Anatomy 1 - Pelvic # and Childbirth

Question 1

What are the other names for the hip bone?

Answer 1

Innominate bone

Pelvic bone

Question 2

What is the pelvic girdle?

Answer 2

Structure formed by bony pelvis (not including coccyx)

Question 3

What bones make up the pelvis?

Answer 3

2 hip bones
Sacrum
Coccyx

Question 4

What makes up the hip bone?

Answer 4

Ilium
Ischium
Pubis

Question 5

Where do the ilium, ishium and pubis fuse?

Answer 5

At the acetabulum

Question 6

What muscle attaches at iliac fossa?

Answer 6

Iliacus

Question 7

What muscle attaches at gluteal fossa?

Answer 7

Gluteal muscles

Question 8

Where does the iliac crest stretch from?

Answer 8

PSIS to ASIS

Question 9

What structures attach at the ASIS?

Answer 9

Inguinal ligament

Sartorius muscles

Question 10

Where does inguinal ligament span to and from?

Answer 10

From ASIS

To pubic tubercle

Question 11

How is the location for a lumbar puncture found?

Answer 11

Palpate the iliac crest to find L4/L5

Question 12

What is the part of the hip bone that you sit on?

Answer 12

Ischial tuberosity

Question 13

What can cause ischial bursitis?

Answer 13

Sitting on hard surface for long time

Question 14

What connects the ischium and pubis?

Answer 14

Ischiopubic ramus

Question 15

Are the greater and lesser sciatic notches more or less blunted in females than males?

Answer 15

More blunted in females

Question 16

What group of muscles attach to the ischial tuberosity?

Answer 16

Hamstrings

Question 17

Where can the ischial spines be palpated on vaginal examination?

Answer 17

At 4 and 8 o’clock postions

Question 18

What is the sacral promontory?

Answer 18

Bulge of first sacral vertebrae

Question 19

What is a ramus?

Answer 19

A ‘branch’ of bone

Question 20

What are the three joints of the pelvis?

Answer 20

Sacroiliac joint
Hip joint (where femur attaches)
Pubic symphysis

Question 21

What type of joint is the hip joint?

Answer 21

Ball and socket synovial joint

Question 22

What type of joint is the pubic symphysis?

Answer 22

Secondary cartilagenous

Question 23

Is there much movement at the sacroiliac joint? Why/ why not?

Answer 23

Not much movement

Held in place by ligaments

Question 24

Describe the course of the pudendal nerve

Answer 24

Out of pelvis via greater sciatic forament, curls around sacrospinal ligament then in via lesser sciatic foramen

Question 25

What covers the obturator foramen?

Answer 25

Ligamentous band which is specialised part of obturator membrane

Question 26

What are the ligaments of the pelvis?

Answer 26

Sacrospinous | Sacrotuberous

Question 27

Where does sacrospinous ligament span?

Answer 27

Sacrum to iliac spine

Question 28

Where does sacrotuberous ligament span?

Answer 28

Sacrum to ischial tuberosity

Question 29

What is the function of the pelvic ligaments?

Answer 29

Ensure the inferior part of the the sacrum is not pushed superiorly when weight is suddenly transferred vertically through the vertebral column e.g. jumping from height/ late pregnancy

Question 30

What hormones relax the pelvic joints during birth?

Answer 30

Relaxin | Progesterone

Question 31

What causes back pain in pregnancy?

Answer 31

Increased tension on sacrotuberous ligament

Question 32

What foraminae do the pelvic ligaments form?

Answer 32

Sciatic foramen

Question 33

What makes up the pelvic inlet?

Answer 33

Sacral promontory Ilium Superior pubic ramus Pubic symphysis

Question 34

What makes up the pelvic outlet?

Answer 34

``` Pubic symphysis Ischiopubic ramus Ischial tuberosities Sacrotuberous ligaments Coccyx ```

Question 35

What makes up the roof of the pelvic cavity?

Answer 35

Peritoneum of pelvic inlet

Question 36

What makes up the floor of the pelvic cavity?

Answer 36

Pelvic floor i.e. levator ani

Question 37

What makes up the false pelvis?

Answer 37

Intestines (ilius and sigmoid colon)

Question 38

What makes up the true pelvis?

Answer 38

Pelvic organs i.e. rectum, bladder, uterus

Question 39

6 functions of bony pelvis?

Answer 39

1. Support upper body when sitting and standing 2. Transfer weight from one long pole (vertebral column) to two poles (legs) 3. Attachment for muscles of locomotion and abdo wall 4. Attachment for external genitalia 5. Protection of pelvic organs, their blood and nerve supply, venous and lymphatic drainage 6. Passage for childbirth

Question 40

What is the significance of the structure of the pelvic for trauma and fractures?

Answer 40

It is a bony ring so fractures tend to be multiple (like a polo mint) or combined with a joint dislocation

Question 41

What is a straddle injury?

Answer 41

Fracture all 4 pubic rami

Question 42

Why is trauma to bony pelvis life threatening?

Answer 42

Because it is highly vascular | Bony fragments can also rupture bladder

Question 43

At what vertebral level does abdominal aorta become common iliac artery?

Answer 43

L4

Question 44

At what vertebral level does common iliac become internal and excternal iliac arteries?

Answer 44

L5 - S1

Question 45

What are the branches of the external iliac artery? (3)

Answer 45

Femoral artery Inferior epigastric Deep circumflex iliac

Question 46

Branches of anterior trunk of internal iliac artery? (6)

Answer 46

``` Obturator artery Umbilical artery Uterine artery Middle rectal artery Internal pudendal artery Inferior gluteal artery ```

Question 47

Branches of posterior trunk of internal iliac artery?

Answer 47

Iliolumbar artery Lateral sacral arteries Superior gluteal arteries

Question 48

What structures does the internal iliac artery supply?

Answer 48

Pelvis | Gluteal muscles

Question 49

What are the minor arteries of pelvis?

Answer 49

Gonadal arteries (testicular and ovarian) Median sacral arteries Superior rectal arteries

Question 50

Where do gonadal arteries arise from?

Answer 50

Abdominal aorta

Question 51

How does testicular artery reach scrotum?

Answer 51

Via inguinal canal therefore doesn't enter the pelvis

Question 52

What is the venous drainage of the pelvis?

Answer 52

Femoral vein External iliac (joins with internal iliac) Common iliac IVC

Question 53

Compare and contrast the female and male pelvic shape and structure

Answer 53

Female Larger AP and transverse diameters at pelvic inlet and outlet Wider pubic arch and subpubic angle Shallower pubic angle

Question 54

What are the fontenelles of foetal skull?

Answer 54

Anterior and posterior

Question 55

What are the sutures of the foetal skull?

Answer 55

Coronal Lamboid Sagittal

Question 56

What is moulding?

Answer 56

Movement of one bone over another during labour - only possible due to fontanelles (foetal skull is not ossified)

Question 57

What foetal skull diameter is the longest?

Answer 57

Occipitofrontal diameter is longer than biparietal diameter

Question 58

What fontanelle is the largest and when does it ossify?

Answer 58

Anterior fontanelle | Ossifes around 9 - 18 months

Question 59

When does posterior fontanelle ossify?

Answer 59

3 months

Question 60

What causes a depression in the fontanelles?

Answer 60

Dehydration of baby

Question 61

What causes bulging in the fontanelles?

Answer 61

Elevated cranial pressure

Question 62

What is meant by the station during labour?

Answer 62

Distance of foetal head from ischial spines?

Question 63

What is meant by negative or positive station?

Answer 63

Negative - head above spines | Positive - head below spines

Question 64

Describe ideal positioning of foetal head during labour

Answer 64

Transverse head at pelvic inlet Rotate and flex as descending through pelvic cavity Occipitoanterior and extended at pelvic outlet Final rotation so shoulders can be delivered