The Pelvis and Perineum Flashcards
What is the true pelvis
the space below the iliac fossa and between the pelvic bones
The upper margin of the true pelvis is limited by
the sacral promontory, the arcuate line, the pectineal line and the top of the symphysis pubis
What is the false pelvis
part of the abdomen and is the entire space bounded by the iliac fossae
The pelvic cavity is limited inferiorly by
the pelvic diaphragm
The pelvic diaphragm is made up of which muscles
levator ani and coccygeus
Where is the Perineum
the region beneath the pelvic diaphragm containing the external genitalia anteriorly, the anal canal posteriorly and the supporting muscular connective tissue, blood supply and innervation
The perineum contains:
- the external genitalia anteriorly
- the anal canal posteriorly
- the supporting muscular connective tissue, blood supply and innervation
Sacral promontory
- the most anterior part of the sacrum and is the body of the first sacral segment
Arcuate line
- continuation of the sacral promontory around the inlet
- defines the lower border of the iliac fossa
Ileopectineal line runs medially to the:
pubic crest
The sacroiliac joint has two components:
one synovial and one fibrous
Sacrum
Ilium
Acetabulum (For hip joint)
Ischium
Orturator foramen
Symphisis pubis
Pubis
Iliac crest
Articular surface
Anterior superior iliac spine
Arcuate line
Anterior Inferior Iliac Spine
Pectineal line
Superior pubic ramus
Pubic tubercle
Articular surface for symphysis for pubis
Inferior pubic ramus
Obturator foramen
Ischial ramus
Ischial tuberositv
Lesser sciatic notch
Ischial spine
Greater sciatic notch
Posterior inferior iliac spine
Posterior superior iliac spine
Ligamentous surface
Auricular surface
The synovial surface on the posterior ileum
Where is the iliac tuberosity
situated immediately superior to the auricular surface
Iliac tuberosity function
provides the appendicular attachement for the fibrous joint components
The sacroiliac joint is reinforced by which ligaments:
sacrotuberous and sacrospinous ligaments
The pelvic diaphragm consists of two muscles:
- anteriorly: levator ani
- posteriorly: coccygeus
The origin of levator ani
horizontal line running from pubis to ischial spine
The levator ani is pierced by the:
- anteriorly: urethra, and in the female, by the vagina
- posteriorly: anal canal
Puborectalis function
pulls the anorectal junction forward
The coccygeus run from the ____ to the _______
- Ischial spine
- Coccyx
Rectum
Levator ani
Coccygeus
Gastrointestinal contents of the pelvis
Rectum
Urinary contents of the pelvis
- Ureters
- Bladder
Male reproductive contents of the pelvis
- Vas deferens
- Seminal vesicles
- Prostate gland
Female reproductive contents of the pelvis
- Ovaries
- Uterine Tubes
- Uterus
- Cervix
- Vagina
Circulatory contents of the pelvis
- Common iliac artery
- Internal iliac artery
- External iliac artery
Nervous contents of the pelvis
- Sacral plexus
- Autonomic innervation
Nervous contents of the pelvis
- Sacral plexus
- Autonomic innervation
Peritoneal contents of the pelvis
- Pouches
Is the rectum retroperitoneal or intraperitoneal
the initial part of the rectum has a mesentery, but it soon becomes retroperitoneal
Anal canal
where the rectum pierces the levator ani
Bladder
Vas deferens
Ampulla of vas
Prostatic urethra
Prostate
Penile urethra
Membranous urethra
Prostate
Ejaculatory duct
Seminal vesicles
What passes through the deep inguinal ring
the paired vas deferens
Where do the paired vas deferens meet
the prostate gland
Ampulla of vas
The vas deferens expand as they approach the midline, forming the ampulla of vas
Where are the seminal vesicles
joins the vas deferens at the termination of the ampulla
The ducts of the seminal vesicles and the vas form the:
ejaculatory ducts
Where is the prostate gland located:
beneath the bladder
Prostatic urethra
the part of the urethra that runs through the prostate gland and internal sphincter of the bladder
After passing through the prostate, the urethra passes through:
the urogenital diaphragm
Where is the membranous urethra
the part of the urethra in the urogenital diaphragm
What surrounds the urogenital diaphragm
the external sphincter
Where are the bulbourethral glands
within the urogenital diaphragm
Where do the bulbourethral glands’ ducts enter
the urethra in the penis
Where is the penile urethra located
the penis
Ovaries
the paired female sex glands
The ovaries produce
the ova
Round ligament of the ovary
suspend the ovaries from the uterus
Where is the round ligament of the uterus?
runs from the wall of the uterus, through the inguinal canal, to labia majora
Suspensory ligament of the ovary
suspends the ovaries from the pelvic wall
Function of the uterine tubes
collect the ova from the ovary and convey them to the uterus
The uterine tubes have 3 parts:
- The infundibulum
- The ampulla
- The isthmus
The infundibulum
The part of the uterine tubes that is open with fimbriae and reach to the ovary
The ampulla
the body of the uterine tubes and is lined with a ciliated epithelium that propels ova toward the uterus
The isthmus
the region of the uterine tubes where the tube opens into the uterus
Infundibulum
Uterine tube
Uterus
Mesosalpinx
Mesovarium
Ovary
Ovarian ligament
Broad ligament
Cervix
Vagina
Labia majora
Inguinal canal
Round ligament of uterus
Ovary
Broad ligament
Mesosalpinx
Mesovarium
Ovary
Where is the uterus
betweenthe bladder and the rectum
Broad ligament
a fold of peritoneum that covers the uterus
The uterus connects
the uterine tubes to the vagina
Function of the uterus
gestation of the embryo/fetus
The cervix has two openings:
- Internal OS
- External OS
Fornix
a circular recess around the external os
The external os opens into the
vagina
Posterior fornix
the deepest part of the fornix
The wall of the uterus has three layers:
- perimetrium
- myometrium
- endometrium
perimetrium
the capsule of the uterine wall
myometrium
the thick, smooth muscle wall of the uterine wall
endometrium
the inner mucosal lining of the uterine wall, which undergoes the changes of the menstrual cycle
Where is the vagina
upper 2/3 in the pelvis and lower 1/3 in the perineum
The vagina pierces the
pelvic floor
Vestibule
opening of the vagina
where is vestibule
between the labia minora, inferior to the external urethral orifice, and anterior to the anus
Recto-uterine pouch
Posterior fornix
Rectum
Anal canal
Vestibule
Urethra
Vagina
Bladder
Anterior fornix
The common iliac artery has two main branches
- External iliac artery
- Internal iliac artery
External iliac artery location
runs down the lateral wall on the pelvic brim and enters the thigh under the inguinal ligament
Internal iliac artery supplies
the artery to the pelvis and the gluteal region
Internal iliac artery main branches
- Lateral sacral artery
- Superior gluteal artery
- Inferior gluteal artery
- Interal pudendal artery
- Uterine artery
- Vesicular arteries
- Obturator artery
- Vaginal artery
Lateral sacral artery goes to
pelvic walls
Internal pudendal artery goes to
the perineum
The uterine artery goes to
the uterus
Vesicular arteries goes to
the bladder
Obturator artery goes to
runs through the obturator canal to the medial compartment of the thigh
Vaginal artery goes to
replaces the inferior vesicular artery
The somatic nerves of the pelvis derive from the:
sacral plexus
Pudendal nerve runs to the
perineum
Pudendal nerve arise from
S2,3,4
The autonomic supply of the pelvis come from the _______ for sympathetic innervation
lower sympathetic trunk
The autonomic supply of the pelvis come from the _______ for parasympathetic innervation
pelvic plexus
Nerves that synapse in the pelvic plexus arise from
S2,3,4
two recesses of the borad ligament
- vesicouterine pouch (anteriorly)
- rectouterine pouch (posteriorly)
The borad ligament spawns two small mesenteries:
- mesovarium
- mesosalpynx
Mesovarium attaches
which attaches the ovary to the broad ligament
Mesosalpynx attaches
attaches the uterine tube to the broad ligament
Vesicorectal pouch
the ouch between the bladder and the rectum in the male
Levator ani
Anus
Urethra
Urogenital diaphragm
The perineum contains the:
- external genitalia
- anal canal
- ischiorectal fossa
Perineum is divided into two triangles:
- Urogenital triangle (anterior)
- Anal triangle (posterior)
Urogenital triangle contains
the external genitalia
Anal triangle contains
the anal canal and the ischiorectal fossa
Urogenital diaphragm covers
inferior surface of the levator ani
Urogenital diaphragm fills the:
triangular space
Perineal membrane
superficial fascia of the urogenital triangle
The urogenital diaphragm is attached on each side along the:
ischiopubic ramus, pubic, and ischium
The male has two parts to his genitalia:
the penis and the testes
The penis consists of three cylinders in its erectile tissue
- the paired corpora cavernosa
- midline corpus spongiosum
- urethra
Where is the crus
proximal on each corpus cavernosum
Ischiocavernosus muscle
attach the crura to the body of the ischium
Corpus cavernosa
Corpus spongiosum
Urethra
Testis
Bulbourethral gland
Prostate
Seminal vesicle
Rectum
Ureter
Bladder
Prostatic urethra
Vas deferens
Penile urethra
3 muscles holding the penis in place
- 2 ischiocavernosis
- 1 bulbospongiosus
Peritoneum
Obturator internus & Fascia
Bulbospongiosus
Urogenital diaphragm
Ischiocavernosus
Levator ani
Where is the corpus spongiosum
between the two corpora cavernosa
Clitoris
an erectile organ with much of its structure homologous to the penis
Where is the clitoris?
at the superior angle of the vestibule
Where do the labia majora meet
superiorly at the mons pubis and posteriorly at the fourchette
The vulva is the
external genitalia
the vulva consists of
- mons pubis
- labis (majora and minora)
- clitoris
- vestibule
Anus
Labia minora
Labia majora
Clitoris
Opening of urethra
Opening of vagina
Anal columns
the upper portion of the anal canal with longitudinal folds
Pectineal line
the inferior border of the anal columns
The internal anal sphincter
a thickening of the smooth muscle wall of the gut
The external anal sphincter
voluntary muscle and has deep, superficial and subcutaneous components
Ischiorectal fossa location
fat filled spacebetween the anal canal, levator ani, and the obturator internus
The ischiorectal fossa contains
the pudendal canal
Pudendal canal contains
- pudendal artery
- pudendal vein
- pudental nerve
The internal pudendal artery enters the perineum via the
pudendal canal
The internal pudendal artery gives off the
inferior rectal artery and the perineal artery
The internal pudendal artery divides into the
deep and dorsal arteries of the penis/clitoris
The pudendal nerve gives off the
inferior rectal nerve
the inferior rectal nerve goes to the
skin of the anal triangle and to the external anal sphincter
The pudendal nerve divides into the
perineal nerves and the dorsal nerve of the penis/clitoris
Testis and ovary generally are supplied by
least splanchnic nerves
Parasympathetic input of reproductive system comes from
pelvic splanchnic via the inferior hypogastric plexus
In the male reproductive system, parasympathetic nerves are responsible for
erection
In the male reproductive system, sympathetic nerves are responsible for
ejaculation
The sympathetic output for ejaculation generally comes from:
L1-2
What type of innervation contracts the sphincter of the bladder, preventing retrograde ejaculation
sympathetic
Ejaculation is assisted by the contraction of
the bulbospongiosus
The bulbospongiosus is innervated by the
pudendal nerve
In the female reproductive system, the sympathetic supply to the uterus and vagina is from
T10-L2
In the female reproductive system, the sympathetic services the
uterine and vaginal arteries and assists the endocrine system in uterine contraction
