pelvic anatomy

Question 1

pelvic inlet boundaries

Answer 1

ant: symphysis pubis
post: promontory and ala of sacrum
lat: iliopectineal lines

Question 2

pelvic outlet boundaries

Answer 2

ant: symphysis pubis
post: coccyx
anterolat: ischiopubic ramus
posterolat: sacrotuberous ligament

Question 3

parts of the hip bone

Answer 3

ilium, pubis, ischium and acetabulum (where the three bones fuse)

Question 4

parts of the pelvic girdle (posterior to anterior)

Answer 4

coccyx, sacrum, ilium, ischium, pubis, pubic symphysis

Question 5

parts of the sacrum

Answer 5

sacral promontory (anterior lip of S1), anterior sacral foramen, sacral canal (entry for cauda equina), sacral hiatus

Question 6

parts of the coccyx

Answer 6

fusion of the spinal column’s last 3-4 vertebrae

Question 7

parts of the iliac fossa

Answer 7

anterior superior iliac spine, anterior inferior iliac spine, iliac crest, sacroiliac joint

Question 8

parts of the pubis

Answer 8

superior rami, pubic crest, pubic tubercle, pubic symphysis, inferior rami

Question 9

parts of the ischium

Answer 9

ischial spine, ischial tuberosity, inferior rami

Question 10

male vs female pelvic bones

Answer 10

bones: heavier and thicker vs lighter and thinner
pelvic cavity: narrow and deep vs wide and shallow
pelvic inlet: heart shaped and small vs oval
sacrum: narrow, long and straight vs wide, short and curved
subpubic angle: acute vs large
coccyx: less flexible, curved vs flexible, straight
ischial spine: medially inverted vs everted

Question 11

pelvic ligaments and their connections

Answer 11

sacrospinous ligament (sacrum to iliac spine)

sacrotuberous ligament (sacrum to pubic tuberosity)

obturator membrane (pubis to ischium)

Question 12

foramens in the pelvis

Answer 12

greater sciatic foramen, lesser sciatic foramen, obturator canal

Question 13

pelvic floor hiatuses

Answer 13

rectal/anal hiatus and urogenital hiatus

Question 14

pelvic floor muscles

Answer 14

levator ani muscles (anterior to posterior): puborectalis, pubococcygeus, iliococcygeus

coccygeus muscle

Question 15

levator ani origin and insertion

Answer 15

origin: ant - pubic body of hip bone, lat - tendinous arch of obturator internus, post - ischial spine

insertion: u-shaped sling inserting at pubis, coccyx, perineal body, anococcygeal ligament

Question 16

coccygeus origin and insertion

Answer 16

origin: ischial spine
insertion: back wall of pelvis

Question 17

prostate functions

Answer 17

produce part of seminal fluid to nourish and transport sperm in semen

Question 18

prostate lobes and zones

Answer 18

lobes: anterior, median, posterior

zones: fibromuscular stroma, transitional zone (BPH), central zone, peripheral zone (prostate cancer)

Question 19

ejaculatory duct anatomy

Answer 19

paired structures formed by the union of vas deferens and seminal vesicle duct, passing through the prostate and opening into the prostatic urethra

Question 20

prostatic urethra parts

Answer 20

prostatic sinuses, urethral crest (where ejaculatory ducts open), prostatic utricle, ducts of glandular elements of prostate, ejaculatory ducts

Question 21

uvula vesicae cause and treatment

Answer 21

uvula vesicae is a projection into the bladder caused by the middle lobe of prostate, may obstruct the passage of urine from the bladder and is surgically removed

Question 22

uterus components

Answer 22

consists of the fundus, body and cervix, internal os between cervix and uterus and external os between cervix and vagina

Question 23

anteversion and anteflexion of uterus angles

Answer 23

anteversion: long axis of cervix to long axis of vagina (90°)

anteflexion: long axis of uterus to long axis of cervix (170°)

Question 24

where is the incision of lower segment caesarean section done?

Answer 24

isthmus uteri: between the internal os and upper 1/5 of the cervix

Question 25

broad ligament location

Answer 25

extends from the sides of the uterus to the lateral walls of the pelvis, enveloping the uterine vessels, lymphatics, ovarian ligament, and vestigial remnants of mesonephric tubules

Question 26

parts of the broad ligament

Answer 26

mesometrium: around the uterus mesosalphinx: around the fallopian tube mesovarium: around the ovary

Question 27

fibromuscular (cardinal) ligament location

Answer 27

extends between the cervix and the side of the pelvic wall, uterine artery travels to the uterus through this ligament anterior to the ureter

Question 28

structures playing a role in uterine support

Answer 28

1. pelvic diaphragm 2. cardinal ligament 3. perineal body 4. anteversion and anteflexion of uterus 5. round ligament of uterus 6. urogenital diaphragm 7. uterosacral ligament 8. pubocervical ligament 9. broad ligament

Question 29

fallopian tubes anatomy

Answer 29

transport the ova from the ovaries to the uterus, consist of the fimbriae, infundibulum, ampulla, isthmus, interstitium

Question 30

where does fertilisation usually occur?

Answer 30

ampulla of the fallopian tubes

Question 31

types of tubectomy of the fallopian tubes

Answer 31

banded, tied, cauterized tubectomy

Question 32

types of ovarian cysts

Answer 32

dermoid cyst, functional cyst, endometrioma, benign cystadenoma, polycystic ovary syndrome

Question 33

divisions of the internal iliac artery

Answer 33

anteriorly: obturator, middle rectal, superior vesical, uterine (in females), inferior vesical (/vaginal in females), inferior gluteal, internal pudendal posteriorly: superior gluteal, iliolumbar, lateral sacral

Question 34

prostatic venous vasculature

Answer 34

prostatic veins form a plexus around the sides and base of the prostatic gland, receiving the deep dorsal veins of the penis and draining into the internal iliac veins

Question 35

uterine arterial vasculature

Answer 35

internal iliac arteries --> ureter at upper part of cervix --> branches to cervix + vagina + runs alongside uterus --> anastamose superiorly with ovarian artery at fallopian tubes uterine arteries anastamose extensively with each other across the midline

Question 36

fallopian tube vasculature

Answer 36

supply by tubal branches of the ovarian artery (directly from aorta) and uterine artery (from internal iliac artery) which anastamose below the tube between the broad ligament

Question 37

uterine venous drainage

Answer 37

uterine veins follow the artery along the lower edge of the broad ligament to drain into the internal iliac vein

Question 38

uterine innervation

Answer 38

inferior hypogastric plexus innervation sympathetic: T12 + L1 to produce uterine contraction and vasoconstriction parasympathetic: S2, S3, S4 pelvic splanchnic nerves to produce uterine inhibition and vasodilation

Question 39

pelvic pain line associations

Answer 39

structures above or in contact with the inferior peritoneum: visceral pain is conveyed via symp splanchnic nerves structures below the inferior peritoneum: visceral pain conveyed via parasymp pelvic splanchnic nerves

Question 40

rectocele definition

Answer 40

rectum pushing into post vaginal wall (due to weakening of pelvic floor muscles and connective tissue bw the back wall of the vagina and rectum)

Question 41

cystocele definition

Answer 41

bladder pushing into anterior vaginal wall (due to weakening of pelvic floor muscles and connective tissue supporting the bladder and front wall of vagina)