Practical 1 - Station 2: Muscles and Walls of the Pelvic Cavity

Question 1

What are the boundaries of the pelvic cavity?

Answer 1

Antero-inferior wall

Two lateral walls

Posterior wall

Question 2

What forms the anterior inferior wall of the pelvic cavity?

Answer 2

The bodies and rami of the pubic bones and pubic symphysis

Question 3

What muscle forms the lateral walls of the pelvic cavity?

Answer 3

Obturator internus

Question 4

What is the action of the obturator internus?

Answer 4

Lateral rotation of the hip

Question 5

What foramen does the obturator internus exit the pelvic cavity?

Answer 5

Lesser sciatic foramen

Question 6

What muscle is present in the posterior wall of the pelvis?

Answer 6

Piriformis

Question 7

What is the action of piriformis?

Answer 7

Lateral rotation of the hip

Question 8

Which foramen does piriformis exit the pelvic cavity through?

Answer 8

Greater sciatic foramen

Question 9

What nerve network lies on top of piriformis?

Answer 9

Sacral plexus

Question 10

What are the 3 muscles that make up the pelvic floor?

Answer 10

Puborectalis

Pubococcygeus

Iliococcygeus

Question 11

Identify

Answer 11

Puborectalis

Question 12

Identify

Answer 12

Pubococcygeus

Question 13

What is the third muscle of the levator ani?

Answer 13

Iliococcygeus

Question 14

What is the perineal body?

Answer 14

Where multiple muscles of the perineum meet

Question 15

What muscles join up at the perineal body?

Answer 15

Anterior levator ani

Bulbospongiosus

External anal sphincter

Superficial transverse perineal muscle

Question 16

What is the anococcygeal body?

Answer 16

Median raphe where the levator ani, external anal sphincter and fibrous connective tissue meet

Question 17

What are the two main functions of the pelvic diaphragm?

Answer 17

Maintain continence

Weight bare above structures

Question 18

What is the innervation of the pelvic diaphragm?

Answer 18

S2, S3, S4 or nerve to levator ani

Question 19

What is the nerve supply to this muscle?

Answer 19

Coccygeus muscle

S4, S5

Question 20

What is a cystocele?

Answer 20

Weakening of fascia between the vaginal canal and the bladder meaning the bladder can prolapse into the vagina

Question 21

What is a rectocele?

Answer 21

Bulging of the front wall of the rectum through a weakness leading to the rectum prolapsing into the vaginal canal

Question 22

Why is injury to the pelvic floor during childbirth potentially damaging?

Answer 22

Damage to the perineal body can lead to incontinence

Question 23

What surgical technique can be used to reduce damage to the perineal body?

Answer 23

Episiotomy

Question 24

What type of episiotomy shown here is the most common and why is an episiotomy good even though you’re still cutting?

Answer 24

Mediolateral episiotomy

• Cutting heals better than tearing
• The perineal body is not damaged

Question 25

In performing a DRE in male and female what structures might you palpate?

Answer 25

Male - prostate

Female - cervix