Pelvis (general & urinary system)

Question 1

what parts of the GI system are present in the pelvis ?

Answer 1

terminal sigmoid colon, rectum & anal canal

Question 2

which parts of the urinary system are present in the pelvis?

Answer 2

ureters, bladder, urethra

Question 3

which main arteries and veins are found in the pelvis region ?

Answer 3

internal iliac artery, external & internal iliac veins & common iliac vein

Question 4

what nerve plexuses are found in the pelvis ?

Answer 4

sacral plexus L4-S4

Question 5

which endocrine organs are associated with the pelvic region ?

Answer 5

ovary & testes

Question 6

What are the 3 components that make up the bony pelvis

Answer 6

sacrum, coccyx, Os Coaxe (hip bone)

Question 7

The Os Coxae (hip bone) is made up of three individuals bones which fuse together at puberty what are these bones ?

Answer 7

illium, ischium, pubis

Question 8

which ligaments stabilise & cover the sacroiliac joint ?

Answer 8

posterior & anterior sacroiliac ligamanet

Question 9

The presence of what two ligaments convert the greater and lesser sciatic notches into the greater and lesser sciatic foramen ?

Answer 9

sacrospinous and sacrotuberous ligaments

Question 10

what are the main differences between female and male pelvis ?

pubic angle, acetabulum, pelvic inlet, greater sciatic notch, iliac blades

Answer 10

pubic angle: F- wide >80 degree M- narrow <70
acetabulum: F- small, M- large
pelvic inlet: F- rounded/oval, M- heart shaped
greater sciatic notch: F-wider ‘v’ shaped M- narrow ‘u’
iliac blades: F- lower, M- illiim is narrower, blade more pronounced s shape

Question 11

what divides the pelvis into greater (false) pelvis and lesser (true) pelvis ?

Answer 11

oblique plane of pelvic inlet

Question 12

what structures are found in the greater pelvis ?

Answer 12

sigmoid colon & some loops of ilium

Question 13

what structures are found in the true pelvis ?

Answer 13

bladder, reproductive organs eg uterus & ovaries

Question 14

what are the functions of the pelvic floor muscles ?

Answer 14

form a sling to support the pelvic, abdominal & thoracic contents

Question 15

The pelvic floor is composed of tow main bodies of muscle, what are they ?

Answer 15

Levator ani, coccygeus

Question 16

What are the names of the three muscles that form the levator ani ?

Answer 16

the pubococcygeus, the iliococcygeus, and the puborectalis.

Question 17

which spinal nerve innervates elevator ani ?

Answer 17

S4

Question 18

what muscle lines the obturator foramen on the lateral walls of the true pelvis and what is its function?

Answer 18

obturator internus, plays no function in the pelvis. it crosses the hip joint and is a lateral rotator of the hip.

The deep fascia covering this muscle provides an attachment for elevator ani via tendinous arch

Question 19

which pelvic muscle forms the majority of the posterior wall of the true pelvis and exits vis the greater sciatic foramen and what is its function ?

Answer 19

Piriformis, it acts on the lower limb and has no function in the pelvis. Important landmark to identify the roots of the sacral plexus, sciatic foramen and sciatic nerve.

Question 20

what important structure lie immediately deep to the piriformis muscle on the posterior wall ?

Answer 20

sacral plexus

Question 21

At what vertebral level is the rectosigmoid junction ?

Answer 21

S3

Question 22

what muscles maintains the 80 degree angle of the anorectal flexure and how does the alter during defaecation ?

Answer 22

puborectailis. when contracted pulls rectum tight & when it relaxes the angle of fecal flow is straighter and allows defaecation.

Question 23

In terms of venous drainage what is the relevance of the pectinate line ?

Answer 23

The pectinate line divides the upper 2/3 and lower 1/3 of the anal canal. Above the line the superior rectal vein draining into the inferior mesenteric vein and subsequently the hepatic portal system. Below the line drains into the middle and inferior rectal veins subsequently to IVC

Question 24

what nerve innervates the superficial genitalia (perineum) ?

Answer 24

pudendal nerve

Question 25

what foramen does the sciatic nerve leave the pelvis through ?

Answer 25

Greater sciatic foramen

Question 26

what spinal nerves make up the sciatic nerve ?

Answer 26

L4-S3

Question 27

Describe the route taken by the pudendal nerve as it travels from the sacral plexus to the perineum ?

Answer 27

leaves the pelvis through the greater sciatic foramen, crosses the sacrospinous ligament & re-enters pelvis through the lesser sciatic foramen & goes through pudendal canal and divides into branches innervating the perineum.

Question 28

Through which foramen does the obtrurator nerve exit the pelvis ?

Answer 28

obturator foramen

Question 29

which spinal segments do the pelvic splanchnic nerves originate ?

Answer 29

S2-S4

Question 30

outline the action of parasympathetic NS on pelvic viscera

Answer 30

contract rectum and bladder - defaecation and urination | prostatic plexus - supply erectile bodies of external genitalia - erection

Question 31

outline the action of sympathetic NS on pelvic viscera

Answer 31

inhibit peristaltic contraction of rectum and stimulate contraction of genital organs during orgasm

Question 32

At what vertebral level does the aorta bifurcate into common iliac arteries

Answer 32

L4

Question 33

what part of the hindgut, present in the false pelvis receives blood directly from IMA ?

Answer 33

sigmoid colon

Question 34

what part of the hindgut present in the true pelvis receives blood from a branch of the IMA and what is the name of this branch >

Answer 34

superior part of the rectum | superior rectal artery

Question 35

What artery supplies the testes/ovaries and which major artery does it branch off of?

Answer 35

Gonadal artery, branch of abdominal aorta

Question 36

The internal iliac artery divides into two trunks: anterior and posterior, which trunk provides predominately the viscera and which trunk predominantly supples muscles, particularly muscles acting on the hip?

Answer 36

viscera: anterior muscles: posterior

Question 37

through which foramen will the gluteal arteries pass

Answer 37

greater sciatic foramen

Question 38

through which Forman foes the obturator artery pass

Answer 38

obturator foramen

Question 39

through which Forman does the internal pudendal artery pass

Answer 39

greater sciatic foramen

Question 40

what artery supplies the superior rectum, inferior rectum & anal canal, and where does each artery branch from ?

Answer 40

superior rectum: superior rectal artery - IMA inferior rectum: middle rectal artery - internal iliac anal canal: inferior rectal artery - internal pudendal artery (branch on internal iliac)

Question 41

what structures lies most anteriorly, posteriorly at the hilum of the kidneys ?

Answer 41

anteriorly - renal vein | posteriorly - renal pelvis

Question 42

the hilum of the kidney is located at which vertebral level ?

Answer 42

L1

Question 43

what endocrine organ is associated with the kidneys ?

Answer 43

suprarenal gland

Question 44

describe the perironisation of the kidney

Answer 44

retroperitoneal

Question 45

The diameter of the ureters is constricted at three points what are they ?

Answer 45

Uretopelvic junction Pelvic brim Where the ureter enters the bladder

Question 46

what is the peritonisation of the ureters ?

Answer 46

retroperitoneal

Question 47

what is the name of the muscle within the bladder walls

Answer 47

detrusor muscle

Question 48

the triangular surface between the openings of the ureters in the bladder is much smoother than the rest of the bladder, what is this area called?

Answer 48

Trigone

Question 49

what is the anatomical surface markings of the kidneys

Answer 49

posterior, bilateral, 3cm lateral from the median plane, between the T11 and L3

Question 50

Which two regions of the body does the inguinal canal connect

Answer 50

Abdominal and perineum

Question 51

The aponeurosis of which abdominal muscle is found along the entire length of the anterior wall of the canal?

Answer 51

external oblique

Question 52

Which parts of the intestine are located within the true pelvis

Answer 52

Sigmoid colon, rectum and anal canal

Question 53

Describe the sub-pubic angle in the female, and compare this to the male pelvis

Answer 53

Obtuse in female, acute in male

Question 54

What type of joint is the symphysis pubis

Answer 54

Secondary cartilaginous

Question 55

Which nerve(s) pass through the inguinal canal in both males and females? What are the root values

Answer 55

Ilioinguinal nerve (L1) and genital branch of genitofemoral nerve (L1-L2)

Question 56

To which muscles does a linear thickening on the deep fascia overlying the pelvic aspect of the obturator internus muscle give attachment

Answer 56

Levator Ani

Question 57

Which spinal nerve supplies levator ani

Answer 57

S4

Question 58

Which spinal segments does parasympathetic nerve supply to the pelvic viscera originate from

Answer 58

Sacral outflow S2-S4

Question 59

What is the root value of the pudendal nerve

Answer 59

S2-S4

Question 60

What is the main function of puborectalis

Answer 60

Acts in a similar way to a sphincter on the anorectal junction to prevent defection.

Question 61

Which four muscles lie posterior to the kidney

Answer 61

Diaphragm, psoas major, quadratus lumborum and transversus abdominis

Question 62

Over which major vascular structure does the ureter cross as it enters the pelvic cavity?

Answer 62

External iliac artery, close to bifurcation of the common iliac artery

Question 63

Which nerves supply the internal sphincter of the (male) bladder?

Answer 63

Autonomic fibres from the inferior hypogastric plexus

Question 64

Which two ligaments help to form the greater and lesser sciatic notches

Answer 64

Sacrospinous and sacrotuberous ligaments

Question 65

Name the three points along the course of the ureter where the diameter is narrowed (and hence likely to be the site of obstruction by ureteric calculi (kidney stones)).

Answer 65

1. Junction of renal pelvis and ureter; | 2. As it crosses the pelvic brim to enter the true pelvis; 3. On entering the bladder.

Question 66

Which muscles form levator ani (the pelvic diaphragm)? What are their main functions

Answer 66

Right and left levator ani (puborectalis, pubococcygeus, iliococcygeus) and coccygeus muscles. Supports pelvic viscera, resists rise in intrapelvic pressure when abdominal wall muscles contract. Control (prevent) defecation, micturition and parturition.