Unit 5 Flashcards
(98 cards)
1
Q
2 parts of pelvis
A
false and true
2
Q
False pelvis
A
- superior
- upper pelvis and lower lumbar
3
Q
True pelvis
A
- inferior
- sacrum, coccyx
- inlet and outlet
4
Q
Pelvic cavity
A
- enclosed by the true pelvis- consists of pelvic inlet, walls and floor
- continuous superiorly with abdominal cavity
- contains support elements for urinary, gastrointestinal and reproductive systems
5
Q
Perineum
A
inferior to floor of pelvic cavity its boundaries form pelvic outlet contains and supports -external genitalia -external opening of genitourinary tract - gastrointestinal systems
6
Q
Pelvic bone
A
irregular bone
- 2 major parts separated by oblique line
1) Above line- lateral wall of false pelvis, and part of abdominal cavity
2) Below line- lateral wall of true pelvis. and part of pelvic cavity
7
Q
Components of the pelvic bone
A
1) Ilium
2) Pubis
3) Ischium
8
Q
linea terminalis v. arcuate line
A
arcuate ligament forms part of linea teriminalis and pelvic brim
9
Q
anteriomedial surface of iliac wing
A
iliac fossa
10
Q
external surface of iliac wing
A
gluteal surface
-related to gluteal surface of lower limb
11
Q
iliac crest
A
superior margin of ilium
- attachment for muscles and fascia of
-back
-lower limb
-abdomen
terminates as
1) anteriorly- anterior superior iliac spine
2) posteriorly- posterior superior iliac spine
12
Q
lateral projection of iliac crest
A
tuberculum of iliac crest
13
Q
thickening of posterior end of iliac crest
A
iliac tuberosity
14
Q
anterior inferior iliac spine
A
inferior to anterior superior iliac spine
-point of attachment for rectus femoris
AND iliofemoral ligament
15
Q
posterior inferior iliac spine
A
inferior to posterior superior iliac spine
16
Q
Bone marrow biopsy
A
iliac crest often used for bone marrow biopsies b/c -close to surface -palpable -easily accessed
17
Q
Pubis
A
anterior inferior part of pelvic bone
Parts:
1) body
2) 2 arms
18
Q
pubic symphysis
A
where bodies of pubic bones from each side articulate with one another
19
Q
Pubic tubercle
A
where body of pubis ends
20
Q
pectan pubis
A
superior surface of superior pubic ramus
21
Q
superior pubic ramus
A
projects posteriorly from pubic tubercle
-joins with ilium and ischium
22
Q
inferior pubic ramus
A
joins with ramus of ischium
23
Q
posterior and inferior part of pelvic bone
A
ischium
24
Q
2 parts of ischium
A
1) body- joins with iliums and superior pubic ramus
2) ramus of ischium- joins with body of ischium and inferior pubic ramus
25
ischeal spine
marks posterior margin of ischium
| -seperates greater and lesser siatic notches
26
ischeal tuberosity
posteroinferior aspect of ischium
| Attachment of lower limb muscles
27
Ala
winglike process on sacrum
28
Promontory
anterior edge of sacral vertebral body
29
anterior sacral foramina
on anterior side of sacrum
| -for anterior ramia
30
posterior sacral foramina
on posterior surface of sacrum
| -for posterior rami
31
sacral canal
continuation of vertebral canal
| terminates as sacral hiatus
32
articulation points of sacrum with coccyx
cornua
| -modified articular processes
33
Zygapophyseal joint
joint between inferior and superior vertebral processes
34
Lumbrosacral joints
1) zygapophyseal joints
2) intervetebral disc
- reinforced by iliolumbar and lumbrosacral ligaments
35
iliolumbar
extend from transverse processes of vert L5 to ilium
36
lumbrosacral ligaments
extent from transverse processes of vert L5 to sacrum
37
Pelvic joints
1) lumbosacral joints
2) sacro-iliac joints
3) Pubic symphysis joint
38
sacro-iliac joints
synovial joints between articular facets of sacrum and ilium of pelvis
-interlock with irregular contours to resist movement
39
sacro-iliac ligaments
```
stabalize sacro-iliac joints
3 for each joint
1) anterior sacro-iliac ligament
2) interosseus sacro-iliac ligament
3) posterior sacro-iliac ligament
```
40
anterior sacro-iliac ligament
thickening of fiberous membrane surrounding joint capsule
| anterior and inferior to joint
41
interosseus sacro-iliac ligament
largest and strongest ligament of sacro-iliac ligaments
posterosuperior to joint
limits gap between ilium and sacrum
42
posterior sacro-iliac ligament
covers interosseus sacro-iliac ligament
43
Problems with sacro-iliac joint
degenerative changes like rheumatoid arthritis, psoriasis, inflammatory bowel disease produce problems
44
superior and inferior pubic ligaments
located above and below the pubic symphysis
45
Orientation of pelvis
pubic symphysis lies in vertical plane
| pelvic inlet faces anteriorly
46
True pelvis
cylindrical with:
- inlet (open)
- wall
- outlet (closed by pelvic wall, separating it from perineum below)
47
Pelvic inlet
circular opening between abdominal and pelvic cavities
| -completely surrounded by bones and joints
48
Pelvic wall
- sacrum
- coccyx
- pelvic bones inferior to linea terminalis
- 2 ligaments
- 2 muscles
49
Pelvic fracture
can be in 3 bony rings or 4 fibro-osseous rings
-cannot break ring on one side w/o breaking other
more info on 213
50
2 ligaments of pelvic wall
sacrospinous and sacrotuberous ligaments
- major components of pelvic wall
- form apertures for passage of structures through pelvic cavity
51
smaller ligament of pelvic wall
```
sacrospinous ligament
-triangular
connects
-apex- to ischeal spine
-base- to coccyx and sacrum
```
52
larger ligament of pelvic wall
```
sacrotuberous ligament
-triangular
-superficial to sacrospinous
connects
-apex- ischeal tuberosity
-base- posterior superior iliac spine
- coccyx and sacrum
```
53
2 muscles of pelvic wall
obturator internus and piriformis
- contribute to lateral walls of pelvic cavity
- originate in pelvic cavity and attach to femur
- function- lateral rotation of extended hip joint and abduction of flexed hip
54
Obturator internus
Origin- anterolateral wall of pelvis
Insertion- medeal surface of greater trochanter of femur
Innervation- L2 and S1
Function- lateral rotation of hip joint and abduction of flexed hip
55
Piriformis
Origin- sacrum
Insertion- greater trochanter of femur
Inervations- L5, and S1 and 2
Function- lateral rotation of extended hip joint and abduction of flexed hip
56
apertures of pelvic wall
allow structures to pass from pelvic cavity to other regions
1) obturator canal
2 and 3) greater and lesser siatic foramen
57
obturator canal
```
at top of obturator foramen
-allow passage of obturator nerves and vessels from pelvis to thigh
bordered by obturator membrane
associated with obturator muscles
ans superior pubic ramus
```
58
Greater siatic foramen
formed by greater siatic notch, sacrotuberous and sacrospinous ligaments, and spine of ischium
Passing through:
- piriformis muscle (divides foramen into 2 parts)
- Above: superior gluteal nerves
- Below: inferior gluteal nerves and vessels
siatic nerve
pudendal nerve
internal pubendal nerve
posterior femoral cutaneus nerve
more on 215
59
Lesser siatic foramen
formed by lesser siatic notch, ischeal spine, sacrospinous ligament and sacrotuberous ligament
Passing through:
- tendon of obturator internus to gluteal region of limb
more on 215
60
Pelvic floor
formed by pelvic diaphram (levator ani and coccygeus), perineal membrane, muscles of deep perineal pouch,
separates pelvic cavity and perineum
61
Pelvic diaphram
formed by levator ani and coccygeus
62
Levator ani
Innervation: anterior rami of S4, inferior rectal branch of pudendal nerver
Function: forms pelvic floor, supports pelvic viscera, maintains rectum and anal canal, reinforces external anal sphincter, functions as vaginal sphincter
63
Coccygeus
Origin: ischeal spine and sacrospinous ligament
Insertion: lateral margin of coccyx and sacrum
Innervation: S3 and 4
Function: contributes to pelvic floor, pulls coccyx foward after defication
64
Urigenital hiatus
separates levator ani anteriorly
65
3 collections of muscle fibers of levator ani
1) pubococcygeus (originates at body of pubis)
2) puborectalis (originates at pubis and forms sling around GI tract)
3) iliococcygeus (originates obturator internus muscle)
66
Steps of Defication
1) Begins with closure of anal sphincter and abdominal muscle contracts causing increase in abdominal pressure
2) circular muscles of rectal wall undergo wave contraction
3) feces emerges and longitudinal muscles of rectum and levator ani contract to expel feces
67
perineal membrane
- thick fascia
- triangular structure
- attached to pubic arch
68
deep perineal pouch
contains layer of skeletal muscle and varius nerovascular elements
69
Muscles within the deep perineal pouch
1) extra urethral sphincter
2) deep transverse perineal
3) compressor urethrae
4) sphincter urethrovaginalis
innervated by perineal branches of pudendal nerve
70
Extra urethral sphincter
Origin: inferior ramus of pubis on both sides to deep perineal pouch
Insertion: surrounds membranous urethera
Innervation: pudendal nerve
Function: compresses membranous urethera
71
Deep transverse perineal
Origin: medial aspect of ischeal ramus
Insertion: peineal body
Innervatoin: pudendal nerve
function: stabilizes perineal body
72
Compressor urethrae
only in women
Origin: ischiopubic ramus on both sides
Insertion: connects to other side anterior to urethera
Innervation: pudenal nerve
function: accessory sphincter of urethera
73
Sphincter urethrovaginalis
women only
origin: perineal body
insertion: blends with one from other side to anterior to urethera
innervation: pudenal nerve
function: closes vagina, accessory sphincter of urethera
74
Perineal body
```
connective tissue structure
muscles of pelvic floor and perineum attach to it
-deep transverse perineal muscles intersect
muscles connecting to it:
-external anal sphincter
-sphincter urethrovaginalis
-superficial transverse perineal muscles
-bulbospongiosus muscles of perineum
```
75
Episiotomy
cutting of perineal body during childbirth to help head of baby get through vagina
-less common now
medial episotomy-
76
Viscera of Pelvis
- part of GI
- urinary system
- reproductive system
77
Part of GI in pelvis
terminal part of sigmoid colon
rectum
anal canal
78
Rectum
begins at end of sigmoid at S3, ends at pelvic floor to become anus
-follows contour of sacrum
3 curvatures - upper, lower and middle
79
rectal ampulla
expanded lower part of rectum
80
anal canal
begins at end of rectal ampulla at the pelvic floor
- terminates as the anus
- surrounded by internal and external sphincters (to keep it closed)
- features reflect those of anococcygeal membrane in fetus
81
upper anal canal
-lined by mucosa
| has anal columns seperated by anal sinuses that are united by anal valves
82
Anal pectan
after upper anal canal
- lined by non-keritinized stratifies squamous epithelium
- ends at white line, where the lining becomes true skin
83
pelvic urinary system
ends of ureters to proximal part of urethera
84
Ureters
pass through pelvic inlet anterior to bifurcation of common iliac arteries
more on 221
85
Bladder
```
three sided pyramid shaped
expands into ab cav when full
Parts:
-apes
-inferolateral surfaces
-superior surface
-trigone
-median umbilical ligament
-internal uretheral orifice
-base
```
86
neck of bladder
surrounds origin of urethera
anchored by fibromuscular bands, connecting it to pubic bone
-women- called pubovesical ligaments
-men- puboprostatic ligaments- b/c connect w/ prostate that surrounds urethera
87
bladder in children
in ab, goes into pelvis with age
88
Bladder cancer
most common tumor of urinary tract
may spread to nearby structures (uterus, rectum, prostate)
may obstruct ureters, causing kidney failure
89
Bladder stones
stones from kidney get into bladder and get bigger, may cause problems emptying bladder, causing infection and making bigger stones
90
Suprapubic catheterization
cathertizing bladder through ab wall
91
Urethera in women
4 cm long
track: passes through pelvic floor into perineum, through deep perineal pouch, opens at vestibule between labia minora (anterior to vaganal opening)
has Skene's glands (mucous glands)
92
Urethera in men
```
20 cm long
track: passes through prostate, deep perineal pouch, root of penis, makes 2nd bend in flaccid penis
4 parts:
1. preprostatic
2. prostatic
3. membranous
4. spongy
```
93
Preprostatic part
1st part of urethera in men
1 cm long
base of bladder to prostate
interurethral spincter, prevents semen from entering bladder
94
prostatic
```
3 cm long
uretheral crest (longitudinal mucosa fold)
```
95
Membranous part
passes through deep perineal pouch
| surrounded by external urethral sphincter
96
Spongy urethera
surrounded by erectile tissue
97
corpus spongiosum
errectile tissue of penis
98
Bladder infection
more common in women
bladder becomes inflamed
<1 yr old, may spread to kidneys
