pelvic wall and floor

Question 1

Name two secondary cartilagenous joints in the pelvic region?

Answer 1

lumbrosacral and pubic tubercle

Question 2

Pelvic boundaries

Posterior wall…..

Answer 2

sacrum, coccyx, piriformis

Question 3

Pelvic boundaries Floor….

Answer 3

floor= muscular pelvic diaphragm

Question 4

Pelvic boundaries Anterior wall …..

Answer 4

Pubic bodies, pubic rami and pubic symphysis

Question 5

which two ligaments form the greater and lesser sciatic foramen?

Answer 5

Sacrotuberous and sacrospinous

Question 6

what is the inguinal ligament?

Answer 6

The inguinal ligament is a band running from pubic tubercle to anterior superior spine. It forms base of inguinal canal through which an indirect inguinal hernia may develop

Question 7

which sacroiliac ligament is fibrous?

Answer 7

Posterior

Question 8

Which sacroiliac ligament is synovial?

Answer 8

Anterior

Question 9

Name the two male hip shapes

Answer 9

Gynecoid and Android

Question 10

Name the two female hip shapes

Answer 10

Anthropoid and Platypelliod

Question 11

Wall muscles - iliacus

Answer 11

> Iliac fossa to join psoas as iliopsoas and insert into lesser trochanter of femur
hip flexion
Femoral nerve

Question 12

Wall muscles - psoas

Answer 12

> T12- L4 bodies and intervertebral discs (superficial) and L1-L5 (deep) to join iliacus as iliopsoas - lesser trochanter of femur

> hip flexion, bend trunk laterally (one), raise trunk from supine position (both)

> Lumber plexus direct branches L2-4 anterior ramii

Question 13

Name the three gluteal muscles

Answer 13

Gluteus maximus, medius and minimus

Question 14

Where do the gluteal muscles attach ?

Answer 14

They attach to pelvic bones but not within pelvic cavity

*more in lower limb lectures

Question 15

Wall muscles - obturator externus

Answer 15

> outer surface of obturator membrane to trochanteric fossa of femur

Question 16

Wall muscles - obturator internus

Answer 16

> inner surface of obturator membrane to medial surface of greater trochanter of femur

> Lateral rotation of hip

> Nerve to obturator internus direct from sacral plexus (L5,S1)

Question 17

Wall muscles - piriformis

Answer 17

> Pelvic surface of sacrum to greater trochanter of the femur
Lateral rotataion of hip
Nerve to piriformis direct branch of sacral plexus (S1, S2)

Question 18

What is the function of the pelvic diaphragm?

Answer 18

Muscular floor to prevent prolapse

Question 19

What muscles make up the pelvic diaphragm?

Answer 19

Levator ani and coccygeus

Question 20

What muscle is the muscular roof of the anal triangle?

Answer 20

Levator ani

Question 21

Coccygeus

Answer 21

> Ischial spine and sacrospinous ligament to the coccyc and inferior sacrum

> support pelvic viscera, flexion of coccyx

> Direct branch from sacrall plexus (S4,5)

Question 22

Levator ani is made up of two main muscles called…

Answer 22

Pubococcygeus and Iliococcygeus

Question 23

Pubococcygeus

Answer 23

most medial fibres, attach to and support vagina/prostate gland and rectum

Question 24

Iliococcygeus

Answer 24

more lateral fibres of levator ani, anterior ro coccygeus

Question 25

What is pubococcygeus split into?

Answer 25

Puborectalis, levator prostatae and pubovaginalis

Question 26

Function of levator ani

Answer 26

Supports the pelvic viscera - contract during forced expiration, coughing etc Must relax to allow urination and defecation

Question 27

Pubococcygeus gets motor innervation from ...

Answer 27

pudendal nerve and nerve to levator ani

Question 28

Levator prostatae

Answer 28

Males= most medial fibres pass around the prostate and insert into the perineal body

Question 29

Pubovaginalis

Answer 29

Females= most medial fibres pass around vagina and insert into perineal body

Question 30

Puborectalis

Answer 30

Both sexes Fibres mix with those from external anal sphincter, modified as a sling around the rectum to help maintain faecal continence Important after rectum has filled (internal anal sphincter open)

Question 31

Nerve innervation of Puborectalis

Answer 31

Pudendal nerve (S2-4) and nerve to levator ani (S4)

Question 32

3 angles of puborectalis

Answer 32

Tonic, Contract , Relax

Question 33

Iliococcygeus

Answer 33

Attaches to fascia of obturator internus and the anococcygeal body/ligament /levator plate More fibrous than pubococcygeus

Question 34

What is described as the tendinous arch of levator ani

Answer 34

Iliococcygeus

Question 35

Nerve innervation of Iliococcygeus

Answer 35

Pudendal nerve and nerve to levator ani

Question 36

What is the perineal body composed of and what attaches here?

Answer 36

Perineal body is composed of fibrous connective tissue Levator prostatae, pubo vaginalis, external anal sphincter and perineal muscles attach here

Question 37

Parietal pelvic fascia

Answer 37

covers internal wall thickened over obturator internus to form tendinous arch of pelvis ``` Anterior> puboprostatic ligament (male) pubovesical liamenr (female) ```

Question 38

Visceral pelvic fascia

Answer 38

Covers organs , parietal and visceral blend as organs pierce the pelvic floor

Question 39

What is the lateral extension of vicera; fascia from vagina to tendinous arch called?

Answer 39

Paracolpium

Question 40

Endopelvic fascia

Answer 40

Acts as a packaging material around the organs,

Question 41

2 basic types of endopelvic fascia

Answer 41

Loose and Condensed

Question 42

Loose endopelvic fascia

Answer 42

Fills spaces in the pelvis ...e.g the retropubic (pre-vesical) space

Question 43

Condensed endopelvic fascia

Answer 43

Thickenings of fascia ...eg the primary condensation is the hypogastric sheaths running along the posterolateral walls of the pelvis