Week 3 Quiz Flashcards
The bony pelvis is composed of what?
Os Coxae (Ilium, Ischium, Pubis)
Sacrum
Coccyx
Pubic symphysis
What are the boundaries of the pelvic cavity?
Pelvic inlet - superior opening
Pelvic outlet - enclosed by pelvic diaphragm inferiorly
Anterior pelvic wall - bodies of pubic rami and pubic symphysis
Lateral pelvic walls - hip bones and obturator internus muscle
Posterior pelvic wall - sacrum, coccyx, SI joint, associated ligaments
Describe the differences between the male and female pelvis.
Male
- general structure thick and heavy
- pelvic inlet heart shaped
- pelvic outlet small
- pubic arch narrow
- obturator foramen round
- acetabulum large
- subpubic angle < 70 degrees
Female
- general structure thin and light
- pelvic inlet oval and rounded
- pelvic outlet large
- pubic arch wide
- obturator foramen oval
- acetabulum smaller
- subpubic angle > 80 degrees
What makes up the pelvic floor?
Formed by the funnel shaped diaphragm and consists of Levator Ani and the coccygeus muscle
The diaphragm stretches anteroposteriorly from the pubis to the coccyx and laterally to the walls of the pelvis on either side
Describe the OINA of Levator Ani.
Consists of pubococcygeus, puborectalis, and iliococcygeus
Most important muscle in the pelvic floor
O: body of pubis, obturator fascia, Ischial spine
I: coccyx
N: nerve to levator ani (S3, S4)
A: forms muscular sling to support a abdominopelvic viscera, holds pelvic viscera in position to prevent sagging, assists with abdominopelvic cavity compression and is utilized with coughing, sneezing, vomiting, etc.
Describe the OINA for coccygeus.
AKA ischiococcygeus
O: Ischial spine
I: sacrum
N: nerve to levator ani (S3, S4)
A: supports pelvic viscera, forms part of diaphragm
What is the main blood supply to the pelvic region and what does it branch into?
Internal iliac artery, branches from the common iliac artery (which branches to internal and external iliac arteries, and from abdominal aorta)
Branches into anterior and posterior branches
Anterior branch branches into obturator artery, pudental artery, and inferior gluteal artery
Posterior branch branches into superior gluteal artery*, iliolumbar artery, and lateral sacral artery
What is the main supplier of blood for the muscles of the pelvic diaphragm? Describe it.
Inferior gluteal artery
Branches from the anterior branch of the internal iliac artery
Exits through the greater sciatic foramen to supply the gluteal region
What is the location of the femoral triangle? What are its boundaries and contents?
Located at the anterior thigh just inferior to the inguinal ligament
Superior boundary - inguinal ligament Lateral boundary - sartorius muscle Medial boundary - adductor longus muscle Roof - fascia lata Floor - iliopsoas and pectineus muscles
Contents - lateral femoral cutaneous nerve, femoral nerve, femoral artery and vein in femoral sheath, profunda femoris artery which gives rise to lateral and medial femoral circumflex arteries
Describe the profunda femoris artery including its location, function, and branching.
Located in the femoral triangle
Function: main supplier of blood to the thigh
Branches into lateral and medial femoral circumflex arteries, which are the main suppliers of blood to the head and neck of the femur
Describe the venous system of the lower extremity.
Dorsal venous arch to great saphenous vein with perforating branches
Blood flows from superficial veins to deep veins
Superficial veins have their own names, deep veins are named according to the artery they accompany
Venous valves are cup-like endothelial tissue that fill form above, prevent reflux of blood distally, and have a valve mechanism that allows blood to overcome gravitational force
Describe the location, function, and contents of the adductor canal. What are its other names?
A narrow fascial tunnel in the anterior thigh that allows passage for the femoral vessels to the popliteal fossa
Location - begins at the point where the sartorius passes over the adductor longus, and ends at the adductor hiatus in the tendon of the adductor magnus
Contents
- femoral artery and vein enter the adductor canal - as the femoral artery and vein exit through the adductor hiatus they change names to the popliteal artery and vein - saphenous nerve (cutaneous branch of femoral nerve) accompanies the femoral artery and vein into the canal
AKA Hunter’s canal or the Subsartorial canal
Describe the components of the thigh and their innervations.
Divided into 3 compartments by extensions of the deep fascia lata called intermuscular septa
Anterior compartment - knee extensors, innervated by the femoral nerve
Medial compartment - hip adductors, innervated by the obturator nerve
Posterior compartment - knee flexors and hip extensors, innervated by sciatic nerve
Describe the cutaneous innervation of the thigh.
Subcostal nerve (T12) - supplies lateral aspect of the thigh anterior to greater trochanter
Iliohypogastric (L1) - divides into lateral (supplies skin over superolateral buttock) and anterior (supplies skin superior to pubis) branches
Ilioinguinal - travels through superficial inguinal ring to innervate inferior pelvis. Also travels to proximal medial thigh
Genitofemoral- innervates skin of thigh inferior to inguinal ligament on the medial aspect
Lateral femoral cutaneous - innervates lateral and anterior parts of skin of thigh, passes under lateral aspect of inguinal ligament, extends laterally and distally from the greater trochanter to the area just proximal to the knee
Femoral nerve - innervates skin of anterior and medial thigh
Anterior femoral cutaneous - arises from femoral nerve in the femoral triangle, runs along sartorius muscle path and innervates skin of anterior, medial aspect of thigh
Name the muscles of the anterior component of the thigh.
Quadriceps femoris - rectus femoris - vastus intermedius - vastus lateralis - vastus medialis Sartorius Iliopsoas
Describe OINA for rectus femoris.
O: AIIS and rim of acetabulum
I: tibial tuberosity via the patellar ligament
N: femoral nerve
A: hip flexion, knee extension
Describe OINA for vastus intermedius.
O: anterior surface of femur
I: tibial tuberosity via patellar ligament
N: femoral nerve
A: knee extension
Describe OINA for vastus lateralis.
O: lateral surface of femur
I: tibial tuberosity via patellar ligament
N: femoral nerve
A: knee extension