The Pelvic Wall Flashcards by Heather Acuff

false pelvis (___):

above the ___

portion of abdomen between the ___

greater
pelvic brim
iliac fossa

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true pelvis (___)

below the ___

lesser

pelvic brim

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borders of the true pelvis (2)

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

pelvic outlet (inferior pelvic aperture)

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

pubic symphysis & crest
iliopectineal lines
sacral promontory

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

pubic symphysis
ischiopubic ramus
ischial tuberosities
sacrotuberous ligaments
coccyx

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pelvic diaphragm:

separates ___ from the ___ below

pelvis

perineum below

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pubic tubercles & the ASIS

located on the ___ in the anatomical position

same vertical plane

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walls of the pelvis:
anterior wall (2)

pubic bone

pubic symphysis

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walls of the pelvis:
lateral wall (3)

hip bone below the pelvic inlet
obturator membrane
obturator internus muscle

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walls of the pelvis:
posterior wall (3)

sacrum
coccyx
piriformis muscle

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membranes & ligaments of the pelvis:
obturator membrane:

___ sheet that almost completely encloses the ___

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

fibrous
obturator foramen

obturator canal
obturator nerve & vessels

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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

lateral part of the sacrum & coccyx
ischial tuberosity

lateral part of the sacrum & coccyx
ischial spine

superficial

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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 ___

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

sciatic notches
sciatic foramina

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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)

the pelvic diaphragm

levator ani muscle
coccygeus muscle

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

anteriorly
urogenital hiatus
urethra
vagina

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nerve supply of the pelvic diaphragm:

pelvic surface - ___

perineal surface - ___

ventral rami of S3 & S4

perineal branch of the pudendal nerve

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actions of the pelvic diaphragm:

supports the ___

resists a rise in ___ during ___

has important ___ actions on the ___ & the ___

pelvic viscera

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

sphincter
ano-rectal junction
vagina

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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 ___

heaver
larger
childbearing

heavier
thicker
bone markings

wider
shallower
pelvic inlet & outlet

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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., ___)

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

dense
muscles
periosteum
bony pelvic boundaries

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

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the pelvic fascia:
visceral pelvic fascia:

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

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

the pelvic fascia:

arcus tendinous

important as the origin of a large portion of the ___

thickening of the obturator internus fascia

levator ani muscle

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 ___

extraperitoneal fascia
abdomen
pelvis

visceral ligaments

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

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

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

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

pelvic brim
sacroiliac joint
external & internal iliac

external iliac
common iliac artery
pelvic brim

internal iliac
pelvis
pelvis

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

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)

blood vessels of the pelvis: internal iliac artery: divides into ___ & ___ divisions great ___ in the branching pattern

anterior posterior variation

blood vessels of the pelvis: | posterior divisions of the internal iliac arteries (3)

iliolumbar artery lateral sacral arteries superior gluteal artery

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

lumbosacral trunk ala of the sacrum lumbosacral trunk obturator nerve psoas major iliacus psoas major

blood vessels of the pelvis: posterior divisions of the internal iliac arteries: lateral sacral arteries: pass medially entering the ___ supplying the ___

pelvic foramina | nerve roots

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

lumbosacral trunk ventral ramus of S1 greater sciatic foramen prirformis

blood vessels of the pelvis: | anterior divisions of the internal iliac artery (8)

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

blood vessels of the pelvis: anterior divisions of the internal iliac artery: umbilical artery: gives off the ___ continues forward as the ___

superior vesical arteries | medial umbilical ligament

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 ___

obturator nerve obturator canal inferior epigastric artery external iliac artery anomalous obturator artery

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

femoral ring obturalor canal femoral hernia divided triangulated or obstructed femoral nernia

blood vessels of the pelvis: anterior divisions of the internal iliac artery: inferior vesical artery: only in ___ usually gives off the ___

males artery of the ductus deferens

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

cardinal ligament broad ligament ureter lateral fornix "water runs under the bridge"

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 ___

inferior vesical artery vagina pelvis perineum bladder

blood vessels of the pelvis: anterior divisions of the internal iliac artery: internal pudendal artery: exits the ___ between the ___ & ___ muscles running with the ___

pelvis piriformis & coccygeus pudendal

blood vessels of the pelvis: anterior divisions of the internal iliac artery: inferior gluteal artery: passes between the ___ exits the ___ through the ___ below the ___

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

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

arteries each other others

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 ___

internal iliac vein tributaries vertebral venous plexus pelvic viscera cancellous cranial cavity

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 ___

pelvic piriformis lumbosacral trunk ventral rami of S1 - S4 greater sciatic formaen

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 ___

ventral ramus of L4 ventral ramus of L5 sacroiliac joint S1 superior gluteal artery

nerves of hte pelvis: | pelvic splanchnic nerves

preganglionic parasympathetic fibers of S2 - S4

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 ___

L2 - L4 lumbar external & internal iliac arteries ovarian fossa obturator artery & vein obturator canal

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 ___

pelvic brim iliac vessels pelvic foramina coccyx ganglion impar