Pelvis, Perineum, Pelvic Floor Flashcards
what is the false pelvis related to
ilium, lower lumbar vertebrae, the lowest part of the abdomen
what does the false pelvis contain
sigmoid colon, cecum
what is the true pelvis related to
pubis, ischium, sacrum, bounded by inlet and outlet
what does the true pelvis contain
urinary and reproductive organs
boundaries of the true true pelvis
intervertebral disc of L5 to the pubic tubercle; coccyx to inferior to pubic symphysis (perineal membrane)
what bones is the pelvis made up of
right and left pelvic bones (os coxae), sacrum, coccyx
what bones make up the acetabulum
ileum, ischium, pubis
ID bony landmarks
ID bony landmarks
body landmarks
what makes up the pubic symphysis
hyaline and fibrocartilage between superior and inferior pubic rami, transversed by superior pubic ligament and inferior pubic ligament
what makes up the lumbosacral joints
articular processes of 2 zygapophyseal joints and an intervertebral disc
what type of joint is the SI joint
synovial
function of the SI joint
transmit forces from lower limb to hip
what is the function of the sacrotuberous ligaments
prevent upward tilting of sacrum
where does the sacrospinous ligament attach
from the ischial spine to the sacrum
where does the sacrotuberous ligament attach
between ischial tuberosity and the sacrum
path of attachment of piriformis
sacrum through the greater sciatic foramen to attach to the greater trochanter of the femur
path of attachment of obturator internus
obturator membrane of obturator foramen through the lesser sciatic forament to attach to the gerater trochanter
what muscles make up the lateral walls of the pelvic wall
piriformis and obturator internus
where does the obturator canal pass
through the obturator membrane and obturator internus
list UG diaphragm layers from superficial to deep
- superficial perineal fascia (Colle’s fascia)
- superficial perineal space
- interior fascia of UG diaphragm (perineal membrane)
- deep perineal space
- superior fascia of UG diaphragm
- pelvic floor muscles
what muscles make up the levator ani?
- pubococcygeus
- puborectalis
- iliococcygeus
what muscles make up the pelvic diaphragm
- Levator ani
- coccygeus (ischiococcygeus)
+their fascial coverings
what innervates the pelvic diaphragm?
pudendal nerve (S2-S4)
functions of the perineum
contain and support pelvic viscera and anchor the roots of the external genitalia
what pelvic viscera does the perineum support
bladder, rectum, anal canal, reproductive organs
where does the rectal triangle and urogenital triangle divide in the perineum
at the level of the perineal body
what are the four corners of the perineum diamone
pubic symphysis anteriorly, coccyx posteriorly, ischial tuberosities laterally
where does the coccygeus attach
sacrum and ischial spine, superior to the iliococcygeus muscle of levator ani, on top of the sacrospinous ligament
components of the pelvic floor
- pelvic diaphgram
- perineal membrane and UG diaphragm
space between rectum and uterus
rectouterine pouch
space between pubic symphysis and bladder
retropubic space
what space is between the bladder and rectum in men
pelvirectal space
what muscles are contained in the superficial space/pouch?
- ischiocavernosus
- bulbospongiosus
- superficial transverse perineal muscle
what erectile tissue/glands are found in the superficial space/pouch?
- crus of clitoris/penis
- bulb of vestibule/penis
- greater vestibular gland (females only)
- perineal membrane
what is contained in the deep perineal space?
- deep transverse perineal muscle
- external urethral sphincter/sphincter urethrae
what muscles are found in the deep perineal space that are in females only
- compressor urethrae
- sphincter urethrovaginalis
what muscles are under somatic control?
levator ani, external urethral sphincter
what structures converge at the perineal body?
- UG diaphragm muscles
- external anal sphincter
- fibers of levator ani
what muscles in the superficial space converge at the perineal body
- superficial transverse perineal
- bulbospongiosus
what muscles in the deep space converge at the perineal body
- external urethral sphincter
- deep transverse perineal
what muscle is important for urinary continence?
specifically, the external urethral sphincter - under somatic control
what erectile tissue/gland is found in the deep space
bulbourethral glands in the MALE only
describe colle’s fascia
it is a continuation of scarpa’s fascia of the abdomen, and is fused to the posterior margin of the perineal membrane
describe the consequence of urethral injury in males
urine or blood or infection can accumulate deep to colle’s fascia in the superficial perineal space
what urethral injury may be seen in a pelvic fracture?
posterior urethral injury to the membranous urethra, may cause urine to leak into retropubic space
what urethral injury may be seen in a perineal straddle injury
anterior urethral injury of the bulbar/spongy urethra, casuing blood accumulation in the scrotum, and if Buck’s fascia is torn urine fills perineal space
presentation of a perineal straddle injury
blood at uretheral meatus and scrotal hematoma
presentation of pelvic fracture that caused posterior urethral injury
blood at urethral meatus and high riding prostate
