Repro - Differneces between sex Flashcards
What bony landmarks make up the pelvic inlet?
Promontory of the sacrum Ala of the sacrum Arcuate line of the ileum Pecten Pubis Pubic crest Pubic symphysis
How do you tell a male from female pelvis?
Mens are:
- Heavier & Thicker
- Taller and narrower
- Smaller pelvic outlet relative to pelvic size
- Narrow sub-pubic angle
- Round rather than oval obturator foraman
- Heart shaped inlet (Rather than round)
- Larger acetabulum
What bony landmarks make up the pelvic outlet?
Pubic symphysis
Inferior rami of pubis
Sacrotuberous ligaments
Tip of coccyx
What is the true and false pelvis?
lesser or true pelvis is below the pelvic inlet, greater or false is above.
What type of joint is the sacroiliac joint?
Synovial Plane
What of joint is the pubic symphysis?
Secondary Cartilaginous
What forms the anterior inferior wall of the pelvic cavity?
Bodies and rami of the pubic bones & pubic symphysis
What forms the lateral pelvic wall?
Obturator internus
Piriformis
What spaces are formed by the obturator internus?
Greater sciatic foramen
Lesser Sciatic foramen
What muscle forms the posterior wall of the pelvic cavity?
Piriformis
What nerve network sits on the piriformis?
Sacral Plexus (S1-4)
What muscles form the pelvic floor?
LEvator Ani
Posteriorly –> Coccygeus
Levator Ani is muscle group, what are its constituent parts?
Ant-Post:
- Puborectalis
- Pubococcygeous
- Iliococcygeous
What is the anocccygeal body?
Mass of fibromusclar tissue where the LEvator ani meet in the middle, posterior to the anus
What is the perineal body?
A mass of fibromuscular tissue between vaginal & anal openings of the pelvic floor.
Many muscles of the perineum and pelvic floor attach here including the levator ani
Whats the function of the pelvic floor/diaphragm?
To maintain continence
Support pelvic viscera
Describe the innervation of the pelvic floor/diaphragm?
Pudendal Nerve (S2-S4)
Define cystoceole and rectocoele?
Hernitation of bladder or rectum into the vaginal due to weakening of the wall
Why do an episiotomy, and why do a mediolateral over a midline?
To make a difficult delivery easier and prevent tearing/rupturing.
Mediolateral is less like to become contaminated (Further from anus) and less likely to involve the anus or rectum
Where does the blood supply to the pelvic organs come from?
The internal iliac arteries
More detailed blood vessels can be found in the workbook
What arteries supply the bladder, seminal gland an prostate of men?
Superior and inferior vesicle arteries
Where do the Sup and Inf Vesicle arteries originate?
Sup from Umbilical Art
Inf from the internal Iliac
What artery supplys blood to the uterus and where does it originate?
Uterine Art
From the internal iliac
What artery supplies blood tot he rectum?
Sup rectal Art - from Inf Mesenteric
Middle & Inf rectal art - From Internal Iliac
What artery supplies the vagina & base of bladder in women?
Vaginal Artery, sourced from uterine artery
What artery supplies the perineum and where does it come from?
The Internal Pudendal Art. Its a branch of the Internal Iliac
What does the obturator artery supply and where does it originate?
- Obturator internus
- Femur
- Medial compartment of the thigh
Internal Iliac
What veins drain the pelvic structures?
- Internal Iliac
- Rectal veins
- Median Sacral
- Gonadal
- Internal Vertebral Venous plexus
Where do the rectal veins drain to?
Sup drains to the portal circulation
The Middle/inf drain to the systemic circulation
How might cirrhosis affect the rectal venous system?
Cirrhosis can lead to portal hypertension
This can cause rectal varices due to the superior rectal vein draining into the portal system
The prostatic venous plexus drains the prostate, where does it communicate on its posterior side?
With the vesicle plexuses
What are the primary somatic nerves supplying the pelvis?
L1 –> Ilioinguinal Nerve
L1/2 –> Genitofemoral Nerve
Sacral Plexus S2/3/4 –> Pudendal Nerve
Where does the illioinguinal nerve travel?
L1 -> Superficial Inguinal Ring
Then supplies the skin at root of penis and labia
Where does the genitofemoral nerve travel?
L1-2 –> Deep Inguinal Ring
Then supplies Scrotal skin, cremaster muscle and dartos fascia in men
Where does the pudendal nerve travel?
Follows the course of the pudendal artery.
It travels from pelvis to perineum via the gluteal region
Where does the sympathetic nerve supply to the pelvis originate?
L1-2 and travels via the hypogastric plexus
What does the sympathetic nerve supply to the pelvis actually supply?
Goes via hypogastric plexus to:
- Vas deferens
- Seminal Vesicles
- Prostate
- Epididymis
In women it supplies the female genital tract via the pelvic and ovarian plexuses
Where does the parasympathetic nerve supply to the pelvis originate?
S2-4
What does the parasympathetic nerve supply to the pelvis actually supply?
Pelvic Splanchnic Nerves (S2-4) supply the female genital tract
Parasympathetic fibres (S2-4) go through hypogastric plexus to innervate erectile tissue in men & women.
List the erectile tissues in both genders?
Corpus Cavernosa of the penis
Clitoris
Vestibular bulbs in both genders
What are the 4 main lymph node groups draining the pelvis?
- External Iliac
- Internal Iliac
- Sacral
- Common Iliac
What structures drain to the external iliac nodes?
Abdominal Wall Glans penis/clitoris Membranous urethra Prostate Cervix Upper Vagina Fundus of Bladder
What structures drain to the internal iliac nodes?
Gluteal Region
Deep Perineum
Inferior Pelvic Viscera
What structures drain to the sacral nodes?
Rectum
Posterior Wall of pelvis
What structures drain to the common iliac nodes?
Drains from the external, internal and sacral lymph nodes
