Pelvis and Pelvis Floor Flashcards
(38 cards)
The pelvis refers to what two structures?
- Bony pelvis: bony framework
- Pelvic cabity: space inside lower part of pelvis
- continuous with the abdominal cavity
Identify the structures indicated by number on the provided image
What is the relationship between teh peritoneum and the structures in the pelvic cavity?
they are beneath the peritoneum “sub-peritoneal”
Identify the bones indicated in the provided image
Identify the bones indicated in the provided image
When do we fusion of these bones?
Acetabulum fuses at 15 -17 years
What are the two part of the pelvis & what is the landmarks that dives them?
- false pelvis (greater pelvis): not part of pelvic cabity, is actually part of abdominal cavity
- true pelvis (lesser pelvis): it is the pelvic cavity
- demarked by the pelvic inlet
How do you orient a pelvis in anatomical position?
ASIS & pubic tubercle in same frontal plane
Describe the path of the pelvic inlet
- sacral promotory
- along sacral ala
- along the arcuate line on the ileum
- along the pectinate line (continuous with arcuate line)
- across the pubic symphesis & back up through the same lines on the opposite side to again reach the sacral promotory
What is the name of the lower apeture of the pelvis?
Describe its path
- Pelvic outlet - has anterior plane & posterior plane
- bottom of public symphesis
- along ischesopubic ramus to the ishial tuberosity
- along sacrotuberous ligaments
- to the coccyx & the repeats the path on the opposite side back to the pubic symphesis
Identify the indicated structures and planes
What is the interspinous breadth?
inlet diameter?
obstetric conjugate?
diagnonal conjugate?
What are these measurements used for?
Used to be important in determing the risk of giving birth, but not widely used anymore
-
interspinous breadth
- distance between two ischial spines
-
transverse inlet diameter
- whereever the inlet is widest
- femalse: usually more anterior as compared to males
- whereever the inlet is widest
- o_bstetric conjugate_
- sacral promotory to the nearest point on the pubic symphesis
-
diagonal conjugate
- physician would stick fingers in vagina & feel for sacral promotory & mark how far in they were
- initally thought to be 2 cm longer than obstetric conjugate– not true
What are the general differences the we see between male and female pelvices?
- Males typically have larger bones reflecting a larger body size
- Females typically hae a larger pelvic cavity to accomodate parturition (birth)
- pelvic inlet in females is often larger & rounder
- pelvic outlet in females is much larger compared to males
- subpubic angle is often more obtuse in females
- greater sciatic notch is often wider in females
- acetabulum is usually smaller in females
- sacrum in females is shorter and less curved
What struces make up the pubic symphesis?
What type of joint is it?
What is its majore function?
- Articulation between the symphyseal surfaces of the two pubic bones with an interpubic disc between
-
Ligaments
- superior pubic
- inferior (arcuate) pubic
- cartilaginous symphysis
- absorbs forces from the lower (focus = stability)
-
Ligaments
Under what circumstance is it helpful for the pubic symphysis to be mobile?
How and why does this happen?
What complication can occur?
During birth
interpubic disc becoems more pliable due to hormones like relaxin
increases the distance between pubic bones & the transverse diameter (10-15%)
If maintained postpartum, called pubic symphysis diastasis & can cause pain
What type of joint is the sacroiliac joint?
What structures articulte here?
What movement occurs at this joint?
- Synovial - may become fibrous with age
- tuberosity articulation forms syndesmosis joint
- Articulation
- auricular surfaces of ilium & sacrum
- transfers force from vertebral column to lower limb
- limited nutation (flexion) & counternutation (extension)
Identify the ligaments of the sacroiliac joint
- Interosseus sacro-iliac ligament is the same thing they call the syndesmosis joint
25% of patients with chronic lower back pain can be explained by problems with which joint?
sacroiliac joint
specific mechanism is often not identifiable
What are the two lumbosacral joints?
Type of joints?
Articulations?
Movements?
- Intervertebral
- Cartilaginous symphisis
- Articulation: L5 & S1 vertebral bodies
- contributes to vertebral column movements
- has intervertebral disc
- Facet
- synovial
- Articulation: L5 inferior articular process & S1 articular process
- contributes to vertebral column movements
Identify the ligaments of the lumbosacral joint.
Where are their attachment points?
- Anterior logitudinal
- down entire vertebral column & ends at the sacrum
- Lumbosacral
- filling in space between the facet joint
- Iliolumbar
- from transverse process of L5 & L4 to iliac crest
- limits rotation of L5
Whta type of joint is the sacrococcygeal?
What are its articulations?
Movement?
- cartilaginous symphis
- Articulation
- apex of sacrum & base of the coccyx
- has intervertebral disc
- Movement
- limited flexion & extension
Identify the ligaments of the sacrococcygeal joint
Attachment points?
- Anterior sacroccygeal ligament
- criss-cross the front of the coccyx
- Posterior sacroccygeal ligament
- superficial & deep part of posterior aspect of cocyx
- Lateral sacrococcygeal ligament
- Transverse process of first coccygeal vertebrae & attach to the sacrum
When performing an epidural, what ligament is pierced?
posterior sacrococygeal ligament that fills the sacral hiatus
Identify the muscles indicated in the provided image.
Together, they from what structure?
the pelvic wall
Identify the muscles indicated in the provided photo.
Together, they form what structure?
The pelvic floor
