Trans - Pelvis Flashcards

1
Q

What separates the major and minor pelvis?

A

Superior pelvic aperture / pelvic brim

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2
Q

Major route of communication between pelvic cavity and lower limb

A

Greater sciatic foramen

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3
Q

Prior to puberty, the ilium, ischium, and pubis are three separate bones connected by:

A

Triradiate cartilage

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4
Q

T/F: The greater sciatic foramen serves as the entry point of neurovascular structures to the abdominal cavity

A

F. It serves as the exit. The lesser sciatic foramen is the entry point

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5
Q

In obstetrics, the most important pelvic diameter measured is:

A

Anteroposterior, because it is the shortest diameter

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6
Q

Most adequate diagonal conjugate for childbirth

A

Greater than or equal to 11.5 cm

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7
Q

Boundaries of the pelvic outlet

A

Anterior: pubic symphysis
Posterior: sacrum, coccyx
Lateral: ischial tuberosity

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8
Q

The normal female pelvic type is termed:

A

Gynecoid – pelvic inlet is rounded, oval shape, transverse diameter is wide

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9
Q

What muscle makes up most of the lateral pelvic wall?

A

Obturator internus

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10
Q

Largest muscle in the pelvic floor

A

Levator ani

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11
Q

Part of the levator ani that forms a muscular sling around the anorectal junction

A

Puborectalis

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12
Q

During childbirth, what is the most likely muscle to be injured? Why?

A

Pubococcygeus, because of its proximity to the uterus

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13
Q

In females, what are the two potential spaces in the pelvic area?

A

Vesicouterine: between bladder and uterus

Retrouterine / pouch of Douglas: between rectum and uterus

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14
Q

Serves as a bed for the sacral and coccygeal plexuses

A

Piriformis

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15
Q

Main nerve of perineum and chief sensory nerve of external genitalia

A

Pudendal nerve

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16
Q

T/F: The inferior gluteal nerve supplies both the gluteus maximus and the gluteus minimus

A

F. The superior gluteal nerve innervates both muscles. The inferior gluteal nerve only innervates gluteus maximus

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17
Q

T/F: The superior gluteal artery arises from the posterior division of the internal iliac artery

A

T

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18
Q

The artery supplying the ductus deferens and prostate originates from where?

A

inferior vesicular artery

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19
Q

The pelvic girdle is composed of:

A
  1. Innominate bones – ilium, ischium, pubis

2. Sacrum and coccyx

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20
Q

Dimples at buttocks are at the level of:

A

PSIS

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21
Q

When in a sitting position, a person is resting on his/her ________

A

Ischial tuberosity

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22
Q

Attachment of the inguinal ligament in the pelvis

A

Pubic tubercle

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23
Q

Sharp oblique ridge at the lateral part of the superior pubic ramus

A

Pectineal line / pecten pubis

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24
Q

The pubic arch is formed by:

A

Ischiopubic rami of both sides of the pelvis

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25
Q

How many longitudinal crests are on the dorsal part of the sacrum

A

5

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26
Q

Median sacral crest is formed from:

A

Fused spinous processes

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27
Q

Intermediate sacral crest is formed from:

A

Fused articular processes

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28
Q

Lateral sacral crest is formed from:

A

Fused transverse processes

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29
Q

`The coccyx is formed from the fusion of how many rudimentary vertebrae

A

4

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30
Q

Strongest ligament in the body

A

Sacroiliac ligament

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31
Q

Thickenings on the superior and inferior aspect of the pubic symphysis

A

Superior: superior pubic ligament
Inferior: arcuate ligament

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32
Q

Narrowest diameter which a baby has to pass through during childbirth

A

Obstetric conjugate

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33
Q

T/F: The obstetric conjugate is directly measurable

A

F, because the bladder is in the way

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34
Q

The diagonal conjugate is measured from:

A

Inferior end/base of the pubic bone to sacral promontory

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35
Q

The pelvic midplane is at the level of the:

A

Ischial spine

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36
Q

Common pelvic types in males

A

Android

Anthropoid

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37
Q

Exit of the urethra and vagina through the pelvic diaphragm

A

Urogenital hiatus

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38
Q

Sacral plexus: components

A

Lumbosacral trunk (L4, L5), ventral rami of S1-S4

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39
Q

Branches of the sacral plexus

A
  1. Sciatic nerve – lower limb
  2. Pudendal nerve – external genitalia
  3. Superior gluteal nerve – gluteus medius and minimus
  4. Inferior gluteal nerve – gluteus maximus
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40
Q

Obturator nerve arises from what plexus

A

Lumbar plexus

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41
Q

Superior gluteal nerve innervates:

A

gluteus medius

gluteus minimus

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42
Q

Inferior gluteal nerve innervates:

A

gluteus maximus

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43
Q

Obturator nerve innervates:

A

Medial thigh muscles

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44
Q

Coccygeal plexus: components

A

Ventral rami of S4, S5

Coccygeal nerves

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45
Q

The pudendal nerve splits the fascia of the obturator internus to form _________

A

Pudendal canal / Alock’s canal

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46
Q

The anterior division of the internal iliac artery mainly supplies ________

A

Organs and viscera

47
Q

The posterior division of the internal iliac artery mainly supplies ___________

A

Muscles

48
Q

Males: inferior vesical artery :: females:_______________

A

Vaginal artery

49
Q

The superior vesical artery originates from ___________

A

Umbilical artery

50
Q

Terminal branch of the internal pudendal artery

A

Dorsal artery of penis or clitoris

51
Q

Females: uterine artery :: Males: ___________

A

Artery to the ductus deferens

52
Q

The uterine artery passes directly ________ to the ureter

A

Superior

53
Q

Iliolumbar artery supplies __________

A

Posterior abdominal muscles (iliacus, psoas major, quadratus lumborum)

54
Q

Lateral sacral artery supplies __________

A

Spinal meninges and spinal nerves

55
Q

In females, what vessels enter the true pelvis

A

2 Internal iliac
2 ovarian
1 median sacral
1 superior rectal

56
Q

In males, what vessels enter the true pelvis

A

2 internal iliac
1 median sacral
1 superior rectal

57
Q

Main venous drainage of the pelvis

A

Internal iliac vein

58
Q

Pelvic venous plexuses are formed by which veins

A

Rectal
Vesical
Uterine
Prostatic

59
Q

Obturator foramen is formed by:

A

ramus of ischium

anterior ramus of pubis

60
Q

The sacral promontory is the:

A

body of S1

61
Q

Inferior borders of pubic arch define the:

A

subpubic angle

62
Q

Structure covering the obturator canal

A

obturator membrane

63
Q

Anterior sacrococcygeal joint is held together by:

A

anterior longitudinal ligament

64
Q

Posterior sacrococcygeal joint is held together by:

A

posterior longitudinal ligament

65
Q

the sacroilac ligament is supported by which other ligaments?

A
  1. sacrotuberous ligament

2. sacrospinous ligament

66
Q

3 planes through which the head of the baby must exit in childbirth

A
  1. Superior pelvic aperture
  2. Pelvic midplane
  3. Inferior pelvic aperture
67
Q

the pelvic brim is formed by:

A

1, promontory and ala of sacrum

2. right and left linea terminalis - arcuate line, pecten pubis, pubic crest

68
Q

continuation of pecten pubis in ilium

A

arcuate line

69
Q

elevations and depressions on surfaces of ilium and sacrum produce:

A

interlocking of bones, giving the sacroiliac joint more strength and stability

70
Q

Sacroiliac joint: type of joint

A

synovial

71
Q

most uncommon pelvic type

A

platypelloid

72
Q

Components of lateral pelvic wall

A
  1. ilium and ramus of ischium

2. obturator internus muscle

73
Q

Components of posterior pelvic wall

A
  1. sacrum
  2. ilium
  3. sacroiliac joint
  4. piriformis muscle
74
Q

The piriformis exits at the

A

greater sciatic foramen

75
Q

The obturator internus exits at the

A

lesser sciatic foramen

76
Q

Piriformis: action

A

laterally rotate thigh

77
Q

Components of the pelvic floor

A
  1. levator ani

2. coccygeus

78
Q

Membrane that closes the urogenital hiatus

A

perineal membrane

79
Q

Shape of pelvic diaphragm

A

hammock-shaped - deeper at the central part, shallower at the end

80
Q

T/F: the pelvic diaphragm is relaxed during forced expiration, coughing, and strong movements of the upper limbs

A

F, the pelvic diaphragm contracts/tightens during these actions to increase support to the viscera and increase abdominal pressure

81
Q

Major consequence of denervation of levator ani

A

Fecal and urinary incontinence

82
Q

Likely consequences of pubococcygeal injury

A
  1. uterine prolapse
  2. cystocoele
  3. rectocoele
83
Q

Cystocoele: definition

A

bladder wall prolapse

84
Q

Rectocoele: definition

A

rectal wall prolapse

85
Q

T/F: the entire rectum is covered by peritoneum

A

F, the inferior third of the rectum does not have a peritoneal covering

86
Q

T/F: the Fallopian tube is not entirely covered by the peritoneum on its posterior aspect

A

F, the Fallopian tube is entirely enclosed by peritoneum

87
Q

The pelvic peritoneum covers what surfaces of the pelvic viscera?

A

Superior and lateral surfaces

88
Q

The space between the peritoneum and the pelvic muscles/pelvic floor is covered by

A

Pelvic fascia

89
Q

Pelvic fascia is a continuation of:

A

endoabdominal fascia

90
Q

T/F: the entire uterus is mobile to allow for enlargement during pregnancy

A

F, the cervix of the uterus is an immobile structure

91
Q

Visceral pelvic fascia: type of connective tissue

A

Loose connective tissue

92
Q

The parietal pelvic fascia covers what structures

A

Obturator internus
Levator ani
Coccygeus
Piriformis

93
Q

T/F: neurovascular structures in the pelvis lie intraperitoneally

A

F

94
Q

T/F: in the pelvis, nerves are generally more lateral to the vessels

A

T

95
Q

T/F: in the pelvis, the veins are generally more medial to the arteries

A

F

96
Q

T/F: all branches of the sacral plexus exit through the greater sciatic foramen

A

F, the nerve to the piriformis does not exit the greater sciatic foramen

97
Q

T/F: the pudendal nerve returns to the pelvis via the lesser sciatic foramen

A

T. It leaves the greater sciatic foramen, hooks around the ischial tuberosity, and reenters the pelvis through the lesser sciatic foramen

98
Q

Obturator nerve exits the pelvis via:

A

obturator foramen

99
Q

The coccygeal plexus innervates:

A

coccygeus

100
Q

The birfurcation of the common iliac arteries into the internal and external iliac arteries occurs at what level

A

L5-S1

101
Q

Main artery of pelvis

A

Internal iliac artery

102
Q

The internal iliac artery divides into anterior and posterior divisions near the __________

A

obturator foramen

103
Q

T/F: the inferior vesicular artery may be found in both sexes

A

F, it is only found in males. its counterpart in females is the vaginal artery

104
Q

The artery to the ductus deferens and the artery to the prostate are branches of:

A

inferior vesicular artery

105
Q

Inferior vesicular artery: structures supplied

A

bladder, seminal vesicle, prostate

106
Q

At the junction of the uterus and the vagina, the uterine artery passes over what structure

A

Ureter

107
Q

junction of vagina and uterus

A

vaginal fornix

108
Q

Critical areas of possible ureter ligation

A
  1. When ligating the uterine arteries near the lateral vaginal fornix
  2. When ligating ovarian vessels near the pelvic brim
109
Q

Only branch in the anterior division of the internal iliac that supplies muscles

A

Inferior gluteal artery

110
Q

Unpaired artery arising from the posterior surface of aorta near the pelvis

A

Median sacral artery

111
Q

T/F: the ovarian artery lies anterior to the ureter as it enters the pelvic brim

A

F. The artery lies adjacent to the ureter as it enters the pelvic brim

112
Q

The ovarian artery runs within what structure

A

suspensory ligament of ovary

113
Q

Largest tributary of internal iliac vein

A

Superior gluteal vein

114
Q

Lateral sacral veins drain into

A

internal vertebral venous plexus