Pelvis - Lecture 5 Flashcards
What are the Bones of the Pelvic Cavity?
- Pelvic Bones (2)
- Sacrum
- Coccyx
What fused bones make up each Pelvic Bone?
- Ilium (Superior)
- Ischium (Inferior Posterior)
- Pubis (Inferior Anterior)
Acetabulum
Cup-shaped depression on the lateral surface of the pelvic bones where the head of the femur articulates
Which two parts of the Pelvis are located Anteriorly in the same plane?
- Anterior Superior Iliac Spine
2. Pubic Tubercle
What is the name of the Anterior vertical plane on the Pelvis that joins the two Pelvic Bones?
Pubic Symphysis
What pats of the Ilium are palpable?
- Anterior Superior Iliac Spine (ASIS)
2. Iliac Crest
What is the name of the thickened ridge at the top of the Ilium?
Iliac Crest
Name the Components of the Pelvis
- Iliac Spine
- Anterior Superior Iliac Spine
- Anterior Inferior Iliac Spine
- Posterior Superior Iliac Spine
- Posterior Inferior Iliac Spine
- Iliac Fossa
- Greater Sciatic Notch
- Lesser Sciatic Notch
- Ischial Spine
- Ischial Tuberosity
- Obturator Foramen
- Superior Pubic Ramus
- Inferior Pubic Ramus (Ischia Pubic Ramus)
- Pubic Tubercle
Where does the Sacrum articulate with the Pelvic bones?
Between the Posterior Superior Iliac Spine and the Posterior Inferior Iliac Spine
Which muscle originates on the Iliac Fossa?
Iliacus
What is the Greater Sciatic Notch used for?
Space allowing structures to pass from inside Pelvis to the Gluteal region
What does the Ischial Spine separate?
Ischial Spine separates the Greater Sciatic Notch from the Lesser Sciatic Notch
Which bone you sit down on?
Ischial Tuberosity
What is the Obturator Foramen?
An opening in the inferior portion of the Pelvis that is mostly covered by a membrane, but has space for the Obturator Artery, Vein, and Nerve to pass through
What innervates the Medial Thigh?
Obturator Nerve
What innervates the Anterior Thigh?
Femoral Nerve
What structures surround the Obturator Foramen?
- Superior Pubic Ramus
2. Inferior Pubic Ramus (AKA Ishia Pubic Ramus
What attaches to the ASIS and the Pubic Tubercle?
Inguinal Ligament
Where does the Inguinal Ligament come from?
Extension of the External Oblique Aponeurosis
Sacro-Iliac Joint
Posteriorly where the medial side of the two pelvic bones are connected to the Sacrum
Pubic Symphysis
Anteriorly where the two Pelvic Bones are connected by dense fibrocartilage
Which direction is the Pelvis tilted and why?
It is tilted anteriorly so the ASIS and the Pubic Tubercles are located in the same plane
Pubic Angle
Angle formed by the two pubic bones ANTERIORLY
Pelvic Inlet
The imaginary Plane formed if you were to draw a “Circle” inside of the bones of the Pelvis and Sacrum
What is demarcated by the Pelvic Inlet?
The plane of the Pelvic Inlet separates the False Pelvis and Abdomen (Superior) from the True Pelvic Cavity (Inferior)
What is the Pelvic Brim?
This is the “Circle” around the bones that indicates the Pelvic Inlet using:
- Sacral Promontory (Top of S1)
- Ala (wings) of Sacrum
- Linea Terminalis of the Pelvis
Female Pelvis Characteristics
- Wider Pubic Angle (80º-85º like making an L with your index and thumb)
- Rounder Pelvic Inlet
Male Pelvis Characteristics
- Smaller Pubic Angle (50º-60º like making a peace sign)
2. Heart/Oval shaped Pelvic Inlet
False Pelvis (Greater Pelvis)
- Larger Pelvic Are
- Area Superior to the plane of the Pelvic Inlet that is still is surrounded by the wings of the Ilium
- in ABDOMINAL CAVITY
- Contains Digestive Organs
What is the Linea Terminalis?
Ridge on the Pelvic bones that forms the outline of the Pelvic Inlet
True Pelvis (Lesser Pelvis)
- Smaller Pelvis area
- Area Inferior to the plane of the Pelvic Inlet
- in Pelvic Cavity
- Contains Pelvic Outlet
Pelvic Outlet
- Inferior border of the Pelvic Cavity
- Plane formed by ligaments and muscles
- Open aside from the barrier formed by the muscles of the Pelvic Floor
What does the Pelvic Floor do?
- Separates the Pelvic Cavity from Perineum and covers the Pelvic outlet
- Synonymous with Pelvic Diaphragm Muscles
- Bowl shaped
What are the boundaries of the True Pelvis?
- Pelvic Inlet (Superior)
- Pelvic Wall (Circumferential)
- Pelvic Outlet (Inferior)
What makes up the Pelvic Wall and provides the Circumferential/Lateral boundaries of the Pelvis?
- Obturator Internus Muscle (Lateral)
- Piriformis Muscle (Lateral)
- Sacrotuberous Ligament
- Sacrospinous Ligament
What is the Sacrotuberous Ligament?
A very strong supportive ligament that attaches the Sacrum to the Ischial Tuberosity
What is the Sacrospinous Ligament?
A ligament that runs perpendicular to the Sacrotuberous ligament attaching the Sacrum to the Ischial Spine
The perpendicular way that the Sacrotuberous and Sacrospinous Ligaments causes the formation of
- Greater Sciatic Foramen
- Lesser Sciatic Foramen
FROM the Greater and Lesser Sciatic Notches
How does the Piriformis Muscle pass from the Pelvic region to the Gluteal region?
Passes through Greater Sciatic Foramen
How does the Obturator Internus Muscle pass from the Pelvic region to the Gluteal region?
Passes through Lesser Sciatic Foramen
What are the boundaries of the Pelvic Outlet?
- Pubic Symphysis (Anteriorly)
- Inferior Pubic Ramus (Anteriorly)
- Ischial Tuberosities (Laterally)
- Sacrotuberous Ligament (Posteriorly)
- Coccyx (Posteriorly)
Lithotomy Position
Patient laying on their back with legs up like birthing position
What are the Pelvic Diaphragm Muscles (Pelvic floor muscles)?
- Levator Ani (bigger)
2. Coccygeus
What is the Levator Ani?
- Largest of the Pelvic Diaphragm Muscles
2. Sling-like muscle with multiple parts called Kegels
Where are the origin and insertion of the Levator Ani?
Origin: Coccyx
Insertion: Pubic Bone
What openings are in the Levator Ani?
- Anal Aperture (Anal Canal)
2. Urogenital Hiatus (Vagina)
What is the Coccygeus?
Smaller Pelvic Diaphragm Muscle that originates at the Ischial Spine and inserts on the Lateral Coccyx
What are the functions of the Pelvic Diaphragm Muscles?
- Supporting and keeping Pelvic Organs inside of the Pelvis
- Supporting Sphincters for passing through organs (Anus and Vagina)
- Rectal Flexion (keeps shape)
What Urinary Organs are in the Pelvic Cavity?
- Bladder
- Distal Ends of the Ureters
- Urethra
What Digestive Organs are in the Pelvic Cavity?
- Terminal end of Digestive Tract
- Rectum
- Anal Canal
What is the Perineum?
Anything Inferior and Superficial to the Pelvic Floor:
- External Genitalia
- Opening of Urinary, Digestive, and Reproductive Tracts
What is the Rectum?
Most posterior structure of the Pelvis that can expand to store feces
Rectum is a continuation of the…
Sigmoid Colon
Where is the Rectum?
Resting on the curve of the Sacrum in the Sigmoid Colon
Rectum terminates at the…
Anal Canal
What does the Anal Canal pass through?
Pelvic Floor Muscles of the Pelvic Diaphragm
Constriction of the Pelvic Floor Muscles does what to the Anal Canal?
Constriction helps close off the Anal Canal to maintain continence
Pelvic Floor Muscles orientation with the Rectum causes what?
A Flexure Point (curve) in the Rectum that angles the Anal Canal
Opening from Anal Canal to the outside world is called the…
Anus
What are the sphincters of the Anal Canal?
- Internal Anal Sphincter (Smooth Muscle)
2. External Anal Sphincter (Skeletal Muscle)
What are the Parasympathetic and Sympathetic controls of the Internal Anal Canal?
- Paraympathetic relaxes Anal Canal muscles allowing defecation
- Sympathetic contracts Anal Canal muscles, NO defecation
Anal Canal goes through what muscle of the Pelvic Floor?
Levator Ani
What is the Pectinate Line?
Demarcation of the Digestive Tract that splits the Rectum in terms of Embryologic Division
What is superior to Pectinate line?
Parts of the Embryologic Hindgut
Why is the Pectinate Line important?
It signifies different:
- Lymph Drainage
- Blood Supply
- Embryonic Origin
- Associated Pathology
What supplies blood to the Rectum SUPERIOR to the Pectinate Line (Hindgut)?
Superior Rectal Artery
Where does blood go from the Rectum SUPERIOR to the Pectinate Line (Hindgut)?
Portal System (Liver) via the Portal Vein
Where does blood go from the Rectum INFERIOR to the Pectinate Line?
Caval System (IVC)
Name the sites of Portal-Systemic Anastomosis and why this is important
These are the places blood goes back to the IVC but does NOT enter the Hepatic Portal System (Liver):
- Esophagus
- Inferior Rectum/Anus
- Paraumbilical Are