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Gross III Final Exam > Pelvis & Perineum > Flashcards

Pelvis & Perineum Flashcards

1
Q

What is the hip bone a fusion of?

A

Iliu, Ishium, Pubis

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2
Q

What are the ilium, ischium, and pubis held together by prior to puberty?

A

Cartilage at the acetabulum

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3
Q

What are the 6 landmarks of the ilium?

A 
Ala
Iliac crest
Anterior/Posterior Iliac Spine
Iliac Fossa
Body
Auricular Surface
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4
Q

What are the 6 landmarks of the ischium?

A 
Body
Ramus
Ischial Tuberosity
Ischial Spine
Lesser Sciatic Notch
Greater Sciatic Notch
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5
Q

What are the 5 landmarks of the pubis?

A 
Superior ramus
Inferior ramus
Pubic crest
Pubic tubercle
Pectin Pubis
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6
Q

What forms the obturator foramen?

A

The ramus of the ischium forms the inferior margin, while the inferior ramus of the ischium forms the anteromedial portion

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7
Q

What kind of cartilage is the pubic symphysis?

A

Fibrocartilage

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8
Q

What is special about the subpubic angle?

A

It is gender different

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9
Q

In anatomical position how is the ASIS positioned?

A

In the same vertical plane as the pubis symphysis

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10
Q

What is included in the pelvic inlet?

A 
- Bounded by pelvic brim consisting of:
Sacral promontory and ala
Ilial arcuate line
Superior pubic ramus
Pubic symphysis
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11
Q

What is included in the pelvic outlet?

A 
- Bounded by:
Pubic Arch
Ischial Tuberosities
Sacrotuberous ligament
Tip of coccyx
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12
Q

What closes the inferior pelvic aperature of the pelvic outlet?

A

Closed by the muscular pelvic diaphragm

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13
Q

What are the other terms for the Greater Pelvis and where is it located?

A

False Pelvis or Pelvis Major

- located superior to pelvic inlet

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14
Q

What are the other terms for Lesser Pelvis and where is it located?

A

True Pelvis or Pelvis Minor

- located between pelvic inlet and pelvic outlet

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15
Q

What are the main differences between male & female pelvus’?

A

Male= heavier & thicker with more prominent bony markings for muscle attachments
- Narrow & deep lesser pelvis
Subpubic angle= 60
Female= wider & shallower with large pelvic inlet & outlet
Subpubic angle = 90

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16
Q

An anteroposterior compression of the pelvis will result in a fracture where?
Lateral compression?

A 
Anteroposterior= Pubic rami
Lateral= acetabula and ilia
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17
Q

Where is the syndesmosis portion of the SI joint?

A

posteriorly between tuberosities of both bones

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18
Q

Where is the synovial portion of the SI joint?

A

anteriorly between auricular surfaces of both bones

unusual synovial joint in that little mobility is possible

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19
Q

What are the 5 ligaments that support the SI joint?

A 
Anterior SI Ligament
Interosseus SI Ligament
Posterior SI Ligament
Sacrotuberous Ligament
Sacrospinous Ligament
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20
Q

Which of the 5 SI ligaments is primarily responsible for weight transfer?

A

Interosseus SI Ligament

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21
Q

Which of the 5 SI ligaments allows the axial weight to draw the ilia inward (medially)?

A

Posterior SI Ligament

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22
Q

Which of the 5 SI ligaments limits upward movement of the inferior part of the sacrum?

A

Sacrospinous Ligament and Sacrotuberous Ligament together

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23
Q

Which of the 5 SI ligaments resists sacral rotation during periods of sudden weight gain (landing a high jump) and contributes to the formation of the Greater & Lesser Sciatic Foramina?

A

Sacrospinous Ligament

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24
Q

In the Lumbosacral joint what prevents L5 from sliding anteriorly?

A

S1 facets face posteromedially

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25
Q

What ligament supports the Lumbosacral joint?

A

Iliolumbar Ligament (spans from L5 TPs to medial surface of ilial ala)

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26
Q

What does the Sacrococcygeal joint consist of?

A

Fibrocartilage disc between apex of sacrum & coccyx

Anterior/posterior Sacrococcygeal Ligament (strengthens this joint)

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27
Q

What ligaments thicken the pubis symphysis?

A

Superior Pubic Ligament- laterally to pubic tubercles

Inferior Pubic Ligament- rounds the subpubic angle to form the pubic arch

28
Q

What happens to the pelvic joint/ligament during pregnancy?

A

Increased levels of sex hormones & RELAXIN= freer movements
SI joint loosens= greater pelvic rotation
Increased distance between pubic bones
Overall pelvic diameter increases 10-15%
Distance between sacral promontory & pubic symphysis does NOT change
therefore most increase is in transverse axis

29
Q

How is the anterior pelvic wall formed?

A

by bodies and rami of pubic bones & pubic symphysis

30
Q

How is the lateral pelvic wall formed?

A

hip bones with obturator foramen

31
Q

What is the obturator foramen closed by?

A

obturator membrane

32
Q

What are the attachments of the Obturator Internus muscle?

A

Internal surface of obturator membrane & ilium/ischium (O) then turns sharply to attach to Greater Trochanter (I)

33
Q

What is the tendinous arch of obturator fascia an attachment for?

A

Levator Ani muscle

34
Q

What is the innervation of obturator internus?

A

Nerve to obturator internus (L5-S2)

35
Q

What is the action of obturator internus?

A

laterally rotate thigh, hold head of femur in acetabulum

36
Q

How is the posterior pelvic wall formed?

A

by sacrum/coccyx, SI joints, & associated ligaments

37
Q

What are the attachments of the Piriformis muscle?

A

2nd-4th sacral segments and sacrotuberous ligament (O) then it exits through greater sciatic foramen to attach to greater trochanter of femur (I)

38
Q

What nerves cross the internal surface of the piriformis?

A

Sacral Plexus

39
Q

What is the innervation of the piriformis?

A

S1-S2 ventral rami

40
Q

What is the action of the piriformis?

A

Laterally rotates and abducts thigh, holds femur head in acetabulum

41
Q

How is the pelvic floor formed and what does it consist of?

A

Formed by Pelvic Diaphgram
Consists of Levator Ani M and Coccygeus M
(Separates pelvic cavity from perineum)

42
Q

What is the importance of the Levator Ani Muscle?

A

Forms a muscular sling for supporting abdominopelvic viscera
Resists increases in intra-abdominal pressure
- Important during forced expiration, coughing, sneezing, vomiting, urinating, defecating, and lifting heavy objects
- role in voluntary control of urinating and defecating

43
Q

What is the innervation of the levator ani muscle?

A

S4 ventral rami & Inferior Rectal nerve (from pudendal)

44
Q

What is the action of levator ani muscle?

A

raises pelvic floor and compress abdominopelvic contents

45
Q

What is the puborectalis muscle? (4)

A

The narrow medial part of levator ani muscle

  • Forms U-shaped sling from R/L pubic bodies to anorectal junction
  • surrounds the urogenital hiatus
  • creates the puborectal sling at anorectal junction forming the anorectal flexure (= important for maintaining fecal continence)
46
Q

What is the pubococcygeus muscle?

A

the main intermediate part of levator ani muscle
spans from pubis to coccyx
attached to anterior part of tendonous arch of obturator fascia

47
Q

What is the iliococcygeus muscle?

A

Posterolateral part of levator ani muscle

spans from posterior part of tendinous arch to coccyx

48
Q

Where is the coccygeus muscle located?

A

spans from ischial spine to inferior sacrum and coccyx

49
Q

What is the innervation of the coccygeus muscle?

A

S4-S5 ventral rami

50
Q

What is the action of coccygeus muscle?

A

Contributes to levator ani in forming the pelvic diaphragm

51
Q

What is pelvic fascia continuous with?

A

Endoabdominal fascia in abdomen

52
Q

What does parietal pelvic fascia cover?

A

Obturator internus, piriformis, coccygeus, levator ani

53
Q

What does visceral pelvic fascia cover?

A

urinary bladder, prostate, vagina, uterus, rectum

54
Q

What is the visceral pelvic fascia continuous with and wehre?

A

With the parietal pelvic fascia at point pelvic organ penetrates pelvic floor

55
Q

What is the tendinous arch of pelvic fascia?

A

Continuous bilateral fibrous sling that spans from pubis to sacrum along pelvic floor

56
Q

What are the ligaments of the tendinous arch in males?

A

Puboprostatic L- anteriorly from prostate to pubis

Sarogenital L- posteriorly from sacrum to prostate

57
Q

What are the ligaments of tendinous arch in females?

A

Pubovesical L- anteriorly from urinary bladder to pubis

Uterosacral L- posteriorly from sacrum to vagina

58
Q

What and where is the perineum?

A

Inferior to pelvic outlet and separated from pelvic cavity by the pelvic diaphgram
= both external surface & shallow compartment of body

59
Q

What are the general borders of the perineum?

A

Mons pubis anteriorly
Medial surfaces of proximal thigh laterally
Gluteal fold & intergluteal cleft posteriorly

60
Q

What are the osseofibrous borders of the perineum? (5)

A 
Pubic symphysis
Ischiopubic rami
Ischial tuberosities
Sacrotuberous Ls
Inferior sacrum & coccyx
61
Q

What subdivides the perineum and what are the subdivisions?

A

An imaginary transverse line connecting the ischial tuberosities.

  • Anal Triangle
  • Urogenital Triangle
  • Perineal Body (central point of perineum)
62
Q

Where is the anal triangle and what does it contain?

A
  • Posterior to transverse line

- Contains anus

63
Q

Where is the urogenital triangle and what does it contain?

A
  • Anterior to transver line

- contains external genitalia

64
Q

What is the urogenital triangle covered by?

A

Perineal membrane spanning pubic arch

attachment point for erectile bodies & is perforated by urethra (both sexes) and vagina

65
Q

What is the perineal body and where is it located?

A

Irregular shaped fibromuscular tissue

  • midpoint of transverse line
  • posterior to vestibule of vagina or bulb of penis
  • anterior to anus & anal canal
66
Q

What attaches to the perineal body?

A
  • Superficial Transerse Perineal M
  • Deep Transverse Perineal M
  • External Anal Sphincter
  • Bulbospongiosus
    • very important support system for pelvic viscera in females
67
Q

What innervates Superficial Transverse Perineal M & Deep Transverse Perineal M and what do they do?

A

Deep Perineal N (from pudendal n)

- supports & anchors perineal body- provides support to pelvic floor

Gross III Final Exam (2 decks)

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