Pelvis and Perineum

Question 1

What is the pelvis comprised of?

Answer 1

2 pelvic bones - right and left os coxae and the terminal vertebral column (sacrum and coccyx)

Question 2

What is the perienum?

Answer 2

Inferior floor of pelvic cavity, contains external genitalia and external openings for UG and GI systems

Question 3

What makes up the false pelvis?

Answer 3

ilium, lower lumbar vertebrae, part of abdomen, sigmoid colon, cecum

Question 4

What makes up the true pelvis>

Answer 4

pubis ischium and sacrum, bounded by inlet and outlet, urinary and reproductive organs

Question 5

What are the borders of the pelvis INlet?

Answer 5

-posterior - sacral promontory and ala
-lateral- arcuate line on inner surface of ilium, pectenial line on superior pubic rems
-anterior - pubic symphysis

Question 6

What does the pelvic inlet contain?

Answer 6

colon, rectum, bladder and some of the reproductive organs

Question 7

What are the borders of the pelvis OUTlet?

Answer 7

– posterior- tip of coccyx
– lateral- ischial tuberosities, inferior margin of the sacrotuberous ligament
– anterior- pubic arch

Question 8

What does the pelvis OUTlet contain?

Answer 8

terminal parts of vagina, urinary and GI tracts

Question 9

What are some differences in male and female pelvises?

Answer 9

male has higher iliac crest, heart shaped pelvic inlet and a smaller pubic arch angle (50-60 degreees)

women have a larger pubic arch angle, a shorter pelvis in general, and a more circular pelvic cavity

Question 10

What structures exit the greater sciatic foramen?

Answer 10

piriformis
superior gluteal n
sciatic n
inferior gluteal n
pudendal n

Question 11

What structures exit the lesser sciatic foramen?

Answer 11

obturator intenus muscle

Question 12

What structures enter the lesser sciatic foramen?

Answer 12

pudendal n, a, v

Question 13

The sacrospinous ligament attaches to the sacrum and what other structure?

Answer 13

Ischial spine

Question 14

what is the action of the piriformis muscle?

Answer 14

lateral rotation of thigh and aBduct thigh at hip

Question 15

what is the action of the Obturator Internus muscle?

Answer 15

lateral rotation of thigh at hip

Question 16

what is the action of the coccygeus muscle?

Answer 16

form pelvic floor, support pelvic viscera, pull coccyx forward after defication

Question 17

Which of the following make up the pelvic diaphragm?
Piriformis
Obturator internus
Obturator externus
Gluteal minimus
Coccygeus

Answer 17

Coccygeus

Question 18

What makes up the levator ani muscle?

Answer 18

puborectalis m., pubococcygeus m., illiococcygeus m.

Question 19

What makes up the pelvic diaphragm?

Answer 19

Levator ani and coccygeus muscle (ishiococcygeus)

Question 20

What innervates the pelvic floor?

Answer 20

pudendal nerve (S2-S4)

Question 21

What is the perineum?

Answer 21

diamond-shaped region inferior to pelvic diaphragm

Question 22

What are the functions of the perineum?

Answer 22

contain and support pelvic viscera (bladder, rectum, anal canal, reproductive organs), anchor the roots of the external genitalia

Question 23

Where is the perineal body?

Answer 23

Between the UG and anal triangles, center point of perineum

Question 24

What are the UG diaphragm muscles?

Answer 24

Superficial perineal space
*Superficial transverse perineal
*Bulbospongiosus

Deep perineal space
*External urethral sphincter m.
*Deep transverse perineal mm.

External anal sphincter
Fibers of levator ani

Question 25

What does the anal triangle contain?

Answer 25

anal aperture, external anal sphincter, ischio-anal fossae

Question 26

What is the anal lined by?

Answer 26

simple columnar epithelium

Question 27

Is internal anal sphincter voluntary or involuntary control?

Answer 27

involuntary

Question 28

Is external anal sphincter voluntary or involuntary control?

Answer 28

volunary

Question 29

What is a hemorrhoid?

Answer 29

dialated and inflamed venous plexuses within the anorectal canal

Question 30

External hemorrhoids are ___________ to the pectineal line

Answer 30

inferior

Question 31

Why are external hemorrhoids painful?

Answer 31

somatic sensory nerve innervation, detect pain

Question 32

Where are Internal hemorrhoids?

Answer 32

Superior to pectineal line

Question 33

Which type of hemorrhoids are usually not painful?

Answer 33

Internal, visceral sensory nerves lack pain receptors

Question 34

What is rectal prolapse?

Answer 34

When rectum drops out of normal place, pushes out of anal opening

Question 35

What is in the urogenital triangle?

Answer 35

Colle's fascia and perineal membrane, forms floor of deep perineal pouch and roof of superficial perineal pouch

Question 36

What muscles are in the superficial perineal space/pouch?

Answer 36

ischiocavernosus, bulbospongiosus

Question 37

What erectile tissues and glands are in the superficial perineal pouch?

Answer 37

crus of clitoris (or penis), bulb or vestibule / clitoris (penis), greater vestibular gland (females only), perineal membrane

Question 38

What muscles are in the deep perineal pouch?

Answer 38

deep transverse perineal muscle, external urethral sphincter

Question 39

What erective tissues/glands are in the deep perineal pouch?

Answer 39

bulbourethral/ Cowper's gland neurovasculatur (pudendal nerve/ internal pudendal artery and vein branches)

Question 40

What is the significance of the deep perineal space clinically?

Answer 40

external urethral sphincter muscle important for urinary continence

Question 41

All of these are levator ani muscles EXCEPT Piriformis Puborectalis Pubococcygeus Iliococcygeus

Answer 41

Piriformis

Question 42

Which of these would be found within the superficial space? Deep transverse perineal muscle Greater vestibular glands Bulbourethral glands Sphincter urethrae muscle

Answer 42

Greater vestibular glands

Question 43

Name the nerves and roots in the sacral plexus

Answer 43

ventral rami of L4-S4 Superior gluteal (L4-S1) Inferior gluteal (L5-S2) Sciatic (L4-S3) Posterior femoral cutaneous (S1-S3) Nerves to obturator internus (L5-S2) and quadratus femoris (L4-S1) Pudendal (S2-S4)

Question 44

What is the course of the pudendal nerve?

Answer 44

exit greater sciatic foramen, hooks around ischial spine and sacrospinous ligament, enter perineum via lesser sciatic foramen

Question 45

What is the motor innervation of the pudendal nerve?

Answer 45

external urethral sphincter, external anal sphincter, perineal muscles

Question 46

What is the cutaneous innervation of the pudendal nerve?

Answer 46

innervation to perineum and clitoris/penis

Question 47

What are the nerve roots of the pudendal nerve?

Answer 47

S2, S3, S4

Question 48

Where is the pudendal canal?

Answer 48

within the fascia of the obturator internus muscle

Question 49

What does the pudendal canal contain?

Answer 49

pudendal nerve, internal pudendal artery and vein

Question 50

Inferior rectal pudendal nerve branches:

Answer 50

Motor->external anal sphincter Sensory->skin around anus

Question 51

Perineal pudendal nerve branches

Answer 51

motor- all superficial and deep space muscles sensory- perineum

Question 52

Is dorsal nerve of penis/clitoris sensory or motor?

Answer 52

sensory

Question 53

anal wink causes what to contract?

Answer 53

external anal sphincter due to bulbocavernosus/bulbospongiosus reflex

Question 54

What nerve is blocked during childbirth?

Answer 54

Pudendal nerve

Question 55

What are landmarks to locate the pudendal nerve?

Answer 55

ischial spine and sacrospinous ligament

Question 56

What are the sympathetic pelvic nerves?

Answer 56

sacral splanchnics and hypogastric nerves

Question 57

What do the sympathetic pelvic nerves do?

Answer 57

vasoconstriction, contract internal urethral and anal sphincters, ejaculation

Question 58

What is the parasympathetic innervation of the pelvis?

Answer 58

Pelvis splanchnics (S2-S4)

Question 59

What does the parasympathetic innervation of the pelvis do?

Answer 59

vasodilation, stimulate bladder contraction for urination, stimulate defecation, stimulate erection

Question 60

Which of these nerves would innervate the perineum? Obturator Inferior gluteal Superior gluteal Femoral Pudendal

Answer 60

Pudendal

Question 61

Internal iliac artery divides into what anterior to the SI joint?

Answer 61

anterior and posterior trunks

Question 62

What does the anterior trunk of the internal iliac artery do?

Answer 62

Supply pelvic viscera, perineum, gluteal region, adductor region

Question 63

What does the posterior trunk of the internal iliac artery do?

Answer 63

Supply posterior pelvic wall, lower posterior abdominal wall, gluteal region

Question 64

Which of these arise from the anterior trunk of the internal iliac artery? Inferior gluteal Lateral sacral Superior gluteal Ovarian Iliolumbar

Answer 64

Superior gluteal

Question 65

Where does the vaginal artery come from?

Answer 65

The vaginal artery is said to come from either the internal iliac artery or the uterine artery.

Question 66

What do the internal iliac arteries do?

Answer 66

Supply pelvic organs

Question 67

What do the internal pudendal arteries do?

Answer 67

Supply viscera located in the perineum

Question 68

Where is the superior gluteal artery in relation to the spinal column?

Answer 68

Between lumbosacral trunk and S1

Question 69

Where is the inferior gluteal artery in relation to the spinal column?

Answer 69

Between S1 and S2

Question 70

Is internal pudendal artery posterior or anterior to coccygeus

Answer 70

posterior

Question 71

What is the male equivalent to the vaginal artery?

Answer 71

Inferior vesicle artery