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SF4 Exam 2 > Structure of Pelvic Wall > Flashcards

Structure of Pelvic Wall Flashcards

1
Q

site in pelvic region that can be used for epidural injection

A

sacral hiatus

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2
Q

Sacral Promontory (what is it)

A

anterior-superior margin of vertebra S1

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3
Q

Sacral Canal (what is it, what does it contain within it)

A

caudal most part of vertebral canal

contains cauda equina

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4
Q

Sacral hiatus (what is it)

A

inferior opening to the sacral canal

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5
Q

Medial Mass of Sacrum (what is it)

A

fused vertebral bodies

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6
Q

Lateral Mass of Sacrum (what is it)

A

fused transverse processes

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7
Q

Median Crest of Sacrum (what is it)

A

fused spinous processes

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8
Q

Anterior and Posterior Sacral Foramen ( what are they)

A

‘windows’ for exit of anterior and posterior rami of sacral spinal nerves

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9
Q

Innominate bone (what is it made up of)

A

3 bones fused together
ilium
ischium
pubis

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10
Q

acetabulum (what is it, what is it made from)

A

where ilium, ischium, and pubis join

cup-like depression for articulation with head of femur

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11
Q

before ages 15-17 what holds the innominate bone together

A

only cartilage (prior to fusion)

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12
Q

Ischial tuberosity (what is it, what attaches to it)

A

roughened, posterior inferior part of ischium

site of attachment for sacrotuberous ligament

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13
Q

Ischial Spine (what is it, what attaches to it)

A

pointed process from posterior border of ischium
lies between greater and lesser sciatic notches
site of attachment of sacrospinous ligament and coccyges muscle

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14
Q

What two parts of the ischium are key landmarks of the pelvis

A

ischial spine

ischial tuberosity

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15
Q

Ischial Ramus (what is it)

A

inferior border of ischium, inferior to obturator foramen

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16
Q

Greater Sciatic Notch (what is it, what makes up its borders)

A

deep indentation in posterior border of innominate bone superior to ischial spine
superior border- ilium
inferior border- ischium

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17
Q

Lesser Sciatic Notch (what is it)

A

deep indentation in posterior border of ischium inferior to ischial spine

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18
Q

Pubic Symphysis (what is it)

A

midline cartilaginous joint between right and left pubic bones

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19
Q

Obturator Foramen (what is it)

A

hole between pubis and ischium

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20
Q

Superior Ramus of Pubis (where is it)

A

superior to obturator foramen and extends into acetabulum

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21
Q

Inferior Ramus of Pubis (where is it)

A

inferior to obturator foramen and extends into ischium

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22
Q

Pubic Arch (what is it)

A

Angle between inferior rami and bodies of both pubes

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23
Q

Pelvic Brim (what makes it up)

A

lateral mass of sacrum
arcuate line of ilium
pecten pubis and pubic crest

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24
Q

Iliopectineal Line (what is it)

A

formed from pecten pubis and arcuate line

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25
Q

Pecten Pubis (what is it)

A

raised ridge along superior rams of pubis Lateral to pubic tubercle

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26
Q

Pubic Crest (what is it)

A

ridge Medial to the pubic tubercle on the body of the pubis

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27
Q

the superior margin of the pubic symphysis and the anterior superior iliac spine have what relation to each other
(in terms of orientation of the pelvis)

A

lie in same vertical plane

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28
Q

in a fracture of the pelvis one must assume damage to what two structures

A

urinary bladder

urethra

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29
Q

what two joints are found in the vertebral column of the pelvis

A

lumbrosacral

sacrococcygeal

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30
Q

Sacroiliac Joint (what is its purpose)

A

transmits weight of trunk to innominate bone (transferring weight to hear of femur in thigh)

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31
Q

Sacroiliac Joint (what is it made up of)

A

held together by strong-
interossous ligaments
anterior and posterior sacroilliac ligaments

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32
Q

Iliolumbar Ligament (what is it, where does it span)

A

strong accessory ligament from transverse process of L5 to iliac crest

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33
Q

Sacrotuberous Ligament (what and where is it)

A

broad attachment to sacrum and narrows inferiorly to attach to ischial tuberosity
posterior to the sacrospinous ligament

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34
Q

Sacrospinous Ligament (what and where is it)

A

triangular shape
attaches to lateral margin of sacrum and ischial spine
anterior to sacrotuberous ligament

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35
Q

What is the purpose of the sacrospinous and sacrotuberous ligaments

A

prevent sacrum and coccyx from rotating posteriorly due to weight of trunk (center of gravity is anterior to sacrum)

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36
Q

The presence of the sacrotuberous and sacrospinous ligaments give rise to what?

A

greater and lesser sciatic foramina

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37
Q

Greater Sciatic Foramen (what is it)

A

‘window’ through which neurovascular structures and a muscle (piriformis) pass from true pelvis into gluteal region

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38
Q

Lesser Sciatic Foramen (what is it)

A

‘window’ through which neurovascular structures and a muscle (obturator internus) pass from buttock to perineum

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39
Q

Obturator Membrane (where and what is it)

A

covers obturator foramen

serves as site of muscle attachment

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40
Q

False Pelvis (what is it)

A

located above pelvic brim

part of posterior wall of abdominal cavity

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41
Q

True Pelvis (contents)

A 
lower part of GI tract
urogenital organs (urinary bladder, rectum, female reproductive organs, associated glands of both sexes)
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42
Q

True Pelvis (boundaries)

A

Pelvic Inlet- superior opening

Pelvic Outlet- inferior opening

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43
Q

Pelvic Inlet (what is it, what are its borders)

A

superior opening of true pelvis
formed form pelvic brim (lateral mass of sacrum, iliopectineal line (arcuate line of ilium and pecten pubis), pubic crest)

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44
Q

Pelvic Outlet (what is it, what are its borders)

A

inferior opening of true pelvis

bordered by tip of coccyx, sacrotuberous ligament, ischial tuberosity, inferior ramus of pubis, and pubic symphysis

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45
Q

measurements of what are used to determine the size of birth canal

A

pelvic inlet

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46
Q

Diagonal Conjugate Diameter (what is it a measurement of, where is it taken)

A

anteroposterior measurement of pelvic inlet

between lower border of the pubic symphysis and the sacral promontory

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47
Q

what measurement is taken between pubic symphysis and sacral promontory

A

Diagonal Conjugate Diameter (anteroposterior diameter)

48
Q

Transverse Diameter (what is it)

A

measurement of pelvic outlet

distance between ischial tuberosities

49
Q

The maximum measurement of pelvic inlet is what

A

transverse diameter

50
Q

Maximum measurement of pelvic outlet is what

A

anteroposterior diameter

51
Q

what happens to babies head during parturition

A

must rotate 90degrees between pelvic inlet and outlet

52
Q

What structures of the pelvis are sexually dimorphic

A

pelvic inlet
pelvic outlet
angle of pubic arches
pelvic cavity

53
Q

Pelvic Inlet (difference b/w male and female)

A

Male- kidney-shaped

Female- Oval

54
Q

Pelvic Outlet (difference b/w male and female)

A

Male- small

Female- large

55
Q

Angle of pubic arches (difference b/w male and female)

A

Male- narrow (60 degrees)

Female- wide (90 degrees)

56
Q

Pelvic Cavity (difference b/w male and female)

A

male- narrow

Female- wide

57
Q

the kidney shape of the male pelvic inlet is due to what

A

protrusion of sacral promontory into pelvic inlet

58
Q

the large female pelvic outlet is due to what

A

greater distance b/w ischial tuberosities

59
Q

The lateral wall of the true pelvis is formed by what structures

A

innominate bone (below pelvic brim)
obturator internus
sacrospinous ligament
sacrotuberous ligament

60
Q

Obturator Internus (what is it)

A

muscle of lower extremity

61
Q

Obturator Internus (origin and insertion)

A

Origin: obturator membrane and adjacent ischium and pubis
Insertion: tendon passes laterally out of true pelvis vis lesser sciatic foramen to enter buttocks and greater trochanter of femur

62
Q

Obturator Fascia (what is it)

A

thick regional expression of endopelvic fascia covering obturator internus

63
Q

Obturator Fascia (is continuous with what

A

endoabdominal fascia (above)

64
Q

Anterior Wall of True Pelvis is formed by what?

A

pubic symphysis and bodies of pubic bones

65
Q

Posterior wall of True Pelvis is Formed by what?

A

sacrum
coccyx
piriformis muscle

66
Q

Piriformis Muscle (origin and insertion)

A

origin: sacrum
insertion: greater trochanter of femur (tendon passes laterally through greater sciatic foramen to enter gluteal region)

67
Q

what muscle of the lower extremity’s name means pear shaped

A

piriformis

68
Q

what muscle of lower extremity passes through the greater sciatic foramen

A

piriformis

69
Q

what muscle of lower extremity passes through the lesser sciatic foramen

A

obturator internus

70
Q

Pelvic Diaphragm (what does it form, what is it, what does it do)

A

forms floor of true pelvis
thin muscle layer
supports pelvic viscera

71
Q

the muscles of the pelvic diaphragm originate from where and attach to where

A

originate from innominate bone

attach to or encircle structures in midline

72
Q

the pelvic diaphragm is covered superiorly and inferiorly by what

A

endopelvic fascia

73
Q

urogenital gap (what is it)

A

gap in anterior portion of pelvic diaphragm that allows for passage of urethra (both sexes) and vagina

74
Q

Region above Pelvic Diaphragm (what is it, what does it contain)

A

main pelvic cavity of true pelvis

contains: urinary bladder, rectum, uterus, etc

75
Q

Region Below Pelvic Diaphragm (what is it, what does it contain)

A

called perineum

contains genitalia and outlet of gut and urogenital system

76
Q

perineum (what is it, what does it contain)

A

region below pelvic diaphragm

contains genitalia and outlet of gut and urogenital system

77
Q

muscles of the pelvic diaphragm are innervated by what and insert on what (in general)

A

innervated by ventral rami of lower sacral nerves (S4, S5)

insert on midline structures (coccyx, sacrum)

78
Q

what muscles make up the pelvic diaphragm

A

levator ani

coccygeus

79
Q

Levator Ani (origins and insertions)

A 
origins:
anterior- body of pubis
middle- tendinous arch
posterior- ischial spine
insertions:
coccyx
anococcygeal body
perineal body
80
Q

tendinous arch (what is it)

A

thickened line of obturator fascia covering obturator internus

81
Q

Anococcygeal body (what is it)

A

fibrous raphe connecting anal canal and coccyx

82
Q

Perineal body (what is it, where is it, what is it important for)

A

small mass of connective tissue (similar to central tendon of thoracic diaphragm) that muscles insert on
b/w anorectal junction and urogenital gap in pelvic diaphragm
important for maintaining support of pelvic viscera

83
Q

what structure if torn during childbirth can result in collapse of organs (prolapse)

A

perineal body

84
Q

Subdivisions of Levator Ani (name from medial to lateral)

A

Levator Prostate or Sphincter Vaginae
Puborectalis
Pubococcygeus
Iliococcygeus

85
Q 
Lavator Prostate (male) or Sphincter Vaginae (female) 
(what is it)
A

most medial portion of levator ani
forms a sling around prostate or vagina (aids in support)
inserts into perineal body

86
Q

Puborectalis (what is it)

A

medial middle portion of levator ani

forms and important sling around anorectal junctions (acts as a sphincter)

87
Q

what muscle (be specific) acts as a sphincter via a sling around anorectal junction

A

puborectalis (medial middle portion of levator ani)

88
Q

what portion(s) of levator ani insert(s) on anococcygeal body and coccyx

A

pubococcygeus

iliococcygeus

89
Q

iliococcygeus (what is it, origin and insertion)

A

most lateral part of levator ani

extends from tendinous arch and ischial spine to insert on coccyx and anococcygeal body

90
Q

what forms the anterior 3/4 of pelvic diaphragm

A

levator ani

91
Q

what forms posterior 1/4 of pelvic diaphragm

92
Q

coccygeus (shape of muscle, continuos with what, located anterior to what)

A

triangular
“continuous” with levator ani
located anterior to sacrospinous ligament

93
Q

levator ani (action)

A

supports pelvic viscera

sphincter to anorectal junction (puborectalis portion)

94
Q

coccygeus (origin, insertion, action, innervation)

A

O: ischial spine
I: sacrum and coccyx
A: Supports pelvic viscera
I: ventral rami of S4-S5

95
Q

Midline Structures of Pelvic Diaphragm (name them from posterior to anterior)

A 
Coccyx
anococcygeal body (or raphe)
anorectal junction
perineal body
urogenital gap (vagina anterior to perineal body and urethra anterior to vagina)
96
Q

Endopelvic Fascia (what does it line/cover, what is it continuous with)

A

lines pelvic cavity
covers pelvic organs
continuous with endoabdominal fascia

97
Q

Parietal Pelvic Fascia (what does it do)

A

invests muscles of pelvic walls (obturator internus)
covers superior and inferior surfaces of pelvic diaphragm
condensations of pelvic fascia hold organs in place

98
Q

Visceral Pelvic Fascia (what is it)

A

fascia on surface of viscera

continuous with parietal pelvic fascia

99
Q

the lumbosacral plexus provides motor supply to what

A

most lower limb muscles
pelvic diaphragm
muscles of perineum
pelvic viscera

100
Q

the lumbosacral plexus can be compressed by what and what does this do?

A

pelvic tumor (ex- rectal tumor)
head of fetus during childbirth
results in pain to lower limb (sciatica)

101
Q

lumbosacral plexus provides sensory innervation to what

A

cutaneous sensory fibers to lower buttock and back of thigh

102
Q

the lumbosacral plexus is made up of what nerves?

A

ventral rami of L4, L5 (lumbosacral trunk)

ventral rami of S1, S2, S3, S4

103
Q

sacral nerves emerge to join the lumbosacral plexus from where

A

sacral canal via anterior sacral foramina

104
Q

the lumbosacral plexus is located anterior to what

A

piriformis muscle

105
Q

what branches of the lumbosacral plexus exit the true pelvis through the greater sciatic foramen

A

Superior Gluteal Nerve
Inferior Gluteal Nerve
Sciatic Nerve
Posterior Cutaneous Nerve of Thigh

106
Q

Superior Gluteal Nerve (course and supply to)

A

leaves pelvis though greater sciatic foramen above piriformis muscle
supply gluteal muscles

107
Q

Inferior Gluteal Nerve (course and supply to)

A

leaves pelvis though greater sciatic foramen below piriformis muscle
supply gluteal muscles

108
Q

what is the largest nerve in the body

A

sciatic nerve

109
Q

sciatic nerve (what makes it up, course, supply to)

A

L4,5 and S1,2,3

leaves pelvis through greater sciatic foramen below piriformis

110
Q

Posterior Cutaneous Nerve of thigh (innervates what, name branches)

A

innervates back of thigh

perineal branch to labium magus or posterior scrotum

111
Q

what nerve of the lumbosacral plexus gives branches to the labium major or posterior scrotum

A

posterior cutaneous nerve of thigh

112
Q

Pudendal Nerve (composed of what, course)

A

ventral rami of S2-4
exits pelvis through greater sciatic foramen and re-enters through lesser sciatic foramen to innervate somatic, skeletal muscles of perineum

113
Q

Pudendal Nerve (supply to what)

A

motor to somatic skeltal muscles of perineum- external anal sphincter, bulbospongiosus and ischiocavernous muscles, sphincter urethrae, and deep and superficial transverse perineal muscles)
sensory- lower half of anal canal and skin of external genitalia

114
Q

what branch(s) of the lumbosacral plexus passes through greater and lesser sciatic foramen

A

pudendal nerve

nerve to obturator internus

115
Q

what branches of the lumbosacral plexus do not leave the true pelvis

A

branches to pelvic diaphragm

pelvic splanchnic nerves

116
Q

pelvic splanchnic nerves (what are they, what do they innervate)

A

composed of parasympathetic preganglionic fibers

innervate terminal ganglia which innervate all hindgut derivatives

SF4 Exam 2 (13 decks)

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