(second midterm) Lecture 11 (5/11/16) PT. 1 Flashcards
How is the pelvic girdle attached to the axial skeleton?
suture
How many elements contribute to the human hip?
six
ilium x2, ischium x2, pubis x2
The sacrum is originally how many independent vertebrae?
5
What attaches from the ischial spine to the sacrum?
sacrospinous ligament
What structures hold bone to bone?
ligament
With the help of ligaments, the greater sciatic notch turns into the…
greater sciatic foramen
Ligament running from sacrum to ischial tuberosity is called…
sacrotuberous ligament
The sacrotuberous ligament closes off the ______ ______ notch and turns it into the ________ ________ foramen.
lesser sciatic
lesser sciatic
The obturator foramen is covered over by what?
obturator membrane
The sciatic nerve exits the pelvis through what?
And goes under what muscle?
greater sciatic foramen
piriformis
What space lies internal to deepest layer (transversals fascia)?
deep perineal space
What lies between urogenital diaphragm and pelvic diaphragm?
ischiorectal fossa
*filled with fat because of blood vessels and nerves
What space is between urogenital diaphragm and superficial fascia plus skin?
superficial perineal space
Pudendal nerve levels:
s2-4
Levator ani components:
puborectalis
pubococcygeus
iliococcygeus
What innervates the components of the elevator ani?
branches from sacral plexus s4
Puborectalis..
origin:
insertion:
origin: superior pubis ramus
insertion: anococcygeal ligament
Pubococcygeus..
origin:
insertion:
origin: lateral to puborectalis
insertion: anococcygeal ligament
Iliococcygeus..
origin:
insertion:
origin: internal obturator fascia
insertion: anococcygeal ligament + coccyx
Perineal subdivision... Superficial layers (urogenital diaphragm):
transversus perinei profundus
external anal sphincter
urethral sphincter
Perineal subdivision…
Intermediate layers:
coccygeus
levator ani
Perineal subdivision…
Deep layers:
transversalis fascia
Transverse perinei profundus..
origin:
insertion:
innervation:
origin: inferior pubic ramus, ischial ramus
insertion: perineal body, wall of vagina or prostate
innervation: pudendal (s2-4)
External urethral sphincter External anal sphincter... origin: insertion: innervation:
origin: encircle urethra and anus
insertion: encircle urethra and anus
innervation: pudendal s2-4
Coccygeus..
origin:
insertion:
innervation:
origin: coccyx
insertion: ischial spine
innervation: branches from sacral plexus s4, 5
In the region of the perineum, are we in foregut, midgut, or hindgut?
hindgut
“A skateboarder slides down a rail, crashes, and lands on his butt. He tells the nurse that he keeps pooping his pants. He said he farts a lot. I can’t digest food and my poop is watery. Where might the damage be?”
sacral outflow s2-4
it’s not just the sphincters because it’s affecting digestion
Innervation…
Superficial layer:
Middle layer:
Deep layer:
Superficial layer: pudendal nerve (s2, 3, 4)
Middle layer: nerve to pelvic diaphragm (s4,5)
Deep layer: reduced to fascia, no innervation necessary
What comes out of the inferior part of the greater sciatic foramen?
inferior gluteal artery, nerve, vein
pudendal nerve
internal pudendal artery and vein
What comes out of the superior part of the greater sciatic foramen?
superior gluteal artery and nerve
