Unit 2 Exam Flashcards
Name 3 Pelvic Landmarks and Quadrants
- Iliac Wings (crest)
- Umbilicus
- Symphysis Pubis
PELVIC CAVITY see pic 1
- Ill-defined area of body where the trunk meets the lower limbs
- Bony pelvis lies in close relationship to cavity
- Female and Male * reproductive organs are mainly located in this cavity
BONY PELVIS see pic 4
- Encloses a funnel – shaped cavity
- Inferior portion of Abdominopelvic cavity
- Divided into Pelvis major Pelvis minor
- Forms the funnel cavity
PELVIS MAJOR also known as the False pelvis
see pic 7,8,9,10
- Also called FALSE pelvis
- Space between iliac fossa and its inferior boundary
- Defined by pelvic brim
- Part of abdominal Cavity
**False Pelvis what organs are within?
Abdominal viscera: parts of small intestine Sigmoid colon and Abominal Muscles
What muscles are in the Major Pelvis, False Pelvis
Psoas Major and Iliacus Muscles
PELVIS MINOR ALSO KNOWN AS
The space below…..
True Pelvis
Most of the female reproductive organs lie here if Norm size
Space below the pelvic brim and enclosed by sacrum, ischium, pubis and portion of ilium
What does the true pelvis contain? see pic 8,9,10
- U-Bladder
- Rectum
- Internal reproductive organs
- Portion of mobile GI tract
What muscles are in the True Pelvic see pic 20, 21
- Obturator Internus
- Piriformis
PELVIS MINOR/FALSE PELVIS see pic 2
what divides them?
- I_maginary line divides the True from false pelvis_
- Extends from Symphysis Pubis to Sacral Promontory
What defines the Pelvic Brim
The False Pelvic
Bony Frame Work of Pelvis
Is formed by? see pic 11
- the sacrum
- the coccyx
- paired os coxae
- (Hip Bones)
THE SACRUM see pic 5
Along with the coccyx the sacrum makes up the posterior midline portion of the bony pelvis
Tips Posteriorly
Where is the Sacrum? see pic 6
- Articulates with L-5
- Tips posteriorly
- Angle formed called Lumbosacral angle
- Transmits with of the body to hip bones, then to lower extremities
- Normally five sacral vertebrae fuse into a triangle-like mass*
SACRUM see pic 5
Anteriorly the upper margin S1 forms the Sacral Promontory
This is the posterior landmark for the True Pelvis, inlet or pelvic brim
made up by the anterior sacral promontory
Is normally fused
Anterior surface of sacrum (pelvic surface) forms a concave curve
Sacral Formina
What is it? what goes through?
Where are the openings?
how many are they? see pic 5
- Both anteriorly and posteriorly are rows of four openings
- This is where nerves pass thru
- Posteriorly surface of sacrum between formina and and fused spinous process from the median crest
- S-5 has no spinal or lamina referred to as Sacral hiatus
- This is where an epidural injection occurs
Where is the COCCYX BONE?
Whats another name for the bone?
Where does it join?
Made by what?
fused by?
- most inferior portion of vertebral column
- Also called the tail bone
- Joined to sacrum by cartilage
- Usually made of 3-4 rudimentary (underdeveloped) vertebra
- usually fused by adulthood
Does the Coccyk Bone offers support?
Where does it attach?
- Offers no support to vertebral column
- Provides attachment for Gluteus Maximus muscle
- Provides attachment for pelvic floor muscles
Where is the OS COXAE see pic 3
what do each consist?
Innominate bones (paired) Lay person may refer to them as hip bones
Right and left ilium
Right and left pubis
Right and left ischium
Right and left ILIUM see pic 3
Is it the smallest? Largest?
Where is it?
What aspect is in it?
Where does it originate?
- Largest of the three bones of the hips
- Superior part of the Ilium presents a large, wing-like surface called the ala
- Inner aspect of the ala is the illiac fossa
- This is the origination of the iliacus muscle
What makes up the coccyk
is joined to sacrum by cartilage
its consist of four rudimentary vertebrae with no processes or foramina
Where is the Illiac crest? in the Ilium see pic 3
Iliac Crest, most superior portion of the Illium
its an Xray landmark
*What make up the pelvis?
Enclosed a funnel shape
Formed by
The Sacrum
The Coccyk
The Paired OS Coxae
The Hip bones
Whats Posteriorly in the Illium see pic 3
Posteriorly ilium articulates with sacrum at the Sacroiliac joint
What in the Hip
What 3 make up the Pelvic Girdle
HIP (ball-and-socket, head of femur and acetabulum of pelvis)
2 Coxa bones (os coxae)
Illium
Ischium
pubis
Where does the Pubis Bone meet?
Meets in the anterior midline at SP (superior pubic)
just lateral to the body forms the pubic turbercle and from this point the superior pubis ramus extends laterally to meet the illium
*What Makes up the Sacrum?
The posterior midline portion of the bony pelvis and the anterior sacral promontory
Normally 5 sacral vertebrae to the lower extremities.they form the triangular mass articulates witht the 5 lumbar vertebra superiorly tilts to form the lumbosacral angle.
*Urogenital Diaphragm Cheat notes
Lies immediately deep to the external Genitalia. Consists of Perinei Muscle and the External Anal Sphicter
External to Pelvic and Urogenital Diaphragm is the Perineum, which extends from the pubic arch to the tip of the coccyx. This is further divided by a line drawn between the ischial tuberosities,
*What are Innominate bones
Two ilium
Two pubis
Two Ischium
*Perineum is part of what?
also part of pelvic outlet
*Perineum (also part of pelvic outlet)
Posterior Anal Region
Anterior Urogenital Region
*Pelvic Diaphragm
Principle supporting structure supporting pelvic viscera
Forms a muscular pelvic floor by the following two muscles (paired)
LAM MUSCLES AND COCCYGEUS
LAM –Larger of two pelvic floor muscles, most important
Originate on pelvic surface of pubis and spine of Ischium, insert at coccyx, and the ipsilateral muscle
Coccygeus- Smaller of the two
Originate is spine of ischium, fibers fan out and inserts on the sacrum and coccyx
Pelvic
- Pelvic surcafe of superior margin of ramus is sharp and form the pectineal line
- Continuos with arcuate line of illium and scaral promontory to mark pelvic brim
- Inferior pubis ramus extends inferiorly from body to connect to with the ischium
Pubic Bones Description
- Inferior rami of pelvic bones meet at the SP to form the pubic arch
- Pubis arch also known as the subpubic angle
- Subpubic angle is 70 degrees in males and 80 degrees in females
- infeiror portion of hip bones is formed by the ischium
- illium, pubic and ischium meet in acetabulum where head of femur articulates
*
MUSCULAR COMPONENTS
Functionally muscles of pelvic wall are associated with movement of the thigh
Some are external to pelvis also
MUSCULAR COMPONENTS
Muscles of the false pelvis are mainly abdominal muscles Psoas (minor) and Iliacus These continue in the pelvis and then go on to the thigh
*PSOAS MUSCLE
Described location, insertion, termination
Long, fleshy muscle
Muscle mass seen lateral to the vertebral bodies extends from abdominal to pelvis
Terminates and inserts on the lesser trochanter of the femur (anterior thigh)
Works along with the iliacus
*Obturator Internus Muscle OIM
Shape
cover…..
Wheres does it originate
know the path
Fan-shaped muscle
Covers lateral wall of true pelvis
Originates on inner surface of pelvic bones
Crosses over obturator foramen and closes off the opening
Leaves pelvis thru the lesser sciatic notch
Turns and inserts of medial surface of greater trochanter
PIRIFORMIS MUSCLE
Located partially on the posterior wall of the true pelvis and partially external to the pelvis, posterior to the hip joint
originates on the anterior surface of sacrum and passes through the greater sciatic notch to insert at greater trochanter
Closely related to sacral nerve plexus and rotates and abducts thigh
PELVIC FLOOR MUSCLES
The floor of the pelvis is formed by the coccygeus and levator ani muscles (as viewed from above).
LEVATOR ANI (LAM)
Largest muscle of the pelvic diaphragm
Integrity of pelvic floor depends on the appropriate function of the LAM
WHAT ARE THE LEVATOR ANI MUSCLES
Made up of:
pubococcygeus, puborectalis iliococcygeus
MORE MUSCLES
Pelvic cavity viewed from above. The piriformis and obturator internus muscles pass out from the pelvis through the sciatic foramina to attach to the greater tuberosity of the femur. These muscles make up the pelvic wall along with iliopsoas
*Obturator Internus
What type of shape?
where does it attach
Fan shaped muscle obturator is just inferior to insertion of OIM at greater trochanter
*Obturator Internus
Muscles of pelvic wall and diaphragm
Originates at obturator foramen and pubic bone
Inserts into greater trochanter of femur medially
Rotates the thigh
Hammocks the bladder posteriorly and laterally
*Piriformis
Originates at ilium and sacrum
Insets into greater trochanter of femur
Laterally rotates and adducts thigh
Lies deep posterior
Levator Ani
Females LAM are vulnerable during delivery childbirth
Can lead to urinary incompetence
and prolapse of uterus
Originate on pelvic surface of pubis and spine of ischium Fibers converge to insert on coccyx and some to colateral muscle
Coccygeus
Smaller of two pelvic diaphragm muscles
Origin is the spine of the ischium
fibers fan out to form a traingular sheet that inserts on sacrum and coccyx
*ILIACUS
Fan-shaped muscle that originates along the crest and fossa of the ilium
Lines the iliac fossa
Appears lateral to Psoas minor
Fibers insert on femur with psoas
Appears to merge with psoas as one muscle
Similar function
Often referred to as iliopsoas if linked with Psoas minor
MUSCLE : TRUE pelvic wall
Obturator internus
Piriformis
Coccyx bone provides attachment where?
Pelvic floor muscles
Coccygeus muscle pic
Urinary bladder
Superior surface is covered by peritoneum Superior
This is the Body area
Posterior surface is fundus or base
Related to ant surface of vagina
Urinary bladder
Pyramid-shaped muscular organ
Rest on pelvic floor
Immediately posterior to SP
Function Temporary Reservoir for storage of urine
Urinary Bladder
what structure does it contain?
Bladder is anchored by what?
Bladder Neck
contains muscular sphincter.
Apex of bladder formed by superior/inferiorlateral surface
Bladder anchored to bladder by pelvic ligaments
Urethra
location
what does it contain
In both genders it passes thru urogenital diaphragm
This contains the urethral sphincter muscle
Female Urethra Short descends inferiorly and anteriorly while embedded in
Urethra
Male Much longer Extends from inferior portion of bladder to tip of penis Divided into three sections Prostatic Membranous Penile Longest portion Function Empty bladder and receive secretions from prostate and ejac ducts as well as bulbourethral glands
Urinary Bladder
Holds 200-250 mL of urine before urge is triggered
Has capacity of 750mL
Empty bladder has four serfaces Superior, Post
2-inf/lateral
*Rectum the location
Where does it come from
how many cm
directional starts and end
Terminal portion of large intestine
Extends from S3 to tip of coccyx
Approximately 15cm
Follows ant/post curve of sacrum and coccyx and ends by an infer/anterior turn to become anal canal
*Rectum function
The rectum is about eight inches long and serves, basically, as a warehouse for poop. It receives waste material from the colon and stores it until you have a bowel movement
Sacral Flexure
Anterioposterior of sacrum and coccyx
*Location of the bladder? in female and male?
When the bladder is empty it lies in the true pelvis whenit fills it can extend to the abdomen In female the bladder rest on the pelvic floor posterior to the symphysis pubis
In the male the prostate gland is between the urinary bladder and the pelvic floor
Perineal Flexure
Turns inferior and anteriorly to become anal canal
Between two flexures is a fold of tussue
Kohlarausch’s Fold
Female Pelvis
Recutm is posterior to uterus
Uterus posterior to Bladder
Anal Canal posterior to vaginal vault
Vaginal Vault posterior to urethra
Uterus size
shape
location
Size:7.5-8cm L 5cm W 2.5-3cm AP Shape: Pear Shaped Location: Anterior portion of pelvis between bladder and rectum
Uterine Cavity
is peritoneum or peritoneal
Mobile, hollow muscular organ
Partially covered by peritoneum except anteriorly where bladder lays against it at the cevicalvaginal connection
Layers of the uterine tissue
which layer is thickest ?
by the fundus or the cervix?
during labor what part contarcts?
Perimetrium External serosal layer
Myometrium Middle muscle layer
by the fundux, labor contracts
Endometrium Inner mucous layer Continuous w/ lining of Vagina
Parts of the Uterus
Cervis, Body, Fundus