Pelvis and Perineum Flashcards

1
Q

What are the functions of the pelvis? (2)

A
  1. Weight-bearing

2. Attachment of the lower limbs

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2
Q

What does the head of the femur attach to?

A

Acetabulum

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3
Q

What does the pelvis consist of? (3)

A
  1. 2 hip bones
  2. 1 sacrum
  3. 1 coccyx
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4
Q

What are the bones of pelvis? (3)

A
  1. Hip (inominate)

2. Greater and Lesser Pelvis

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5
Q

What is the hip comprised of?

A

A pair of bones joined anteriorly to each other at the pubic sympysis and posteriorly to the sacrum.

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6
Q

What are the 3 parts of the hip?

A
  1. Ilium
  2. Ischium
  3. Pubis
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7
Q

Where do the junctions of the hip go through?

A

Acetabulum

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8
Q

What is the acetabulum?

A

Cup shaped cavity for articulation with head of femur

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9
Q

What does the greater pelvis consist of?

A
  1. Upper larger cavity
  2. Surrounded ilium
  3. Upper sacrum
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10
Q

What does the lesser pelvis consist of?

A
  1. Lower, smaller cavity closed by soft tissue of pelvic floor
  2. Junction between greater and lesser pelvis is pelvic brim/pelvic inlet
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11
Q

What is the function of the head of femur?

A

The ball and socket joint with the pelvis called the hip joint

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12
Q

What is the function of the less trochanter?

A

Where muscles attach that move thigh inwards at the hip joint. Adductor muscles.

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13
Q

What is the function of the greater trochanter?

A

Where muscles attach that move thigh outwards at the hip joint. Abductor muscles

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14
Q

What is the function of the medial condyle?

A

The medial part of the hinge joint with the tibia called the knee joint.

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15
Q

What is the function of the lateral condyle?

A

The lateral part of the hinge joint with the tibia called the knee joint.

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16
Q

What is the iliac crest?

A

Upper extent of ilium.

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17
Q

What are the two ways the iliac crest ends?

A
  1. Anteriorly as the ANTEROSUPERIOR ILIAC SPINE (ASIS)

2. Posteriorly as the POSTEROSUPERIOR ILIAC SPINE (PSIS)

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18
Q

What is the AIIS adjacent to?

A

Acetabulum

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19
Q

Where is the PSIS located?

A

PSIS is located on the posteromedial part of ILIAC TUBEROSITY

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20
Q

What attaches to the iliac tuberosity?

A

Interosseous ligament and of posterior sacroiliac ligament

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21
Q

What is the tubercle of iliac crest?

A

A thickening of the central part of the crest

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22
Q

Where does the tubercle of the iliac crest lie?

A
  1. Above greater sciatic foramen

2. Not palpable but location is recognisable in some individuals as a surface dimple

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23
Q

What is the gluteal surface?

A

Outer, posterior surface of ilium. Attachment of gluteal muscles.

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24
Q

What is the iliac fossa?

A

Inner/anterior concave surface, attachment of iliacus

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25
Q

What are the features of the pubis?

A
  1. Pubic symphysis
  2. Pubic crest and pubic tubercle
  3. Pecten pubis
  4. Obturator foramen
  5. Superior pubic ramus
  6. Inferior ramus
  7. Ileopubic eminence
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26
Q

What is the pubic symphysis?

A

Cartilaginous joint between anteromedial parts of BODY of each pubic bones

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27
Q

What is the pubic crest?

A

Short rounded upper part of the body of the pubis about 2.5 cms long, ending laterally as pubic tubercle (for attachment of inguinal ligament)

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28
Q

What is the pecten pubis?

A
  1. A sharp ridhe running posteriorly from pubic tubercle
  2. For attachment of lacunar ligament
  3. Forms part of pelvic brim
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29
Q

What is the obturator foramen?

A

Anterior opening in pelvis bounded by pubis and ilium

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30
Q

What is the superior pubic ramus?

A

Above obdurator foramen to acetabulum

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31
Q

What is the inferior ramus?

A

Below obdurator foramen to join ISCHIAL RAMUS to form ISCHIOPUBIC RAMUS

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32
Q

Where is the ileopubic eminence?

A

At junction of ilium and pubis

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33
Q

What are the features of the ischium?

A
  1. Body
  2. Ischial tuberosity
  3. Ischial spine
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34
Q

Where is the ischium body located?

A

Adjacent to acetabulum

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35
Q

Where is the ischial tuberosity located?

A

On thelower posterior surface (attachment of sacrotuberous ligament)

36
Q

Where is the ischial spine?

A

Above ischial tuberosity, at junction of GREATER AND LESSER SCIATIC NOTCHES

37
Q

What are the other features of the pelvis?

A
  1. Greater sciatic notch
  2. Lesser sciatic notch
  3. Acetabulum
38
Q

Where is the greater sciatic notch and what is its function?

A

Between PIIS and ischial spine.

Transmits piriformis

39
Q

Where is the lesser sciatic notch and what is its function?

A

Below ischial spine.

Transmits tendon of obdurator internus, obdurator nerve, internal pudenal vessels and nerve.

40
Q

Where is the acetabulum?

A

A hemispherical cavity on the lateral side of the pelvis directed anteroinferiorly.

41
Q

What joins onto the acetabulum?

A

Ilium, ischium, pubis form a junction in this cavity.

42
Q

What is the acetabulum lined with?

A

Cartilage and articulates with the head of the femur (also covered with articular cartilage) to form the acetbulofemoral joint (hip joint)

43
Q

What is the hip joint supported by?

A

Capsule, ligaments and some of the pelvic muscles

44
Q

What are the features sacrum? (6)

A
  1. Five fused vertebrae
  2. Anterior and posterior sacral foramina - anterior (pelvic) and posterior (dorsal) foramina communicate
  3. Median sacral crest - fused spines of vertebrae
  4. Anteriorsuperior margin forms sacral promontary
  5. Sacral canal - continuous with vertebral canal (contains spinal nerves and meninges but no spinal cords - ends at L2)
  6. Auricular surface for sacroiliac joint, roughened area posterior to this for interosseous ligament
45
Q

What are the features of the coccyx? (2)

A
  1. 4 fused rudimentary vertebrae

2. Tip of coccyx level with pubic symphysis

46
Q

What type of joint is the sacroiliac joint?

A

A synovial joint

47
Q

Where is the sacroiliac joint recognisable?

A

Recognisable on ilium and sacrum as smooth auricular surfaces

48
Q

What cartilage lines the sacroiliac joint?

A

Hyaline cartilage

49
Q

The movement of sacroiliac joints is limited. True or false?

A

True. Limited movement due to the way articulating bones interlock (slight sliding and rotation only).

50
Q

What may happen to the sacroiliac joint at old age?

A

Adhesions are common across joint cavity and joint may fibrose or ossify in old age.

51
Q

Where is the lumbosacral joint located?

A

Interveterbral disc between L5 and sacrum.

52
Q

What is the lumboscarl joint stabilised by?

A

Iliolumbar ligament

53
Q

Where is the acetabular joint and what type of joint is it?

A

Synovial joint between acetabulum of hip and head of femur.

54
Q

Where is the interosseous ligament located?

A

Posteriorsuperior to sacroiliac joint.

55
Q

Where is the interosseous ligament recognisable?

A

It is recognisable on the ilium and sacrum as roughened regions superior to smooth auricular parts.

56
Q

Where is the iliolumbar ligament located?

A

5th lumbar vertebra to iliac crest

57
Q

What does the iliolumbar ligament prevent?

A

Prevents L5 from slipping anterioly and also transmits some of the weight directly to ilium thus partly bypassing sacroiliac joint.

58
Q

What are the sacroiliac ligaments?

A

Collagenous bands of various lengths conneting sacrum to ilium on both anterior and posterior surfaces.

59
Q

What is the difference between the anterior and posterior bands?

A

Posterior are interlacing bands, anterior part runs from sacrum to iliac fossa.

60
Q

Where does the sacrotuberous ligament extend? What else does it include?

A

Ischial tuberosity to sacrum. Blends with sacroiliac ligament. Also includes a band of fibres which extend upwards to both PSIS and PIIS.

61
Q

Where the sacrospinous ligament extend?

A

Ischial spine to lateral; sacrum and coccyx. It is anterior to the sacrotuberous ligament, anterior surface is coccygeus muscle

62
Q

What does the sacrospinous ligament prevent?

A

Prevent rotation of sacrum in the vertical plane.

63
Q

What are the apertures of pelvis?

A
  1. Superior aperture of lesser pelvis (Pubic symphysis and crest, arcuate line, pecten pubis, sacral promontary)
  2. Inferior pelvic apertue (Pubic symphysis, ischiopubic ramus, ischial tuberosity, sacrotuberous ligament, coccyx)
64
Q

What are the attachments of the obturator internus?

A
  1. Ilium and ischium surrouding obturator foramen
  2. Obturator fascia - covers medial surface of muscle, thickened to form tendinous arch below obturator foramen - part of attachment of levator ani
65
Q

What does the obturator internus pass?

A

Obturator internus passes around anterolateral wall of true pelvis and through lesser sciatic foramen as tendinous bands which bend through a right angle around the foramen.

66
Q

Where does the tendon attach to?

A

Tendon attaches to greater trochanter of femur (below attachment of piriformis)

67
Q

What action is the obturator internus responsible for?

A

Rotates thigh laterally.

68
Q

Where is the piriformis located?

A

Pelvic surface of S2-4.

69
Q

What is the piriformis pierced by?

A

Often piereced by sacral ventral rami arising from anterior sacral foramina (forming among other structures the sciatic nerve).

70
Q

Where does the piriformis pass through?

A

Pases through the greater sciatic notch.

71
Q

What action is the piriformis responsible for?

A

Rotates thigh laterally.

72
Q

What is the levator ani?

A
  1. Extensive attachment to bones of lesser pelvis

2. Tnedinous arch of obdurator fascia

73
Q

What is the function of the levator ani?

A

Suppots pelvic viscera. Raises pelvic floor - important in forced expiration, coughing, urination defecation, heavy lifting etc.

74
Q

What are the attachments coccygeus?

A

Ischial spine
Coccyx
Sacrum

75
Q

What is the function of the coccygeus?

A

Part of the pelvic diaphragm

76
Q

Where is the obdurator internus located?

A

Deep to obturator membrane and arises partly from it. Also from adjacent ilium and ischium. Inserts into greater trochanter of femur. Crossed by obturator canal.

77
Q

What is the obdurator fascia?

A

Fascia of medial surface of obdurator internus. Thickened infrior part is tendinous arch - origin of levator ani.

78
Q

How are the levator ani muscles arranged?

A

Muscles are paired and unite in midline.

79
Q

What does the levator ani consist of?

A

Iliococcygeus, pubococcygeus, puborectalis, pubovaginalis

80
Q

What is the pubococcygeus?

A

Back of body of pubic bone and anterior half of tendinous arch to coccyx.

81
Q

Where is the puborectalis located? What is its function?

A

Originates with pubococcygeus and extends below it to pass around anorectal junctin. Joins puborectalis from opposite side to form a sling around anorectal junction.

Role in fecal continence.

82
Q

Where is the pubovaginalis?

A

Attached to the back of body of pubis to form a sling attach to walls of vagina or prostate and then passes into perineal body. Also relates to spingter urethrae and thus plays a role in urinary continence.

83
Q

What is the function of the anococcygeal ligament?

A

It is a musculotendinous raphe extending from coccyx to anal margin.

84
Q

What inserts into the anococcygeal ligament?

A

Fibres from the left and right iliococcygeus and pubococcygeus, puborectalis and external anal sphincter insert into the anococcygeal ligament.

85
Q

What is the pelvic diaphragm consist of?

A

Consists of levator ani, coccygeus and their superior and inferior fasciae