Pin test (pelvis) Flashcards
What is the name of this ligament?
sacrospinous ligament
What is the name of this ligament?
sacrotuberous ligament
What is the name of this ligament?
anterior sacroiliac ligament
What is the name of this ligament?
posterior sacroiliac ligament
What do the anterior and posterior sacroiliac ligaments cover?
the sacroiliac joint
What is the name of this ligament?
iliolumbar ligament
A 76 year old woman with osteoporosis falls and breaks her hip in 2 places. Where are the two fracture locations?
pubic rami and sacrum
A patient comes to you with sacroiliitis. If you took an xray or their pelvis, what pathological findings would you see?
Sclerosis and osteophytes (‘spur’)
What hormone is secreted during pregnancy by the ovaries that softens and relaxes the pubic symphysis and associated ligaments? What condition can this lead to?
relaxin
pubic symphysitis
What two places do the levator ani muscles attach?
tendinous arch and perineal body
name the blanks
name the blanks
Name the muscle and its fascia(e)
levator ani
superior and inferior fascia of pelvic diaphragm
Name the muscle and its fascia(e)
obturator internus
obturator fascia
A woman who just gave birth to a child via vaginal canal comes to you saying “my junk doesn’t look right down there”. You order imaging and this is what you see (see image). What muscle is responsible?
levator ani muscle is weakened and allowed for prolapse of bladder and vagina
What are the boundaries of the perineum?
pubic symphysis
ischiopubic rami
sacrotuberous ligaments
coccyx
What are the two triangles in the perineum?
urogenital triangle
anal triangle
What are the boundaries of the urogenital triangle?
pubic symphysis
ischiopubic rami
superficial transverse perineal
What are the boundaries of the anal triangle?
coccyx
sacrotuberous ligament
superficial transverse perineal
name the blanks
name the blanks
green arrow = ischioanal fossa
What is the space between the labia majora? Labia minora?
majora = pudendal cleft (smuggling a yoyo)
minora = vestibule
name the blanks
name the blanks
What are the differences between 1st, 2nd, 3rd, and 4th degree vaginal tears?
1st = tear in the vaginal mucosa
2nd = tear in the vaginal mucosa + perineal muscle tear
3rd = tear in the vaginal mucosa + perineal muscle tear + anal sphincter tear
4th = tear in the vaginal mucosa + perineal muscle tear + anal sphincter tear + torn rectum
name the blanks
name it
What are the layers of the scrotum?
skin
Dartos muscle and fascia
external spermatic fascia
cremasteric muscle and fascia
internal spermatic fascia
tunical vaginalis (parietal and visceral)
A 34 year old male comes to your office presenting with right testicular pain. He said the pain started when he was trying to “kick his trailer onto his pickup hitch”. Shortly after the pain onset, his testicle began to swell. You order imaging and this is what you see. What’s going on? Where specifically is the issue?
hydrocele = build up of fluid in the tunica vaginalis
*take note of the structures in the images*
where does lymph from the testes drain? Scrotum?
testes = lumbar lymph nodes
scrotum = inguinal nodes (deep and superficial)
What fills the ischioanal fossa?
fat
A 42 year old man presents to you clinic with pain in his butt. He shows you his butt and you notice there is swelling and redness next to his butthole. Where is the infection?
ischioanal fat pad in the ischioanal fossa
name it
Where does fluid buildup in the female pelvis occur?
recto-uterine pouch
What is the name of the procedure that pulls fluid from the recto-uterine pouch?
culdocentesis
name it
Where are hemorrhoidal veins located in the anus?
behind the anal columns
What is the significance of the pectinate line in the anus?
somatic innervation is below the pectinate line and visceral innevation is above the pectinate line.
Why are external hemorrhoids painful and internal hemorroids painless?
external are below the pectinate line (somatic innervation)
internal are above the pectinate line (visceral innervation)
name it
name the orientation of the uterus
name it
name it
What structure is at risk during a hysterectomy?
ureter
the uterine artery lies just above the ureter (brisdge over water)
name it
name it
What closes the internal ureteric orifices?
the detrusor muscle
What closes the internal urethral orifice?
internal urethral sphincter
name it
What zone in the prostate enlarges to cause BPH?
transitional zone
what zone in the prostate is the main site for prostate cancer development?
peripheral zone
name the zones
What are the different portions of the male urethra?
prostatic urethra
intermediate urethra
bulbar urethra (spongy)
pendulous urethra (spongy)
The internal pudental gives off the _______ artery, which supplies the anus
inferior rectal artery
what artery gives rise to the middle rectal artery?
anterior division of the internal iliac artery
What nerve roots give rise to the obturator nerve?
L2-L4
What plexus holds the pelvic splanchnic and sacral splanchinc nerves?
inferior hypogastric plexus
What nerve roots give rise to the superior gluteal nerve?
L4-S1
What nerve roots give rise to the inferior gluteal nerve?
L5-S2
What nerve roots give rise to the sciatic nerve?
L4-S3
What nerve roots give rise to the pudendal nerve?
S2-4
What is the pelvic pain line? What is its significance?
imaginary line
above the line, visceral afferents carrying pain travel with the sympathetic innervation (Sacral T10-L2)
below the line, visceral afferents carrying pain travel with the parasympathetic innervation (pelvic splanchnics S2-S4)
Where would you give a woman an epidural for childbirth and why?
L3/4 level to block the pain below the pelvic pain line (pelvic splanchnic) to block the pain of childbirth, but to allow the mothers to feel the contractions during childbirth
What nerve roots make up the lumbosacral trunk?
L4 and L5
