The Pelvic Wall

Question 1

false pelvis (___):

above the ___

portion of abdomen between the ___

Answer 1

greater
pelvic brim
iliac fossa

Question 2

true pelvis (___)

below the ___

Answer 2

lesser

pelvic brim

Question 3

borders of the true pelvis (2)

Answer 3

pelvic inlet (pelvic inlet, pelvic brim, superior pelvic aperture)

pelvic outlet (inferior pelvic aperture)

Question 4

borders of the true pelvis:
pelvic inlet (pelvic inlet, pelvic brim, superior pelvic aperture) (3)

Answer 4

pubic symphysis & crest
iliopectineal lines
sacral promontory

Question 5

borders of the true pelvis:
pelvic outlet (inferior pelvic aperture) (5)

Answer 5

pubic symphysis
ischiopubic ramus
ischial tuberosities
sacrotuberous ligaments
coccyx

Question 6

pelvic diaphragm:

separates ___ from the ___ below

Answer 6

pelvis

perineum below

Question 7

pubic tubercles & the ASIS

located on the ___ in the anatomical position

Answer 7

same vertical plane

Question 8

walls of the pelvis:
anterior wall (2)

Answer 8

pubic bone

pubic symphysis

Question 9

walls of the pelvis:
lateral wall (3)

Answer 9

hip bone below the pelvic inlet
obturator membrane
obturator internus muscle

Question 10

walls of the pelvis:
posterior wall (3)

Answer 10

sacrum
coccyx
piriformis muscle

Question 11

membranes & ligaments of the pelvis:
obturator membrane:

___ sheet that almost completely encloses the ___

leaves a small gap (___) for the passage of the ___

Answer 11

fibrous
obturator foramen

obturator canal
obturator nerve & vessels

Question 12

membranes & ligaments of the pelvis:
sacrotuberous & sacrospinous ligaments:

sacrotuberous - strong ligament extending from the ___ to the ___

sacrospinous ligament - strong ligament extending from the ___ to the ___

the sacrotuberous is ___ to the sacrospinous ligament

Answer 12

lateral part of the sacrum & coccyx
ischial tuberosity

lateral part of the sacrum & coccyx
ischial spine

superficial

Question 13

membranes & ligaments of the pelvis:
sacrotuberous & sacrospinous ligaments:
functions:

the sacrotuberous & sacrospinous ligaments prevent the ___ from being ___ at the ___ by the ___

they also covert the greater & lesser ___ into the greater & lesser ___

Answer 13

lower end of the sacrum & coccyx
rotated upward
sacroiliac joint
weight of the body

sciatic notches
sciatic foramina

Question 14

the pelvic floor (___):

consists of the extensive ___ & the smaller ___ posteriorly

a ___ sheet of muscle through which the ___, ___, & ___ pass into the ___ below

it is incomplete ___ at the ___ to allow for the passage of the ___ (males & females) & the ___ (females)

Answer 14

the pelvic diaphragm

levator ani muscle
coccygeus muscle

thin, funnel-shaped
urethra, vagina, & anal canal
perineum

anteriorly
urogenital hiatus
urethra
vagina

Question 15

nerve supply of the pelvic diaphragm:

pelvic surface - ___

perineal surface - ___

Answer 15

ventral rami of S3 & S4

perineal branch of the pudendal nerve

Question 16

actions of the pelvic diaphragm:

supports the ___

resists a rise in ___ during ___

has important ___ actions on the ___ & the ___

Answer 16

pelvic viscera

intrapelvic pressure
straining or expulsive efforts of the abdomen (e.g., during coughing)

sphincter
ano-rectal junction
vagina

Question 17

sex differences of the pelvis

the sexual differences of the male & female pelvis are due mainly to the ___ build & ___ muscles of men & to the adaptation of the female pelvis for ___

the male pelvis is ___ & ___ & has more prominent ___

the female pelvis is ___, ___, & has a larger ___

Answer 17

heaver
larger
childbearing

heavier
thicker
bone markings

wider
shallower
pelvic inlet & outlet

Question 18

the pelvic fascia:
parietal pelvic fascia:

continuous above /w the fascia lining the ___

forms relatively ___ membranes on the pelvic surface of ___ & blends with the ___ of the ___

named according to the ___ (e.g., ___)

Answer 18

abdominal wall (endoabdominal fascia layer: e.g., transversalis fascia)

dense
muscles
periosteum
bony pelvic boundaries

underlying muscle (e.g., obturator internus fascia)

Question 19

the pelvic fascia:
visceral pelvic fascia:

___ tissue investing the ___ (e.g., ___)

Answer 19

looser connective
pelvic viscera (e.g., bladder, vagina, uterus, rectum)

Question 20

the pelvic fascia:

arcus tendinous

important as the origin of a large portion of the ___

Answer 20

thickening of the obturator internus fascia

levator ani muscle

Question 21

the pelvic fascia:
subperitoneal pelvic fascia:

continuation of the ___ from the ___ into the ___

condensations (dense portions) of the fascia form ___

all ligaments blend medially with the ___ of either the ___, ___, ___, or ___ & laterally with the ___

Answer 21

extraperitoneal fascia
abdomen
pelvis

visceral ligaments

visceral fascia
prostate, bladder, vagina, or cervix
parietal pelvic fascia

Question 22

examples of visceral ligaments formed by the condensations of the subperitoneal pelvic fascia in females (3)

Answer 22

pubovesical ligaments
transverse cervical ligaments (cardinal ligaments, mackenrodt’s ligament)
sacrouterine ligament

Question 23

blood vessels of the pelvis:
common iliac artery:

bifurcates at the ___ in front of the ___ into ___ (1) & ___ (2) arteries

the ___ artery continues the course of the ___ along the ___

the ___ artery passes downward into the ___ & contributes most of the blood supply to the ___ with three exceptions

Answer 23

pelvic brim
sacroiliac joint
external & internal iliac

external iliac
common iliac artery
pelvic brim

internal iliac
pelvis
pelvis

Question 24

the internal iliac artery contributes most of the blood supply of the pelvis with the following exceptions (3)

Answer 24

ovarian artery (branch of abdominal aorta)

superior rectal artery (terminal branch of the infererio mesenteric artery)

median sacral artery (branch of abdominal aorta right before bifurcation)

Question 25

blood vessels of the pelvis:
internal iliac artery:

divides into ___ & ___ divisions

great ___ in the branching pattern

Answer 25

anterior
posterior

variation

Question 26

blood vessels of the pelvis:

posterior divisions of the internal iliac arteries (3)

Answer 26

iliolumbar artery
lateral sacral arteries
superior gluteal artery

Question 27

blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
iliolumbar artery:

ascends along the ___ in front of the ___

often separates the ___ from the ___ medial to the ___ muscles

supplies the ___ & ___ muscles

Answer 27

lumbosacral trunk
ala of the sacrum

lumbosacral trunk
obturator nerve
psoas major

iliacus
psoas major

Question 28

blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
lateral sacral arteries:

pass medially entering the ___ supplying the ___

Answer 28

pelvic foramina

nerve roots

Question 29

blood vessels of the pelvis:
posterior divisions of the internal iliac arteries:
superior gluteal artery:

usually separates the ___ form the ___

leaves the ___ above the ___ muscles

Answer 29

lumbosacral trunk
ventral ramus of S1

greater sciatic foramen
prirformis

Question 30

blood vessels of the pelvis:

anterior divisions of the internal iliac artery (8)

Answer 30

umbilical artery
obturator artery
inferior vesical artery (males only)
middle rectal artery
uterine artery
vaginal artery (females only)
internal pudendal artery
inferior gluteal artery

Question 31

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
umbilical artery:

gives off the ___

continues forward as the ___

Answer 31

superior vesical arteries

medial umbilical ligament

Question 32

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
obturator artery:

passes with the ___ through the ___

in 30% of cases, it arises from the ___ or the ___ & is termed the ___

Answer 32

obturator nerve
obturator canal

inferior epigastric artery
external iliac artery
anomalous obturator artery

Question 33

an anomalous obturator artery is clinically significant b/c it runs close to or across the ___ to reach the ___

b/c of its close association to the neck of a ___, the artery is in danger of being ___ when a ___ or ___ is surgically corrected

Answer 33

femoral ring
obturalor canal

femoral hernia
divided
triangulated or obstructed femoral nernia

Question 34

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
inferior vesical artery:

only in ___

usually gives off the ___

Answer 34

males

artery of the ductus deferens

Question 35

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
uterine artery

passes medially within the ___ below the root of the ___

passes above the ___ near the ___ of the vagina

Answer 35

cardinal ligament
broad ligament

ureter
lateral fornix

“water runs under the bridge”

Question 36

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
vaginal artery:

homolog of the ___ in the male

runs to the side of the ___ in the ___ & then descends into the ___

also helps supply the ___

Answer 36

inferior vesical artery

vagina
pelvis
perineum

bladder

Question 37

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
internal pudendal artery:

exits the ___ between the ___ & ___ muscles running with the ___

Answer 37

pelvis
piriformis & coccygeus
pudendal

Question 38

blood vessels of the pelvis:
anterior divisions of the internal iliac artery:
inferior gluteal artery:

passes between the ___

exits the ___ through the ___ below the ___

Answer 38

ventral ramus of S1 & S2 or S2 & S3
pelvis
grater sciatic foramen
piriformis muscle

Question 39

blood vessels of the pelvis:
veins of the pelvis:

correspond closely to the ___

the tributaries of the internal iliac vein communicate freely with ___ & ___ outside their territory of drainage

Answer 39

arteries

each other
others

Question 40

clinically significant anastomoses b/n the ___ & the ___ via veins which pass through the pelvic foramina

metastasis of neoplasms from ___ may pass through these veins & lodge in ___ bone of the vertebrae or even reach the ___

Answer 40

internal iliac vein tributaries
vertebral venous plexus

pelvic viscera
cancellous
cranial cavity

Question 41

nerves of the pelvis:
the sacral plexus:

forms on the ___ surface of the ___ muscle

formed by the ___ & ___

all branches leaving the pelvis exit through the ___

Answer 41

pelvic
piriformis

lumbosacral trunk
ventral rami of S1 - S4

greater sciatic formaen

Question 42

nerves of the pelvis:
the sacral plexus:
lumbosacral trunk:

composed of the descending portion of the ___ & all of the ___

descends over the ___ & joins ___ in the pelvis just beyond the ___

Answer 42

ventral ramus of L4
ventral ramus of L5

sacroiliac joint
S1
superior gluteal artery

Question 43

nerves of hte pelvis:

pelvic splanchnic nerves

Answer 43

preganglionic parasympathetic fibers of S2 - S4

Question 44

nerves of the pelvis:
obturator nerve:

levels ___ from ___ plexus

runs along the lateral wall of the pelvis between the ___ & ___ within the ___

meets the ___ & ___ at the ___

Answer 44

L2 - L4
lumbar

external & internal iliac arteries
ovarian fossa

obturator artery & vein
obturator canal

Question 45

nerves of the pelvis:
pelvic sympathetic trunk:

passes over the ___ behind the ___

the trunks descend & converge medial to the ___

the trunks fuse w/ each other in front of the ___ to form the small enlargement ___

Answer 45

pelvic brim
iliac vessels

pelvic foramina

coccyx
ganglion impar