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3rd year anatomy > perineum / pelvis > Flashcards

perineum / pelvis Flashcards

1
Q

what does the pelvic girdle connect

A

axial skeleton to lower limbs

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2
Q

where do the internall iliac lymph nodes drain

A

Gluteal region, deep perineum and inferior pelvic viscera

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3
Q

what is the perineal body

A

an irregular fibromuscular mass - contains skeletal muscle, smooth muscle and collagenous and elastic fibre

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4
Q

what separates the perineum form the pelvic cavity

A

pelvic floor

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5
Q

what are the 2 muscles that make up the pelvic floor

A

levator ani

coccygeus

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6
Q

what bones make up the pelvis

A

2 hip bones, sacrum, coccyx

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7
Q

what control is the external anal sphincter under

A

voluntary

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8
Q

what are the main contents of the anal triangle

A

Anal aperture – the opening of the anus.
External anal sphincter muscle
Ischioanal fossae (x2)

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9
Q

what do The veins along the sides and base of the prostate join to form

A

the prostatic venous plexus

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10
Q

what is the distribution of the uterine artery

A

Pelvic part of ureter, uterus, ligament of uterus, uterine tube and vagina
travels in cardinal ligament

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11
Q

what are the 2 holes in the pelvic floor

A

urogenital hiatus - urehtra + vagina

rectal hiatus

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12
Q

what innervate the erectile tissues (corpora cavernosa, corpus spongiosum, clitoris, bulbs of vestibule)

A

Parasympathetic fibres from S2, 3, 4 via the hypogastric plexus

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13
Q

what part of the levator ani actually lifts the canal

A

illiococcygeus - elevate pelvic floor and the anorectal canal

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14
Q

where does the interior iliac artery divide into the anterior and posterior branches

A

superior border of the greater sciatic foramen

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15
Q

what are the 3 parts of the hip bone

A

ilium, pubis, ischium

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16
Q

what are the main actions of the Superficial transverse perineal & deep transverse perineal muscles

A

Support and fix perineal body to support abdominal/ pelvic viscera and resist increased abdominal presure

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17
Q

what muscle creates the anorectal angle

A

puborectalis - where the rectum meets the anus

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18
Q

what muscles does the perineal branch of the pudendal nerve innervate

A

• Bulbospongiosus
• Ischiocavernosus
• Levator ani muscles (including the iliococcygeus, pubococcygeus and puborectalis).
external urethral sphincter

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19
Q

what are branches of the posterior trunk of the internal iliac artery

A

iliolumbar artery
lateral sacral
superior gluteal

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20
Q

why is the coccygeus not part of the levator ani

A

doesn’t life anus

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21
Q

what is the innervation of the bulbospongiosus

A

Branch of pudendal – S2-4 (muscular branch of perineal)

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22
Q

does the male or female have a larger acetabulum

A

male

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23
Q

what are the lateral borders of the perineum

A

inferior pubic rami and inferior ischial rami (ischiopubic) and the sacrotuberous ligament

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24
Q

what are the boundaries of the anal triangle

A

the coccyx, sacrotuberous ligaments, and a theorectical line between the ischial tuberosities

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25
Q

why is it essential to aspirate before injecting LA in a pudendal nerve block

A

pudendal nerve accompanied by the internal pudendal artery

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26
Q

what fascia forms the pudendal canal

A

obturator internus

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27
Q

what does the iliac crest extend between

A

the anterior superior iliac spine (ASIS) to the posterior superior iliac spine (PSIS).

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28
Q

what nodes drain the body of the uterus

A

External iliac

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29
Q

where do the external iliac lymph nodes drain

A

Pelvic viscera (especially superior parts of the anterior pelvic organs)

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30
Q

what are the main actions of the external urethral sphincter

A

Compress urethra to maintain urinary continence

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31
Q

what is the distribution of the internal pudendal artery

A

Main artery to perineum, including muscles of anal canal and perineum, skin, uro-genital triangle, erectile bodies

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32
Q

where do the sacral lymph nodes drain

A

Concavity of the sacrum, postero-inferior pelvic viscera

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33
Q

what 2 important ligaments attach to the ischium

A

sacrospinous ligaemnt

sacrotuberous ligament

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34
Q

what muscle is the pudendal canal in

A

obturator internus

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35
Q

how does the pudendal nerve leave the pelvis

A

greater sciatic foramen

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36
Q

what is the filum terminale

A

a continuation of the pia mater from the conus medullaris of the spinal cord

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37
Q

what is contained in the superficial perineal pouch

A

the erectile tissues that form the penis and clitoris
three muscles – the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles.
vestibular glands

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38
Q

what is in the central canal of the sacrum

A

sacral fibres of the cauda equina

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39
Q

what ligament creates the greater sciatic foramen

A

sacrospinous ligament

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40
Q

what is the subpubic angle in the female

A

Obtuse – greater than 90

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41
Q

what is the joint between the sacrum and coccyx

A

sacrococcygeal symphysis - fibrocartilaginous joint

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42
Q

what is the uterine artery a branch of

A

Anterior division of internal iliac artery

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43
Q

what indentation os found on the posterior aspect of the ilium

A

greater sciatic notch

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44
Q

what does the sacrospinosu ligament run between

A

ischial spine to the sacrum

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45
Q

what bones make the obturator foramen

A

ischium + pubis

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46
Q

what is the deep perineal pouch

A

a potential space between the deep fascia of the pelvic floor (superiorly) and the perineal membrane (inferiorly).

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47
Q

where is the common iliac vein formed

A

upper margin of the pubic symphis

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48
Q

what are the roles of the pelvic floor muscles

A

Support of abdominopelvic viscera
Resistance to increases in intra-pelvic/abdominal pressure
Urinary and fecal continence

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49
Q

what are the main functions of the pelvis

A

Transfer of weight from the upper axial skeleton to the lower appendicular components of the skeleton, especially during movement.
Provides attachment for a number of muscles and ligaments used in locomotion.
Contains and protects the abdominopelvic and pelvic viscera.

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50
Q

what is the distribution of the obturator artery

A

Pelvic muscles, nutrient artery to ilium and head of femur

thigh adductor region

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51
Q

what is the best way to strengthen the pelvic floor muscles

A

Kegel exercises

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52
Q

has the male or female got a more shallow greater pelvis

A

female

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53
Q

what is the common illaic vein formed from

A

internal and external illaic vein

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54
Q

what nodes drain the scrotum

A

Skin – superficial inguinal

Cavernous body/ spongy urethra – internal iliac

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55
Q

what is the vaginal artery a branch of

A

uterine artery

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56
Q

what is the innervation of the superficial transverse perineal and deep transverse perineal

A

Muscular (deep) branch of perineal nerve – branch of pudendal nerve & dorsal never of penis/ clitoris

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57
Q

what muscles attach to the perineal body

A
  • Levator ani (part of the pelvic floor).
  • Bulbospongiosus muscle.
  • Superficial and deep transverse perineal muscles.
  • External anal sphincter muscle.
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58
Q

where is the perineal body

A

the junction of the urogenital and anal triangles – the central point of the perineum

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59
Q

what muscle forms the lateral wall of the pelvic cavity

A

obturator internus

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60
Q

where to the R and L common illiac veins combine to form the IVC

A

L5

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61
Q

what is the anterior border of the pelvic inlet

A

pubic symphis

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62
Q

what is the roof of the perineum

A

pelvic floor

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63
Q

what is the terminal continuation of the inferior mesenteric artery

A

The superior rectal artery

64
Q

what are the gonadal arteries a a branch of

A

abdominal aorta

65
Q

where is the internal lilac vein formed

A

near the greater sciatic foramen

66
Q

what nerve is motor to the cremasteric muscle

A

genitofemoral (L1/2)

67
Q

where does the pudendal nerve supply

A

whole perineum

68
Q

what is the role of perineal membrane

A

to provide attachment for the muscles of the external genitalia

69
Q

what is the main arterial supply to the pelvic cavity

A

internal iliac artery

70
Q

what shape is the puborectalis

A

U shaped sling

71
Q

what are the main actions of the bulbospongiosus

A

Supports/ fixes perineal body and pelvic floor

72
Q

what nerve plexus lies on the posterior wall of the pelvic cavity

A

sacral plexus

73
Q

what are the middle/ inferior rectal arteries a branch of

A

Anterior division of internal iliac artery

74
Q

where is the internal lilac artery to the external illaic vein

A

medial

75
Q

what is the internal pudendal artery a branch of

A

Anterior division of internal iliac artery

76
Q

what is the major innervation of the perineum

A

pudendal nerve S2-4

77
Q

what innervates the coccyges

A

the anterior rami of S4 and S5

78
Q

what ligament forms the lesser sciatic foramen

A

sacrotuberous

79
Q

what is the innervation of the external anal sphincter

A

Branch of pudendal nerve- inferior anal nerve S4

80
Q

what muscles attach to the anterior surface of the sacrum

A

piriformis
coccygeus
illiacus

81
Q

what type of joints are the sacroiliac joints

A

syndesmosis

82
Q

name some branches of the pudendal nerve

A

inferior rectal nerve,
perineal nerve,
dorsal nerve of the penis or clitoris

83
Q

what are the main actions of the ischiocavernous

A

Maintain erection of penis and clitoris by constricting outflow veins

84
Q

what nodes drain the lower vagina

A

Sacral and common iliac

85
Q

what other 2 veins drain into the common illaic vein

A

Iliolumbar vein – drains the L4 and L5 vertebrae, and the iliopsoas muscle.
Middle sacral veins – drain part of the sacrum

86
Q

what does the sacrotuberous ligament run between

A

sacrum to the ischial tuberosity

87
Q

what are the 3 major vessels that drain the pelvis

A

the external iliac vein, internal iliac vein and common iliac vein

88
Q

what are the main actions of the external anal sphincter

A

Constricts anal canal during peristalsis, resisting defecation

89
Q

what type of joint is the pubic symphis

A

synovial ball and socket

90
Q

what is the lateral border of the pelvic outlet

A

The ischial tuberosities

91
Q

why are haemorrhoids associated with cirrhosis of the liver

A

increased portosystemic pressure, leading to varices in the rectum.

92
Q

what nodes drain the ovary

A

Lumbar and para-aortic

93
Q

where does the body weight fall when sitting

A

ischial tuberosities

94
Q

what shape is the pelvic inlet in a male and female

A

male - heart

female - oval

95
Q

what is the course of the pudendal nerve in and out the pelvis

A

out greater sciatic , crosses sacrospinous ligament , enters through lesser sciatic

96
Q

what is the term for the male and the female pelvis

A

female - gynaecoid

male - android

97
Q

does the male or female have a larger pelvic outlet

A

female

98
Q

where do the common iliac lymph nodes drain

A

Drainage from the 3 main groups – external, internal and sacral lymph nodes

99
Q

what is the obturator artery a branch of

A

Anterior division of internal iliac artery

100
Q

what is a cystocele and rectocele

A

Cystocele – bladder herniation (anterior prolapse)

Rectocele – rectal herniation (posterior prolapse)

101
Q

what is the external illaic vein a continuation of

A

femoral vein

102
Q

what muscles are most prone to damage during childbirth

A

Pubococcygeus and puborectalis - situated medially

103
Q

what nodes drain the fundus and upper uterus

A

Pre- aortic group of lymph nodes

104
Q

what are the 3 muscles of the levator ani

A

pubococcygeus, puborectalis and iliococcygeus

105
Q

where is the pelvic outlet

A

end of the lesser pelvis, and the beginning of the pelvic wall

106
Q

what is the anterior border of the pelvic outlet

A

The pubic arch (the inferior border of the ischiopubic rami).

107
Q

what are the superior/ inferior vesical arteries a branch of

A

Anterior division of internal iliac artery

108
Q

what is there erector spinae important in

A

achieving extension and lateral bending of the head and vertebral column.

109
Q

what nerve is commonly blocked beforevaginal childbirth/ episiotomy

A

pudendal nerve block

110
Q

what type of joint is the hip joint

A

synovial ball and socket

111
Q

where on the sacrum does the sacrospinous ligament attach

A

median sacral crest - fusion of S1-3

112
Q

what does the head of femur articulate with in the hip joint

A

acetabulum

113
Q

where does the levator ani insert into the obturator internus

A

tendinous arch

114
Q

what is the motor function of the pudnedal nerve

A

innervates various pelvic muscles, the external urethral sphincter and the external anal sphincter

115
Q

what is the lateral border of the pelvic inlet

A

arcuate line on the inner surface of the ilium

116
Q

what nodes drain the scrotum

A

Superficial inguinal

117
Q

what is the sensory function of the pudnedal nerve

A

innervates the external genitalia of both sexes and the skin around the anus, anal canal and perineum

118
Q

what is the posterior border of the perineum

A

tip of the coccyx

119
Q

what is the distribution of the superior/ inferior vesical arteries

A

Urinary bladder, pelvic part of ureter

In males – vas deferens, seminal gland and prostate

120
Q

what are the boundaries of the urogenital triangle

A

pubic symphysis, ischiopubic rami, and a theorectical line between the two ischial tuberosities

121
Q

what is the main function of the puborectalis

A

maintain faecal continence – during defecation this muscle relaxes.

122
Q

what are the nerve roots of the pudendal nerve

A

S2-4

123
Q

what is the terminal branch of the anterior trunk of the internal iliac artery

A

inferior gluteal artery

124
Q

what is the superior rectal artery a branch of

A

Inferior mesenteric artery

125
Q

what are the ischioanal fossa

A

spaced lateral to the anus
contain fat and connective tissue
allow for expansion of the anal canal during defecation

126
Q

is the greater pelvis superior or inferior to the true pelvis

A

superior

127
Q

what can avoid a prolapse of the pelvic viscera by tearing ht perineal body in childbirth

A

episiotomy - surgical cut in the perineum

128
Q

what is the junction between the greater and lesser pelvis

A

pelvic inlet

129
Q

what nodes drain the cervix and upper vagina

A

Internal iliac and sacral lymph nodes

130
Q

what nodes drain the seminal vesicle

A

External and internal iliac

131
Q

what separates the 3 hips bones before puberty

A

the triradiate cartilage

fuses at 15-17

132
Q

what is the role of the greater (false) pelvis

A

it provides support of the lower abdominal viscera (such as a ileum and sigmoid colon).

133
Q

what nerve is responsible for the afferent component of penile and clitoral erection

A

Dorsal nerve of the penis or clitoris

134
Q

when does the femoral vein become the external iliac vein

A

crosses underneath the inguinal ligament

135
Q

what nodes drain the prostate

A

Internal iliac and sacral

136
Q

what is the subpubic angle in the male

A

Acute – less than 90

137
Q

what things perforate the perineal membrane in a female

A

vagina

urethra

138
Q

where does the majority of the blood in the pelvis drain

A

internal iliac

139
Q

what is the posterior border of the pelvic inlet

A

sacral promontory (the superior portion of the sacrum) and sacral wings (ala).

140
Q

what innervates the levitator ani

A

pudendal nerve (roots S2, S3 and S4).

141
Q

what is palpated for a pudendal nerve block

A

ischial spine

142
Q

what is the terminal part of the vertebral column

A

coccyx

143
Q

what nerve is sensory to the anterior scrotal skin

A

genitofemoral (L1/2)

144
Q

what is the innervation of the external urethral sphincter

A

Pudendal nerve – S2, 3, 4

145
Q

what are the 3 main articulations of the hip bone

A

•Sacroiliac joint – articulation with the sacrum
•Pubic symphysis – articulation between the left and right hip bones
Hip joint – articulation with the head of femur

146
Q

why is a mediolateral episiotomy preferable to a midline episiotomy

A

avoids potential tear of the medial puborectalis fibres, avoiding rectal herniation

147
Q

what is the autonomic function of the pudnedal nerve

A

carries sympathetic nerve fibres to the skin of the S2-S4 dermatomal region

148
Q

what is the anterior border of the perineum

A

pubic symphis

149
Q

what is the innervation of the ischiocavernous

A

Branch of pudendal – S2-4 (muscular branch of perineal)

150
Q

does the foetus pass through the lesser or greater canal in childbirth

A

lesser

151
Q

what is the terminal branch of the posterior trunk of the internal iliac artery

A

superior gluteal artery

152
Q

how many sacral vertebrae are there

A

5

153
Q

what is the posterior border of the pelvic outlet

A

• The tip of the coccyx

154
Q

where does the internal lilac artery originate

A

bifurcation of the common iliac artery into its internal and external branches, L5-S1

155
Q

what muscle forms the posterior wall of the pelvic cavity

A

piriformis

3rd year anatomy (5 decks)

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