Anatomy Pelvis

Front 1

In a child what hold the 3 components of the Os coxae together?

Back 1

the Triradiate cartilage

Front 2

State whether the following is male or female:

1. Greater pelvis: Deep/shallow
2. General structure: thick & heavy/think & light
3. Lesser pelvis: wide & shallow/narrow & deep
4. Pelvic outlet: comparatively large/comparitively small
5. Pubic arch: narrow/wide
6: acetabulum: small/large

Back 2

1. Greater pelvis: Male-Deep/Female-shallow
2. General structure: Male-thick & heavy/ Female-think & light
3. Lesser pelvis:female-wide & shallow/ Male-narrow & deep
4. Pelvic outlet: female-comparatively large/ female-comparitively small
5. Pubic arch: male-narrow/ female-wide
6: acetabulum: female-small/l male-large

Front 3

Weight is transferred from the axial skeleton to the ilia and then to the femurs during standing. where is the weight transferred to (instead of the femors when sitting?

Back 3

the ischial tuburosities

Front 4

When is the shape and size of the pelvic inlet important?

Back 4

during childbirth (it is the birth canal)

Front 5

Indicate which is the male and which is the female pelvic characteristic:

1. heavier
2. thinner
3. larger pelvic inlet
4. thicker
5. larger pelvic outlet

Back 5

1. heavier
2. thinner: male
3. larger pelvic inlet: female
4. thicker: male
5. larger pelvic outlet: female

Front 6

What type of joint is the pubic symphysis?

What ligament joins the pubic bones?

Is it thicker in men or women?

Back 6

secondary cartilaginous joint

women

the superior and inferior pubic ligaments

Front 7

What hormone permits freer movements in the pelvis and lumbar region?

Back 7

Relaxin

Front 8

Give the following for the OBTURATOR muscle:

Innervation:

Blood supply:

Action:

Back 8

Innervation: obterator internus (L5-S2)

Blood supply: Obturator artery (a branch of the posterior division of the Internal iliac artery

Action: Rotate thigh laterally and hold head of femor in the acetabulum

Front 9

Where does the obturator muscle attach on the pelvis?

Back 9

the ilium and ischium

Front 10

What makes up the lateral pelvic wall?

Back 10

the hip bones and the obturator membrane/obturator muscle

Front 11

What type of hernia will effect the blood supply of the obturator atery?

When does this happen

Back 11

Femoral hernia

When the obturator artery comes off of the inferior epigastric as opposed to the anterior division of the internal iliac.

Front 12

What makes up the anterior wall of the pelvis?

Back 12

the bodies and the rami of teh pubic bones and the pubic symphysis

Front 13

What makes up the lateral wall of the pelvis?

Back 13

the hip bones, and the obturator membrane and muscle

Front 14

What make up the posterior pelvic wall?

Back 14

the sacrum and the coccy (and parts of the ilia and ligaments)

Front 15

What 5 things make up the posterior pelvic wall?

Back 15

the sacrum and the coccyx, parts of the ilia and ligaments, and the piriformis muscl

Front 16

What makes up the pelvic floor (the pelvic diaphragm)?

Back 16

the levator ani, the coccygeus muscles and their fascia covering (both the superior and inferior aspects of these muscles.)

Front 17

What is the innervation for the following?

1. piriformis m.
2. levator ani m.
3. coccygeus m.

Back 17

1. piriformis m.: anterior rami of S1-S2
2. levator ani m.: S4 via pudendal
3. coccygeus m. S4-S5

Front 18

What is the cause of uterine prolapse in older women?

Back 18

divarcation (division) of the levator ani by multiparity

Front 19

What nerve innervates teh coccygeus?

Back 19

Branches of S4-S5

Front 20

what is the tendenous arch?

Back 20

* thickened fascia of obturator internus muscle.

*attachments: ischial spine and pubic bone.

* Serves as a lateral attachment to the iliococcygeus m.

Front 21

Besides resisting increases in abdominal pressure, what 3 things does the levator ani do?

Back 21

1. voluntary control of urination

2. voluntary control of defication

3. support of the uterus

Front 22

Which boundaries make up the Pelvic Inlet?

Back 22

Anterior: superior margin fo teh pubic symphysis adn posterior border of the pubic crest.

Lateral: pecten pubis and arcuate line of teh ilium

Posterior: anterior border of the ala of teh sacrum and the sacral promontory

Front 23

Compare the pubic angles of men and women?

Back 23

women :>80%

men: <70%

Front 24

Compare the pelvic inlet shape difference between men and women

Back 24

Men: heart shaped
Women: rounded oval

Front 25

At what levels do you find the skin dimples over the PSIS?

Back 25

S2 adn the middle of the sacroiliac joints

Front 26

At what level would one be at if they drew a line across the two highest point of the iliac crests?

Why is this clinically relevant?

Back 26

L4

This is the level of the lumbar puncture

Front 27

what type of tissue do external hemorrhoids arise?

Back 27

perianal skin

Front 28

What is the natal cleft?

Back 28

the midline sulcus between the buttock

Front 29

What structures does the pudendal nerve innervate?

Which sacral nerves compose the pudendal nerve?

Back 29

1. Bladder, rectum and external genitalia

2. S2, S3, S4

Front 30

What separates teh greater and the lesser pelvis?

Back 30

the pelvic inlet (the pelvic brim)

Front 31

What limits the movement of the sacroiliac joints?

Back 31

the interlocking of the articulating bones and teh interosseous and posterior sacroiliac ligaments... thus movement is limited to sliding and rotatating

Front 32

What limits the upward movement of the sacrum?

Back 32

the sacrotuberous and sacrospinous ligaments

Front 33

What type of joint ist he pubic symphysis?

Back 33

secondary cartilaginous joint (w/ a fibrocartilaginous interpubic disc)

Front 34

Which hormone accounts for the relaxation of teh pelvic joints and ligaments during childbirth?

Back 34

"Relaxin"

Front 35

Answer the following for the "Obturator Internus" muscle:

1. innervation
2. Action

Back 35

1. innervation: nerve to the obturator inturnus (L5-S2)

2. Action: rotates thigh laterally, and hold femor in the acetabulum

Front 36

Answer the following for the "Periformis" muscle:

1. innervation
2. Action

Back 36

1. innervation: Anterior rami of S1-S2
2. Action: rotates thigh laterally, holds femur in the acetabulum

Front 37

Answer the following for the "Levator Ani" muscle:

1. innervation (3 each)
2. Action

Back 37

1. innervation: nerve to the levator ani (branches of S4), interior anal, & coccygeal plexus.

2. Action: helps support the pelvic viscera and resists incerasese in intra-abdominal pressure

Front 38

Answer the following for the "coccygeus" muscle:

1. innervation
2. Action

Back 38

1. innervation: branches of S4-S5 nerves
2. Action: supports pelvic viscera

Front 39

Which muscle plays an important role in the voluntary control of urination, and fecal continance as well as the suppor tof the uterus?

Back 39

levatator ani

Front 40

Which nerves are most pelvic structures innervated by?

Back 40

Sacral (S1-S4) and coccygeal nerves of the ANS

Front 41

What is the source of the lumbosacral trunk?

Where does it pass when entering the sacrum

what does it join when in the pelvis?

Back 41

L4 and L5

inferior/anterior to the ala of the sacrum

Sacral plexus

Front 42

Which nerves is the sciatic nerve formed by?

Where do these nerves converge to form the sciatic nerve?

Which foramen does the sciatic nerve pass through to go the ______region?

Back 42

L4-S3

They converge on the anterior surface of the piriformis

it passes through the greater sciatic foramen --> inferior to the piriformis to enter the gluteal (buttocks) region

Front 43

What is the main nerve of the perineum and chief sensory nerve of teh external genitalia?

What is the origin of this nerve?

What artery accompanies this nerve?

How does this nerve enter the perineum?

Back 43

Pudendal nerve

Origin: anterior division of the anterior rami of S2-S4

Accompanying artery: pudendal artery

Enters the perineum by hooking around the sacrospinous ligament and finally passes through the lesser sciatic forament to enter the perineum

Front 44

What specifcially does the pudendal nerve innervate?

Where does the pudendal nerve end?(hint: male v. female)

Back 44

the skin /muscles of the perineum:

Male: dorsal nerve of the penis
Female: nerve of the clitoris

Front 45

Where does the superior gluteal nerve arise from?

How does it exit the pelvis:

What 2 muscles and "tensor" does it supply?

Back 45

1. posterior divisions of the anterior rami of L4-S1

2. exits through the greater sciatic foramen superior to the piriformis muscle

3. gluteus medius and minimus... as well as the tensor of the fascia lata

Front 46

Where does the inferior gluteal nerve arise from?

How does it exit the pelvis:

What muscle does it innervate

Which artery accompanies this nerve?

Back 46

1. posterior divisions of the anterior rami of L5-S2

2. greater sciatic foramen

3. gluteus maximus

4. inferior gluteal artery

Front 47

Where does the "obturator" nerve arise from?

Where does it divide into anterior and posterior branches?

What muscle(s) does it innervate?

Back 47

1. Lumbar plexus (anterior divisions of the the anterior rami of L2-L4) in the abdomen.

2. the obturator canal

3. medial thigh muscles

Front 48

During childbirth a mother's pelvic plexus is compressed and produces pain.

1. Which nerve is vulnerable to injury

2. What are the clinical consequences of the injury to this nerve?

Back 48

1. obturator nerve

2. spasms to the adductor muscles of the thigh... and sensor deficits in the medial aspects of the thigh

Front 49

What is the origin of the sacral sympathetic trunks?

2. How many ganglia do they usually have?

3. where do they converge?

Back 49

they are a continuation of the lumbar sympathetic trunks

2. 4 ganglia

3. ganglion impar

Front 50

What is the primary function of the sacral sympathetic trunks?

Back 50

provide postsynaptic fibers to the sacral plexus for sympathetic innervation of the lower limbs

Front 51

What is the relationship between the following?

a. superior hypgastric plexus
b. hypogastric nerves
c. inferior hypgastric plexuses

2 Where does the superior hypogastric plexus arise from?

Back 51

superior hypgastric plexus --> Right/ left: hypogastric nerves --> leads to inferior hypgastric plexuses

2. intermesenteric plexus (which also receives the L3 and L4 splanchnic nerves.

Front 52

What do the inferior hypogasatric nerves innervate? (hint: males, female, both)

Back 52

Both: parts of the rectum and bladder

male: prostate and seminal glands

female: cervix and lateral parts of the fornix

Front 53

Do the inferior hypogastrics have sympathetic or parasympathetics?

Back 53

both

Front 54

What are the 4 main arteries of the pelvis?

What are the 5 main veins of the pelvis?

Back 54

Arteries:
1. internal iliac arteries (main)
2. ovarian
3. median sacral
4. superior rectal

Veins:
1. internal iliacs (main)
2. superior rectal veins ( important in collateral drainage)
3. median sacral
4. gonadal

Front 55

From the Common Iliac name:

1. the first bifurcation
2. second bifurcation of the internal branch?

Back 55

1. internal and external iliac
2. posterior and anterior branches of the internal iliac

Front 56

Name 4 branches of the posterior branch of the internal iliac.

Back 56

1. iliolumbar
2. lateral sacral
3. superior gluteal
4. inferior gluteal

Front 57

Name ? branches of the anterior branch of the internal iliac.

Back 57

?

Front 58

are the ureters retroperitoneal?

Back 58

yes

Front 59

what artery supplies the ureters while they run through the pelvis?

Back 59

iliac arteries

Front 60

In females what is the most "constant arterial supply of the ureters?

In males what is the most "constant arterial supply of the ureters?

Where do these arteries arise?

Back 60

uterine arterise

inferior vesical arteries

anterior branch of the internal iliac

Front 61

What is the autonomic nerve supply of the ureters?

What route do the afferent (pain) fibers for the ureters follow?

Back 61

autonomic plexuses of teh renal , aortaic and superior and inferior hypogastric

they follow the sympatheic fibers retrograde and spinal cord segments T11 -L2