Split Pelvis Flashcards
what makes up the bony pelvis?
ilium, ischium and pubis (os coxa) sacram and coccyx
what is the pelvic inlet bounded by?
pubic symphysis, iliopectineal lines and sacral promontory
the pelvic outlet is bounded by?
the pubic arch, ischial tuberosities, and coccyx
where is the true pelvic cavity?
the space between the inlet and outlet
what is the difference between a male and female pelvis?
the subpubic angle is greater in the female than the male, the ischial tuberosities and ischial spines are everted and the sacrum is tipped more posteriorly in the femal
best way to tell whether a pelvis is male or female
examine the subpubic angle
diagonal conjugate
distance between the inferior border of the pubic symphysis and the sacral promontory
what is directly anterior to the sacrum?
the rectum
position of the ureters?
they descend along the posterior abdominal wall and continue inferiorly to open into the base of the urinary bladder
the part of the parietal peritoneum that surrounds and fuses around the uterus, ovary and uterine fallopian tubes is referred to?
as the broad ligament
a fold of peritoneum that passes from the lateral pelvic wall to the ovary and contains its vasculature
suspensory ligament
smaller, inferior region of the uterus is?
the cervix
the body of the uterus is
anteflexed relative to the cervix
the cervix is (blank) relative to the vagina
anteverted
As the cevix opens on the anterior wall of the vagina, and protrudes lightly into the vaginal lumen- this forms shallow recesses in the vagina around the cervical opening called?
the anterior and posterior vaginal fornices
posterior tilt of the body on the cervix is called?
retroflexion
posterior tilt of the cervix on the vagina is termed?
retroversion
what happens if the uterus is aligned vertically with the vaginal lumen?
it is subject to herniation of prolapse
Difference in pelvic organs for males and females
The urinary, reproductive and digestive systems all have organs within the pelvis and in females the three organ systems are anatomically separate. In males they are not independent
what are the regions of the male urethra
the prostatic urethra, membranous urethra and penile/spongy urethra
the ejaculatory duct is formed by
the vas deferens and seminal vesicals
where does the ejaculatory duct pass and drain into
is passes through the prostate gland and drains into the prostatic urethra
the rectoanal junctions assists with?
fecal incontinence
indicate the passageway of sperm from its production to its release from the body
testis- epididymis- vas deferens- ejaculatory duct- prostatic urethra- membranous urethra- penile urethra
because most of the pelvic urinary, reproductive and digestive organs are deep within the pelvis and covered superiorly by peritoneum they are typically called
infra-peritoneal
the parietal peritoneum forms recesses (dead ends) as it reflects from one pelvic organ to another. In males- what is this recess?
rectovesical pouch
what are the two pouchese in females
vesicouterine pouch between the urinary bladder and uterus and the rectouterine pouch (of douglas) between the rectum and uterus
What are the low spots in the peritoneal cavity?
rectovesical pouch in males and rectouterine pouch in females
fluid can be withdrawn from the peritoneal cavity by inserting a needle through the?
posterior fornix of the vagina
what is the main blood supply to the structures of the pelvis?
internal iliac artery
the descending aorta typically bifurcates at? what does it form?
vertebral level L4
forms the common iliac arteries
branches of the internal iliac are generally to?
the pelvic wall, lower limb/perineum and the pelvic viscera
the pelvic wall branches are?
the iliolumbar and lateral sacral arteries
what helps supply the iliacus and psoas major muscles
iliolumbar arteries
what supplies the bone of the sacrum and dura mater of the sacral nerve roots
lateral sacral arteries
what arteries supply muscles of the hip and thigh? where do they exit?
the superior and inferior gluteal arteries. They exit through the greater sciatic foramen
How does the obturator artery travel? what does it supply?
the obturator artery travels on the lateral wall of the pelvis before exiting the obturator foramen to reach the medial thigh
what does the internal pudendal artery supply?
supplies the anus, muscles of the deep and superficial perineal spaces, the clitoris/penis, and the skin of the scrotum/labium majoris
the internal pudendal artery is positioned where in relation to the inferior gluteal artery?
anteriorly when exiting the pelvis
major blood supply to the urinary system in both sexes is derived from
branches of the umbilical artery
As the umbilical artery passes by the urinary bladder it branches to form what? what does that supply
the superior vesical artery- supplies the upper margin of the bladder
when the umbilical cord is clamped following childbirth what happens to the umbilical artery?
the proximal segment of the umbilical artery remains patent and carries blood to its superior vesical branch. The distal part of the umbilical artery which is no longer transmitting blood, collapses and becomes obliterated
the nomenclature of the internal iliac branches is comparable in females and males with the exception of?
the visceral branches to the reproductive tracts
blood supply to the pelvic reproductive organs in males is derived from? what does it supply?
the inferior vesical artery. it supplies both urinary and reproductive organs, the lower portion of the bladder, seminal vesicles and the prostate gland
most reproductive organs in females are supplied by? how does it run? what does it supply?
the uterine artery- it courses medially toward the cervix of the uterus. it supplies the body and cervix of the uterus and sends additional branches to the vagina and inferior bladder
in both sexes, the ureter passes under? why is this important
the inferior vesical/uterine artery- a surgeon must take care to isolate the ureter from the uterine artery otherwise drainage from the kidney would be disrupted
the middle rectal artery supplies
the middle and inferior portions of the rectum and anal canal
the rectum and anal canal receive their blood supply from?
the superior, middle and inferior rectal arteries
middle and inferior rectal arteries are branches of?
the internal iliac artery
which rectal artery is a direct branch? which branches off of the internal pudendal artery?
the middle rectal artery is a direct branch of the internal iliac
the inferior rectal artery is a branch of the internal pudendal artery
the inferior rectal veins are also called
hemorrhoidal veins
the portion of the rectal venous plexus related to the middle rectal vein found just below the epithelium of the rectum gives rise to
internal hemorrhoids
the portion of the rectal venous plexus external to the muscular wall form
external hemorrhoids
nerves found in the pelvis can be distinguished as?
somatic or visceral nerves
somatic nerves in the pelvis include ?
vental rami of lower lumbar and sacral spinal nerves that innervate the pelvic wall and lower limbs
visceral nerves of the pelvis include?
splanchnic nerves that innervate internal organs
both ventral rami and splanchnic nerves converge with other nerves
to form plexuses
the sacral plexus is what type of plexus? constructed of what
the sacral plexus is a somatic plexus constructed of ventral rami
the hypogastric plexus is a
visceral plexus constructed of various splanchnic nerves
the sacral plexus includes?
the large ventral rami of both lumbar and sacral spinal nerves (L4-S4)
The ventral rami of L4 and L5 first form
the lumbosacral trunk within the lower abdomen- then pass inferiorly into the pelvis to join the sacral ventral rmai
the pelvic somatic plexus includes which fibers
somatosensory, somatomotor and sympathetic fibers
the hypogastric and all visceral plexuses contain
sympathetic, parasympathetic and viscerosensory fibers
near the bifurcation of the aorta is the
superior hypogastric plexus
the superior hypogastric plexus splits into
left and right hypogastric nerves
the hypergastric nerves travel inferiorly and split into
inferior hypogastric plexuses
what enters the hypogastric plexus through lumbar and sacral splanchnic nerves?
sympathetic fibers
what fibers in the hypogastric plexus arise from levels S2, 3, 4 of the spinal cord?
parasympathetic fibers
what fibers exit the pelvic splanchnic to join the inferior epigastric plexus?
preganglionic parasympathetic fibers
which fibers distribute to pelvic viscera a branches from the inferior hypogastric
sympathetic and parasympathetic fibers
damage to the plexus’s that run along organs can cause
urinary or fecal incontinence or impotence
