Lower abdomen

Question 1

What distinguishes the abdominal cavity from the pelvic cavity?

Answer 1

The pelvic inlet (pelvic brim)

Question 2

What forms the pelvic brim?

Answer 2

Sacral promontory and ala
Iliopectineal line
Symphysis pubis

Question 3

What resists forward rotation of upper sacrum?

Answer 3

The Interosseous sacroiliac ligament

Question 4

Where is the interosseous sacroiliac ligament?

Answer 4

Suspends sacrum b/w two iliac bones

Question 5

Which sacroiliac ligament is larger/stronger, anterior or posterior?

Answer 5

Posterior

Question 6

What resists backward rotation of the lower sacrum?

Answer 6

Sacrotuberous ligament and sacrospinous ligament

Question 7

Where is the sacrotuberous ligament?

Answer 7

From ischial tuberosity to lower sacrum and coccyx

Question 8

Where is the sacrospinous ligament?

Answer 8

From ischial spine to lower sacrum and coccyx

Question 9

What is the true conjugate diameter of the pelvis?

Answer 9

The shortest diameter through which the head must pass

From sacral promontory to a point just below the superior margin of the pubic symphysis

Question 10

What is the diagonal conjugate diameter?

Answer 10

Distance from sacral promontory to lower border of pubic symphysis

Question 11

What is the obstetric conjugate diameter?

Answer 11

From sacral promontory to thickest part of the pubic bone

Question 12

What muscles make up the pelvic walls?

Answer 12

Obturator internus

Piriformis

Question 13

What makes up the pelvic floor…thus separating pelvis from the perineum?

Answer 13

The pelvic diaphragm…hammock suspended from iliacus fascia

Question 14

What makes up the anterior portion of the pelvic diaphragm?

Answer 14

Levator ani

Question 15

What makes up the posterior potion of the pelvic diaphragm?

Answer 15

Coccygeus

Question 16

What reproductive organs are contained in the female pelvis?

Answer 16

Ovaries
Uterine tubes
Uterus
Vagina

Question 17

What does the endopelvic fascia do?

Answer 17

Covers/supports pelvic viscera

Transmits neurovasculature to the organs

Question 18

What does the endopelvic fascia form from?

Answer 18

The endopelvic fascia is continuous with the fascia transversalis in the abdomen

Question 19

What is the endopelvic fascia divided into?

Answer 19

Parietal pelvic fascia

Visceral pelvic fascia…more important in repair of prolapsed structures than muscles

Question 20

What separates the bladder from the uterus?

Answer 20

Vesicouterine pouch

Question 21

What separates the rectum from the uterus?

Answer 21

Rectouterine pouch (of Douglas)

Question 22

What is the broad ligament of the uterus?

Answer 22

Two layered fold of peritoneum that extends across the pelvic cavity from the uterus to the lateral pelvic walls

Question 23

What are the four divisions of the broad ligament?

Answer 23

Mesovarium
Suspensory ligament
Mesosalpinx
Mesometrium

Question 24

What does the mesovarium do?

Answer 24

Connects the ovary to the posterior layer of the broad ligament

Question 25

What does the suspensory ligament do? Where is ti?

Answer 25

Transmits ovarian vessels, lymphatics, and nerves Lies lateral to the attachment of the mesovarium

Question 26

What is the mesosalpinx?

Answer 26

The superior margin of the broad ligament

Question 27

What is the mesometrium?

Answer 27

Below the mesovarium and mesosalpinx

Question 28

What connects the ovary to the uterus?

Answer 28

The round ligament of the ovary (proper ovarian ligament)

Question 29

What represents the lower remnant of the gubernaculum? Where does it pass?

Answer 29

Round ligament of the uterus Passes from the uterus to the deep inguinal ring and through the inguinal canal

Question 30

What is the most common cause of a prolapsed uterus?

Answer 30

Laxity or atonia from repeated obstetrical trauma

Question 31

What is the most common cause of a cystocele (bulging of the bladder through the vaginal wall)?

Answer 31

Weakened/torn pelvic diaphragm from repeated obstetrical trauma

Question 32

What is the most likely cause of a rectocele (bulging of the rectum through the vaginal wall)?

Answer 32

Incompetent pelvic diaphragm

Question 33

What reproductive organs are contained in the male pelvis?

Answer 33

``` Ductus (vas) deferens Seminal vesicles Ejaculatory ducts Prostate gland Urethra ```

Question 34

What contributes to the sacral plexus?

Answer 34

``` Lumbosacral trunk (0.5 of L4 and L5) Ventral rami of S1-4 ```

Question 35

What type of nerves make up the sacral plexus?

Answer 35

Somatic nerves

Question 36

Where do the nerves of the sacral plexus go?

Answer 36

Through the greater sciatic foramen | Into the pelvis

Question 37

What branches of the sacral plexus go to the pelvis (what is their origin)?

Answer 37

Nerve to piriformis (S1, 2) | Branches to levator ani (S3, 4)

Question 38

With the exception of the gonads, all of the pelvic organs have the same autonomic innervation: where is it from?

Answer 38

Inferior hypogastric (pelvic) plexus

Question 39

Where is the inferior hypogastric plexus?

Answer 39

The extraperitoneal tissues of the pararectal fossae

Question 40

What makes up the sympathetic component of the pelvic plexus?

Answer 40

Lumbar splanchnics | Sacral splanchnics

Question 41

What is the effect of the sympathetics of the pelvic plexus?

Answer 41

Inhibit contraction of the wall of the rectum and bladder

Question 42

What makes up the parasympathetic component of the pelvic plexus?

Answer 42

Pelvic splanchnic nerves (from S2-4)

Question 43

What is the effect of the parasympathetics of the pelvic plexus?

Answer 43

Contraction of detrusor muscle of bladder and muscular wall of rectum Relaxation of internal sphincters of rectum and bladder

Question 44

There are visceral afferent fibers in the inferior hypogastric plexus, what messages do they send?

Answer 44

Pain | Distention

Question 45

Which artery do nerves off the hypogastric plexus follow to form subsidiary plexi?

Answer 45

Internal iliac artery

Question 46

What are the parts of the uterine tube from lateral to medial?

Answer 46

Infundibulum Ampulla Isthmus Uterine part

Question 47

Where/what are fimbriae? What do they do?

Answer 47

Finger-like projections coming off the infundibulum Catch the oocyte and insert it into uterine tube

Question 48

Where is the most likely site of fermentation?

Answer 48

Ampulla