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(1) Organ Anatomy > S3_L1: The Pelvic Wall > Flashcards

S3_L1: The Pelvic Wall Flashcards

1
Q

The symphysis pubis and anterior superior iliac spines lie in the same vertical plane. Anteriorly, the symphysis pubis faces (1)___. Posteriorly, the anterior surface of the sacrum is directed (2)___.

A
  1. upward and backward
  2. down and forward
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2
Q

Enumerate the boundaries of the pelvis

A
  1. Two hip bones (os coxae)
  2. Sacrum and coccyx
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3
Q

Determine the corresponding descriptions of the following structures

  1. Posterior boundary is Sacral promontory
  2. Contains the internal organs of reproduction, urinary bladder, and lower portion of the intestines and rectum
  3. Anterior boundary is pubic arch and symphysis pubis
  4. Lateral boundary is ischial tuberosities
  5. Lateral boundary is Iliopectineal lines

A. Pelvic inlet / pelvic brim
B. Pelvic outlet
C. Pelvic cavity

A
  1. A
  2. C
  3. B
  4. B
  5. A
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4
Q

After the ___ month of pregnancy, the false pelvis helps support the gravid/pregnant uterus.
During early stages of labor (after 9 mos), it guides the fetus to the true pelvis.

A

3rd

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5
Q

Enumerate the boundaries of the false pelvis.

A
  1. Anteriorly: Abdominal muscles, lower part of anterior abdominal wall
  2. Posteriorly: lumbar vertebrae
  3. Laterally: Iliac fossae, iliacus muscle
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6
Q

Determine the corresponding descriptions of the following structures

  1. Anterior boundary is symphysis pubis
  2. Posterior boundary is Sacrotuberous ligaments and coccyx
  3. Short, curved canal, with shallow anterior wall and deeper posterior wall
  4. Diamond shaped
  5. Lies between the inlet and outlet

A. Pelvic inlet
B. Pelvic outlet
C. Pelvic cavity

A
  1. A
  2. B
  3. C
  4. B
  5. C
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7
Q

Enumerate the notches of the pelvic outlet

A
  1. Pubic arch between the ischiopubic rami anteriorly
  2. Sciatic notches laterally (2)
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8
Q

Divided by the sacrotuberous and sacrospinous ligaments into the greater and lesser sciatic foramen.

A

Sciatic notches

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9
Q

Shallowest pelvic wall formed by bodies of the pubic bones, pubic rami and symphysis pubis

A

Anterior wall

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10
Q

Determine the corresponding descriptions of the autonomic nerves in the pelvis

  1. Lie on each side of rectum, base of bladder and vagina
  2. In front of the sacral promontory, the continuation of aortic plexus from L3-4 sympathetic ganglia
  3. Form parasympathetic part of autonomic nervous system in pelvis
  4. Supplies the large bowel from left colic flexure to upper half on anal canal
  5. Continuous above, behind the common iliac vessels
  6. Formed from a hypogastric nerve and pelvic splanchnic nerve

A. Pelvic part of sympathetic trunk
B. Pelvic splanchnic nerves
C. Superior hypogastric plexus
D. Inferior hypogastric plexus

A
  1. D
  2. C
  3. B
  4. B
  5. A
  6. D
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11
Q

Determine the corresponding descriptions of the ligaments of the SI joints

  1. Thin and lies in front of the joint
  2. Prevent rotatory movements
  3. Connects tip of L5’s transverse process to the (superior aspect) iliac crest
  4. Strong and suspend the sacrum between two iliac bones

A. Iliolumbar ligament
B. Anterior sacroiliac ligament
C. Sacrotuberous and sacrospinous ligaments
D. Posterior and interosseous sacroiliac ligaments

A
  1. B
  2. C
  3. A
  4. D
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12
Q

Determine the corresponding descriptions of the joints in the pelvis

  1. Cornua of the sacrum and coccyx are joined by ligaments
  2. Little and limited gliding movement possible in this joint
  3. Cartilaginous joint between 2 pubic bones
  4. Extensive flexion and extension are possible in this joint
  5. Almost no movement possible here, but if a woman gets pregnant, it has room for expansion for the cavity to give way to the baby
  6. Its primary function is to transmit weight of body from vertebral column to bony pelvis

A. Sacroiliac joints (2)
B. Symphysis pubis
C. Sacrococcygeal joint

A
  1. C
  2. A
  3. B
  4. C
  5. B
  6. A
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13
Q

Determine the corresponding descriptions of the pelvic fascia

  1. In some locations, the fascia thickens and extends from viscus to pelvic walls and provides support
  2. Covers sphincter urethrae muscle and perineal membrane
  3. Forms superior fascial layer of urogenital diaphragm

A. Parietal pelvic fascia
B. Visceral pelvic fascia

A
  1. B
  2. A
  3. A
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14
Q

This stretches across the pelvis and divides the true pelvis into main pelvic cavity (above) and perineum (below)

A

Pelvic diaphragm

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15
Q

It runs down and forward around inner surface of the ilium; serve to divide the false from true pelvis

A

Iliopectineal line

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16
Q

Covered by the obturator membrane for the passage of obturator nerve to leave the pelvis and enter the thigh (medial compartment)

A

Obturator foramen

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17
Q

Remains of the pedicles and superior articular processes.

A

Cornua

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18
Q

This coccygeal vertebra has a rudimentary transverse process and cornua

A

1st coccygeal vertebra

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19
Q

The sacrum is tilted forward so that it forms an angle with L5. This angle is referred to as the ___

A

Lumbosacral angle

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20
Q

This is formed due to the failure of the laminae of S5 and sometimes S4 to meet in the midline

A

Sacral hiatus

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21
Q

The anterior and posterior surfaces of sacrum have how many foramina on each side?

A

four

For the passage of anterior and posterior rami of upper four sacral nerves

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22
Q

The anterior and upper margin of S1 is referred to as the ___

A

Sacral promontory

Additional: It is an important obstetric landmark used when measuring the size of pelvis

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23
Q

Enumerate the four arteries that enter the pelvic cavity

A
  1. Internal iliac artery
  2. Superior rectal artery
  3. Ovarian artery
  4. Median sacral artery
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24
Q

This artery supplies all of the organs within the pelvis and sends branches out through the upper margin of greater sciatic foramen to supply the pelvic viscera, gluteal muscles, pelvic wall, buttocks and the perineum. After passing over the pelvic brim, this artery divides into anterior and posterior trunks.

A

Internal iliac artery

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25
Q

Determine the corresponding structures supplied by the branches of the anterior trunk / division of the internal iliac artery

  1. Vagina and base of bladder
  2. Base of bladder, prostate and seminal vesicles in male
  3. Upper part of bladder

A. Umbilical artery
B. Vaginal artery
C. Inferior vesical artery
D. Obturator artery

A
  1. B
  2. C
  3. A
26
Q

Determine the corresponding structures supplied by the branches of the anterior trunk / division of the internal iliac artery

  1. Muscle of anal canal, skin and muscles of perineum
  2. Uterine tube
  3. Muscle of the lower rectum

A. Uterine artery
B. Internal pudendal artery
C. Inferior gluteal artery
D. Middle rectal artery

A
  1. B
  2. A
  3. D
27
Q

Determine the corresponding structures supplied by the branches of the posterior trunk / division of the internal iliac artery

  1. Sacrum
  2. Gluteal region
  3. Pelvic inlet, psoas, and iliacus muscles

A. Iliolumbar artery
B. Lateral sacral artery
C. Superior gluteal artery

A
  1. B (supplies sacrum before terminating as the posterior gluteal artery)
  2. C
  3. A
28
Q

Determine the corresponding descriptions of the blood supply to the pelvis

  1. Small artery from bifurcation of aorta
  2. Crosses external iliac artery, enters suspensory ligament of ovary and passes into the broad ligament to supply ovary
  3. Supplies the mucous membrane of rectum and upper half of anal canal
  4. Runs along the medial border of psoas muscle, following pelvic brim
  5. Its name changes as inferior mesenteric crosses the common iliac artery

A. Common iliac artery
B. External iliac artery
C. Inferior epigastric artery
D. Deep circumflex artery
E. Superior rectal artery
F. Ovarian artery
G. Median sacral artery

A
  1. G
  2. F
  3. E
  4. B
  5. E
29
Q

Determine the corresponding descriptions of the blood supply to the pelvis

  1. Direct continuation of inferior mesenteric artery
  2. Main supply of pelvic cavity (viscera, muscles, etc.)
  3. Ends at pelvic inlet in front of the sacroiliac joint and divides into external and internal iliac arteries
  4. From the abdominal aorta at level of L1
  5. Leaves the false pelvis by passing under the inguinal ligament to become the femoral artery
  6. Descends over anterior surface of sacrum and coccyx

A. Common iliac artery
B. External iliac artery
C. Inferior epigastric artery
D. Deep circumflex artery
E. Superior rectal artery
F. Ovarian artery
G. Median sacral artery

A
  1. E
  2. C
  3. A
  4. F
  5. B
  6. G
30
Q

TRUE OR FALSE: In males, the testicular artery enters the inguinal canal and does not enter the pelvis.

A

True

31
Q

Determine the corresponding descriptions of the muscles of the pelvic wall and floor

  1. Wide thin sheet from the back of the body of pubis, a tendinous arch formed by thickening of the fascia covering the obturator internus and spine of the ischium
  2. Small triangular muscle forms the smaller, more posterior portion of pelvic diaphragm
  3. Formed by paired levatores ani muscle and coccygeus muscles and their covering fascia
  4. Gutter shaped sheet of muscle
    and is incomplete anteriorly to allow passage of urethra (in both genders) and vagina (females)
  5. Serves as a constrictor in some of the structures it covers / supports

A. Pelvic diaphragm
B. Levator Ani
C. Coccygeus

A
  1. B
  2. C
  3. A
  4. A
  5. B
32
Q

The skeleton / bony portion of the pelvic girdle that is a bowl / basin-shaped. It provides a strong, stable connection between the trunk (abdomen) and lower extremities.

A

Pelvis

33
Q

The true pelvis is the area (1)___ the pelvic brim, while the false pelvis is the area (2)___ the pelvic brim.

A
  1. Below
  2. Above
34
Q

A pair of strong plane synovial joints formed between the auricular surfaces of sacrum and iliac bones.

A

Sacroiliac joints

35
Q

A cartilaginous joint between the bodies of the last sacral vertebra and first coccygeal vertebra

A

Sacrococcygeal joint

36
Q

Determine the corresponding descriptions of the pelvic inlet types

  1. Classical female pelvis
  2. Known as the male or funnel shape pelvis
  3. Pelvis favors transverse presentations
  4. Pelvis favors occiput posterior presentations
  5. Oval at the inlet

A. Android pelvis
B. Anthropoid pelvis
C. Gynecoid pelvis
D. Platypelloid pelvi

A
  1. C
  2. A
  3. D
  4. B
  5. C
37
Q

Determine the corresponding descriptions of the pelvic inlet types

  1. Most common pelvic inlet type
  2. Oval at the inlet, but narrow and has a long axis
  3. Flattened at the inlet
  4. Larger babies have difficulty traversing this pelvis
  5. More triangular in shape at the inlet, with a narrowed subpubic arch
  6. The subpubic arch is generally wide but the ischial spines are prominent.

A. Android pelvis
B. Anthropoid pelvis
C. Gynecoid pelvis
D. Platypelloid pelvis

A
  1. C
  2. B
  3. D
  4. A
  5. A
  6. D
38
Q

Determine the corresponding descriptions of the fetal presentations

  1. Baby’s shoulder area comes out first
  2. Baby’s foot or butt comes out first
  3. Usually C-section is opted for this as it’s risky
  4. Baby’s head comes out first

A. Cephalic
B. Breech
C. Transverse

A
  1. C
  2. B
  3. C
  4. A
39
Q

Determine the corresponding descriptions of a male and female pelvis

  1. Pubic arch is narrower
  2. Shallower false pelvis
  3. Sacrum is shorter, wider and flatter
  4. Pelvic cavity is roomier
  5. Obturator foramen is round and oval

A. Male pelvis
B. Female pelvis

A
  1. A
  2. B
  3. B
  4. B
  5. A
40
Q

Determine the corresponding descriptions of a male and female pelvis

  1. Pelvic inlet is heart shaped
  2. Sacrum is longer and narrower
  3. Obturator foramen is triangular
  4. Deeper false pelvis
  5. Pelvic outlet is larger because of everted ischial spines
  6. Pelvic inlet is transversely oval/narrower

A. Male pelvis
B. Female pelvis

A
  1. A
  2. A
  3. B
  4. A
  5. B
  6. B
41
Q

TRUE OR FALSE: In the male pelvis, stronger muscles are responsible for thicker bones and more prominent bony markings.

A

True

42
Q

Term for herniation of the bladder

A

Cystocele

43
Q

It is part of the pelvis that forms part of the abdominal cavity.

A

False pelvis

44
Q

Determine the corresponding descriptions of the branches of the anterior trunk / division of the internal iliac artery

  1. gives off artery to vas deferens
  2. Its branch is the superior vesical artery
  3. commonly arises with inferior vesical artery
  4. takes place of inferior vesical artery present in males

A. Umbilical artery
B. Vaginal artery
C. Inferior vesical artery
D. Middle rectal artery

A
  1. C
  2. A
  3. D
  4. B
45
Q

Determine the corresponding descriptions of the branches of the anterior trunk / division of the internal iliac artery

  1. Leaves the pelvis through greater sciatic foramen below the piriformis; passes between first and second or second and third sacral nerves
  2. Runs along the wall of the pelvis together with the obturator nerve
  3. Anastomoses with ovarian artery; runs medially on pelvic floor and crosses the ureter superiorly; gives off a vaginal branch

A. Obturator artery
B. Inferior gluteal artery
C. Internal pudendal artery
D. Uterine artery

A
  1. B
  2. A
  3. D
46
Q

Determine the corresponding descriptions of the parts of the levator ani

  1. Puborectalis forms a sling around junction of rectum and anal canal
  2. Inserts into a fibromuscular structure called perineal body (in front of anal canal)
  3. Levator prostatae (male) or Sphincter vaginae (female) form a sling around the prostate or vagina
  4. Pubococcygeus passes posteriorly to insert the anococcygeal body
  5. iliococcygeus is inserted to anococcygeal body and coccyx
  6. Stabilize the perineal body

A. Anterior fibers
B. Intermediate fibers
C. Posterior fibers

A
  1. B
  2. A
  3. A
  4. B
  5. C
  6. A
47
Q

small fibrous mass between tip of coccyx and anal canal

A

Anococcygeal body

48
Q

TRUE OR FALSE: In adults, the empty bladder is a pelvic organ. In children (until 6 years old), it is an abdominal organ even when empty.

A

True

49
Q

At the ___, the obturator nerve (L2-4) divides into anterior and posterior branches to enter adductor region of thigh.

A

obturator canal

50
Q

The sacral plexus is found in front of the ___ in the posterior pelvic wall. It is
formed by anterior rami of L4-5, S1-4 and from the lumbosacral trunk

A

piriformis

51
Q

The largest nerve in the body

A

Sciatic nerve (L4-S3)

52
Q

Formed by the vertebral foramina. It
contains anterior and posterior roots of lumbar, sacral, and coccygeal spinal nerves, the filum terminale, fibrofatty material, and the lower part of subarachnoid space until lower border of S2.

A

Sacral canal

53
Q

TRUE OR FALSE: There is no true boundary between abdomen and pelvis

A

True

54
Q

The pelvic joints undergo changes with pregnancy. The symphysis pubis, ligaments of sacroiliac and sacrococcygeal joints undergo ___ to increase mobility and size of pelvis during childbirth in response to hormones like estrogen, progesterone, and relaxin.

A

softening

55
Q

A pelvic joint disease that can give low back pain and referred pain along the sciatic nerve (sciatica). The pain is extreme on rotation of the vertebral column and worst at the end of forward flexion.

A

Sacroiliac joint disease

56
Q

Determine whether the following is true or false regarding complications of pelvic fx

  1. Internal iliac vein and tributaries can be a source of massive hemorrhage
  2. Rectum is rarely damaged
  3. Bladder can be injured especially if empty than full
  4. Female urethra is often damaged
  5. Peroneal portion of sciatic nerve is most often involved

A. True
B. False

A
  1. A
  2. A
  3. B
  4. B
  5. A
57
Q

The inability of a conscious patient to dorsiflex the ankle and failure of an unconscious patient to reflexly plantar flex (ankle jerk) are manifestations of damage to what nerve?

A

Sciatic nerve

(especially from fracture of the greater sciatic notch)

58
Q

Determine the corresponding descriptions of the minor fractures of the pelvis

  1. from contraction of rectus femoris (straight head)
  2. from pull of hamstring
  3. from forceful contraction of the Sartorius in athletes

A. pulled ASIS
B. avulsed AIIS
C. avulsed ischial tuberosities

A
  1. B
  2. C
  3. A
59
Q

Determine the corresponding descriptions of the fractures of the pelvis

  1. Can be caused by disruption of the bony ring causing anteroposterior compression, lateral compression or shearing
  2. Lateral masses of sacrum may be fractured as part of the pelvic fracture
  3. These are rare
  4. Caused by direct trauma
  5. Heavy fall on greater trochanter may drive femoral head through acetabular floor and into pelvic cavity

A. Fracture of false pelvis
B. Fracture of true pelvis
C. Fracture of sacrum
D. Fracture of coccyx

A
  1. B
  2. C
  3. D
  4. A
  5. B
60
Q

Common and caused by direct trauma to the coccyx as in falling down a flight of concrete steps

A

Coccydynia

(1) Organ Anatomy (11 decks)

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