SUGER: anatomy of the posterior abdominal wall, urogenital triangle and pelvic floor muscles Flashcards

1
Q

what are the superior and inferior borders of the posterior abdominal wall?

A
  • attached to diaphragm above

- attached to pelvis rim below

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2
Q

what part of the spine is in the posterior abdominal wall?

A

lumbar

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3
Q

what are the 4 muscles of the posterior abdominal wall?

A
  • quadrates lumborum
  • iliacus
  • psoas minor
  • psoas major
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4
Q

what is the plexus on the posterior abdominal wall that innervates parts of the abdomen, genitalia and thigh?

A

THE LUMBAR PLEXUS

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5
Q

which spinal nerves make up the lumbar plexus?

A
T12
L1
L2
L3
L4
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6
Q

what do the Iliohypogastric and ilioinguinal nerves (branches of lumbar plexus) innervate?

A
  • anterior abdominal wall muscles

- skin of the external genitalia

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7
Q

what does the Genitofemoral nerve (branch of lumbar plexus) innervate?

A

the skin of the external genitalia

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8
Q

what does the Lateral femoral cutaneous nerve (branch of lumbar plexus) innervate?

A

the skin over the lateral thigh.

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9
Q

what does the Femoral nerve (branch of lumbar plexus) innervate?

A

the muscles and skin of the anterior thigh

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10
Q

what does the Obturator nerve (branch of lumbar plexus) innervate?

A

the muscles and skin of the medial thigh.

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11
Q

where and what is the perineum?

A

diamond shape between the thighs

between the external genitalia and the anus.

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12
Q

what are the 2 triangles of the perineum?

A

the urogenital triangle

the anal triangle

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13
Q

what does the urogenital triangle contain?

A

the external genitalia and urethra

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14
Q

what does the anal triangle contain?

A

the anal canal
the external anal sphincter
the 2 ischioanal fossa
pedendal nerve

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15
Q

where is the theoretical line dividing the perineum into 2 triangles?

A

line connecting the two ischial tuberosities of the pelvis

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16
Q

what separates the perineum from the pelvic cavity superiorly?

A

the pelvic floor

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17
Q

what are the boundaries of the urogenital triangle?

A

the pubic symphysis, ischiopubic rami, and a theorectical line between the two ischial tuberosities.

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18
Q

why is the urogenital triangle seen as more complex than the anal triangle?

A

because it has an additional layer of strong deep fascia

  • the perineal membrane

this creates pouches and surfaces

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19
Q

what are the 5 layers of the urogenital triangle (deep to superficial)

A
  1. deep perineal pouch
  2. perineal membrane
  3. Superficial perineal pouch
  4. Perineal fascia
  5. skin
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20
Q

where is the deep perineal pouch?

A

superior border = deep fascia of the pelvic floor

inferior border = the perineal membrane

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21
Q

what structures are contained within the deep perineal pouch?

A
  • the urethra,
  • external urethral sphincter

FEMALES
-vagina

MALES

  • bulbourethral glands
  • the deep transverse perineal muscles.
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22
Q

what structures are attached to the Perineal membrane?

A

muscles of the external genitalia
urethra
vagina

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23
Q

what does the Superficial perineal pouch contain?

A
  • the erectile tissues that form the penis and clitoris,
  • three muscles( the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles.)
  • The greater vestibular glands (Bartholin’s glands) are also located in the superficial perineal pouch.
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24
Q

what are the 2 layers of the perineal fascia?

A

deep

superficial

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25
Q

what is the innervation of the perineum?

A

the pudendal nerve (S2 to S4)

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26
Q

what is the main artery that supplies the perineum?

A

internal pudendal artery.

27
Q

which bones make up the bony pelvis ?

A

the sacrum + two hip bones (left and right)

28
Q

what 3 bones make up the hip bone?

A

hip bone = the ilium + ischium + pubis

29
Q

where is the hip joint?

A

where femur head articulates with acetabulum on bony pelvis

30
Q

where is the sacroiliac joint ?

A

where sacrum (bottom of spine) articulates with ilium bone

31
Q

where is the pubic symphysis?

A

where the L&R pubis bones meet in the midline

inferior

32
Q

where is the Lumbosacral joint?

A

where L5 connects to sacrum w/intervertebral disc

33
Q

where is the Sacrococcygeal joint?

A

where inferior sacrum meets coccyx

34
Q

name 3 surface landmarks on the ilium hip bone?

A
  • the iliac crest
  • the anterior iliac spine (ASIS)
  • the iliac tubercle
35
Q

where is the most anterior point of the ilium bone?

A
  • the anterior iliac spine (ASIS)
36
Q

where is the most lateral point of the ilium bone?

A
  • the iliac tubercles
37
Q

where is the line that separates lower and middle 1/3 abdomen ?

A

between the L&R iliac tubercles

called the inter tubercular plane

38
Q

name 1 surface landmark on the pubis hip bone? describe where it is

A

the L&R pubic tubercles

  • most medial point on pubic bone
  • either side of pubic symphysis
39
Q

what is the pelvic inlet?

A

= the boundary between greater and lesser pelvis

essentially the hole created by the pelvic brim

40
Q

what 3 features make the female pelvis larger than the males?

A
  1. ANGLE between the INFERIOR RAMI of the PUBIS bones is wider on females (obtuse v acute)
  2. DISTANCE between ISHIAC SPINE and SACRAM is larger in females, creating a wider, more circular pelvic inlet
  3. SACRUM is more curved forwards in males. In females, wider and shorter.
41
Q

which organs does the pelvis contain?

A
  1. rectum
  2. bladder
  3. female reproductive organs
  4. male productive organs
42
Q

which arteries supply the pelvis?

A

R&L internal iliac arteries

vesical,uterine,vaginal,recta,internal pedendal, gluteal

43
Q

which veins drain the pelvis?

A

several plexuses that mostly drain into the internal iliac vein.

44
Q

what plexus innervates the pelvis?

A

the sacral plexus

45
Q

which key nerve of the sacral plexus innervates the lower limb?

A

the sciatic nerve

46
Q

which key nerve of the sacral plexus innervates the majority of the perineum?

A

Pudendal nerve

S2-S4

47
Q

which key nerves of the sacral plexus innervates the gluteal region?

A

Superior and inferior gluteal nerves

48
Q

which key nerves of the sacral plexus innervates the pelvic viscera/organs?

A

Pelvic splanchnic nerves

carry parasympathetic fibres from the S2-S4 spinal cord segments to the pelvic viscera.

49
Q

where is the pelvic cavity?

A

within the lesser part of the pelvis, beneath the pelvic brim.

50
Q

what are the 2 sets of muscles of the pelvic cavity

A
  1. the pelvic floor/ diaphragm (= floor of the pelvic cavity)
  2. the lateral wall muscles
    (= form walls around the pelvic cavity)
51
Q

what is the shape of the pelvic floor?

A

funnel shape

52
Q

what does the pelvic floor separate the pelvic cavity from?

A

the perineum

53
Q

what are the 2 gaps in the pelvic floor?

A
  1. Urogenital hiatus (anterior)

2. Rectal hiatus (central)

54
Q

what structures pass through the Urogenital hiatus?

A
  • the urethra

- and the vagina in females

55
Q

what structures pass through the Rectal hiatus?

A
  • the anal canal
56
Q

what are the roles of the pelvic floor?

A
  1. support abdominopelvic organs
  2. provide resistance to intra-pelvic/abdominal pressure eg. coughing
  3. Urinaryandfaecal continence
57
Q

what are the muscles of the pelvic floor?

A

the 3 paired levator ani muscles + the coccygeus

58
Q

what are the 3 paired muscles that form the levator ani muscles?

A

3 paired muscles

  1. pubococcygeus
  2. puborectalis
  3. iliococcygeus
59
Q

what are the attachments of the puborectalis?

A

U shaped sling around rectum

  • pubis bone
  • around the anal canal
60
Q

what are the attachments of the pubococcygeus?

A
  • pubis bone

- coccyx + sacrum

61
Q

what are the attachments of the iliococcygeus?

A
  • ischial spines

- coccyx

62
Q

what are the attachments of the coccygeus?

A
  • ischial spines

- coccyx

63
Q

which muscles make up the lateral walls of the pelvic cavity?

A
  • the obturator internus

- the piriformis