Region 7 - Pelvis Flashcards
1
Q
Where does the bladder sit in relation to the pubic bones?
A
Posterosuperior
2
Q
What does the bladder rest on?
A
Anteriorly: - Pubic bones and pubic symphysis Posteriorly: - Prostate (males) - Anterior vagina (females)
3
Q
What features of the bladder inner surface allow stretching?
A
Transitional epithelium
Rugae
4
Q
Where does the bladder lie in infants and children?
A
Abdomen (empty and full)
5
Q
At what age does the bladder begin to lie in the greater pelvis?
A
6 years
6
Q
Where does the bladder lie from puberty onwards?
A
Lesser pelvis when empty
Rises to suprapubic region as it fills
7
Q
What connects the pubic symphysis to the apex of the bladder?
A
Urachus:
- Remnant of allantois; a canal draining foetal bladder via umbilical cord
8
Q
What is the trigone of the bladder?
A
The inferoposterior, triangular base of the bladder
An internal area of smooth mucous membrane
9
Q
What muscle encircles the orifices of the trigone?
A
Detrusor muscle
10
Q
What is the alternative name for the internal urethral sphincter? What muscle is it a continuation of?
A
Sphincter vesicae (not complete) Detrusor muscle
11
Q
What ligaments how the neck of the bladder in place?
A
Puboprostatic (males)
Pubovesical (females)
12
Q
What is the blood supply to the bladder in males?
A
Superior vesical arteries (x2)
Inferior vesical artery
13
Q
What is the blood supply to the bladder in females?
A
Superior vesical arteries (x2)
Vaginal artery
14
Q
Where do the arteries that supply the bladder arise from?
A
Superior vesical arteries:
- Patent umbilical artery (anterior division of internal iliac artery)
Inferior vesical/vaginal artery:
- Anterior division of internal iliac artery
15
Q
What arteries can give small branches to the bladder?
A
Obturator artery
Inferior gluteal artery
16
Q
What is the venous drainage of the bladder?
A
Vesical plexus -> Internal iliac vein
17
Q
What provides SNS innervation to the bladder?
A
Inferior thoracic and upper lumbar cord:
- Via hypogastric plexus and nerves to the vesical plexus
18
Q
What provides PNS innervation to the bladder?
A
Pelvic splanchnic nerves -> Inferior hypogastric plexus
19
Q
What does PNS innervation to the bladder do?
A
Contracts detrusor muscle
Inhibits internal urethral sphincter
20
Q
Where does lymph from the ureter drain?
A
Lumbar
Common iliac
External iliac
Internal iliac
21
Q
Where does lymph from the bladder drain?
A
Internal iliac
(Some to external iliac superiorly)
(Some from neck to sacral nodes)
22
Q
Where does lymph from the urethra drain?
A
Internal iliac Males: - Spongy urethra -> Deep inguinal Females: - Some to sacral nodes
23
Q
What is the relation of the rectum to the peritoneum?
A
Upper 1/3 covered by visceral peritoneum
Middle 1/3 has peritoneum on anterior surface
Lower 1/3 is infraperitoneal
24
Q
What is the course of the rectum?
A
From S3 (rectosigmoid junction) To tip of coccyx
25
What forms the 3 lateral flexures in the rectum?
3 internal transverse rectal folds:
- 2 on left
- 1 on right
26
What supports the rectal ampulla?
Levator ani
| Anococcygeal ligament
27
What is the arterial supply to the rectum?
Superior rectal artery (inf. mesenteric)
Middle rectal artery (int. iliac)
Inferior rectal artery (int. pudendal)
28
What conveys SNS supply to the rectum?
Lumbar splanchnic nerves
Hypogastric/pelvic plexuses
(Via peri-arterial plexuses)
29
What conveys PNS supply to the rectum?
Pelvic splanchnic nerves (S2-S4):
| - Inf. hypogastric plexus -> Rectal plexuses
30
What is the lymphatic drainage of the rectum?
Pararectal nodes:
- Inferior mesenteric
- Internal iliac
31
What is the broad ligament?
Double layer of peritoneum extending from sides of uterus to lateral walls and floor of pelvis
32
What part of the broad ligament is prolonged laterally over and contains the ovarian vessels?
Suspensory ligament of the ovary
33
What ligament lies posterosuperiorly between the layers of the broad ligament?
Ligament of the ovary
34
What ligament lies anteroinferiorly between the layers of the broad ligament?
Round ligament of the uterus
35
What part of the broad ligament do the uterine tubes lie in anterosuperiorly?
Mesosalpinx
36
What part of the broad ligament do the ovaries lie in posteriorly?
Mesovarium
37
What part of the broad ligament lies inferiorly and is the main part?
Mesometrium
38
What are the ligaments, attached to the cervix, that support the uterus?
```
Uterosacral (sacrocervical)
Transverse cervical (cardinal):
- Cervix to obturator fascia (lateral pelvic wall)
Pubocervical (pubovesical):
- Cervix to pubic symphysis
```
39
What is anteversion of the uterus?
Long axis of uterus bent forward on long axis of vagina
40
What is the angle of anteversion of the uterus?
90 degrees
41
What is anteflexion of the uterus?
Long axis of uterus bent forward at internal os with long axis of vagina/cervix
42
What is the angle of anteflexion of the uterus?
170 degrees
43
What is the arterial supply to the ovaries?
Paired para-aortic branches at L2
44
Where does the right ovarian vein drain?
IVC
45
Where does the left ovarian vein drain?
Left renal vein
46
Where do nerves supplying the ovaries arise?
Aortic plexus
47
What structures of the female reproductive system drain lymph to the aortic nodes at L2?
Ovaries
Fundus
Uterine tubes
48
Where does lymph from the isthmus of the uterine tubes drain to?
Superficial inguinal niodes
49
Where does lymph from the body of the uterus drain?
External iliac nodes (via broad ligament)
50
Where does lymph from the cervix drain?
Internal iliac nodes
| Some to sacral
51
Where does lymph from the external cervical os drain?
Internal iliac nodes -> Superficial inguinal nodes
52
What is formed when the vas deferens and the duct from the seminal vesicle join?
Ejaculatory duct
53
Within what structure does the urethra meet the ejaculatory duct?
Prostate
54
What are the dimensions of the seminal vesicles?
5cm long
| 10-15cm long is uncoiled
55
What do the seminal vesicles secrete?
Liquid component of semen
| Fructose
56
What part of the prostate is related to the neck of the bladder?
Base of prostate
57
What proportions of the prostate are glandular and fibromuscular?
2/3 glandular
| 1/3 fibromuscular
58
What surrounds the prostate?
Fibrous capsule
59
What is the structure of the anterior surface of the prostate?
Muscular
60
What is the posterior surface of the bladder related to?
Rectal ampulla
61
What is the inferolateral surface of the prostate related to?
Levator ani
62
What does the prostate produce?
Proteolytic enzymes
| Acid phosphatase
63
What structures support the prostate?
```
Puboprostatic ligament (to pubic symphysis)
Levatore prostatae
```
64
What is the venous drainage of the prostate?
Deep dorsal vein of penis -> Prostatic venous plexus -> Internal iliac vein
65
What is the arterial supply to the seminal vesicles?
Branches from:
- Inferior vesical arteries
- Middle rectal arteries
66
What is the arterial supply to the prostate?
Prostatic branches from:
- Internal iliac arteries
- Inferior vesical arteries
- Internal pudendal arteries
- Middle rectal arteries
67
What lobe of the prostate often enlarges most? What can this cause?
Middle lobe
| Obstruction of internal urethral orifice
68
How does prostatic enlargement affect urination?
Impedes urination by distorting prostatic urethra
69
What are the symptoms of prostate enlargement?
Nocturia
Dysuria
Urgency
70
In what populations is prostatic enlargement most common?
Males older than 50 years
71
What is the lymphatic drainage of the seminal vesicles?
Upper parts -> External iliac
| Lower parts -> Internal iliac
72
What is the lymphatic drainage of the prostate?
Internal iliac
73
What is the lymphatic drainage of the male urethra?
Prostatic part -> Internal iliac
Spongy part -> External iliac and deep inguinal (distally)
Membranous/Intermediate part -> External iliac
74
What is the lymphatic drainage of the testes?
Aortic nodes at root of testicular artery at L2
75
What is the lymphatic drainage of the skin of the penis and the scrotum?
Superficial inguinal
76
What structures form the urogenital triangle?
Lines from pubic symphysis to each ischial tuberosity and a line between the ischial tuberosities
77
What structures form the anal triangle?
Lines from coccyx to each ischial tuberosity and a line between the ischial tuberosities
78
What are the boundaries of the perineum?
Anteriorly - Pubic symphysis
Anterolaterally - Ischiopubic rami
Laterally - Ischial tuberosities
Posterolaterally - Sacrotuberous ligaments
Posteriorly - Inferiormost sacrum and coccyx
79
What structures form the anterior boundaries of the ischioanal (rectal) fossa?
Colles' fascia
| Inferior urogenital diaphragm
80
What structures form the lateral boundaries of the ischioanal (rectal) fossa?
Ischial tuberosity
| Obturator internus
81
What structures form the medial boundaries of the ischioanal (rectal) fossa?
Levator ani
| External anal sphincter
82
What structures form the posterior boundaries of the ischioanal (rectal) fossa?
Gluteus maximus
| Sacrotuberous ligament
83
What structure forms the superior boundary of the ischioanal (rectal) fossa?
Levator ani
84
What structure forms the inferior boundary of the ischioanal (rectal) fossa?
Skin
85
What are the contents of the ischioanal fossae?
Branches of pudendal vessels and nerves:
- Inferior rectal nerve
- Inferior rectal artery and vein
Adipose tissue
86
What is the course of the anal canal?
From superior aspect of pelvic diaphragm
| To anus
87
What parts of the anal canal does the internal anal sphincter surround?
Superior 2/3
88
What type of muscle is the internal anal sphincter and what nerves innervate it?
Smooth:
- SNS (maintains contraction)
- PNS (allows defaecation)
89
Where do the anal columns lie?
In the mucous membrane of the internal superior half of the anal canal
90
What is contained in the anal columns?
Terminal vessels of:
- Superior rectal artery
- Superior rectal vein
91
What lies at the superior ends of the anal columns?
Anorectal junction
92
What joins the anal columns at their inferior ends? What are these lying just inferior to?
Anal valves
| Lying just inferior to the anal sinuses (secrete mucus to aid defaecation)
93
What parts of the anal canal does the external anal sphincter surround?
Inferior 2/3
94
What are the attachments of the external anal sphincter?
Anteriorly - Perineal body
| Posteriorly - Anococcygeal ligament
95
What is the function of the external anal sphincter?
Closes the anus (aided by puborectalis)
96
What is the innervation to the external anal sphincter?
Inferior rectal branch of pudendal nerve (S2-S4)
97
What is the pectinate line?
Site of anal membrane in foetus dividing the upper 2/3 (visceral; hindgut-derived) of the anal canal from the lower 1/3 (somatic; proctodeum derived)
98
What is the blood supply to the anal canal?
Superior rectal artery (above pectinate line)
| Inferior rectal artery (below pectinate line)
99
What is the name of the line that is the true transition to skin from the anal canal?
Anocutaneous line
100
What is the lymphatic drainage of the anal canal?
```
Internal iliac (above pectinate line)
Superficial inguinal (below pectinate line)
```
101
What is the fatty Camper's fascia of the perineum continuous with?
```
Ischiorectal fossa (fat)
Thigh
```
102
What is the Camper's fascia replaced by in males?
Dartos fascia in the:
- Penis
- Scrotum
103
What does the Camper's fascia contribute to in females?
Labia majora
| Mons pubis
104
Where does the membranous Colles' fascia attach?
Posterior border of urogenital diaphragm (perineal membrane and body) posteriorly
Fascia lata of thigh laterally
105
What is the membranous Colles' fascia continuous with in males?
Dartos fascia anteriorly in the:
- Penis
- Scrotum
106
What does the membranous Colles' fascia contribute to in females?
Labia majora
107
What are the boundaries of the urogenital diaphragm?
Superiorly:
- Superior UG fascia (blending with perineal body)
Inferiorly:
- Inferior UG fascia (the perineal membrane)
108
What is contained between the fascial layers of the urogenital diaphragm?
Deep perineal pouch:
- Sphincter urethrae
- Deep transverse perineal muscles
109
What do the layers of the urogenital diaphragm do anteriorly?
Fuse and leave a small gap near pubic symphysis
110
What do the posterior aspects of the layers of the UG diaphragm fuse with?
Each other
Membranous Colles' superficial fascia
Perineal body
111
What are the boundaries of the deep perineal pouch by more modern understandings?
```
Superiorly:
- Inferior fascia of pelvic diaphragm
Inferiorly:
- Perineal membrane
Laterally:
- Inferior part of the obturator membrane (covering internal aspect of obturator internus)
```
112
What are the contents of the deep perineal pouch in both sexes?
```
Urethra
Sphincter urethrae (ext. urethral sphincter)
Deep transverse perineal muscles
Internal pudendal vessels and branches
Ischio-anal fat
```
113
What are extra contents of the deep perineal pouch in males?
Membranous urethra
Dorsal nerves of penis (branch of pudendal n.)
Bulbourethral glands
Penile arteries (from int. pudendal a.)
114
What are extra contents of the deep perineal pouch in females?
Vagina
| Dorsal nerves of clitoris (branch of pudendal n.)
115
What are the boundaries of the superficial perineal pouch?
```
Superiorly:
- Perineal membrane
Inferiorly:
- Skin (membranous Colles' fascia)
Laterally:
- Ischiopubic rami
```
116
What muscles are contained in the superficial perineal pouch?
Ischiocavernosus
Bulbospongiosus
Superficial transverse perineal
117
What are the other contents of the superficial perineal pouch?
```
Urethra
Vagina
Clitoris
Penis
Branches of internal pudendal vessels and pudendal nerves
```
118
What erectile tissues are contained in the superficial perineal pouch?
Crura
Bulb:
- Of vestibule (females)
- Of penis (males)
119
What is the perineal body?
A small fibrous structure at the posterior margin of the UG diaphragm. It is a mass in the middle line of the junction between the urogenital and anal triangles
120
What attaches to the perineal body?
External anal sphincter
Bulbospongiosus
Superficial transverse perineal muscles
121
What structures in the penis are extensions of the crura?
Corpus cavernosus (x2):
- Paired structures
- Lie posteriorly (ie. when penis erect)
122
What structure in the penis is an extension of the bulb?
Corpus spongiosum (lies anteriorly)
123
What arteries run within the corpora cavernosa?
Deep arteries of penis
124
Where do the dorsal arteries of the penis run?
In the dorsal groove between the corpora cavernosa
125
Where do the dorsal nerves of the penis run?
Lateral to the dorsal arteries of the penis
126
What are the branches of the pudendal nerve?
Inferior rectal nerve
Perineal nerve (superficial and deep):
- Posterior scrotal/labial branches
Dorsal nerve of penis/clitoris
127
What are the root values for the sacral plexus?
L4-S4
128
What are the root values of the sciatic nerve? Where does it form?
L4-S3 anterior rami
| On anterior surface of piriformis
129
Where does the sciatic nerve leave the pelvis?
Via greater sciatic foramen:
- Inferior to piriformis
- Deep to gluteus maximus
130
What does the sciatic nerve supply?
Posterior thigh
| All leg and foot
131
What are the root values for the superior gluteal nerve?
L4-S1
132
What does the superior gluteal nerve run alongside?
Superior gluteal vessels
133
Where does the superior gluteal nerve leave the pelvis?
Greater sciatic nerve:
| - Superior to piriformis
134
What does the superior gluteal nerve supply?
Gluteus medius
Gluteus minimus
Tensor fascia lata
135
What are the root values of the inferior gluteal nerve?
L5-S2
136
What does the inferior gluteal nerve run alongside?
Inferior gluteal vessels
137
What does the inferior gluteal nerve supply?
Gluteus maximus
138
What are the root values of the nerve to obturator internus?
L5-S1
139
What is the course of the nerve to obturator internus?
Leaves pelvis via greater sciatic foramen:
- Inferior to piriformis
Descends posterior to sacrospinous ligament
Enters pelvis via lesser sciatic foramen
140
What does the nerve to obturator internus supply?
Obturator internus
| Superior gemellus
141
What are the root values of the nerve to piriformis?
Direct S1-S2
142
What is the course of the nerve to piriformis?
Enters anterior surface of piriformis
143
What nerves supply the levator ani?
```
Nerve to levator ani (direct S4)
Pudendal nerve (via inf. rectal nerve)
```
144
What nerves supply coccygeus?
Direct S4 and S5 branches
145
What are the root values of the pudendal nerve?
S2-S4
146
What is the course of the pudendal nerve?
1. Leaves pelvis via greater sciatic foramen:
- Between piriformis and coccygeus
2. Hooks around ischial spine
3. Enters pelvis via lesser sciatic foramen
4. Runs with internal pudendal vessels anterosuperiorly on lateral wall of ischioanal fossa
5. Into perineum
147
What muscles does the pudendal nerve supply?
Levator ani
External anal and urethral sphincters
Bulbospongiosus
Ischiocavernosus
148
What are the parts of levator ani?
Iliococcygeus
Pubococcygeus
Puborectalis
Pubovaginalis/Puboprostaticus
149
Where do the lumbar splanchnic nerves arise from and travel to?
From sympathetic chain
| To superior hypogastric plexus
150
Where do the sacral splanchnic nerves arise from and travel to?
From sympathetic chain
| To inferior hypogastric plexus
151
Where do the pelvic splanchnic nerves travel to?
Inferior hypogastric plexus then to the inferior mesenteric plexus (via superior hypogastric and aortic plexuses)
152
What effect does the SNS have on defaecation?
Prevents it:
- Reduces movement in rectum
- Contracts internal anal sphincter
153
What effect does the SNS have on urination?
Prevents it:
- Contracts internal urethral sphincter
- Relaxes detrusor muscle
154
How does the SNS cause ejaculation?
Contracts:
- Ductus deferens
- Seminal vesicles
155
What effect does the SNS have on the uterus?
Can contract/relax it (hormonal)
156
What does the PNS have no effect on?
Seminal vesicles
Ductus deferens
Uterus
157
How does the PNS cause erection?
Vasodilation
158
What nerves supply the penis and what type of sensation do they carry?
```
Dorsal nerve of penis:
- Somatic sensory
- Sympathetic
Cavernous nerves (from prostatic plexus):
- Parasympathetic
```
159
What nerve supplies the perineal muscles in males?
Perineal branch of the pudendal nerves
160
What nerves supply give somatic sensory supply to the scrotum?
Anterior scrotal nerve (from ilioinguinal/genitofemoral):
| Posterior scrotal nerve (from perineal branch of pudendal)
161
What nerves supply give somatic sensory supply to the female perineum?
Anterior labial nerve (from ilioinguinal/genitofemoral)
| Posterior labial nerve (from perineal branch of pudendal)
162
What nerve supplies the labia?
Posterior labial nerve
163
What nerve supplies the orifice of the vagina?
Deep branch of pudendal nerve
164
What nerve supplies the perineal muscles in females?
Muscular branches of pudendal nerve
165
What nerve supplies the clitoris and deep perineal muscles in females?
Dorsal nerve of clitoris (from pudendal)
166
What nerve supplies parasympathetic outflow to the bulb of vestibule and clitoris?
Cavernous nerves (from uterovaginal plexus)
167
At what vertebral level does the aorta divide?
L4
168
What are the branches of the anterior division of the internal iliac artery?
Umbilical artery -> Superior vesical arteries
Obturator artery
Inferior vesical/Uterine artery -> Prostatic/Vaginal branches
Middle rectal artery
Inferior gluteal artery
169
What are the branches of the posterior division of the internal iliac artery and what do they supply?
```
Iliolumbar artery:
- Psoas
- Quadratus lumborum
Lateral sacral:
- Piriformis
- Vertebral column
Superior gluteal
```
170
What are the boundaries of the pelvic inlet?
```
Anterior:
- Pubic crest (and symphysis)
Lateral:
- Iliopectineal lines
Posterior:
- Sacral promontory
- Ala of sacrum
```
171
What are the boundaries of the pelvic outlet?
```
Anterior:
- Pubic arch
Lateral:
- Ischial tuberosities
Posterolateral:
- Inferior margin of sacrotuberous ligament
Posterior:
- Tip of coccyx
```
172
What forms the anteroinferior wall of the pelvis?
Pubic bodies
Pubic rami
Pubic symphysis
173
What forms the lateral walls of the pelvis?
Both hip bones
| Obturator membranes and obturator internus muscles
174
What forms the posterior walls of the pelvis?
Sacrum
Coccyx
Piriformis
175
What forms the roof of the pelvis?
Pelvic inlet
176
What forms the floor of the pelvis?
Pelvic diaphragm:
- Levator ani
- Coccygeus
177
Where does the sacrotuberous ligament originate?
Posterior ilium
| Lateral sacrum and coccyx
178
Where does the sacrotuberous ligament insert?
Ischial tuberosity
179
Where does the sacrospinous ligament originate?
Lateral sacrum and coccyx
180
Where does the sacrospinous ligament insert?
Ischial spines
181
What does the sacrotuberous ligament do?
Creates sciatic foramen
182
What does the sacrospinous ligament do?
Divides foramen into greater and lesser sciatic foraminae
183
Where does the inguinal ligament run to and from?
From ASIS
| To pubic tubercle
184
What are the anterior sacroiliac ligaments?
Anterior parts of the fibrous capsules of the SIJs (covers synovial part of SIJ)
185
What are the posterior sacroiliac ligaments?
Posterior external continuations of the interosseous sacroiliac ligaments (covers fibrous part of SIJ)
186
What is the function of the posterior sacroiliac ligaments?
Run superolaterally:
- Axial weight on sacrum
- Pulls ilia medially
- Locks the SIJs
187
What type of cartilage is present at the SIJ?
Sacral - Hyaline
| Iliac - Fibrocartilage
188
What type of cartilage is present at the pubic symphysis?
Fibrocartilage (secondary cartilaginous)
189
What is the shape of an android pelvis, why and who is it common in?
Heart shaped inlet (prominent sacrum)
| Men
190
What is the 'normal' female pelvis with an oval inlet and wide transverse diameter?
Gynecoid
191
What type of pelvis has a long pelvic inlet (AP > Transverse)?
Anthropoid
192
What is the uncommon pelvis shape that has a flat, kidney-shaped inlet (transverse >> AP)?
Platypelloid
193
What are the origins and insertions of the iliacus?
```
Origin = Iliac fossa
Insertion = Lesser trochanter of femur
```
194
What is the function of iliacus?
Flexes hip
195
What is the nerve supply to iliacus?
Femoral nerve (L2-L3)
196
What are the origins of psoas?
T12-L4 bodies and IV discs (superficial)
| L1-L5 bodies and IV discs (deep)
197
What is the insertion of psoas?
Lesser trochanter of femur
198
What are the functions of psoas?
Flexes hip
Bends trunk laterally (one)
Raises trunk from supine (both)
199
What is the nerve supply to psoas?
Lumbar plexus direct L2-L4 anterior rami
200
What is the origin and insertion of the obturator internus?
```
Origin = Inner surface of obturator internus
Insertion = Medial surface of greater trochanter of femur
```
201
What is the function of obturator internus?
Lateral rotation of hip
202
What is the nerve supply to obturator inernus?
Nerve to obturator internus (L5-S1)
203
What are the origins of piriformis?
Anterior/pelvic surface of sacrum
| Sacrotuberous ligament
204
What is the insertion of piriformis?
Superior border of greater trochanter of femur
205
What is the function of piriformis?
Lateral rotation of hip
206
What is the nerve supply to piriformis?
Nerve to piriformis (S1-S2)
207
What are the origins of coccygeus?
Ischial spine
| Sacrospinous ligament
208
What are the insertions of coccygeus?
Coccyx
| Inferior sacrum
209
What are the functions of coccygeus?
Supports pelvic viscera
| Flexes coccyx
210
What is the nerve supply to coccygeus?
Direct branches from sacral plexus S4-S5
211
What are the most medial fibres of levator ani?
Puborectalis
212
What are the four parts of the pubococcygeus?
(Puborectalis)
Puboprostaticus/Pubovaginalis
Puboanalis
Puboperinealis
213
What is the function of pubococcygeus?
Attach to and support:
- Vagina/Prostate
- Rectum
214
What is the most lateral part of levator ani?
Iliococcygeus
215
What are the functions of iliococcygeus?
```
Support pelvic viscera:
- Contracts during coughing
Relaxes to allow:
- Urination
- Defaecation
```
216
What is the motor innervation to pubococcygeus?
```
Pudendal nerve (via inferior rectal nerve)
Nerve to levator ani (S4)
```
217
What do the most medial fibres of pubococcygeus wrap around and insert into in males?
Wrap around prostate
| Insert into perineal body -> Levator prostatae (puboprostaticus)
218
What do the most medial fibres of pubococcygeus pass around and insert into in females?
Pass around vagina
| Insert into perineal body -> Pubovaginalis
219
What do fibres of puborectalis mix with to form?
External anal sphincter
| Form a modified sling
220
What is the function of puborectalis?
Maintains faecal continence:
| - Especially after rectal filling (int. anal sphincter open)
221
What is the nerve supply to puborectalis?
```
Pudendal nerve (S2-S4)
Nerve to levator ani (S4)
```
222
What does iliococcygeus attach to?
Fascia of obturator internus -> Tendinous arch of levator ani
Anococcygeal body/ligament/levator plate
223
What is more fibrous; pubococcygeus or iliococcygeus?
Iliococcygeus
224
What is the nerve supply to iliococcygeus?
Pudendal nerve
| Nerve to levator ani
225
Where is the parietal pelvic fascia thickened and what does it form?
Over obturator internus:
| - Tendinous arch of pelvis (and levator ani)
226
What do the anterior extensions of the tendinous arch of the parietal pelvic fascia form?
```
Puboprostatic ligament (males)
Pubovesical ligament (females)
```
227
Where do the parietal and visceral pelvic fasciae blend?
As organs pierce pelvic floor
228
What is the paracolpium?
Lateral extensions of visceral fascia from vagina to tendinous arch
229
What does the endopelvic fascia act as?
Packing around organs
230
What does the loose type of endopelvic fascia do?
Fills 'space' in pelvis (eg. retropubic and retrorectal spaces)
231
What is the condensed endopelvic fascia?
Thickenings of fascia
232
What are the primary condensations of the endopelvic fascia condensed type?
Hypogastric sheaths:
| - Along posterolateral pelvic walls
