Anatomy of Pelvis and Perineum

Question 1

What is the function of the bony pelvis?

Answer 1

support of upper body when sitting/standing
transferance of weight from the vertebral column to the femurs to allow standing and walking
attachment for external genitalia and muscles of locomotion and abdominal wall
protection of the pelvic organs, their blood and nerve supplies

Question 2

At what age do the pubis and ischium fuse?

Answer 2

age 2-8

Question 3

When does the ilium fuse with the pubis and ischium?

Answer 3

puberty
11-14 women
14-17 men

Question 4

What makes up the pelvic outlet?

Answer 4

pubic symphysis
ischiopubic ramus
ischial tuberosities
sacrotuberous ligaments
coccyx

Question 5

What makes up the pelvic inlet?

Answer 5

sacral promontory
ilium
superior pubic rams
pubic symphysis

Question 6

What relaxes during pregnancy?

Answer 6

ligaments of the pelvis

Question 7

What are the attachments of the sacrospinous ligament?

Answer 7

sacrum -> ischial spine

Question 8

What are the attachements of the sacrotuberous ligament?

Answer 8

sacrum -> ischial tuberosity

Question 9

What is the role of the sacrospinous and sacrotuberous ligaments?

Answer 9

stabalisation and ensure the inferior part of the sacrum is not pushed superiorly

Question 10

What does the presence of the sacrospinous and sacrotuberous ligaments form?

Answer 10

greater and lesser sciatic foramen

Question 11

What covers the obturator foramen?

Answer 11

obturator membrane

Question 12

What passes through the obturator foramen?

Answer 12

obturator canal - for obturator nerves and vessels

Question 13

What is different about a female pelvis compared to a male pelvis?

Answer 13

larger diameter of female pelvis and pelvic outlet and inlet
larger subpubic angle
shallower pelvic cavity

Question 14

What diameter is wider in the pelvic inlet - transverse or AP?

Answer 14

transverse>AP

Question 15

What diameter is wider in the pelvic outlet - transverse or AP?

Answer 15

AP>transverse

Question 16

What allows the babies head to mould in childbirth?

Answer 16

presence of fontanelles and sutures

Question 17

What are the two fontanelles called?

Answer 17

anterior and posterior

Question 18

Which fontanelle is bigger?

Answer 18

anterior

Question 19

What is the vertex?

Answer 19

area of the skull outlined by the anterior and posterior fontanelle and the parietal eminences

Question 20

What is longer - the biparietal diameter or the occipitofrontal?

Answer 20

occipitalfrontal

Question 21

What is a fetus’ station?

Answer 21

position in relation to the ischial spines

Question 22

What does a negative station indicate?

Answer 22

head is superior to the ischial spines

Question 23

How should the fetal head be at the pelvic inlet?

Answer 23

transverse

Question 24

How should the fetal head be at the pelvic cavity?

Answer 24

flexed

Question 25

What makes up the pelvic cavity?

Answer 25

ovaries uterine tubes uterus superior part of the vagina

Question 26

What makes up the perineum?

Answer 26

``` inferior part of the vagina perineal muscles bartholins glands clitoris labia ```

Question 27

What separates the pelvic cavity and perineum?

Answer 27

levator ani

Question 28

What are the only intraperitoneal structures?

Answer 28

uterine tubes

Question 29

What forms the recto-uterine and vesico-uterine pouches?

Answer 29

the perineum

Question 30

How can the recto-uterine pouch be accessed?

Answer 30

needle through the posterior fornix

Question 31

What is the role of the broad ligament?

Answer 31

contains the uterine tubes and proximal part of the round ligament maintains the uterus in its midline position

Question 32

What is the round ligament?

Answer 32

embryological remnant of the gubernaculum

Question 33

What is the role of the round ligament?

Answer 33

guides the testis and ovaries from their origin in the posterior wall

Question 34

Whatre the 3 levels of uterine support?

Answer 34

strong ligaments endopelvic fascia muscles of the pelvic floor

Question 35

What is the normal position of the uterus?

Answer 35

anteverted and anteflexed

Question 36

What is a normal variation of the uterus?

Answer 36

retroverted and retroflexed

Question 37

What is a salpingoophrectomy?

Answer 37

removal of uterine tubes and ovaries | can be bilateral = both or unilateral = one

Question 38

What end of the uterine tubes enter into the peritoneal cavity?

Answer 38

fimbriated end - so infection can transfer between these two areas

Question 39

What shows whether the uterine tubes are patent or not?

Answer 39

hysterosalphingogram

Question 40

What are the the fornix of the vagina?

Answer 40

form when the cervix is held open posterior anterior 2 lateral

Question 41

What are the two perineal triangles?

Answer 41

ano-genital and anal

Question 42

What is the nerve supply to the levator ani?

Answer 42

nerve to the levator ani - S2,3,4

Question 43

What is the role of the levator ani?

Answer 43

tonic contraction | reflexively contracts more during raised intra abdominal pressure

Question 44

What nerve supplies the perineal muscles?

Answer 44

pudendual nerve

Question 45

What is the perineal body?

Answer 45

bundle of collagenous and elastic tissue into which the perineal muscles attach important for pelvic floor strength - can be distrupted during labour

Question 46

What are bartholians glands?

Answer 46

secrete mucus for lubrication can become infected sit on the labia