Pelvis And Perineum (Jones) Flashcards
(61 cards)
What is the degree of inclination of the pelvic brim?
55 degrees
What structures exit through which foramina in the sacrum?
Anterior Sacral Foramina: Ventral Rami
Posterior Sacral Foramina: Dorsal Rami
Sacral Hiatus: Fat, Filum terminale, S5, and Coccygeal nerves
What is the average width of the pelvis?
10.5 cm
What is characteristic of the male pelvis?
- Thick/heavy
- Deep false pelvis
- Narrow, deep, and tapering true pelvis
- Heart shaped
- Narrow pubic arch
- Round Obturator foramen
- Large acetabulum
- Narrow sciatic notch
What is characteristic of the female pelvis?
- Thin/light
- Shallow False pelvis
- Wide/shallow cylindrical true pelvis
- Oval and rounded pelvic inlet
- Large Pelvic outlet
- wide pubic arch
- Oval Obturator foramen
- Small acetabulum
- Wide greater sciatic notch (90 deg)
What connects the superior aspect of the pubic bone and the interpubic disc?
Superior pubic ligament
What are the boundaries of the pelvic outlet?
- Coccyx
- Ischial tuberosity
- Inferior pubic ramus
Pubic symphysis
What makes up the birth canal? How does the pelvic cavity pass?
- Pelvic inlet
- Deep pelvis
- Pelvic outlet
Passes:
- backward and downward
- Longer posteriorly thananteriorly
What passes superiorly to the piriformis muscle?
Superior neurovascular bundle
What passes inferiorly to the piriformis?
- Inferior gluteal bundle
- sciatic nerve
- Pudendal neurovascular bundle
What spinal roots innervates the Levator Ani? What are the three muscle of the levator ani?
- S2-4 (Pudendal)
- Iliococcygeus
- Pubococcygeus
- Puborectalis
Which muscle forms a rectal sling?
Puborectalis
what forms the walls of the pelvic outlets?
Lateral Wall: Oburator Internus
Posterosuperior wall: Piriformis
What pathologies are associated with the vesicouterine pouch?
- Endometriosis
- retroverted uterus
What are the branches off the internal iliac artery?
- Inferior Gluteal artery
- Obturator artery
- Umbilical artery ( —> Superior and Middle Vesical)
- Uterine Artery
- Deferential artery
- middle rectal (HEmorrhoidal)
- Inferior vesicular artery
- Internal pudendal artery (—> Inferior rectal, Scrotal/labial, Perineal, and deep arteries of penis/Clitoris)
What are the Posterior branches off the internal iliac artery?
- Iliolumbar
- Lateral Sacral Artery
- Superior Gluteal Artery
What are the anastomoses of the Internal iliac artery? What is the significance of them?
- Lumbar (Aorta) —>Iliolumbar
- Median Sacral (Aorta) —> Latreral Sacral
- Superior rectal (IMA) —> Middle rectal
*Ligation of IIA will not stop blood flow, but will reduce it allowing hemostasis
Differentiate venous drainage from the uterus.
LOV —> Left Renal Vein —> IVS
ROV —> IVC
What are the lymph nodes of the pelvis and where do they drain?
External Iliac: Aling femoral vein
Internal Iliac: Perineum and gluteal
Sacral: Btwn pelvic organs and nternal iliac nodes
What are the three methods of anesthesia for childbirth?
Spinal: L3-L4 subarachnoid space (Waist down)
Pudendal: S2-S4 dermatomes
Epidural: Roots S2-4 Pain fibers from uterus and upper vagina; NO LOWER EXTREMITIES
What are the vertices and sides of the anal triangle?
Vertices:
- One vertex at the Coccyx bone
- The two ischial tuberosities of the pelvic bone
Sides:
- Posterior Perineal membrane (Anterior Wall)
- The two Sacrotuberous ligaments
What are the bounds of the Ischioanal Fossa?
Laterally: Ischium and overlapping inferior part of the Obturator Internus covered with Obturator fascia
Medially: External anal sphincter, Sloping roof of levator Ani
Posteriorly: Sacrotuberous ligament and gluteus Maximus
Anteriorly: Bodies of pubic bone inferior to origin of Puborectalis
What are the contents of the Anal triangle?
- Dense fat
- Pudendal nerve and internal pudendal vessels
- Inferior rectal vessels and nerve
Compare and contrast Urogenital sinus and the anal triangle
- Share levator ani muscle
- Share same innervation and blood supply (Ramus of S4 and branches of pudendal nerve)
- Different special musculature
