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Y3 Obs and Gynae Anatomy > Bony Pelvis, Pelvic Fracture and Childbirth > Flashcards

Bony Pelvis, Pelvic Fracture and Childbirth Flashcards

1
Q

List the components of the bony pelvis

A

2 x innominate (hip) bones
Sacrum
Coccyx

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2
Q

List the components of the pelvic girdle

A

2 x innominate (hip) bones
Sacrum
(Does not include coccyx)

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3
Q

What are the three parts of an innominate bone?

A

Ilium
Ischium
Pubis

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4
Q

Which component of the ilium connects the ASIS to PSIS?

A

Iliac crest

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5
Q

What part of the bony pelvis is the attachment site for the iliacus muscle?

A

Iliac fossa

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6
Q

List the ANTERIOR components of the ilium

A

Iliac crest
Iliac fossa
ASIS

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7
Q

List the POSTERIOR components of the ilium

A

Iliac crest

PSIS

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8
Q

List the main ANTERIOR components of the ischium

A

Ischiopubis ramus

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9
Q

List the POSTERIOR components of the ischium

A

Ischial spine

Ischial tuberosity

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10
Q

Which part of the ischium is the ‘part you sit on’?

A

Ischial tuberosity

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11
Q

List the ANTERIOR components of the pubis

A

Ischiopubis ramus
Pubic arch
Pubic tubercle
Superior pubis ramus

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12
Q

The angle created by the pubic arch is known as the…

A

Sub-pubic angle

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13
Q

Give the attachment sites for the inguinal ligament

A

ASIS

Pubic tubercle

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14
Q

List the main joints of the pelvis and give their types

A 
Sacroiliac joint (synovial)
Hip joint (synovial)
Pubic symphysis (secondary cartilaginous)
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15
Q

List the ANTERIOR palpable surface landmarks of the pelvis from superior to inferior

A

Iliac crest
ASIS
Pubic tubercle
Pubic symphysis

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16
Q

List the POSTERIOR palpable surface landmarks of the pelvis from superior to inferior

A 
Iliac crest
PSIS
Sacrum
Coccyx
Ischial tuberosity
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17
Q

Which part of the bony pelvis is palpable on vaginal examination? Where can it be palpated?

A

Ischial spines

Finger breadth into vagina (4 and 8 o’clock)

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18
Q

Ligaments are found…

A

Across a joint to stabilise it

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19
Q

List the main ligaments of the pelvis and give their attachment sites

A 
Sarcotuberous ligament (sacrum + ischial tuberosity)
Sacrospinous ligament (sacrum + ischial spine)
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20
Q

Recognise the main bony landmarks of the pelvis on X-ray

A

See image

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21
Q

What is the main function of the sacrotuberous and sarcospinous ligaments?

A

Ensure part of the sacrum is not pushed superiorly when weight is suddenly transferred vertically through the vertebral column e.g. when jumping or during late pregnancy

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22
Q

The sacrotuberous and sacrospinous ligaments are involved in the formation of which two structures?

A

Greater sciatic foramen (superior)

Lesser sciatic foramen (inferior)

23
Q

List the components of the pelvic inlet

A

Sacral promontory
Ilium
Superior pubic ramus
Pubic symphysis

24
Q

List the components of the pelvic outlet

A 
Coccyx
Pubic symphysis
Ischial tuberosities 
Sacrotuberous ligaments
Ischiopubic ramus
25
Q

The pelvic cavity is found between the _____ and the _____

A

Pelvic inlet

Pelvic floor

26
Q

Which muscle forms the musculofascial part of the pelvic cavity

A

Levator ani muscle (pelvic floor)

27
Q

List the functions of the bony pelvis

A

Support upper body when sitting/standing
Transfer weight from 1 pole (vertebral column) to 2 poles (femurs) for standing/walking

Attachment form muscles of locomotion and abdominal wall
Attachment for external genitalia

Protect pelvic organs, their blood and nerve supply, venous and lymph drainage
Passage for childbirth

28
Q

Trauma to the bony pelvis usually results in a single fracture. True/ False?

A

False

Usually multiple fractures or combined with joint dislocation, compared to a ‘pretzel’

29
Q

Fracture of all four pubic ramii is known as a…

A

Straddle injury

30
Q

What is the consequence of fracture of the acetabulum?

A

Femoral head driven through the acetabulum into the lesser pelvis

31
Q

Life-threatening haemorrhage due to trauma of the bony pelvis, typically originates from which important blood vessels?

A

Common iliac artery

Common iliac vein

32
Q

Pelvic organs are commonly damaged in bony pelvis trauma. List pelvic structures that are commonly damaged.

A 
Pubic symphysis
Uterus
Sacrum
Bladder
Rectum
Lumbosacral plexus
33
Q

What are the main differences between the male and female pelvis?

A

AP and transverse diameters in females are greater at the pelvic inlet/ outlet
Sub-pubic angle (and pubic arch) is wider in females
Pelvic cavity is shallower in females (more spread iliac crests)

34
Q

List the bones which collectively form the fetal skull

A

Frontal, parietal, occipital and temporal bones

35
Q

State the name of the largest fontanelle present in the fetus

A

Anterior fontanelle

36
Q

What is the anterior fontanelle?

A

The junction where the two frontal and two parietal bones meet

37
Q

What is the posterior fontanelle?

A

This is the junction of the 2 parietal bones and the occipital bone

38
Q

The frontal and parietal bones in the fetal skull are separated by the…

A

Coronal suture

39
Q

The two parietal bones in the fetal skull are separated by the…

A

Sagittal suture

40
Q

The parietal and occipital bones in the fetal skull are seperated by the…

A

Lamboid suture

41
Q

What is the vertex?

A

Area of skull outlined by the anterior and posterior fontanelles and the parietal eminence

42
Q

Which suture is found between the anterior and posterior fontanelles?

A

Sagittal suture

43
Q

Explain the process of ‘moulding’ which occurs during labour to the fetal skull. What structures allow this to happen?

A

Movement of one bone over another to allow fetal head to pass through the pelvis during labour
Sutures and fontanelles (‘soft spots’)

44
Q

The _____ diameter (length) is longer/shorter than the _____ (width) diameter in the fetal skull

A

The occipitofrontal diameter (length) is longer than the biparietal (width) diameter in the fetal skull

45
Q

The fetus should enter the pelvic cavity facing which direction? Anatomically, how is this direction of passage encouraged?

A

Transverse direction (right or left)
Transverse > AP diameter at pelvic inlet
Occipitofrontal > biparietal diameter in fetal skull

46
Q

What is the ‘station’ of the fetus during labour?

A

Distance of fetal head from ischial spines
- = superior to ischial spines
+ = inferior to ischial spines

47
Q

While descending the pelvic cavity, the fetal head should undergo which movements? Anatomically, how is this direction of passage encouraged?

A

Rotation
Flexion (chin on chest position)
At pelvic outlet, AP > transverse diameter

48
Q

At pelvic inlet, ____ is greater than ____ diameter

A

Transverse

AP

49
Q

At pelvic outlet, ____ is greater than ____ diameter

A

AP

Transverse

50
Q

The baby should leave the pelvic cavity in which position?

A 
Occipitoanterior position (OA)
Occipital bone of the fetal skull is anterior in the mother
51
Q

During delivery, the foetal head should be in flexion/ extension.

A

Extension

52
Q

Summarise the change in position of the fetal skull during labour from pelvic inlet to pelvic outlet

A

Pelvic inlet: TRANSVERSE
Pelvic cavity: ROTATION + FLEXION
Pelvic outlet: OCCIPITOANTERIOR POSITION +
EXTENSION

53
Q

The ischial spines is closely associated with which spinal nerve?

A

Pudenal nerve (S2,3,4)

54
Q

Outline the route taken by the pudenal nerve through the pelvis

A

Originates from S2-S4 spinal cord
Leaves the pelvis via greater sciatic foramen
Crosses sacrospinous ligament
Reenters pelvis via lesser sciatic foramen
Accompanies internal pudenal artery and vein through the pudenal canal

Y3 Obs and Gynae Anatomy (7 decks)

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