Exam 4 Flashcards
The ______ is the principle muscle of inspiration
diaphragm
The diaphragm is _____ shaped with its posterior attachment placed much more ______ its the anterior attachment
dome;
inferior
The diaphragm forms the ____ of the thoracic cavity and the ______ of the abdominal cavity
floor; roof
During respiration, when the diaphragm contracts, the vertical dimension of the thoracic cavity is _______. When the diaphragm ascends as it relaxes, the vertical diameter of the thoracic cavity ______
increased;
decreased
During abdominal straining, movement of the diaphragm is important in ____ _____
blood circulation, blood from IVC is forced superiorly
What are the peripheral attachments of the diaphragm to?
inferior margin of osteocartilaginous thoracic cage (ribs and costal cartilages) and superior lumbar vertebrae
Name the two parts of the diaphragm.
peripheral muscular part and central tendon
True or False: The fibers of the peripheral muscular part of the diaphragm converge to the central tendon.
True
Name the three parts of the peripheral muscular part of the diaphragm
- sternal part
- costal part
- lumbar part
The lumbar part of the peripheral muscular part of the diaphragm arises by….
two musculotendinous crura
The ____ _____ ligament arches between the two musculotendinous crura
median arcuate
The ____ _____ ligaments are thickening of the fascia of the psoas major muscle
medial arcuate
The _____ ______ ligaments are thickenings of the fascia of the quadratus lumborum muscle
lateral arcuate
The central tendon is an _________ that fuses with the inferior surface of the fibrous pericardium
aponeurosis
The central tendon has ____ leaves
3 (clover)
The diaphragmatic ______ (______) permit structures to pass between the thorax and abdomen
apertures (hiatuses)
Name the diaphragmatic apertures.
- vena caval
- esophageal
- aortic
What passes through each of the following diaphragmatic apertures:
- vena caval
- esophageal
- aortic
- IVC, some branches of right phrenic nerve, but most branches pass directly through diaphragm
- esophagus, anterior and posterior vagal trunks
- aorta, thoracic duct, azygos vein
Name other structures passing through the diaphragm.
phrenic nerves, musculophrenic vessels, inferior intercostal vessels, subcostal nerves and vessels, sympathetic trunks, greater and lesser splanchnic nerves, hemiazygous vein
What is the blood supply to the superior surface of the diaphragm?
superior phrenic artery
branches of the internal thoracic artery (musculophrenic and pericardiacophrenic)
What is the blood supply to the inferior surface of the diaphragm?
inferior phrenic artery
For venous drainage, the superior surface of the diaphragm is drained by….
pericardiacophrenic, musculophrenic; both empty into the internal thoracic veins
For venous drainage, the inferior surface of the diaphragm is drained by….
inferior phrenic vein, empties into IVC
The entire motor supply and most of the sensory supply to the diaphragm is from the ______ nerves.
phrenic (C3, C4, C5)
______ ________ nerves and the _____ nerve are sensory to the periphery of the diaphragm
lower intercostal, subcostal
Name the muscles of the posterior abdominal wall.
psoas major, psoas minor, iliacus, quadratus lumborum
The lumabr plexus is embedded in the….
psoas major muscle
Describe the psoas minor muscle.
small weak
present in 50-60% of people
located anterior to psoas major
assists psoas major in flexion of trunk
What two muscles make up the iliopsoas? What is its primary function?
psoas major and iliacus;
principle flexor of the thigh
Each muscle of the posterior abdominal wall is enclosed in fascia that is continuous with the _____ _____- iliac fascia, psoas fascia, quadratus lumborum fascia, and thoracolumbar fascia
transversalis fascia
The psoas fascia is associated with what ligament?
medial arcuate ligament of the diphragm
The quadratus lumborum fascia is associated with what ligament?
lateral arcuate ligament
The quadratus lumborum lies between the ______ and _____ layers of the thoracolumbar fascia
anterior and middle
Blood supply to the posterior abdominal wall includes….
subcostal artery and abdominal aorta and its branches
Name the unpaired visceral branches of the abdominal aorta.
celiac, superior mesenteric, inferior mesenteric
Name the paired visceral branches of the abdominal aorta.
suprarenal, renal arteries, testicular/ovarian arteries
Name the paired parietal branches of the abdominal aorta.
inferior phrenic, 4 pairs of lumbar arteries
Name the unpaired parietal branches of the abdominal aorta.
median sacral artery
Name veins draining the posterior abdominal wall (the IVC and its tributaries)
common iliac veins, 3rd and 4th lumbar veins, right testicular/ovarian veins, renal veins, azygos vein, right suprarenal vein, inferior phrenic veins, hepatic veins
Describe the path of lymphatic drainage for the posterior abdominal wall.
external and internal iliac lymph nodes –> common iliac lymph nodes –> lumbar lymph nodes –> efferent vessels form the right and left lumbar trunks –> thoracic duct
What forms the thoracic duct?
the intestinal lymphatic trunks (cisterna chyli)
The thoracic ducts drains most of the body except…
the right upper quadrant
The lumbar plexus includes the ventral rami of ____-_____ nerves
L1-L4
In about 50% of people, there is a contribution to thel lumbar plexus from the _______ nerve
subcostal, T12
Why is L5 not included in the lumbar plexus?
the ventral ramus of L5 and part of L4 join to form the lumbosacral trunk which aids in the formation of the sacral plexus
The lumbar plexus runs _____ to the deep fascia
deep
The arteries in the region of the lumbar plexus run in the _____ fascia
subserous
What are the largest and most important branches of the lumbar plexus?
obturator and femoral nerves
The _________ and ________ nerves are formed from ____ and often arise by a common stem
ilioinguinal and iliohypogastric;
L1
The ilioinguinal nerve is more _____ while the iliohypogastric is more ______
inferior
superior
The ilioinguinal and hypogastric nerves enter the abdomen ______ to the medial arcuate ligament and pass _____ to the quadratus lumborum
posterior
anterior (posterior to kidney)
The ______ nerve pierces the transversus abdominus and internal oblique muscles with its branches supplying the abdominal muscles
iliohypogastric
The lateral cutaneous branch of the the iliohypogastric nerve is distributed in the _____ region
gluteal
The ilioinguinal nerve passes through the external and internal oblique muscles (where they form the anterior wall of the inguinal canal) and exits through the….to supply the skin of the suprapubic and inguinal regions
superficial inguinal ring
The genitofemoral nerve is formed by ____-____ and pierces what muscle?
L1-L2;
psoas major
The genitofemoral nerves divides into ____ and ______ branches lateral to the common and external iliac arteries
femoral and genital
The genital branch passes through the _____ _____ ____ and supplies the cremaster muscle in a male and emerges from the ______ ____ _____ and supplies the scrotum.
deep inguinal ring;
superficial inguinal ring
In a female the genital branch ends…
in the skin of the labia major
The femoral branch supplies the skin…
just inferior to the inguinal ligament on the anterior surface of the thigh
The lateral cutaneous nerve of the thigh is formed from ____-____
L2-L3
The lateral femoral cutaneous nerve (lateral cutaneous nerve if the thigh) passes through the psoas major muscle and emerges superior to the ____ _____ and enters the thigh just medial to the ____
iliac crest, ASIS
The lateral femoral cutaneous nerve supplies skin of the…..
anterolateral surface of the thigh
The obturator nerve is formed from….
L2, L3, L4
The obturator nerve pierces the ____ ___ and emerges at its medial edge
psoas major
The obturator nerve leaves the pelvis through the _____ ________ and enter the medial thigh
obturator membrane (obturator foramen)
What does the obturator nerve innervate?
adductor muscles of the thigh
Occasionally an accessory obturator nerve us found arising from L3-L4 and descends along the medial border of the psoas major and enters the thigh. It may innervate the….
pectineus muscle, the hip joint, or may substitute for a portion of the obturator nerve
The femoral nerve is formed by….
L2, L3, L4
The femoral nerve pierces the psoas major muscles and emerges between the ____ _____ and _____ muscles. It supplies these two muscles and innervates the knee extensors.
psoas major and iliacus
True or False: The lumbosacral trunk is included in the lumbar plexus.
False, it is not
The lumbosacral trunk is ____ - ____ and takes part in formation of the sacral plexus
L4-L5
True or False: The lumbar plexus is less vulnerable to injury than the brachial plexus.
True; because it is deeply placed; also limited mobility of the hip joint (in comparison to shoulder joint) reduces the potential for stretching injuries
L1 divides into _____ and _____ divisions
superior and inferior
The superior division of L1 gives rise to the ….. nerves; The inferior division joined with a twig from L2 forms the …. nerve
ilioinguinal and iliohypogastric;
genitofemoral
L2, L3, and L4 each divide into….
a small ventral branch and large dorsal branch
All 3 ventral divisions of L2-L4 join to form the _____ nerve
obturator
There are two smaller branches of the dorsal divisions of L2 and L3 which join to form….
lateral femoral cutaneous nerve
The two larger branches of the dorsal branches of L2 and L3 join the dorsal branch of L4 to form the _____ nerve
femoral
The obturator nerve gives branches to the ____ and _____ joints
hip and knee
Clinical question! Pain from a diseased hip joint will often be referred to the…..
area of the medial surface of the hip; If this is the case both joints should be checked thoroughly for disease
The psoas muscle is enclosed in fascia, therefore a collection of blood may result in….
pressure on the plexus
Since the proximal part of the plexus is fixed, space occupying lesions may compress the plexus against…
the posterior abdominal wall
The pelvis is the region where the ____ and ____ ____ meet
trunk and lower limbs
What forms the pelvic girdle?
the right and left hip bones articulating with the sacrum
The hip (coxal) bones (anteriorly and medially) have three portions that meet at the acetabulum. What are they?
ilium, ischium, and pubis
What is the acetabulum?
cup shaped socket on the lateral aspect for the articulation with the head of the femur (hip joint)
Before puberty, the hip bones are separated by _____. Ossification begins at age ___-___ and is complete by age ____
cartilage;
15-17, 23
The ilium forms the superior _____ of the hip bone and the superior ____ of the acetabulum.
2/3, 2/5
Name some important landmarks on the ilium
ala (wing)-iliac fossa iliac crest (internal and external lips) ASIS, AIIS, PSIS, PIIS Auricular surface (medial) greater sciatic notch gluteal lines arcuate line body tuberosity of ilium
The highest point of the iliac crest is associated with _____ vertebra
L4
There are _____ gluteal lines. Name them
3; posterior, anterior (middle), inferior
The ischium forms the posteroinferior ____ of the hip bone and posterior _____ of the acetabulum
1/3, 2/5
Name some important landmarks of the ischium.
body, ischial tuberosity, ischial spine, ramus
The ischial tuberosity is also known as the….
butt bone, sits bone
What does the ischial spine separate?
the greater sciatic notch from the lesser sciatic notch
The ramus of the ischium joins the inferior ramus of the pubis to form the ______ ______ which completes the obturator foramen
ischiopubic ramus
The pubis forms the_______ part of the hip bone and the anteromedial _____ of the acetabulum
inferoanterior; 1/5
Name some of the important landmarks of the pubis.
body, pubic crest, pubic tubercle, pectin pubis, 2 rami (superior and inferior), pubic arch, subpubic angle
The body of the right pubis joins the body of the left pubis at the _____ ______
pubic symphysis
The pectin pubis is also called the ______ ______
pectineal line
The superior ramus of the pubis fuses with….
ilium and ischium
The ASIS and pubic symphysis are in the same ______ plane
frontal/coronal
What is the pelvic brim?
bony outline formed by the pubic crest, pecten pubis, arcuate line, ala and promontory of the sacrum
The pelvic brim divides the pelvis into the…
greater pelvis (major )and lesser pelvis (minor)
The greater pelvis is located _____ the brim while the lesser pelvis is located _____ the brim
above, below
The greater pelvis is called the _____ _____ and is part of the abdominal cavity
false pelvis
The lesser pelvis is called the _____ _____ and contains the pelvic cavity
true pelvis
The lesser pelvis has both a superior and inferior ____ _____
pelvic aperture
The sacrum is made up of….
5 fused vertebrae
Name some important landmarks of the sacrum and coccyx.
sacral promontory, ala, sacral foramina (anterior and posterior), sacral canal, auricular surface, median sacral crest, intermediate sacral crest, lateral sacral crest
What structure go into the sacral canal?
cauda equina and filum terminale
What is the median sacral crest?
fused spinous processes
What is the intermediate sacral crest?
fused facet (zygopophyseal) joints
What is the lateral sacral crest?
fused transverse processes
The sacroiliac joints are strong synovial joints between the articular surfaces of the ____ and _____
sacrum and ilium
What are the strongest ligaments in the body?
sacroiliac ligaments
The interosseous sacroiliac ligaments unite the….
iliac and sacral tuberosities
The posterior (dorsal) sacroiliac ligaments are composed of…
- strong short transverse fibers and
2. long vertical fibers
The strong short transverse fibers of the posterior sacroiliac ligaments join the ilium and the….of the lateral crest of the sacrum
1st and 2nd tubercles
The long vertical fibers of the posterior sacroiliac ligaments unite the…. of the sacrum to the posterior iliac spines
3rd and 4th transverse tubercles
The anterior sacroiliac ligaments are located on the anterior and inferior aspects of the sacroiliac joint. What is unique about them?
They are replaced by bone after 50 years of age
Although sacroiliac joints are strong, weight-bearing synovial joints, the possess little _______
mobility (slight gliding and rotary movement)
The sacroiliac joints function for stability. Particularly to…
transmit weight of most of the body to the lower extremities
L5 and S1 articulate with one another at an anterior intervertebral joint and two posterior synovial joints. This is the ______ joint
lumbosacral
What is spondylolysis?
defect in which vertebral body is separated from the inferior articular process (pars interarticularis defect)
What is spondylolisthesis
vertebral body slips forward
The sacrococcygeal joint is a ______ _______ joint united by fibrocartilage
secondary cartilaginous
The pubic symphysis is a _____ _____ joint
secondary cartilaginous
Both the sacrococcygeal joint and pubic symphysis are important during childbirth because…
they loosen to help the baby have enough space to pass through along the birth canal
The iliolumbar ligaments extend from the….. to the …. and is very strong
transverse process of L5 (sometimes L4) to the iliac crest
The iliolumbar ligament plays a significant role in….
stabilizing the 5th lumbar vertebrae, prevents shifting anteriorly
The sacrotuberous ligaments passes from the sacrum to the ischial tuberosity forming the _____ ______ ______
lesser sciatic foramen
Name structures that pass through the lesser sciatic foramen.
- tendon and nerve of obturator internus
- pudendal nerve
- internal pudendal vessels
The sacrospinous ligament passes from the lateral margin of the sacrum and coccyx to the ischial spine forming the ______ _____ ______
greater sciatic foramen
Name some structures passing through the greater sciatic foramen.
- piriformis muscle
- sciatic nerve
- superior and inferior gluteal vessels/nerves
- pudendal nerve
- internal pudendal vessels
True or False: There is both parietal and visceral pelvic fascia.
True
The parietal pelvic fascia is continuous superiorly with the _______ and ______ fascia
transversalis and iliopsoas fascia
The anterior wall of the pelvis is made up of…
pubic bones and pubic symphysis
The lateral walls of the pelvis is made up of…
obterator internus
The posterior wall of the pelvis is made up of…
sacrum, ilium, sacroiliac joints and ligaments, piriformis lines lateral aspect
The pelvic floor is formed mainly by the ______ ______
pelvic diaphragm
Name the muscles of the pelvic diaphragm.
- 2 levator ani muscles (on right and left)
a. puborectalis
b. pubococcygeus
c. iliococcygeus - 2 coccygeus (ishiococcygeus) muscles
The ____ _____ muscles are the largest and most important muscles in the pelvic floor
levator ani
The levator ani muscles are innervated by the ventral rami of ____-_____
S2-S4
The puborectalis is attached to the posterior aspect of the pubic bodies, it forms a sling around the anorectal junction and maintains the _____ _____
anorectal angle (about 80 degrees)
The _______ is the main part of the levator ani. It is attached to the posterior aspect of the pubic bodies, the tendinous arch and the coccyx.
pubococcygeus
The pubococcygeus united with the contralateral muscle at the _______ _________
anococcygeal body (tendinous raphe- fibrous septum)
The _______ is a very thin muscle attached to the tendinous arch and the ischial spine, it blends posteriorly with the anococcygeal body
iliococcygeus
The two coccygeus muscles (ischiococcygeus) arise from the ischial spine and attach to the coccyx and sacrum. They are innervated by the ventral rami of…
S4 and S5
What is the function of the two coccygeus muscles?
to support the abdominopelvic viscera
Name the functions of the pelvic diaphragm.
- supports pelvic viscera
- resists the inferior thrust that accompanies increases in intraabdominal pressure
- raise the pelvic floor and assist the anterior abdominal muscles in compressing the abdominal and pelvic contents
- important in coughing, forced expiration, fixation of the trunk when lifting heavy objects
What forms the sacral plexus?
the lumbosacral trunk (L4, L5) and the ventral rami of S1-S4
The sacral plexus is closely related to the anterior surface of what muscle?
piriformis
all branches of the sacral plexus leave the pelvis through the _____ _____ _______ expect the perforating cutaneous nerves and those supplying the pelvic diaphragm
greater sciatic foramen
Which nerve is the largest in the body?
Sciatic nerve
The sciatic nerve is formed from the ventral rami of…
L4-S3
The vental rami forming the sciatic nerve converge on the anterior surface of the ______ muscle
piriformis
The sciatic nerve passes through the greater sciatic foramen ______ to the piriformis to enter the gluteal region
inferior
The pudendal nerve is formed from the ventral rami of…
S2, S3, S4
The pudendal nerve is accompanied by what artery?
internal pudendal artery
The pudendal nerve leaves the pelvis between the _______ and _______ muscles via the greater sciatic foramen
piriformis and coccygeus
The pudendal nerve enters the perineum through the…
lesser sciatic foramen
The superior gluteal nerve is formed by the dorsal divisions of…
L4, L5, S1
The superior gluteal nerve leaves the pelvis via the greater sciatic foramen superior to the piriformis muscle. It supplies the….
gluteus medius, gluteus minimus, tensor fascia lata
The inferior gluteal nerve is formed from….
L5, S1, S2
The inferior gluteal nerves leaves the pelvis via the greater sciatic foramen _______ to the piriformis muscle and supplies the gluteus maximus.
inferior
Other components of the sacral plexus include the following: 1. twigs to piriformis 2. twigs to pelvic diaphragm 3. nerve to the quadratus femoris 4. nerve to the obturator internus Each is made up from what?
- S1-S2
- Not listed
- L5-S1
- L5-S1
The coccygeal plexus is formed from…
ventral rami of S4-S5 and the coccygeal nerves
The _____ ______ artery supplies most of the pelvic viscera as well as the musculoskeletal part of the pelvis and the gluteal region
internal iliac artery
The internal iliac artery divides into _____ and ______ divisions at the superior edge of the greater sciatic foramen
anterior and posterior
Name the branches of the anterior division of the internal iliac artery
- umbilical
- obturator
- inferior vesical (males only)
- vaginal (females only)
- uterine
- middle rectal
- internal pudendal
- inferior gluteal
The umbilical artery is obliterated at a point and forms the ____ _____ _____. It also gives off a _____ ______ artery which supplies the bladder.
medial umbilical fold;
superior vesical
The obturator artery exits the pelvis through the obturator foramen with the…
obturator nerve
Anytime you hear pudendal think…
perineum, likely supplies perineum
The inferior gluteal artery exits the pelvis through the greater sciatic foramen inferior to the piriformis- it supplies skin of the…..and usually passes between S2 an S3
buttocks and posterior surface of the thigh
Name the branches of the posterior division of the internal iliac artery.
- superior gluteal
- iliolumbar
- lateral sacral
The superior gluteal artery exits the pelvis through the greater sciatic foramen superior to the piriformis- it supplies the…..and usually passes between the lumbosacral trunk an S1
gluteal muscles
The iliac branch of the iliolumbar artery supplies the…while the lumbar branch supplies the…
iliacus and ilium;
psoas major and quadratus lumborum
The spinal branches of the lateral sacral artery supply the…
spinal meninges and roots of the sacral nerves
The pelvis is drained mainly by the…
internal iliac veins and their tributaries
The internal and external iliac veins unite to form the….which unite to form the…
right and left common iliac veins
IVC
What are the largest tributaries of the internal iliac veins
superior gluteal veins
The pelvic venous plexuses unite and drain mainly into the ______ ______ vein
internal iliac
The ureters pass over the pelvic brim _____ to the origins of the external iliac arteries
anterior
The ureters carry urine from the _____ _____ to the ______ by way of peristalsis
renal pelvis to bladder
True or False: The blood supply of the ureters includes the common and internal iliac arteries, the ovarian/testicular arteries, uterine arteries (female), and inferior vesical arteries (male).
True
Why is the blood supply for the ureters so vast?
Because they travel a long distance
The nerve supply of the ureters is derived from….
adjacent autonomic plexuses
The _____ ______ is a potential space between the pubic bone and bladder
retropubic space
The neck of the bladder is held in place by the _____ ______ (male) and _____ _____ (female) as well as lateral ligaments of the bladder
male: puboprostatic ligament
female: pubovesical ligament
The urinary bladder has strong muscular walls with and internal sphincter and _____ muscles
detrusor
The _____ is a smooth area outlined by where the two ureters come into the bladder and where the urethra begins
trigone
The urinary bladder is enveloped in loose connective tissue called ____ ______
vesical fascia
True or False: The main arterial blood supply of the urinary bladder is branches of the internal iliac arteries (superior vesical and inferior vesical (male) and vaginal arteries (female)
True
The urinary bladder is innervated by a vesical nerve plexus specifically the _____ _______ nerves which are ______
pelvic splanchnic
parasympathetic
The pelvic splanchnic nerves are motor to the ______ and inhibitory to the ______
detrusor;
sphincter
The nerve fibers of the pelvic splanchnic nerves are stimulated by ______- bladder contracts, bladder relaxes to allow for urine flow
stretching
The sympathetic innervation of the urinary bladder is ____-_____
T11-L2
_____ is a hernia of the bladder (can sink into vagina in female)
cystocele
The ______ ______ is a long muscular tube the conveys urine from the internal urethral orifice to the external urethral orifice at the tip of the penis. It also conveys semen
male urethra
Name the four parts of the male urethra.
- intramural (pre-prostatic)
- prostatic (through prostate)
- intermediate (membranous)
- spongy (longest)
Blood supply to the male urethra is…
inferior vesical and middle rectal arteries
The female urethra is a short muscular tube with blood supply from the internal pudendal and vaginal arteries. Females are more likely to develop….because of its characteristics
UTIs
Male internal genital organs include…
- ductus deferens
- seminal glands (vesicles)
- prostate gland
The ductus deferens is a continuation of the ______
epididdymus
The ductus deferens ends by joining the….to form the….
seminal gland
ejaculatory duct
The blood supply for the ductus deferens is…
artery to the ductus deferens–>arises from superior vesical artery
The seminal vesicles are supplied by the inferior vesical and middle rectal arteries. What do that do?
secrete thick, alkaline fluid that mixes with sperm
The prostate gland is ______ size. It secretes a milky white fluid that provide ____% of volume of semen
walnut, 20%
True or False: Arterial supply for the prostate gland in mainly from the superior vesical arteries.
False, it is mainly from inferior vesical arteries
BPH- benign prostatic hyperplasia can cause problems with ______
urination
The ______ ______ function to cause secretions during sexual arousal
bulbourethral glands
Give specific information regarding the innervation (sympathetic and parasympathetic, etc) of the male genital organs
sympathetic: lumbar splanchnic nerves (T12-L2)
parasympathetic: pelvic splanchnic nerves (S2, S3)
inferior hypogastric/pelvic plexus
Name the female internal genital organs
vagina and uterus
The vagina lies posterior to the _____ and anterior to the _____
urethra, rectum
Name the muscles that compress the vagina and act as spinchters
- pubovaginalis muscles
- external urethral sphincter (especially urethrovaginal sphincter part)
- bulbospongiosus muscle
The position of the uterus is typically….
anteverted and anteflexed
Name the parts of the uterus.
- Fundus- upper part
- body
- isthmus- lower part into cervix
- cervix-leads into vagina
Name the three layers of the walls of the urethra from outside to inside
perimetrium, myometrium, endometrium
The broad ligament of the uterus contains…
suspensory ligament of the ovary uterine tube round ligaments of the uterus mesovarium mesosalpinx
The suspensory ligament of the ovary carries…
blood vessels
The round ligament of the uterus is associated with the _____ inguinal ring
superficial
The ______ ______ ligaments also called ______ ligaments are the principal ligamentous supports of the uterus
transverse cervical or Cardinal
True or False: There are uterosacral ligaments in a female.
True
What is the principle support of the uterus is the ….
pelvic floor
Name the two puches associated with the uterus.
vesicouterine pouch rectouterine pouch (Pouch of Douglas) --deepest point in pelvis
The uterine tubes are also called fallopian tubes. They lie within the ______ part of the broad ligament
mesosalpinx
Name the 4 parts of the uterine tubes.
- infundibulum (fimbriae)
- ampulla
- isthmus
- uterine part
Fertilization usually occurs in the
ampulla
What is the function of the fimbriae?
When an egg is released, the fimbriae move and pull the egg into the fallopian tube
Describe the innervation of the uterus and vagina.
sympathetic-T12-L2-lumbar splanchnic nerves-infeior hypogastric
parasympathetic- S2-S4-pelvic splanchnic nerves
The ovaries are contained in the ______ part of the broad ligament
mesovarium
The ligament of the ovary attaches the ovary to the ______ and the suspensory ligament of the ovary conveys…
uterus;
conveys ovarian vessels/nerves
The _____ is the fixed terminal part of the large intestine.
rectum
The _____ pouch is present in males only while the ______ pouch is present in females only.
rectovesical pouch- males
rectouterine pouch of Douglas- females
The rectum has 3 sharp flexures including the terminal anorectal flexure that should be _____ degrees
80
The blood supply for the rectum is the…
superior rectal artery (branch of inferior mesenteric)
2 middle rectal arteries (branches of internal iliac arteries)
2 inferior rectal arteries (branches of internal iliac arteries)
The ______ is defined as the region of the trunk inferior to the pelvic diaphragm, which overlies the pelvic outlet
perineum
The male perineum includes the…
anal canal, membranous and spongy parts of the urethra, root of scrotum and penis
Superficial muscles of the perineum for a male include
- bulbospongiosus- role in erection
- ischiocavernosus- compresses blood
- superficial transverse perineal- small
The female perineum (vulva) includes the…
mons pubis, labia majora and minora, vestibule of the vagina, clitoris, bulb of the vestibule and greater vestibule glands
Superficial muscles of the perineum for a female include
- bulbospongiosus- erection of clitoris
- ischiocavernosus
- superficial transverse perineal
The muscles of the perineum are all supplied by the ____ nerve
pudendal
The perineum is divided into two unequal triangles by an imaginary line joining the ischial tuberosities. Name them.
anal triangle and urogenital triangle
The _____ ______ is a thin sheet of striated muscle stretching between the two sides of the pubic arch covering the anterior part of the pelvic outlet.
perineal membrane
The sphincter urethrae muscle in a male functions to….In a female it functions to…..
male- constricts the membranous urethra
female- compresses the urethra and vagina
The sphincter urethrae muscle in innervated by a branch of the ______ nerve
pudendal
The deep transverse perineal muscle are innervated by a branch of the pudendal nerve and function to steady the perineal body- this supports the…..
pelvic floor and viscera
The anal triangle contains….
anal canal, external anal sphincter, and ishioanal fossa
What does the ischioanal fossa contain?
internal pudendal artery, vein and pudendal nerve
The ____ _____ is the midpoint of a line joining the ischial tuberosities
perineal body
The perineal body is the site of…
convergence of several muscles including the bulbospongiosis, external anal sphincter, superficial and deep transverse perineal muscles and slips of muscle from the external urethral sphincter, levator ani and muscular coat of the rectum. It is also the last support of the pelvic floor
The gluteal region is bounded superiorly by the ___ _____ and inferiorly by the inferior border of the _____ ______ muscle
iliac crest; gluteus maximus
The PSIS corresponds to vertebra ____
S2
Name the following bursa:
- between greater trochanter and gluteus maximus
- between ischial tuberosity and gluteus maximus
- between ITB and vastus lateralis
- trochanteric
- ischial
- gluteofemoral
What muscle is the chief extensor of the hip?
gluteus max
Clinical! What is the most common bursitis?
trochanteric
The gluteus medius is a powerful ______ of the hip
abductor
What does a positive trendelenberg sign signify?
Weak hip abductors (gluteus medius) on the opposite side of the pelvis drop
The gluteus minimus is the ______ of the three glute muscles
deepest
The superior border of the piriformis is marked by a line from the _____ to the ____ ______ and exits the pelvis through the greater sciatic foramen
PSIS to the greater trochanter
The piriformis is known as a…. because many vessels are named depending on their location relative to this muscle
landmark of the gluteal region
The obturator internus exits the pelvis through the…
lesser sciatic foramen
The superior and inferior gemellus muscles can be described as ______
fleshy
