Pelvic Contents Flashcards Preview

Genitourinary System > Pelvic Contents > Flashcards

Flashcards in Pelvic Contents Deck (27):
1

Label

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2

Label

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3

Label Sacrum

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5x vertebrae fused
4x paired foramen (nerve passage)

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4

Label posterior sacrum

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5

What makes up the pelvic inlet. What is this the boundary of?

  • Sacral promontory
  • Alae of sacrum
  • Arcuate line
  • Pectineal line
  • Pubic tubercle
  • Pubic Crest
  • Pubic symphysis

Above this= false pelvis
Below this= true pelvis

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6

Describe the 'Pelvic Tilt'

~60 degree tilt anteriorly.

ASIS in line with Pubic tubercle

(sacrum also tilted)

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7

What are the pelvic boundaries?

Ant, Post and Lat = bone

Floor = muscular (pelvic diaphragm)

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8

Male/female variation of the pelvis

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9

What forms the greater and lesser sciatic foramen?

Sacrospinous and sacrotuberous ligaments

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10

Other ligaments of the pelvis?

Posterior sacroiliac ligament: fibrous (for strength)

Anterior sacroiliac ligament: synovial

Pubic symphysis

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11

Muscles of the pelvic wall

Piriformus and Obturator Internus 

OI: fills entire obturator foramen except obturator canal, has 90 degree bend

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12

Draw out the vessel passages through the greater and lesser sciatic foramen.

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13

Journey of Pudendal Nerve and vessel

Leave through Greater sciatic foramen, loop under and around sacrospinous ligament and re-enter below pelvic floor into perineum

14

Label nerves. Why do we need to know where these are?

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Superior Gluteal Nerve: at risk during lateral approach to surgery

Sciatic Nerve: at risk during intramuscular injection

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15

Draw the branching of the anterior division!

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Don't learn the pattern!!

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16

Male/female differences of the anterior division of the internal iliac

Male: inferior vesical + middle rectal supply prostatem seminal vesicles and ductus deferens.
Testicular arteries from abdo aorta @L2

 

Female: uterine artery gives off vaginal artery (supplies femal genitalia)

17

Draw branches of the posterior division

To superior gluteal → GSF above piriformis

18

Venous drainage of the pelvis (EASY)

ALL draining to the Internal Iliac Veins

 

Exception: Deep dorsal vein of the penis/clitoris, drsins through deficiency in perineal membrane → vesical/prostatic plexuses

19

The sacral plexus

S1-4 is joined by L4-5 (lumbrosacral trunk), although it's mostly going to structures external of the pelvis, some are important!

  • Gluteal Nerves
  • Sciatic Nerves
  • Nerves to Levator Ani and Coccygeus
  • Pudendal Nerves

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20

Gluteal Nerves

Superior Gluteal (L4,L5,S1): to gluteus medius and minimus

Inferior Gluteal (L5,S1,S2): to gluteus maximus

Passing above and below piriformis

21

Sciatic Nerves

L4-S3

Tibial always leaves below piriformis

Common peroneal can be above, below or thorugh

22

Nerves to Levator Ani (direct S3-4) and Coccygeus

 

 

  • Direct branches of sacral plexus
  • Lie atop muscle → risk of damage → risk of prolapse

23

Pudendal Nerve

"S2,3,4 keeps the penis off the floor

  • Supplies everything in perineum (M and S)

24

Branches of the Pudendal Nerve

  • Inferior rectal
  • Perineal
  • DOrsal nere to clitoris/penis
  • Scrotal/labial

25

2 Plexuses of the ANS to the pelvic Viscera

  1. Superior Hypogastric : Sits on anterior body of L5 and sacral 
  2. Inferior Hypogastric: on pelvic Floor (compression risk!)

 

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26

Sympathetic supply to pelvic viscera

L1/2 fibres descends into pelvis via Sup. hypogastric and sacral splanchnic. Splits to form two big right and left hypogastric nerves

  • Contract int urethral and anal sphincters (continence)
  • Ejaculation
  • Moves secretions along epididymis

27

Parasympathetic supply via pelvic viscera

S2-4, ascend via HG nerves → sup. hypogastric plexus → abdomen

Direct into Inf. HG

  • Vasodilation (for erection)
  • Bladder contraction