SDR L6 - Anatomy of the Pelvis I

Question 0

1) Conjugal (AP) Diameter (part of Pelvic Inlet)

2) Ischial Diameter (Pelvic Outlet)

Answer 0

These are the two important diameters that restrict the pelvis

Question 1

Pubic Tubercle

Answer 1

In the anatomical position the ASISs and the (1) are in the same vertical plane

Question 2

Sacral Promontory

Answer 2

The Conjugal Diameter is the distance from the (1) in the back to the pubic symphysis in the front

Question 3

Ischial Spines

Answer 3

The Ischial Diameter is the distance between
the two (1)

Question 4

1) Estrogen
2) Relaxin
3) 15%

Answer 4

Hormones like (1) and (2) released during labor help to relax the pubic symphysis in order to help expand these diameters by about ~_____% to help with parturition

Question 5

1) S2-4
2) Posterior/Lateral
3) Sacrospinous

Answer 5

The pudendal nerve originates from the anterior rami of (1) then loops ((anterior/posterior)* to the ischial spine and (3) Ligament and enters the perineum

Question 6

1) Inferior Rectal

2) Perineal

Answer 6

Once it passes around the ischial spine the pudendal nerve gives off the (1) nerve, after which point the pudendal is called the (2) nerve.

Question 7

1) Dorsal Nerve of the Penis or Clitoris

Answer 7

The perineal nerve continues down after the ischial spine, and gives off the (1)

Question 8

T

Answer 8

(T/F) The pudendal nerve innervates the entire perineum

Question 9

Transvaginally (with a guiding finger that palpates the sacrospinous ligament)

Answer 9

The preferred method of implementing a pudendal block is (transvaginally/transcutaneously)

Question 10

1) Size: M = thicker/heavier
2) Subpubic Angle: F > 90; M < 90
3) Inlet Shape: F = Round; M = Heart
4) Outlet Size: F = larger
5) Ischial Spines: M = inward protrusion; F = No inward protrusion

Answer 10

5 main differences between the male and female pelvis

Question 11

Pelvic Diaphragm

Answer 11

Pelvic floor aka

Question 12

Levator Ani muscles

Answer 12

Dr. Dym collectively referred to the pelvic floor muscles as the

Question 13

1) Fecal Continence (Puborectalis Muscle)
2) Increase intrabdominal pressure
3) Prevent Prolapse of abdominal components

Answer 13

Functions of the pelvic floor muscles

Question 14

F (Relaxes to remove the angle)

Answer 14

(T/F) The defecation reflex constricts the puborectalis muscle to remove the angle between the rectum and anal canal, which allows feces to be excreted

Question 15

1) Urogenital Triangle

2) Anal Triangle

Answer 15

The perineum is a diamond shaped area below the pelvic floor composed of these two triangles

Question 16

1) Pubic Symphysis
2) Ischial Tuberosities
3) Sacrum

Answer 16

The perineum is bounded anteriorly by the (1), laterally by the (2), and posteriorly by the (3)

Question 17

1) UG Diaphragm
2) Roots of external genitalia
3) Skin/superficial fascia

Answer 17

The perineum has 3 main layers. From superior to inferior they are

Question 18

External Urethral Sphincter

Answer 18

UG Diaphragm aka

Question 19

1) Pelvic

2) Urogenital

Answer 19

The (1) Diaphragm is superior and makes up the entire

floor of the pelvis while the (2) Diaphragm is inferior and is only found in the urogenital triangle

Question 20

F (2 in F; 1 in M)

Answer 20

(T/F) The UG Diaphragm is mainly responsible

for suspending the roots of the external genitalia, so there will be one opening in it in females and two in males

Question 21

Perineal Membrane

Answer 21

Inferior Fascia of the UG Diaphragm aka (there is also a less imp superior fascia)

Question 22

1) Bulb

2) Crura

Answer 22

The erectile tissue suspended from the UG Diaphragm is comprised of a (1) and two (2)

Question 23

Ischioanal Fossa (Common site of abscess)

Answer 23

These are triangular spaces lateral to the pelvic viscera that are filled with liquid fat. Their role is to maintain flexibility of the area to accommodate feces

Question 24

Perineal Body

Answer 24

The integrity of this part of the pelvic floor is important for entire region b/c 8 pelvic floor muscles converge here. Tear may lead to prolapse.

Question 25

Episiotomy

Answer 25

A procedure sorta common during childbirth, where an incision is made in order to prevent a jagged tear that would heal slower and be harder to stitch up

Question 26

1) Infection
2) Pain
3) Longer healing times compared to no tear at all
4) Increased discomfort when resuming intercourse

Answer 26

Downsides of Episiotomies (4)

Question 27

T (Due to the fact that the fallopian tubes are open to the peritoneum at the proximal end)

Answer 27

(T/F) Female perineal infections can lead to peritonitis

Question 28

Bartholin’s Glands

Answer 28

Cysts in these glands are common in women (2% of all women will have them), especially in women aged 20-29

Question 29

1) UGD
2) Urethra
3) Vagina

Answer 29

In females the deep perineal pouch contains these three things

Question 30

1) UGD
2) Membranous Urethra,
3) Bulbourethral (Cowper’s) glands

Answer 30

In males the deep perineal pouch contains these three things

Question 31

1) Erectile Structures of the Penis

2) Proximal Spongy Urethra

Answer 31

In males the superficial perineal pouch contains these three things

Question 32

1) Erectile Structures of the Clitoris

2) Bartholin’s Glands

Answer 32

In females the superficial perineal pouch contains these three things

Question 33

The Superior and Inferior Fascia of the UGD

Answer 33

The Deep Perineal Pouch is between

Question 34

The Inferior Fascia of the UGD and superficial fascia of the perineum

Answer 34

The Superficial Perineal Pouch is between

Question 35

L4

Answer 35

As the aorta descends it branches into the common iliac arteries at this vertebrae

Question 36

1) Iliolumbar A.
2) Lateral Sacral A.
3) Superior Gluteal A. (Largest)

Answer 36

The posterior division of the of the internal iliac has 3 arteries

Question 37

1) umbilical
2) superior vesical (vesical=bladder)
3) inferior vesical/vaginal
4) middle rectal
5) obturator
6) internal pudendal
7) inferior gluteal
8) Uterine

Answer 37

The anterior division of the of the internal iliac has 3 arteries

Question 38

Ureter

Answer 38

The (1) passes posterior/inferior to the uterine artery

Question 39

Superficial Inguinal Nodes

Answer 39

Lymph from the perineum first drains into the

Question 40

1) Great Saphenous Vein

2) Inguinal Ligament

Answer 40

Superficial Inguinal Nodes are arranged in
a ‘T’ with the trunk of the ‘T’ overlying the (1) and the cross of the ‘T’ lying parallel and directly inferior to the (2)

Question 41

Genitals –> Superficial Inguinal Nodes –> Deep Inguinal Nodes –> External Iliac Nodes –> Common Iliac Nodes –> Aortic Nodes

Answer 41

The pathway of lymph from the genitalia

Question 42

L4-S4

Answer 42

The sacral plexus is made up of the anterior rami from these vertebrae

Question 43

L4-S3

Answer 43

The Sciatic N. is made up of the anterior rami from these vertebrae

Question 44

1) External Genitalia
2) buttocks
3) uterus (via the round ligament)
4) lower anal canal
5) legs
6) trunk/back below the umbilicus.

Answer 44

6 regions that drain to the Superficial Inguinal Nodes