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Gross Anatomy > Abdomen: Pelvis > Flashcards

Abdomen: Pelvis Flashcards

(120 cards)

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1
Q

Pelvic girdle

A
  • Coxal bones

- Articulate posteriorly with the sacrum (forms the pelvic skeleton/pelvic ring)

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2
Q

Coxal bones

A
  • Ilium
  • Ishium
  • Pubis
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3
Q

Coccyx is often included as

A
  • Part of the pelvic skeleton
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4
Q

Pelvic girdle function

A
  • Strong and rigid
  • Connects vertebral column to lower extremity
  • Weight transfer
  • Muscle attachment
  • Protect and support pelvic/abdominal viscera
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5
Q

Pelvis subdivisions

A
  • Greater pelvis

- Lesser pelvis

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6
Q

Greater pelivis

A
  • Superior to pelvic inlet
  • Surrounded by superior pelvic girdle
  • Abdominal viscera
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7
Q

Lesser pelvis

A
  • Inferior to pelvic inlet, superior to pelvic outlet
  • Pelvic cavity
  • Surrounded by inferior pelvic girdle
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8
Q

Perineum

A
  • Inferior to pelvic floor
  • Between coccyx to pubic symphysis
  • External genitalia, anus
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9
Q

Coxal bone

A
  • os coxae, hip bone
  • 3 separate bones
  • Multiple secondary centers
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10
Q

Coxal bones are separated by

A
  • Triradiate cartilage
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11
Q

Coxal bone development

A
  • Begins to fuse around puberty

- Completely fused by early 20s

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12
Q

Coxal bone articulates with

A
  • Sacrum posteriorly (sacroiliac joint)
  • Contralateral coxal bone anteriorly (pubic symphysis)
  • Femur laterally (acetabofemoral joint, hip joint)
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13
Q

Function of the Pelvis

A
  • Weight transfer
  • Muscle and ligament attachment
  • Protect abdominopelvic viscera
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14
Q

Pelvic inlet (superior pelvic aperture)

A
  • Passageway between greater and lesser pelvis

- Pelvic brim: edge of the pelvic inlet

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15
Q

Pelvic inlet is formed by

A
  • Linea terminalis

- Pubic crest and symphysis

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16
Q

Linea terminalis

A
  • Sacral promontory
  • Sacral ala
  • Arcuate line
  • Pectineal line
  • Pubic crest and symphysis
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17
Q

Arcuate line

A
  • Rounded inner border of ilium

- Inferior to iliac fossa

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18
Q

Pectineal line

A
  • Ridge on superior pubic ramus
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19
Q

The arcuate and pectineal lines are called

A
  • iliopectinal lines
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20
Q

Pelvic outlet (inferior pelvic aperture) boundaires

A
  • Anterior: Pubic arch (formed by ischiopubic rami)
  • Lateral: ischial tuberosities
  • Posterolateral: sacrotuberous ligament
  • Posterior: coccyx
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21
Q

Pelvic outlet (inferior pelvic aperture) POSTERIOR boundary

A
  • Coccyx
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22
Q

Pelvic outlet (inferior pelvic aperture) ANTERIOR boundary

A
  • Pubic arch (formed by ischiopubic rami)
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23
Q

Pelvic outlet (inferior pelvic aperture) LATERAL boundary

A
  • Ischial tuberosities
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24
Q

Pelvic outlet (inferior pelvic aperture) POSTEROLATERAL boundary

A
  • Sacrotuberous ligament
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25
ASIS and superior edge of pubic symphysis are
- In the same vertical plane
26
Inlet angle
- 50-60 degrees above horizontal plane
27
Pelvic cavity projects
- Posteriorly
28
Other passageways in/out of the pelvis
- Greater sciatic foramen - Lesser sciatic foramen - Obturator foramen
29
Greater sciatic foramen
- Passageway to gluteal region
30
Greater sciatic foramen Boundaries
- Greater sciatic notch (ilium) is anterior (anterolateral) - Anterior sacroiliac ligaments are superior - Ischial spine and sacrospinous ligament are inferior - Sacrotuberous ligament is posterior (posteromedial)
31
Greater sciatic foramen ANTERIOR boundary
- Greater sciatic notch/ilium (anterolateral)
32
Greater sciatic foramen SUPERIOR boundary
- Anterior sacroiliac ligaments
33
Greater sciatic foramen INFERIOR boundary
- Ischial spine and sacrospinous ligament
34
Greater sciatic foramen POSTERIOR boundary
- Sacrotuberous ligament (posteromedial)
35
Lesser sciatic foramen
- Passageway to gluteal region/perineum
36
Lesser sciatic foramen boundaries
- Lesser sciatic notch (ischium) is anterior - Ischial tuberosity is anterior, inferior - Ischial spine is anterior, superior - Sacrospinous ligament is superior - Sacrotuberous ligament is posterior
37
Obturator foramen
- Mostly covered by obturator membrane | - Passageway to medial thigh
38
Obturator canal (in obturator foramen)
- Superior opening between obturator membrane and superior pubic ramus
39
Sacroiliac joint (SI)
- Sturdy, designed for weightbearing - Interlocking bony auricular surfaces of ilium and sacrum - 2 parts
40
2 parts of sacroiliac joint
- Anterior synovial joint (limited motion) | - Posterior syndesmosis, fibrous join
41
Ligaments of the sacroiliac joint
- Anterior sacroiliac - Interosseous sacroiliac - Posterior sacroiliac - Iliolumbar - Sacrotuberous & sacrospinous ligaments
42
Interosseous sacroiliac ligament
- Connect tuberosities of sacrum/ilium | - Weight transfer
43
Sacrotuberous & sacrospinous ligaments
- Resist anterior/inferior motion of sacrum | - Superior rotation of pelvis (weight-bearing)
44
Pubic symphysis
- Fibrocartilaginous joint (Symphysis joint) | - Superior and inferior pubic ligaments
45
Lumbosacral joint
- L5/S1 - Synovial joint between articular facets - Symphysis joint between L5 body and sacral base
46
Male vs. Female pelvis
- Differences due to body size/muscle mass | - Adaptation for childbearing and birth
47
Male pelvis
- Larger/heavier - Narrow and deep lesser pelvis - Comparatively smaller pelvic inlet/outlet - Narrower subpubic angle and greater sciatic notch - Round obturator foramen - Longer sacrum - Mostly android shaped pelvis
48
Female pelvis
- Lighter - Shallower/wider greater and lesser pelvis - Inlet/outlet are comparatively wider - Inlet more oval - Obturator foramen is smaller and triangular shaped - Acetabulum faces more anteriorly - Wider subpubic angle and greater sciatic notch - Mostly gynecoid shaped pelvic inlet
49
Subpubic angle
- Reflects distance between ischial tuberosities | - Narrower in males (< 90 degrees) than females (> 90 degrees)
50
Peritoneum in the pelvis
- Reflects onto viscera and pelvic fascia - Does not reach pelvic floor - Most pelvic viscera are below the peritoneum
51
Uterine tubes
- Intraperitoneal
52
Ovaries
- Suspended by peritoneum
53
Female peritoneum
- Recto-uterine pouch (pouch of Douglas) | - Most inferior extent of peritoneal cavity
54
Male peritoneum
- Rectovesical pouch is most inferior extent
55
Supravesical fossa
- Between bladder and anterior abdominal wall
56
Pararectal and paravesical fossae
- Separated by broad ligament (females) and uteric fold (males)
57
Broad ligament (females)
- Lateral extension of peritoneum from uterus
58
Pelvic fascia (2 components)
- Between peritoneum and pelvic wall/floor - Fills potential spaces (retropubic and rectrorectal) - Allows for passage of vessels/nerves - Supports pelvic viscera
59
2 components of pelvic fascia
- Parietal pelvic fascia | Visceral
60
Parietal pelvic fascia
- Covers muscles forming the pelvic floor and wall
61
Visceral pelvic fascia
- Ensheaths pelvic organs | - Allows for movement and volume changes
62
Pelvic viscera support
- Organ prolapse and incontinence can result if damaged/lax
63
Antero-inferior wall of pelvic cavity
- Pubic bone | - Pubic symphysis
64
Anterolateral wall of pelvic cavity
- Obturator internus muscle/fascia
65
Posterolateral wall of pelvis
- Sacrum and coccyx - Sacroilial, sacrotuberous, and sacrospinous ligaments - Piriformis muscle and fascia
66
Floor of pelvic cavity
- Pelvic diaphragm (coccygeus and levator ani muscles) | - Pelvic fascia
67
Obturator internus attaches to
- Ischiopubic rami/obturator membrane
68
Obturator internus exits pelvis through
- Lesser sciatic foramen
69
Piriformis attaches to
- Anterior sacrum (S2-4) | - Sacrotuberous ligament
70
Piriformis exits pelvis through
- Greater sciatic foramen
71
Pelvic diaphragm
- Spans pelvic outlet - Gaps allow for the passage of organs - Tonic and dynamic contraction - Supports viscera
72
Gap allowing for the passage of organs in the pelvic diaphragm
- Urogenital hiatus
73
If viscera of pelvic diaphragm is weak it may result in
- Urinary and fecal incontinence - Organ prolapse - Rectocele, cystocele, enterocele, uterus prolapse
74
Pelvic diaphragm can be damaged
- During childbirth (muscle tearing, nerve trauma)
75
Muscles of the Pelvic diaphragm
- Coccygeus | - Levator ani
76
Coccygeus attachments
- ischial spine | - inferior sacrum/coccyx
77
Coccygeus innervation
- S4,5
78
Levator ani consists of
- Puborectalis - Pubococcygeus - Iliococcygeus
79
Puborectalis
- Major role in fecal continence
80
Levator ani attachments
- Pubic bone, tendinous arch of obturator fascia, ischial spine - Perineal body, coccyx, anococcygeal ligament, raphe - Walls of pelvic viscera
81
Levator ani innervation
- Nerve to levator ani (S4) | - Pudendal nerve
82
Perineum
- Area between thighs - Anterior to gluteal fold - Posterior to mons pubis and penis base
83
Perineum boundaries
- Superior: pelvic floor - Inferior: skin - Anterior: pubic symphysis - Anterolateral: ischiopubic ramus - Lateral: ischial tuberosities - Posterolateral: sacrotuberous ligament - Posterior: coccyx
84
Perineum SUPERIOR boundary
- Pelvic floor
85
Perineum INFERIOR boundary
- Skin
86
Perineum ANTERIOR boundary
- Pubic symphysis
87
Perineum ANTEROLATERAL boundary
- Ischiopubic ramus
88
Perineum LATERAL boundary
- Ischial tuberosities
89
Perineum POSTEROLATERAL boundary
- Sacrotuberous ligament
90
Perineum POSTERIOR boundary
- Coccyx
91
Line passing through ischial tuberosities divides into
- Urogenital triangle | - Anal triangle
92
Urogenital triangle content
- External genitalia - Urethra - Erectile tissue of penis and clitoris - Muscles - Nerves, vessels, glands
93
Anal triangle content
- Anus | - Anal canal and associated structures
94
Muscles of the perineum
- EAS - Bulbospongiosus - Ischiocavernosus - Superficial and deep transverse perineal muscles
95
Muscles of the perineum function
- Support pelvic floor | - Help with maintaining erectile tissue turgor
96
Perineal body
- Fibromuscular structure between anus and vagina vestibule/bulb of penis
97
Perineal body is important in
- Pelvic floor support, especially during increased abdominal pressure
98
Perineal body resists
- Tearing between vagina and external anal sphincter during childbirth
99
Damage to the perineal body can cause
- Vaginal prolapse | - Pelvic viscera prolapse
100
Muscles that attach to perineal body
- levator ani - Bulbospongiosus muscle - Transverse perineal muscles - External anal sphincter
101
Pudendal nerve (S2-4)
- Branch of the sacral plexus - Sensation from external genitalia, urethra, anus, perineum - Passes through greater and lesser sciatic foramen
102
Branches of the pudendal nerve (S2-4)
- Inferior rectal - Perineal nerve - Deep perineal nerve - Superficial perineal nerve - Dorsal nerve of clitoris/penis
103
Deep perineal nerve (branch of pudendal nerve) supplies
- Muscles of the perineum
104
Branches of superficial perineal nerve
- Posterior scrotal/labial nerves
105
Dorsal nerve of clitoris/penis supplies
- Skin and glans of penis/clitoris
106
Pudendal nerve block
- Blocks the perineum for vaginal childbirth and minor surgeries of the perineum - Is local for the perineum, does not block higher structures
107
Pudendal nerve block targets
- Nerve trunk as it enters lesser sciatic foramen
108
Pelvic visceral pain sensation follows
- Sympathetics if above the pelvic pain line | - Parasympathetics (S2-4) if below the pelvic pain line
109
Above the pelvic pain line means
- In contact with peritoneum | - Superior bladder and uterus are above the pelvic pain line
110
Pain afferents of intraperitoneal structures follows sympathetics
- Distal half of sigmoid colon and rectum are the exception (follows parasympathetics)
111
Anesthesia for parturition
- Spinal anesthesia via lumbar puncture into subarachnoid space
112
Spinal anesthesia via lumbar puncture into subarachnoid space produces
- Complete anesthesia of uterus, cervix, vagina, perineum, lower extremities, and inferior abdominal wall
113
Lumbar epidural
- Most common type of anesthesia during labor
114
Caudal epidural nerve block via injection through sacral hiatus and canal
- Bathes S2-4 spinal nerve roots | - Anesthetizes the cervix, vagina, and perineum
115
Caudal epidural nerve block does not affect
- Sensation from structures above pelvic pain line (body and fundus of uterus)
116
Pudendal nerve block
- Local anesthesia of perineum only (S2-4 dermatomes)
117
Blood Supply to the perineum
- Internal pudendal artery
118
Internal Pudendal Artery
- Branch of the internal iliac artery | - Passes through greater and lesser sciatic foramen
119
Branches of the internal pudendal artery
- Inferior rectal - Perineal - Deep artery of clitoris/penis - Dorsal artery of clitoris/penis
120
Perineal branch of internal pudendal artery supplies
- Posterior scrotal/labial arteries

Gross Anatomy (50 decks)

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