Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

123 Cards in this Set

  • Front
  • Back
pelvic girdle
▪ formed by fusion of ilium, pubis, ischium
▪ articulates with sacrum and forma
▪ transfers weight from upper body to lower extremities, serves as bottom of abdominopelvic cavity, protects lower abodimonopelvic organs
- superiormost of the hip bones, and is comprised of a body and a wing
- forms the superior part of the acetabulum
parts of ilium
ala, body, iliac crest, anterior iliac spine
the wing of the ilium as it sweeps laterally
body of the ilium
the "handle" of the fan, or the solid part of the bone
iliac crest
superior rim of the ala
anterior superior ilia spine
most anterior part of iliac crest; palpable and prominent landmark
McBurney's point
1/3 of the way from ASIS to umbilicus; appendix location and site of surgery
parts of the ischium
body, ramus, ischial tuberosity, ischial spine
body of ischium
helps to form acetabulum
ischium ramus
extends inferiorly and then curves anteriorly, serving as inferior border of obturator foramen
ischial tuberosity
protrusion inferiorly and posteriorly from the body of the ischium
ischial spine
protrusion from posterior body of ischium, origin of sacrospinous ligament, an important clinical landmark
third bone of pelvis, has body and two rami which are both fused with ischium
superior pubic ramus
forms anterior part of acetabulum
inferior pubic ramus
fuses with ischium to form inferior boundary of obturator space
body of pubis
attaches in midline to opposite pubic bone to complete circle of pelvic girdle
retropubic space
cave of Retzius; area posterior to pubic arch; lies posterior to pubis and anterior to bladder
ischiopubic rami (pubic arch)
formed as two arches come together in midline anteriorly, varies significantly between sexes
cup like socket that articulates with head of the femur, where hip replacements are done, superior rim much heavier as it is weight bearing, inferior rim is incomplete; formed by body of ischium and superior pubic ramus (form anterior part), superior part formed by ilium
obturator foramen
large foramen inferior to acetabulum, closed by membrane in life, becoming important in some types of surgical procedures for urinary incontinence
obturator membrane
covers obturator foramen with exception of small opening at superior aspect called the obturator canal
obturator canal
opening in obturator membrane by which obturator vessels and nerve leave the pelvis to enter the medial compartment of the thigh
greater sciatic notch
large concavity on posterior ischium and ilium above ischial spine
lesser sciatic notch
smaller concavity between ischial spine and ischial tuberosity
fusion of five sacral vertebrae, articulates with pelvic girdle
sacral promontory
smooth ventral surface of sacrum, forms posterior part of pelvic cavity
3-4 rudimentary vertebrae attached at bottom of sacrum, end of vertebral column, may be fused, “tailbone”
sacrotuberous ligament
posterior strong bracing ligament attaching sacral vertebrae (sacrum) to the ischial tuberosity, medial border of both greater and lesser sciatic foramen
sacrospinous ligament
smaller ligament attaching coccyx and sacrum to ischial spine, divides greater sciatic foramen from lesser sciatic foramen
sacroiliac joints
strong weight bearing joints, supporting upper body as attaches to sacrum to pelvic girdle
pubic symphysis
cartilaginous joint from the joining of the two pubic bones in the midline, wider in women than men
obturator internus
lies on inner surface of pelvic bones, exits posteriorly through lesser sciatic foramen and attaches to femur (trochanteric fossa)

innervation: branches of sacral plexus
action: laterally rotate & stabilize hip joint
lines inner pelvis posteriorly, exits through greater sciatic foramen
laterally rotates and stabilizes hip joint
inn. by sacral plexus
pelvic diaphragm
funnel shaped floor of pelvis, comprised of levator ani and coccygeus
levator ani
complex muscle comprised of three main muscles, function in support of pelvis structures but also assists in some of the functions of the pelvic organs
posterior part of pelvic diaphragm, extends from inferior sacrum and coccyx to ischial spine
obturator arteries and veins
arises from internal iliac vessels and runs across surface of obturator internus, exits obturator canal to supply pelvic muscles and head of femur
internal pudendal arteries and veins
arise from internal iliac, exits through greater foramen and enters perineum by lesser foramen, primary artery to perineum
superior gluteal arteries and veins
arise from internal iliac, exits through greater sciatic foramen, superior to piriformis muscle, distributed to buttock
inferior gluteal arteries and veins
arise from internal iliac, pass through greater sciatic foramen, inferior to piriformis muscle and superior to the coccygeus muscle, and distributed to buttock
sacral plexus (parts)
muscular branches of sacral plexus, sciatic nerve, pudendal nerve, superior gluteal nerve, inferior gluteal nerve, obturator nerve
sciatic nerve
(L4-S3), largest nerve in body, leaves body by greater sciatic foramen inferior to piriformis muscle into buttock then turns caudal to supply hamstring muscles and all of leg and foot; Very important clinically as care has to be taken so as not to give intramuscular injections into the nerve as it passes through buttock, can cause lifelong pain or paralysis of leg and foot
pudendal nerve
(S2-S4); main nerve of perineum and primary
sensory nerve of external genitalia, very susceptible to damage with childbirth with significant pelvic symptoms
superior gluteal nerve
(L4-S1); exits pelvis through greater sciatic foramen, superior to piriformis, and supplies muscles of buttocks (gluteus medius, minimus, tensor fascia lata)
inferior gluteal nerve
(L5-S2); exits through greater sciatic foramen, inferior to piriformis, and supplies muscles of buttocks (gluteus maximus)
muscular branches of sacral plexus
small branches to muscles of pelvis (e.g., obturator internus, piriformis, levator ani)
damage to pelvic floor & prolapse/incontinence
see page 4 of pelvis I
o Primarily retroperitoneal
o Terminal portion of the large intestine (a hindgut derivative)
o Continuous proximally with sigmoid colon
o Continuous distally with anal canal (located in the perineum)
o Lacks teniae coli, haustra, and omental appendices
o Not a straight tube (it has lateral flexures)
anorectal flexure
o where rectum and anal canal meet at an abrupt angle, created and maintained by a portion of the levator ani
rectal ampulla
lies superior to the flexure; it expands to store fecal material
the levator ani relaxes, permitting the anorectal flexure to straighten and fecal material to move inferiorly from the ampulla into the anal canal
rectal exam
• In females, the anterior wall of the rectum is related to the vagina
• In males, the anterior wall of the rectum is related to the prostate (posterior lobe) and seminal vesicles
o Primarily retroperitoneal
o Ureters descend into the pelvis near the bifurcation of the common iliac vessels into external and internal branches
o Course inferior/posterior to the uterine artery in the female and ductus deferens in the male (“water under the bridge”)
o Due to its close proximity to the uterine artery, the ureter is vulnerable to injury during a hysterectomy, when the uterine artery is ligated and severed to remove the uterus
o Ureters pass obliquely through posterosuperior bladder wall (its oblique passage forms a one-way valve, preventing reflux of urine into the ureters
urinary bladder
o Primarily retroperitoneal
o Related to the rectovesical pouch in the male and the vesicouterine pouch in the female
o The bladder receives urine from the ureters, stores it, then expels it through the urethra
o Highly distensible organ with smooth muscle walls (detrusor muscle)
internal urethral sphincter
o Smooth muscle sphincter at the neck of the bladder that surrounds the opening of the urethra
o Sympathetic innervation stimulates its contraction (preventing micturition)
o In males, it is continuous with smooth muscle of base of prostate
effect of para/symp innervation on rectum
o Parasympathetic innervation (pelvic splanchnic nerves) stimulates peristaltic contractions (defecation); Sympathetic innervation inhibits contractions
parasympathetic innervation of urinary bladder
(pelvic splanchnic nerves); stimulate contraction of detrusor muscle, allowing micturition to occur
rugae of urinary bladder
o Mucosal folds are prominent when the bladder is empty
o Folds disappear as the bladder distends
• Triangular portion of the posterior wall defined by the two ureteric orifices superiorly and the urethral orifice inferiorly
• Smooth (no rugae)
• Very sensitive to stretch (stimulates urge to void)
position of bladder in males
bladder rests upon the prostate gland
position of bladder in babies and children
until puberty, the bladder (even when empty) extends superior to the pubis, into the abdomen, where it is susceptible to injury
distended bladder
in adult, extends into the abdomen; When the bladder is full, a suprapubic incision can be made to access the bladder without traversing the peritoneum and entering the peritoneal cavity
female pelvic organs
broad ligament, ovaries, uterine tubes, uterus, vagina
broad ligament
o Double layer of peritoneum (mesentery) that extends from the sides of the uterus to the lateral walls and floor of the pelvis
o Helps hold the uterus in position
o The uterine tubes lie in the superior edge of the broad ligament
o The ovaries are attached to the posterolateral border of the broad ligament
o Also encloses the remnants of the gubernaculum (ovarian ligament, round ligament of uterus)
suspensory ligament of the ovary
o An extension of the broad ligament, encloses the ovarian arteries and veins, lymphatic vessels, and nerves

attaches ovary to lateral walls?
ovarian ligament
between ovary and uterus, remnant of gubernaculum, enclosed by broad ligament
round ligament of uterus
between uterus and labium majus, remnant of gubernaculum, enclosed by broad ligament
o Female gonads originate on the posterior abdominal wall, attached to the gubernaculum
o Descend into the pelvis and become attached to the posterior aspect of the broad ligament (ovaries are intraperitoneal)
o The ovarian vessels, nerves, and lymphatics that accompanied the descent of the ovary are enclosed within the suspensory ligament of the ovary
o During ovulation, an oocyte is expelled from the ovary into the peritoneal cavity, towards the abdominal orifices of the uterine tubes
uterine tubes
o Intraperitoneal (enclosed in the superior edge of the broad ligament)
o Uterine tubes open into peritoneal cavity at their abdominal orifices which are surrounded by finger-like fimbriae
o Uterine tubes enter the superolateral walls of the uterus at their uterine orifices
o The uterine tubes are the most common site of an ectopic pregnancy
peritoneal cavity (males vs. female)
o The peritoneal cavity is open in the female and closed in the male
• Pelvic inflammatory disease is much more common in females, as the vagina, uterus and uterine tubes provide a pathway into the peritoneal cavity
o Most of the uterus is intraperitoneal (due to broad ligament)
o Pear-shaped organ located between the bladder and rectum
o includes myometrium, endometrium, body, isthmus, cervix, supporting ligaments
myometrium of uterus
• Smooth muscle of uterus (distends greatly during pregnancy)
endometrium of uterus
• Internal lining, glandular mucosa, site of implantation, shed each month during menses
body of uterus
• Superior two thirds of the uterus
• Fundus (rounded superior portion of the body, located superior to the orifices of the uterine tubes)
isthmus of uterus
• Constriction marking the junction of the body and the cervix
cervix of uterus
• Cylindrical inferior one third of the uterus
• Central canal opens superiorly into the body of the uterus at the internal os
• Central canal opens inferiorly into the vagina at the external os (site of pap smears, small and round if the woman has never given birth vaginally, wide and slit-like if she has)
supporting ligaments of uterus
(e.g., cardinal ligaments)
• Located deep to the parietal peritoneum
• Connect the cervix to the pelvic walls
• Support the uterus, prevent it from descending
• However, the pelvic diaphragm is the primary supporter of the uterus
• During childbirth, these means of support can be damaged/weakened, allowing the uterus to descend through the vagina (prolapse of the uterus)
o Located between the urinary bladder and the rectum
o Continuous with the cervix at the external os
o Runs superiorly and posteriorly
o Anterior and posterior walls contact each other
o The cervix projects into the vagina at its superior end, creating recesses anteriorly, laterally, and posteriorly called vaginal fornices
male pelvic organs
testes, epididymis, ductus defernes, seminal vesicles, ejaculatory ducts, prostate
o Male gonads originate on the posterior abdominal wall, attached to the gubernaculum
o Descend into inguinal region, pass through deep ring and the inguinal canal, and exit the superficial ring to enter the scrotum
o Each testis is covered by a tough fibrous coat, the tunica albuginea
o Internally, the testis contains seminiferous tubules (where the spermatozoa mature)
path of spermatozoa
seminiferous tubules > rete testis > efferent ductules > epididymis > ductus deferens > seminal vesicles > ejaculatory duct > prostatic urethra
o Highly coiled tube located on the posterior surface of the testis
o Connects the testis to the ductus deferens
ductus deferens
o connected to testis via epididymis
o Thick walled muscular tube
o Ascends within the spermatic cord, through the superficial ring and inguinal canal, and into the abdomen via the deep inguinal ring (lateral to the inferior epigastric vessels)

o Crosses the ureter superiorly near the superior angle of the bladder (“water under the bridge”)
o When it reaches the posterior aspect of the bladder the ductus deferens enlarges to form an ampulla
o The ampulla of each ductus deferens joins the duct of the seminal vesicle
seminal vesicles
o Thin walled tubes that are coiled to form a mass that lies between the posterior wall of the bladder and the rectum
o When enlarged due to disease, the seminal vesicles can be palpated through the anterior wall of the rectum
o The seminal vesicles secrete a nutrient rich fluid that mixes with the spermatozoa
o Ducts of the seminal vesicles join the ampullae of the ductus deferens to form the ejaculatory ducts
ejaculatory ducts
o formed by ducts of seminal vesicales joining ampullae of ductus deferens
o Ejaculatory ducts enter the posterosuperior part of the prostate gland
o Open into the prostatic urethra
o Surrounds the prostatic urethra
o Secretes a thin fluid into the prostatic urethra via numerous ducts
o parts include base, apex, lobes
base and apex of prostate
• Located superiorly
• Surrounds the neck of the bladder
• Internal urethral sphincter of the bladder is continuous with the smooth muscle of the prostate
apex: located inferiorly
vaginal fornices
o The cervix projects into the vagina at its superior end, creating recesses anteriorly, laterally, and posteriorly called vaginal fornices
posterior fornix
deepest of the vaginal fornices and is related to the rectouterine pouch, the rectum and anal canal posteriorly
• An incision can be made through the posterior fornix to examine the peritoneal cavity endoscopically
- plate 360
lobes of prostate
anterior (ant to prostatic urethra), two lateral lobes (either side of PU), middle lobe (btwn PU and ejaculatory ducts), posterior lobe (posterior to PU and inferior to ejaculatory ducts)
median (middle) lobe of prostate (clinical)
commonly involved in benign hypertrophy of the prostate. When the median lobe is enlarged, it stretches the internal urethral sphincter (causing urine leakage), puts pressure on the trigone (creating intense desire to void, especially at night-nocturia), and can obstruct/narrow the prostatic urethra
posterior lobe of prostate (clinical)
most common site of prostatic carcinoma; Posterior lobe is palpable through the anterior wall of the rectum
pelvic arteries
superior rectal artery, gonadal (ovarian/testicular), common iliac, internal iliac artery (superior gluteal, inferior gluteal, internal pudendal), umbilical, obturator, middle rectal, female only: uterine, vaginal, male only: inferior vesical
superior rectal artery
o Terminal branch of the inferior mesenteric artery
o A major source of blood to the rectum
gonadal arteries (ovarian or testicular)
o Branches of the abdominal aorta
o Testicular arteries travel within the spermatic cords inferiorly
o Ovarian arteries travel within the suspensory ligaments of the ovaries
o In addition to supplying the gonads, the ovarian arteries also supply the uterus
common iliac arteries
divide into the external and internal iliac arteries
internal iliac artery
o Primary blood supply to the pelvis, perineum and gluteal region
o Branching pattern varies greatly

o Major Branches (paired, left and right): superior and inferior gluteal, internal pudendal
superior gluteal artery
branch of internal iliac; Exits greater sciatic foramen superior to piriformis to supply gluteal region
inferior gluteal artery
branch of internal iliac; exits greater sciatic foramen inferior to piriformis to enter the gluteal region
internal pudendal artery
branch of internal iliac
• Exits greater sciatic foramen inferior to the piriformis to enter the gluteal region
• It then travels with the pudendal nerve to the perineum
• Eventually gives rise to inferior rectal artery which supplies the anal canal
umbilical artery
• Courses along the lateral wall of the pelvis
• Gives off the superior vesical artery (or arteries) supplying the superior aspect of the bladder (and ductus deferens in the male)
• Obliterated portion continues on the internal surface of the anterior abdominal wall as the medial umbilical ligaments
obturator artery
• Courses along the lateral wall of the pelvis with the obturator vein and nerve
• Exits the pelvis via the obturator canal to enter the thigh
middle rectal artery
branch of internal iliac; Anastomoses with the superior and inferior rectal arteries
uterine artery
• Passes anterior to the ureter (“water under the bridge”)
• Enters the broad ligament to reach the uterus (where the body and cervix meet)
• Anastomoses with the ovarian and vaginal arteries
• During a hysterectomy, one must ligate both the uterine and ovarian arteries (and upper vaginal branches if necessary) to control bleeding
vaginal artery
Supplies vagina, inferior bladder (via inferior vesical branch), and urethra
inferior vesical artery
o (direct branch of internal iliac in male only)
o Supplies inferior bladder, urethra, seminal vesicles, prostate
pelvic veins
o Venous pattern is similar to arterial pattern (share same names)
o In addition, there are numerous venous plexuses around the pelvic organs (e.g., prostatic, uterine, vaginal, rectal, and vesical plexuses)
Portal-caval anastomosis related to the rectum and anal canal (hemorrhoids)
o Proximal drainage into the superior rectal vein > IMV (portal system)
o Distal drainage into the inferior rectal vein > internal pudendal vein(caval system)
Pelvic Lymphatics
o Most of the lymph from structures within the pelvic cavity drains to internal iliac nodes
o Drainage pattern: internal iliac nodes -> common iliac nodes -> lumbar nodes (along the aorta)-> chyle cistern -> thoracic duct
o Exception: lymph from the ovaries and testes follows the ovarian and testicular vessels, and drains directly into lumbar lymph nodes
pelvic nerves
obturator nerve, sacral plexus (lumbosacral trunk, ventral rami S1-S4), parasympathetics, sympathetics
obturator nerve
o Branch of the lumbar plexus (ventral rami L2-L4)
o Located medial to psoas major
o Courses along the lateral wall of the pelvis, with obturator vessels along surface of obt internus muscle
o Exits the pelvis through the obturator canal (in the obturator membrane) to reach the thigh
sacral plexus
ventral rami L4-S4, includes lumbosacral trunk (L4-L5), ventral rami S1-S4
o can be compressed by pelvic tumors or the fetal head during childbirth
lumbosacral trunk
- L4-L5; part of sacral plexus
• Located medial to psoas major
• Descends from the abdomen to join the sacral ventral rami
ventral rami S1-S4
part of sacral plexus;
- emerge from the anterior sacral foramina and travel through the piriformis muscle
• Inflammation of the piriformis muscle can compress the sacral ventral rami
parasympathetic innervation of pelvic organs
• Preganglionic cell bodies: S2-S4 spinal cord (lateral horn)
• Preganglionic fibers: pelvic splanchnic nerves
• Postganglionic cell bodies and fibers: walls of organs
sympathetic of pelvic organs (not rectum, ovary, testes)
• Preganglionic cell bodies: lateral horn of the thoracolumbar spinal cord
• Preganglionic fibers travel from ventral root > spinal nerve> white ramus communicans > sympathetic trunk > lumbar and sacral splanchnic nerves
• Postganglionic cell bodies: superior or inferior hypogastric ganglia (primarily the inferior hypogastric)
• Postganglionic fibers: follow arterial branches to target organ
ovary / testes sympathetic innervation
• Preganglionic fibers: thoracic splanchnic nn.
• Postganglionic cell bodies: superior mesenteric ganglion
• Postganglionic fibers: follow gonadal vessels to target organ
visceral pain of pelvic organs
• Follow the sympathetic and parasympathetic pathways back to the spinal cord
performed by making an incision in superior aspect of scrotum to expose and ligate ductus deferns
aberrant obturator artery
• In approximately 20% of the population, there is an aberrant obturator artery arising from the inferior epigastric artery
o Courses over the superior pubic ramus to exit via the obturator canal
o An aberrant obturator artery can be accidentally damaged during hernia repairs
Spermatozoa + secretions of seminal vesicles, prostate, and bulbourethral glands
one must ligate both the uterine and ovarian arteries (and upper vaginal branches if necessary) to control bleeding; must be careful of ureter