shallow greater pelvis, wide and shallow lesser pelvis, inlet is oval shaped, outlet is larger, subpubic angle is obtuse (Over 90), oval obturator foramen and small acetabulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the features of the male pelvis when compared to female?

A

Deep greater pelvis, narrow and deep lesser pelvis, heart shaped inlet, smaller outlet, acute subpubic angle (less than 90), round obturator foramen and large acetabulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the narrowest diameter of the pelvic inlet?

A

10.5cm - obstetrical conjugate diameter
Smallest area baby’s head has to pass through in childbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the narrowest diameter of the pelvic outlet?

A

13.5cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is A?

A

Piriformis muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is B?

A

Obturator internus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What muscle is present in the posterior wall of the pelvis?

A

Piriformis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What nerve network lies on the piriformis muscle?

A

Sacral plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is A?

A

Urethral hiatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is B?

A

Vaginal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is C?

A

Rectal hiatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is E?

A

Puborectalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is F?

A

Iliococcygeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the perineal body?

A

Fibromuscular node lying in the midline of the perineum - provides an anchor point for several muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the anococcygeal body?

A

layered musculotendinous intersection of 2 halves of levator ani muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the 2 muscles which make up the majority of the pelvic floor?

A

Coccygeus
Levator ani - 3 paired separate muscles

22
Q

What are the functions of the pelvic floor?

A

Resistance to increase in intra-pelvic/ abdominal pressure
Urinary and faecal continence

23
Q

What is a cystocele?

A

Anterior vaginal prolapse - bladder bulges into vagina

24
Q

What is a rectocele?

A

Posterior vaginal prolapse - rectum bulges into vagina

25
Q

What is the distribution/ organs of the superior and inferior vesical artery?

A

Bladder, seminal gland and prostate in males

26
Q

What is the origin of the superior and inferior vesical artery?

A

Anterior division of internal iliac

27
Q

What is the origin of the uterine artery?

A

Anterior division of internal iliac

28
Q

What organ does the uterine artery supply?

A

Uterus

29
Q

What does the gonadal artery supply?

A

Testes and ovaries

30
Q

What is the origin of the gonadal artery?

A

Abdominal aorta

31
Q

What is the origin of the superior rectal artery?

A

Inferior mesenteric artery

32
Q

What is the origin of the middle and inferior rectal artery?

A

Internal iliac artery

33
Q

What is the origin of the vaginal artery?

A

Uterine artery

34
Q

What is the main artery of the perineum and what is its origin?

A

Internal pudendal artery
Posterior division of the internal iliac

35
Q

What is the origin of the obturator artery?

A

Internal iliac artery

36
Q

What part of the rectum drains into portal circulation?

A

Superior rectal

37
Q

What parts of the rectum drain into the systemic circulation?

A

Inferior and middle

38
Q

Which venous plexus does the prostatic venous plexus communicate with on it’s posterior side?

A

Internal vertebral venous plexus

39
Q

What spinal segment does ilioinguinal nerve originate from?

A

L1

40
Q

Describe the course of the ilioinguinal nerve

A

Enters the inguinal canal at superficial inguinal ring to supply skin at root of penis in males and labia in females

41
Q

Describe the course of the genitofemoral nerve

A

Originates from L1-2 and enters the deep inguinal ring

42
Q

What structures n males are supplied by the genital branch of the genitofemoral nerve?

A

Cremaster muscle and anterior scrotal skin - involved in the cremasteric reflex

43
Q

What segmental levels does the pudendal nerve arise from?

A

S2-4

44
Q

What bony landmark is used when performing a pudendal nerve block in labour?

A

Ischial spine

45
Q

Where do the sympathetic fibres of the pelvis arise from?

A

L1 and L2 via hypogastric nerve and terminal aspect of sympathetic trunk
Supply all internal pelvic organs

46
Q

What do the sympathetic fibres supply in the pelvis?

A

Male - vas deferens, seminal vesicles, prostate and epididymis
Female - ovaries, uterus, fallopian tubes and vagina

47
Q

Where do the parasympathetic fibres of the pelvis originate from?

A

Pelvic splanchnic nerves S2-4
All internal pelvic organs and innervate erectile tissues in males and females

48
Q

What part of the autonomic nervous system is involved in ejaculation in males?

A

Sympathetic

49
Q

What do the external iliac lymph nodes drain?

A

Bladder, uterus and prostate

50
Q

What do the internal iliac lymph nodes drain?

A

Gluteal region, deep perineum and inferior pelvic viscera

51
Q

What do the sacral lymph nodes drain?

A

Lower part of rectum and upper part of the anal canal

52
Q

What do the common iliac lymph nodes drain?

A

3 main groups - external, internal and sacral lymph nodes