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PHA 500 > 10. Pelvis I > Flashcards

10. Pelvis I Flashcards

(62 cards)

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1
Q

Pelvic Girdle

A

Os coxae (hip bones)
Sacrum
Coccyx

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2
Q

Bony Pelvis

A

Connects thoracic cavity to LE

Consists of 4 bones

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3
Q

Os Coxae

A

Ilium
Ischium
Pubis

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4
Q

Acetabulum

A

Fusion of ilium, ischium, pubis

Fuses at about age 16

Head of femur articulates here, forming hip joint

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5
Q

Obturator Foramen

A

Ischium + pubis

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6
Q

Ilium

A

Iliac crest (connects ASIS to PSIS)
Iliac fossa (concave medial surface)(iliacus sits here)
ASIS
PSIS

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7
Q

Pubis

A

Pubic tubercle

Pubic symphysis

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8
Q

Pubic Symphysis

A

Pubic bones articulate at midline to form

Fibrocartilaginous joint (not much movement)

Ligaments relax right before birth

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9
Q

Pubis + Ischium

A

Superior pubic ramus (unites ilium and ischium superiorly)
Inferior pubic ramus
Ischial ramus
Isciopubic ramus

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10
Q

Isciopubic Ramus

A

Inferior pubic ramus + ischial ramus

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11
Q

Ischium

A

Greater sciatic notch
Ischial spine
Lesser sciatic notch
Ischial tuberosity (muscle attachment)

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12
Q

Pubic Arch

A

2 ischiopubic rami

Inferior borders define subpubic angle

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13
Q

Sacrum

A

5 fused vertebrae

Base (articulates with L5/S1 intervertebral disc and L5 vertebra)

Apex (articulates with coccyx)(S5)

Sacroiliac joints

Sacral promontory

Sacral foramina

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14
Q

Sacral Promontory

A

Anterior edge of S1 projection

Obstetrical landmark

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15
Q

Sacral Foramina

A

4 pair anterior
4 pairs posterior

For transmission of ventral and dorsal rami of sacral spinal nerves

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16
Q

Coccyx

A

4 fused vertebrae

Articulates with sacrum at sacrococcygeal joint

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17
Q

Pelvic Inlet

A

Divides pelvis into greater and lesser pelvis

Normally tilted about 55 degrees from horizontal plane (tipped in anatomic position)

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18
Q

Greater (False) Pelvis

A

Superior to pelvic inlet

Occupied by abdominal viscera

Between ilium

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19
Q

Lesser (True) Pelvis

A

Inferior to pelvic inlet

Occupied by pelvic viscera

Very small region

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20
Q

Pelvic Outlet

A

Boundaries:

  • coccyx and sacrum
  • sacrotuberous ligaments
  • ischial tuberosities
  • ischiopubic rami (pubic arch)
  • pubic symphysis

Normally tilted at 15 degrees from horizontal plane (tipped in anatomic position)

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21
Q

Pelvic Diaphragm

A

Muscle separating pelvis above from perineum below

Closes up pelvic outlet

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22
Q

Sex Differences in Pelvis

A

Pelvis inlet:

  • F: larger, round/oval
  • M: heart shaped, narrower anteriorly

Pelvic outlet:
-F: ischial tuberosities and ischial spines more laterally displaced (for babies)

Subpubic angle

  • F: wider (>80)
  • M: narrower (<70)
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23
Q

Sacroiliac Ligaments

A

Anterior
Posterior
Interosseus

Ligaments relax for baby time

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24
Q

Sacrotuberous Ligament

A

Sacrum/coccyx to ischial tuberosity

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25
Sacrospinous Ligament
Sacrum/coccyx to ischial spine
26
Axis of Rotation
Sacrotuberous and sacrospinous ligaments resist the influence of body weight that rotates the sacrum and coccyx posteriorly and superiorly
27
Greater Sciatic Foramen
Superior to ischial spine Passageway to/from gluteal region
28
Lesser Sciatic Foramen
Inferior to ischial spine Passageway to/from perineum
29
Obturator Membrane
Closes obturator foramen except obturator canal
30
Obturator Canal
Passageway to medial compartment of thigh Conveys neurovascular structures (obturator nerve)
31
Muscles of Lesser Pelvis: Piriformis
Posterior wall of lesser pelvis Origin: ant surface of sacrum Courses through greater sciatic foramen Insertion: femur Innervation: sacral plexus
32
Muscles of Lesser Pelvis: Obturator Internus
Lateral walls of lesser pelvis Origin: obturator membrane and margin of obturator foramen Courses through lesser sciatic foramen Insertion: femur Innervation: sacral plexus Covered on medial surface by thick obturator fascia (attachment for muscles of pelvic diaphragm)
33
Muscles of Lesser Pelvis: Pelvic Diaphragm
Bowl/funnel shaped R and L fuse in midline to form median raphe Closes inferior pelvic aperture/pelvic outlet and forms pelvic floor Supports pelvic viscera superiorly, perineum lies inferior Pelvic structures pass through to reach perineum (urethra, vagina, rectum) Innervation: branches of sacral and coccygeal plexuses
34
Tendinous Arch of Levator Ani
Obturator fascia thickens centrally as tendinous arch for attachment of levator ani Ends at ischial spine
35
Pelvic Diaphragm: Composed of 2 Muscles
Levator Ani | Coccygeus
36
Coccygeus
Extends from ischial spine to coccyx/inf sacrum Lies on internal surface of sacrospinous ligament
37
Levator Ani
Extends from pubis/ischial spine to coccyx/median raphe
38
Levator Ani: Openings
Posterior: anal aperture Anterior: urogenital hiatus (passageway for urethra)(F: also vagina, vaginal canal) ``` Ant urethra vagina rectum Post ```
39
Levator Ani: Portions
Pubococcygeus | Iliococcygeus
40
Pubococcygeus
Fibers wrap around pelvic viscera Muscular slings = support Pubovaginalis (F) Puboprostatiucs (M) Puborectalis
41
Puborectalis
Sling around anorectal junction Maintains anorectal flexure Relaxes during defecation - rest of levator ani/pelvic diaphragm contracts to prevent viscera from herniating
42
Pelvic Diaphragm: Weakness
Urinary stress incontinence Bowel incontinence Prolapse of pelvic viscera
43
Pelvic Arteries
Gonadal (ovarian/testicular) Abdominal aorta Common iliac External iliac Internal iliac
44
Gonadal Arteries
Branches of ab aorta Testicular: travel within spermatic cords inf Ovarian: travel within suspensory ligaments of ovaries -supply gonads, uterine tubes, uterus
45
Common Iliac Arteries
Divide into external and internal iliac arteries
46
External Iliac Artery
Supplies anterolateral ab wall and LE
47
Internal Iliac Artery
Primary blood supply to pelvis, perineum, gluteal region
48
Internal Iliac Artery: Branches
``` Superior gluteal artery Inferior gluteal artery Internal pudendal artery Umbilical artery Obturator artery *Aberrant obturator artery* Superior vesicle artery Inferior vesical artery Uterine artery (F) Vaginal artery (F) Middle rectal artery ```
49
Superior Gluteal Artery
Exits greater sciatic foramen Superior to piriformis to supply gluteal region
50
Inferior Gluteal Artery
Exits greater sciatic foramen Inferior to piriformis to supply gluteal region
51
Internal Pudendal Artery
Makes a U turn - exits greater sciatic foramen Travels to perineum via lesser sciatic foramen Supplies structures of perineum Gives rise to inferior rectal artery (supplies anal canal)
52
Umbilical Artery
Gives rise to superior vesical artery supplying superior aspect of bladder (and ductus deferens in M) Obliterated portion continues on as medial umbilical ligaments
53
Obturator Artery
Courses along lateral wall of pelvis with obturator vein and nerve Exits pelvis via obturator canal to enter medial compartment of thigh
54
Aberrant Obturator Artery
20% of population Arises from inferior epigastric artery (branch of external iliac) Courses over superior pubic ramus to exit via obturator canal Can be accidentally damaged during inguinal hernia repairs
55
Inferior Vesical Artery
Direct branch of internal iliac (M) Supplies inferior bladder, urethra, seminal vesicle, prostate
56
Uterine Artery
F Passes superior to ureter
57
Vaginal Artery
F Supplies vagina, inf bladder (via inferior vesical branch), urethra Anastomoses with uterine arteries which anastomose with ovarian arteries
58
Middle Rectal Artery
Emerges off pudendal Anastomoses with superior and inferior rectal arteries (branch of IMA)
59
Pelvic Veins
Similar to arterial pattern (share names)
60
Venous Plexuses
``` Prostatic Uterine Vaginal Vesical Rectal ```
61
Pelvic Lymphatics
Internal iliac nodes --> common iliac nodes --> lumbar nodes --> chyle cistern --> thoracic duct
62
Gonadal Lymphatics
Ovaries, testes --> lumbar nodes --> chyle cistern --> thoracic duct

PHA 500 (11 decks)

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