Anatomy of the pelvis Flashcards

(57 cards)

1
Q

What 4 bones make up the pelvis?

A

Sacrum

Ilium

Ischium

Pubis

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2
Q

Where are the 2 coxal hip bones joined?

A

Pubic symphysis anteriorly

SI joint posteriorly

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3
Q

What 3 bones unite to form the acetabulum?

A

Ilium

Ischium

Pubis

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4
Q

What important structures/landmarks does the ilium contain?

A

Ala of ilium

4 iliac spines: posterior superior and inferior
Anterior superior and inferior

Greater sciatic notch

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5
Q

What important structures/landmarks does the ischium contain?

A

The ischial spines

Ischial tuberosity

Lesser sciatic notch

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6
Q

What are the components of the pubis?

A

Pubic symphysis

Pubic tubercle

Pubic crest

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7
Q

What 2 structures of the anterior pelvis are on the same plane?

A

anterior superior iliac spine is on the same plane as the pubic tubercle

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8
Q

What is the difference between the greater and lesser pelvis?

A

Greater pelvis is above pelvic inlet and lesser pelvis is inside pelvic inlet

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9
Q

What is another name for the greater pelvis?

A

False pelvis and the opposite is true (pun intended)

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10
Q

What are the boundaries of the greater pelvis?

A

Posteriorly the lumbar spine

Posterolaterally the ala of the illium

The abdominal wall anteriorly

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11
Q

What are the boundaries of the pelvic inlet?

A

Sacral promontory + sacral alae posteriorly

Arcuate + pectineal lines laterally

Upper margin of pubic symphysis anteriorly

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12
Q

What are the boundaries of the pelvic outlet?

A

Tip of coccyx posteriorly

Sacrotuberous ligament posterolaterally

Ischial tuberosity laterally

Ischiopubic ramus anterolaterally

Lower margin of pubic symphysis anteriorly

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13
Q

What are the boundaries of the pelvic cavity?

A

Sacrum + Coccyx posteriorly

Ilium + ischium laterally

Body of pubic bone, pubic rami, and pubic symphysis anteriorly

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14
Q

What is in the pelvic cavity?

A

Pelvic viscera

Nerves

Blood vessels

Muscles

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15
Q

What is the most common pelvic shape in males?

A

Android

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16
Q

What is the most common pelvic shape in females?

A

Gynecoid

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17
Q

What is a pelvic shape sometimes seen in males and black females?

A

Anthropoid

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18
Q

What is the transverse diameter of the pelvic inlet?

A

11cm

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19
Q

What is the transverse diameter of the pelvic outlet?

A

13cm

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20
Q

What is the anteroposterior diameter of the pelvic inlet?

A

13 cm

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21
Q

What is the anteroposterior diameter of the pelvic outlet?

A

11cm

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22
Q

What is the oblique diameter of both the inlet and outlet?

A

12cm

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23
Q

What is the interspinous distance?

24
Q

Do the pelvic inlet and outlet lie in a completely horizontal plane in anatomical position?

A

No the inlet is oblique angle of 55 degrees with horizontal plane whereas outlet is at an angle of 45 degrees with horizontal plane

25
How is the female pelvis different to the male pelvis?
Outlet is wider Inlet is open and circular Ischial spines are more distant Wider greater sciatic notch Longer pubis and shorter ischium Sacrum is flatter and shorter Broader hips and tailbone Pubic arch/ subpubic angle is greater than 90 degrees lighter bones
26
Where does the sacrospinous ligament attach?
laterally attached to the ischial spine Medially attached to the sacrum and coccyx
27
Where does the sacrotuberous ligament attach?
Ischial tuberosity inferiorly Posterior superior iliac spine, lower part of posterior surface of sacrum and upper part of coccyx
28
What landmarks constitute the surfaces of the pelvic cavity?
Anterior wall Pelvic floor: levator ani and coccygeus Posterior wall is composed of pelvic surface of the sacrum and coccyx Lateral walls composed of pelvic surface of ilium and obturator internis and its fascia
29
Where does the piriformis muscle originate?
On the sacrotuberous ligament The gluteal surface of the ilium The sacrum at S2 - S4
30
Where does the piriformis insert?
Greater trochanter of the femur
31
What spinal nerves innervate the piriformis?
The anterior rami of S1 - S2
32
What does the piriformis do?
Rotates femur laterally and holds femur head in acetabulum
33
Where does the obturator internis originate?
Obturator membrane and pelvic surface of the ilium and ischium
34
Where does the obturator internis insert?
Greater trochanter of the femur
35
What does the obturator internis do?
Laterally rotates femur and keeps head of femur in acetabulum
36
Where does obturator internus get its nerve supply?
Anterior rami of L5 S1 and S2
37
What are the main muscles of the pelvic floor?
Levator ani coccygeus
38
What are the levator ani muscles?
Pubococcygeus (consists of puborectalis and puboprostaticus/pubovaginalis) Iliococcygeus Coccygeus
39
Where does the iliococcygeus originate and insert?
Origin: tendinous arch of obturator fascia and iscial spine Inserts: anococcygeal raphe and coccyx
40
Where does the coccygeus originate?
Ischial spine
41
Where does the coccygeus insert?
lower sacrum and coccyx
42
Where does nerve supply of coccygeus come from?
S4 and S5 spinal nerves
43
Where does levator ani get its nerve supply?
S4 branches Inferior anal nerve Coccygeal plexus
44
What is the closest muscle to the center around anus ?
Puborectalis
45
What is the role of the pelvic floor?
Supports viscera of pelvis Equalizes intraabdominal pressure during defacation and parturition
46
Which muscle is most often torn during childbirth?
Pubococcygeus
47
What does puborectalis do?
Forms sling around anus that helps with fecal continence
48
What is a possible consequence of injury to pelvic floor muscles?
Prolapse in uterus or rectum Neck of bladder can be moved resulting in urinary incontinence.
49
Where is the uterovesical pouch?
Anterior to the uterus Posterior to the bladder
50
Where is the rectouterine pouch?
Between rectum and uterus
51
What is another name for the rectoterine pouch?
Pouch of douglas
52
What does the rectouterine pouch cover?
Anterior part of middle third of the rectum and upper rectum The uterus anteriorly The posterior fornix of the vagina inferiorly
53
Describe the rectovesical pouch and who has it?
The male peritoneal pouch covers the base of the bladder as well as the superior portion of the bladder it also covers the anterior part of the middle third of the rectum and continues to cover it superiorly until it becomes continuous with the posterior abdominal wall
54
What is the clinical significance of the abdominal pouches?
Any free fluid accumulates in those pouches. For example, pus from abscesses or blood from rupture of blood vessels.
55
What are the paravesical fossae?
Some peritoneum is reflected laterally into lateral pelvic wall from superior bladder wall and is continuous with the pelvic wall.
56
What is the broad ligament?
Membrane is folded over fallopian tubes in such a way that underneath them the membrane meets itself in the form of a double membrane. As a result this tissue connects the ovary to the uterus and is called the broad ligament. It also covers the ovary
57
What is the difference between male and female peritoneal cavity?
In males the lower extent the peritoneal cavity is closed. In females inferiorly the peritoneal communicates with exterior atmosphere via the uterine tube. Any infection in vagina or uterine tube could spread into the peritoneam called peritonitis.