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45 Cards in this Set

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  • Back
arises from anterior surface of sacral vertebrae 2-4; sacral plexus formed on the substance of muscle; almost fills the greater sciatic foramen; tendon passes thru and almost fills lesser sciatic foramen; attaches to greater trochanter; "pear-shaped"
obturator internis
arises from internal aspect of obturator membrane and almost total cirumference of the foramen; fleshy fibers converge to form a tendon which passes @ 90 deg angle between ischial spine and ischial tuberosity thru lesser sciatic foramen to attach posteriorly to greater trochanter; inferior part lies inferior to pelvic diaphragm so same muscle lies in the lateral wall of pelvis and perineum
coccygeus (ischiococcygeus)
arises from ischial spine and extends back towards the sacrum and coccyx; lies anterior to sacrospinous ligament
(levator ani)
arises from pubis, extends to posterior coccyx; circumscribes urethra, vagina, and rectum; 3 parts: pubourethralis, pubovaginalis, puborectalis
(levator ani)
arises from tendonous arch of levator ani
tendonous arch of levator ani
thickened part of obturator internus fascia
most medial and anterior fibers of pubococcygeus; attaches to one side fo pubis running posterior takin 90 deg bend around rectal/anal junction and attaches to the other side
broad ligament
double layered fold of peritoneum; anterior and posterior leaflets; anterior leaflet-comes over the top of the oviduct and passes posteriorly over ovarian ligament; 4 parts
4 parts of broad ligament
infundibulopelvic (suspensory ligament of ovary); mesoovarium; mesosalpinx; mesometrium <major part>
1)anteflexed (curved/bent forwards) at junction of uterine body & cervix; 2)anterverted (tilted forward) at junction of cervix & vagina; 3)muscular
cornu (horns); fundus (upper part); body; uterine cavity; internal os <about same position as isthmus>; cervix (lower 1/3); external os
smooth muscular tube; lower 1/4 innervated by pudendal n (n of perineum); fornices-surround lips of cervix, to reach rectouterine pouch <Douglas> go thru posterior fornix into most inferior part of peritoneal cavity/also important in infection (abortion)
ampulla (2/3 of oviduct, where fertilization occurs); infundibulum (funnel)-distal end; fimbria-fingerlike processes on end of infundibulum
urinary bladder
surfaces: superior, anterior, posterior; subperitoneal (extraperitoneal); ligaments: pubovesical and pubocervical (female), and puboprostatic (male); lies in retropubiv space (space of Retsius)
interior aspect of bladder
detrusal muscle (smooth)-innervated by pelvic splanchnic nn (S2-S4), also called nervi erigentes, which also carry afferent and efferent limbs of bladder emptying reflex arc
bladder trigone
area of interior wall of bladder that is smooth-mucosa is so adherent to muscle tissue; bounded by ureters (ureteric orifices) and urethra
triangular shape with base superiorly and apex inferiorly(urogenital diaphragm); 4 lobes: two lateral, anterior, posterior; ejaculatory duct passes thru posterior lobe, dividing in into median and posterior lobe proper
clinical assns: prostate
median lobe is usually the lobe that enlarges in BPH (benign prostatic hypertrophy)-can occlude ureter/20% @ age 40, 90% @ age 80; posterior lobe proper is initial site for prostate cancer-2nd leading cause of death in men over 50.
male urethra
3 parts: prostatic, membranous, spongy portions
prostatic urethra
urethral crest-along posterior aspect; Seminal Colliculus (vernumontanum)-enlargement @ middle of crest where ejaculatory ducts open; prostatic utricle-blind opening <homologue to uterus>
begins @ junction of sigmoid colon where loses its mesocolon; @ vertebral level S3; ampulla-dilation lies inferior to 3 rectal shelves (shelves of Houston)
anal canal
4-5cm; 3 areas:cutaneous, transitory zones, and mucous membrane (5-10 vertical columns-Morgagni's)
arterial supply of rectum
superior rectal a (continuation of IMA); median sacral (aorta); middle rectal (internal iliac); inferior rectal (internal pudendal)
internal iliac artery
(anterior and posterior divisions)
posterior division (hypogastric): 3 parietal br-iliolumbar (iliacus m), lateral sacral (sacral foramina), superior gluteal (passes out btwn lumbosacral trunk and S1); Anterior division: 3 parietal-obturator, inferior gluteal, and internal pudendal/ 4 visceral br-umbilical (gives rise to superior vesical), middle rectal, inferior vesical and vaginal, uterine (runs with cardinal lig @ base of cervix)
obturator nerve
only nerve found in pelvis that is branch of lumbar plexus
sacral plexus
formed on piriformis muscle; formed by lumbosacral trunk joining with S1-S5
sciatic nerve
largest nerve, formed by L4-S4
pudendal nerve
almost sole somatic nerve supply of perineum; passes out of greater sciatic foramen (beteen piriformis and coccygeus muscles)then run deep to sacrospinous lig and thru lesser sciatic foramen to give off inferior rectal nerves, then continues into pudendal canal (ischiorectal fossa), gives off posterior scrotal and labial nerves and perineal nerve continues deep to perineal membrance and becomes the dorsal nerve of penis or clitoris
pelvic splanchnic nerves
from S2-S4; causes erection (parasympathetics); carry afferent and efferent limbs (bladder reflex arc fibers)
points @ which structures may enter or leave pelvis
1)enter pelvis by passing across pelvic brim into true pelvis from abdomen;2)greater sciatic foramen-connects pelvis to buttock;3)lesser sciatic foramen-pelvis to perineum;4)obturator canal-medial thigh
L-shaped, has body and ramus;greater and lesser sciatic notches lying in between ischial tuberosity and ischial spine
body lies medially; pubic crest; superior ramus; inferior ramus, which joins with the single ramus of ischium (ischiopubic ramus), one of the most frequently fractured sites of oscoxy
pectineal line
lies in superior and posterior aspect of superior ramus (pubis); pectineus attaches here
1) sacrospinous lig
2) sacrotuberous lig
1) is anterior to 2); both help to convert greater and lesser sciatic notches into foramina; extrinsic ligs of SI joint; 1) attaches to ischial spine and coccygeus muscle lies anterior to it.
Peritoneum related to pelvis (male)
comes off the anterior abdominal wall and passes onto superior aspect of vesicle of bladder then passes deeply in the interval of the vesicle and rectum and back over anterior and lateral surfaces of rectum--forms most inferior, dependent protion of male peritoneal cavity <rectovesical pouch>; excess liquid in peritoneal cavity called ascites
comes off ant abdominal wall down to superior surface of bladder, hits uterus; change is the intervention btwn urinary bladder and rectum with vagina and cervix; anterior layer runs over ant aspect of uterus and runs over top part (fundus) and is located posteriorly as well; relationship to rectum is similar to in male; 2 spots that are most dependent: 1)rectouterine pouch <pouch of Douglas or cul-de-sac>--inferior to 2)vesicouterine pouch
Pelvic fascia
Parietal-a continuation of abdominal transversalis fascia; more or less equal to deep fascia enveloping muscles; visceral-Endopelvic or extraperitoneal fatty tissue; acts as a cushion,and supports and lies adjacent to organs
2 thickenings of parietopelvic fascia-used to suture uterus or bladder to lateral wall
1) tendinous arc of levator ani-condensation of obturator interin fascia, lies against wall of pelvis; 2) tendinous arc of pelvic fascia-thickening of fascia covering pelvic diaphragm
Separation of normally joined parts, such as the separation of certain abdominal muscles during pregnancy.
A bursting open or splitting along natural or sutured lines
pudendal artery
gives rise to inferior rectal aa then on to posterior labial aa and on to deep artery of clitoris <homologous structures in male>
pectinate line
point where voluntary muscle in external anal sphincter, and involuntary muscle in internal anal sphincter; internal area supplied by pelvic sympathetics and parasympathetics, external by somatic nerves
suspensory lig of ovary
(infundibulopelvic lig)
part of broad ligament; fold of peritoneum convering anterior aspect of ovarian vessels as cross the pelvic brim
ovarian ligament
connects other end of ovary to uterus; the distal portion of gubernaculum ovary, or round lig--artery of round lig <Artery of Samson>
cardinal ligament
represents 90% of ligamentous support; NOT part of peritoneum