Pelvic/Perineal Osteology

Question 1

Answer 1

Question 2

Answer 2

Question 3

what makes up the pelvic brim

Answer 3

arcuate line, pectin pubis, sacral promontory

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Pelvic shapes common in male vs female

• uncommon in both?
• safety of child birth

Answer 8

Anrdoid is classically male, gynecoid female, anthropid in some black females.

platypelloid uncommon in both.

platypelloid or markedly android funnel shaped presents hazard to vaginal delivery

Question 9

Spondylolysis of L5/S1

Spondylolisthesis of L5/S1

Answer 9

spondylolysis is fracture of posterior projection of vertebral body so articular, transverse, spinal processes are separated from the body

-Spondylolisthesis would occur if defect in L5 were bilateral, body of L5 might slide anteriorly and overlap the promontory. reduces the AP diameter (bad for child birth), and can compress spinal nerves.

Question 10

• True obstetrical conjugate
• diagnoal conjugatge, why its used, ideal distance
• interspinous distance

Answer 10

true conjugate is middle of sacral promontory to posterosuperior margin of the pubic symphysis

diagonal conjugate used because bladder in way for true

interspinous distance is narrowest part of pelvic canal through which a babys head will pass.

Question 11

Anteroposterior compression of pelvis produces what type of fracture

Answer 11

fractures of pubic rami

Question 12

Fracture of pubo-obturator area poses complications of what?

Answer 12

relationship to urinary bladder/urethra which may rupture or be torn

Question 13

What happens to the pelvic ligaments during pregnancy?

-which biomolecules

Answer 13

increased levels of sex hormones and hormone relaxin causes pelvic ligaments to relax during latter half of pregnancy. relaxation occurs at si joint and pubic symphysis.

Question 14

Answer 14

Question 15

what type of joint is L5/S1

Answer 15

Intervertebral joint: symphysis

Zygopophyseal joint: planar synovial

Question 16

Answer 16

Question 17

Answer 17

Question 18

the lumbosacral L is most like what other ligament?

Answer 18

intertransverse ligament

Question 19

Answer 19

Question 20

Sacroiliac joint types

• anteriorly?
• posteriorly?

Answer 20

Compound joint overall

anteriorly between auricular surface of sacrum and articular surface of the ilium it is planar synovial

posteriorly between the sacral and ishial tuberosisities it is fibrous synesmosis

Question 21

Posterior sacroiliac L

• long origin, insertion
• short origin, insertion

Answer 21

• long posterior sacroiliac L is two bands that come from the PSIS and medial sacral crest of S3/S4 and then inserts and blends w/ sacrotuberous L.
• Short originates from the median Sacral Crest of S1/S2 and inserts onto the posterior surface of the iliac crest and iliac tuberosity

Question 22

joint type of sacrococcygeal

Answer 22

symphysis

Question 23

Answer 23

make sure to note rectovesical pouch

Question 24

Answer 24

Question 25

Answer 25

Question 26

Pelvic fascia organization

Answer 26

Question 27

Parietal pelvic fascia lines muscular walls of what?

Answer 27

of the pelvis: obturator internus M., Piriformis M., Levator Ani Ms., and the Coccygeus M.

Question 28

Obturator fascia: - lines what? - continuous superiorly with what? - forms walls of? - forms tendinous arch of?

Answer 28

lines the pelvic side of the obturator internus M., continuous superiorly with transversalis fascia, forms the walls of the pudendal canal, forms the tendinous arch of the Levator Ani Ms

Question 29

Tendinous arch of pelvic fascia in males vs females

Answer 29

- puboprostatic L is anterior part in males, pubovesicle L is anterior in females - sacrogenital L is posterior in both, but can be broken down into rectoprostatic in males, and uterosacral\* in females

Question 30

Loose endo fascia - fat filled potential spaces - name them/describe them

Answer 30

Retropubic space: between pubis and urinary bladder, continuous paravesical space Paravesical space: between obturator fascia and anterior part of hypogastric sheath Pelvirectal space: surrounds rectum, separated into a/p parts by Lateral rectal L Retrorectal Space: presacral space between sacrum and rectum, continous anterolaterally w/ pelvirectal space

Question 31

Condensed Endopelvic fascia: -why condensed, what does it do?

Answer 31

increased density of collagen and elastic fibers, responsible for compartmentalizing the loose endopelvic fascia

Question 32

Hypogastric sheath: - type of fascia - purpose - three parts

Answer 32

thick band of condensed fascia, conduit for nerves and vessels from lateral pelvic wall to pelvic viscera Anterior: Lateral L of the bladder- extension of the hypogastric sheath to the urinary bladder Middle: in males the rectovesical septum between the rectum and urinary bladder in females it is the \*transverse cervical ligament\* or the \*cardinal ligament\*, which extends the hypogastric sheath to the cevix of the uterus lateral rectal L is posterior aspect of sheath

Question 33

Quadrangular space of perineum: what are the points? how is it devided further

Answer 33

anterior is pubic symphysis, coccyx posterior, ischial tubs laterally. line can be drawn between the two ischial tuberosisites... get two triangles. urogenital anterior, anal triangle posterior

Question 34

Contents of the anal triangle

Answer 34

ischioanal fossa (around the wall of the anal canal, inferior to pelvic diaphragm, allows for expansion of anal canal during defecation pudendal canal, made of obturator fascia, transmits the internal pudendal A, V, and Pudendal N.

Question 35

Urogenital triangle contents

Answer 35

perineal membrane, superficial perineal fascia, deep perineal fascia, superficial perineal pouch, deep perineal pouch

Question 36

Perineal membrane: what does it cover?

Answer 36

extends between the two sides of the pubic arch, covers the anterior portion of the pelvic aperture

Question 37

Superficial perineal fascia: - continuous with? - fatty part in females vs males - membranous part

Answer 37

superficial perineal fascia is continuous with the supeficial fascia of the abdomen, and has a fatty and membranous component - fatty component is more superficial and in women forms the fatty layers of the labia majora and the mons pubis, in males this component is replaced by penis/scrotum - the membranous part is more deep and forms the dartos fascia of the penis and scrotum

Question 38

Deep perineal fascia female vs male

Answer 38

in females exists primarily as the perineal membrane, in the male it makes up the deep fascia of the penis and the perineal membrane

Question 39

Superficial perineal pouch: - location - contents male vs female

Answer 39

located between membranous superficial perineal fascia and the perineal membrane - in males: bulb and crura of the penis, superficial perineal muscles, proximal spongy urethra, branches of the internal pudendal A./V., and of the pudendal N. - in females: crura of the clitoris, bulbs of the vestibule, superficial perineal muscles, greater vestibular glands, branches of the internal pudendal A/V, and the pudendal N.

Question 40

Deep perineal pouch: - location - contents male vs female

Answer 40

opens superiorly, lies inferoanteriorly to the urinary bladder - males contains membranous urethra, muscles of the urogenital diaphragm, bulbourethral glands - in the female it contains muscles of urogenital diaphragm