Walls of true pelvis, joints and muscles of the pelvis.

Question 1

Pelvic wall is formed by

Answer 1

Bones.
Ligaments.
Joints
Membranes
Muscles

Question 2

Bones

Answer 2

2 hip bones
sacrum
coccyx

Question 3

Ligaments

Answer 3

sacrospinous
sacrotuberous
iliolumbar

Question 4

Joints

Answer 4

Pubic symphysis
sacroiliac

Question 5

Membrane

Answer 5

obturator
perineal

Question 6

Muscles

Answer 6

piriformis- form posterior wall on each side.
obturator internus- form anterolateral wall on each side
levator ani and coccygeus- form pelvic floor inferiorly

Question 7

Separation of the 2 hip bones is prevented by

Answer 7

sacroiliac ligament
iliolumbar ligament
ligaments of pubis symphysis.

Question 8

Pelvic floor muscles

Answer 8

Piriformis
Obturator Internus
Levator ani
Coccygeus

Question 9

Levator ani muscles are made up of how many components

Answer 9

3 and they include:
puborectalis
pubococcygeus
iliococcygeus

Question 10

Coccygeus Origin

Answer 10

Inner surface of ischial spine.

Question 11

Coccygeus insertion

Answer 11

Inferior ends of sacrum and coccyx

Question 12

C action

Answer 12

Supports coccyx during defecation and labour and also supports the pelvic viscera

Question 13

C nerve supply

Answer 13

anterior rami branches from s4 and s5

Question 14

C arterial supply

Answer 14

Inferior vesical, inferior gluteal and pudendal arteries.

Question 15

Puborectalis

Answer 15

Origin: Posterior surface of pubis

Insertion: It forms puborectal sling posterior to the rectum, and attaches to the pubis on the contralateral side.

Action: Tonic contraction of the muscle bends the anal canal anteriorly. This creates the anorectal angle which contributes to faecal continence. It is voluntarily inhibited during defecation.

Innervation: Nerve to levator ani (S4) and pudendal nerve.

Question 16

Pubococcygeus

Answer 16

Origin: Posterior surface of pubis lateral to puborectalis

Insertion: It inserts into the anococcygeal ligament, Coccyx and Perineal body

Action: Stabilizes and supports abdominopelvic viscera.

Innervation: Nerve to levator ani (S4); branches of pudendal nerve.

Question 17

Iliococcygeus

Answer 17

Origin: Tendinous arch of the internal obturator fascia and Ischial spine

Insertion: Anococcygeal ligament and Coccyx

Action: Elevates the pelvic floor and anorectal canal.

Innervation: Nerve to levator ani (S4)

Question 18

What is the obturator fascia

Answer 18

It is a deep fascia that covers the pelvic surface of obturator internus.

It shows a thickened line extending from back of pubis to ischial spine and this line is called white line or tendinous arch.

Question 19

What does the tendinous arch give origin to

Answer 19

Levator ani

Question 20

Above tendinous arch, obturator fascia is

Answer 20

Thick

Question 21

At what point does the obturator fascia split into two layers to form pudendal canal

Answer 21

Below tendinous arch

Question 21

Below tendinous arch, obturator fascia is

Answer 21

Thin and it forms lateral wall of ischirectal or anal fossa

Question 22

List the types of pelvic fascia

Answer 22

Parietal
Visceral

Question 23

Parietal includes

Answer 23

Obturator fascia
Fascia covering piriformis and sacral plexus
fascia of pelvic diaphragm

Question 24

Visceral is of two types, first type includes:

Answer 24

fascia that surrounds extraperitoneal parts of pelvic viscera. thin and loose( bladder, rectum) and dense and non distensible in some organs(prostate)

Question 25

Second type includes

Answer 25

Cardinal ligaments uterosacral ligaments pubocervical fascia They are extraperitoeal condensations of connective tissue connecting pelvic viscera to pelvic wall.