Pelvis (sem 4) Flashcards

1
Q

what nerves run down the sacral hiatus/canal

A

coccygeal nerve

4th sacral nerve

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2
Q

what level does the spinal cord / dura mater terminate

A

spinal cord ends at L2/3

then continues as cauda equina (lumbar puncture from here)

dura mater ends at S2 (as it protects cauda equina)

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3
Q

what nerve and artery wind around the ischial spine

A

pudendal nerve

internal pudendal artery

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4
Q

2 structures that exit greater foramen ABOVE piriformis

A

superior gluteal vessels (artery + vein)

superior gluteal nerve

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5
Q

6 nerves and 2 arteries that leave the greater foramen BELOW piriformis

A

nerves

  • sciatic (deep to piriformis)
  • pudendal
  • inferior gluteal nerve
  • nerve to posterior femoral cutaneous
  • nerve to obturator internis
  • nerve to quadrates femoris

arteries

  • inferior gluteal
  • internal pudendal
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6
Q

Alcock’s canal (pudendal canal) + structures that enter

A

canal within the obturator fascia = medial surface of obturator internus

  • internal pudendal artery/vein
  • nerve to obturator internus
  • pudendal nerve
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7
Q

the one structure that leaves the pelvis via LESSER sciatic notch

A

obturator internus muscle (inserts into greater trochanter - above where the externus inserts)

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8
Q

levator ani muscles + innervation (+ what if this is damaged)

A

inferior rectal branch of pudendal nerve S2-4
+ Branches direct from the ventral ramus of S4

(damage to nerve = incontinence + organ prolapse)

  • puborectalis
  • pubococcygeus
  • iliococcygeus
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9
Q

commonest cause that damages the pelvic floor

A

vaginal child birth

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10
Q

6 structures that contribute to the perineal body

A
  • Levator ani
  • External anal sphincter
  • External urethral sphincter
  • Deep transverse muscle
  • Superficial transverse muscle
  • Bulbospongious muscle
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11
Q

6 structures that contribute to the perineal body

A
  • Levator ani
  • External anal sphincter
  • urethrovaginalis sphincter (female)
  • Deep transverse muscle
  • Superficial transverse perineal muscles
  • Bulbospongious muscle
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12
Q

sacrum:

  • ala
  • promontory
A

ala = inward protruding large triangular surface either side of sacral base

promontory= anterior part of the body of the first sacral vertebra

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13
Q

How do you differentiate between a male and a female pelvis?

A

pelvic inlet

women = circular "gynaecoid" (due to less distinct promontory and broader ala)
men = heart shaped "anthropoid"

pubic angle is wider in women

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14
Q

How is the pelvis orientated in the anatomical position?

A

pubic tubercle and ASIS are in the same vertical line

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15
Q

4 types of pelvis (shape)

A

gynaecoid
anthropoid
android
platypelloid

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16
Q

pudendal nerve roots

A

S2,3,4

17
Q

pudendal nerve course

A

S2,3,4
out of greater foramen inferior to piriformis
around the sacrospinous ligament
enters the anal triangle of perineum by passing medially through the lesser foramen
through the lateral wall of ischiocanal via the pudendal canal

18
Q

coccygeus muscle

A

origin = sacrospinous ligament + ischial spine

insertion = lateral margin of coccyx

action = pulls coccyx forwards after defecation

19
Q

perineum

A

a diamond shaped space forming the outlet of the pelvis

(coccyx, pubic symphysis, ischial tuberosities)

divided by the ischial tuberosities into

  • urogenital triangle
  • anal triangle
20
Q

perineal membrane

A

covers the anterior U shape space (urogenital hiatus)

separates the deep perineal pouch from the superficial

21
Q

contents of the deep perineal pouch

A

female

  • external urethral sphincter
  • compressor urethrae
  • sphincter urethrovaginalis
  • deep transverse perineal muscles
  • skenes glands

male

  • external urethral sphincter
  • deep transverse perineal muscles
  • bulbourethral glands
22
Q

structures in the superficial perineal pouch

A

male

  • crus of penis (attached to corpus cavernosum)
  • bulb of penis
  • ischiocavernous muscle
  • bulbospongiosus muscle
  • perineal body
  • superficial transverse perineal muscle

female

  • crus of clitoris (attached part of corpus cavernosum)
  • bulb of vestibule
  • greater vestibular gland(bartholin’s)
  • ischiocavernous muscle
  • bulbospongiosus muscle
  • perineal body
  • superficial transverse perineal muscle