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Flashcards in Pelvis Deck (58)
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1
Q

pelvis is enclosed by _____

A

pelvic girdle

2
Q

the pelvis is closed off inferiorly by …

A

pelvic and urogenital diaphragms

3
Q

perineum

A

area of surface of trunk between thighs and buttocks and the shallow compartment lying deep to this area and inferior to the pelvic diaphragm

includes anus and external genitalia

4
Q

mons pubis

A

rounded mass of fatty tissue overlying pubic bones

5
Q

bony pelvic girdle

A

two coxal (hip) bones (fused ilium,pubis, ischium - join in acetabulum) + sacrum + coccyx

6
Q

pelvic inlet

A

open

sacral promontory to superior margin of pubic symphysis

7
Q

joints of the pelvis loosen under the action of _______ during pregnancy

A

joints of the pelvis loosen under the action of relaxin during pregnancy

8
Q

greater pelvis

A

false pelvis, pelvis major

  • inferior pt of abd cavity
  • holds some abd viscera
9
Q

lesser pelvis

A

true pelvis, pelvis minor

  • between pelvic inlet and outlet
  • holds pelvic viscera
10
Q

pelvic axis shape? what does it join?

A

curved

joins center points of pelvic inlet and outlet

11
Q

pelvic outlet

A

closed

inferior margin of pubic symphysis to tip of coccyx

12
Q

female differences in pelvis

A

female measurements longer

bones thinner, lighter

inlet oval, rounded, wider

outlet larger

pubic arch larger and angle wider

iliac wing more flared

ischial tuberosity more apart (everted)

13
Q

true conjugate

A

obstetrical conjugate

narrowest fixed diameter through which head of baby passes

  • measure radiographically
  • approximate from diagonal conjugate
14
Q

pelvic floor

A

pelvic diaphragm
urogenital diaphragm

bears weight of abdpelvic viscera
maintains continence

15
Q

walls of pelvic cavity

A

ant: pubis bone/pubic symphysis
lat: obturator internus m.
inf: pelvic floor m. (pelvic diaphragm)
post: piriformis m.

16
Q

levator ani

A

puborectalis
pubococcygeus
illococcygeus

supportive m. for midline pelvis organs
weakness –> incontinence

17
Q

pelvic diaphragm

A

levator ani + coccygeus m.

18
Q

puborectalis

A

forms puborectal sling

19
Q

m. possibly torn during childbirth

surgical tx to widen birth canal?

A

bulbospongiosus m., levator ani (especially pubococcygeus)

episiotomy

20
Q

the most inferior extent of peritoneum in the male

A

rectovesical pouch

21
Q

recto-prostatic fascia of denonvilliers

A

separates the rectum (posterior) from the genito-urinary tract (anterior)

prostate cancer can spread to rectum

22
Q

internal sphincter of urinary bladder (male)

A

smooth muscle of neck of bladder

23
Q

external sphincter of unrinary bladder (male)

A

sphincter urethrae m. (skeletal)

24
Q

Benign prostatic hyperplasia

A

enlarged prostate

obstructs urethral orifice, usually due to middle lobe enlargement

leads to nocturia, dysuria and urgency

25
Q

seminal vesicles

A

pair of glands posteroinferior to the bladder

secrete fluid that becomes semen

excretory ducts open into vas deferens as it enters the prostate gland and become the ejaculatory ducts

26
Q

the most inferior extent of peritoneum in the female

A

retro-uterine pouch
aka DOUGLAS’ POUCH

where peritoneum reflects from vagina onto rectum

fluid can pool here

27
Q

female pelvic organs

A

rectum
anal canal

distal ureters
urinary bladder
urethra

ovaries
oviducts
uterus
vagina

28
Q

rectovaginal fascia of Otto

A

separates vagina and rectum

cervical cancer can spread to rectum from here

29
Q

female homologue of prostate gland

A

parauretheral glands (Skene’s duct) –> G-spot?

30
Q

hyster- refers to

A

uterus

31
Q

salphingo- refers to

A

oviduct

32
Q

oophoro- refers to

A

ovary

33
Q

The normal position of the uterus is _________ and ________ and lies almost in the ____________ position

A

The normal position of the uterus is ANTEFLEXED and ANTEVERTED and lies almost in the HORIZONTAL position

34
Q

flexion is defined by angle between

w/ regard to female pelvis

A

angle between axes of body of uterus and the cervix

35
Q

verision is defined by angle between

w/ regard to female pelvis

A

angle between axis of cervix against vagina

36
Q

broad ligament of the uterus

A

double layer of peritoneum, is draped over oviducts and forms “sleeves” on either side of uterus

holds uterus in place

37
Q

uterine artery is ______ to ureter

A

uterine artery is INFERIOR to ureter

38
Q

rim around cervix

A

vaginal fornix

39
Q

ectopic pregnancy

A

outside uterus

frequently in Fallopian tube

40
Q

endometriosis

A

benign disorder

mass of endometrial tissue occurs aberrantly in various locations (uterine wall, ovaries, or other extraendometrial sites)

frequently forms cysts containing altered blood

41
Q

leiomyoma/fibroid

A

most common benign neoplasm of the female genital tract derived from smooth muscle

occurs in the wall of the uterus

large fibroid can cause bleeding, pressure and pain in the pelvis, heavy menstrual periods and infertility

42
Q

cervix is held in place by which ligaments?

A
  1. cardinal ligament (transverse cervical) ligament AKA Mackenrodt’s
  2. uterosacral ligament
  3. round ligament of uterus
43
Q

relaxation of Macenrodt’s ligament can lead to…

A

uterine prolapse

Mackenrodt’s ligament=cardinal (transverse cervical) ligament

44
Q

transformation zone and cervical cancer

A

Columnar cells constantly changing into squamous cells in an area of the cervix

Most common place on the cervix for abnormal cells to develop

45
Q

pelvic innervation

A

sacral plexus (sciatic and pudendal)
nerves to pelvic diaphragm (n. to levator ani and coccygeus)
pelvic plexus

46
Q

sciatic n.

A

L4-S3

47
Q

pudendal n.

A

S2-S4

48
Q

n. to pelvic diaphragm

A

n. to levator ani
n. to coccygeus

S3-S4

49
Q

pelvic plexus

A

pelvic splanchnic n. (S2-S4) parasympathetic and visceral afferent

hypogastric plexuses (mixed)

50
Q

most of the autonomic nerves to the pelvic viscera arise in the ______________

A

paired inferior hypogastric plexuses

51
Q

describe referred pain above pelvic pain line

A

visceral afferent fibers conducting pain from abdominal pelvic viscera follow SYMPATHETIC fibers

ascend through hypogastric/aortic plexus, abdominopelvic splanchnic n., lumbar sympathetic trunks, and white rami communicates to reach cell bodies in inferior thoracic/upper lumbar spinal ganglia

52
Q

describe referred pain below pelvic pain line

A

visceral afferent fibers conducting pain from viscera follow PARASYMPATHETIC fibers

go through pelvic and inferior hypogastric plexus and pelvic splanchnic n. to reach cell bodies in spinal sensory ganglia S2-S4

53
Q

anesthesia for childbirth

A

spinal block via lumbar puncture
caudal epidural block
pudendal n. block

54
Q

Only the lower portion of the vagina is ________ ________

A

Only the lower portion of the vagina is somatic efferent

55
Q

Main blood supply of male pelvis

A

ant. division of internal iliac a.
- internal pudendal
- inferior vesical
- obliterated umbilical a.
- superior vesical
- middle rectal

aorta –> common iliac –> internal iliac

56
Q

Batson’s plexus

A

veins draining pelvic viscera

valveless, prostate cancer can spread thru

graining veins unite to form internal iliac veins of each side, which unite with the corresponding external iliac veins to form the common iliac veins to the IVC

57
Q

Main blood supply of female pelvis

A

ant. division of internal iliac a.
- internal pudendal
- middle rectal
- vaginal, w/ br. to bladder
- uterine
- obliterated umbilical a.
- superior visceral

aorta –> common iliac –> internal iliac

58
Q

lymphatic drainage of testes and ovaries

A

lumbar (caval/aortic nodes)