Anatomy: The Pelvis And Perineum

Front 1

Which five bones make upt the pelvis?

Back 1

Ileum, Ischium, Pubis, Sacrum, and Coccyx

Front 2

The most superior point of the iliac crest as palpated posteriorly is located at which vertebral level?

Back 2

L4

Front 3

What are the four major articulations of the pelvis?

Back 3

1. The lumbrosacral joint 2. The sacroiliac joints 3. The sacrococcygeal joints 4. The symphysis pubis

Front 4

Which of the articulations of the pelvis are cartilaginous joints?

Back 4

The symphysis pubis, the sacrococcygeal joint, and the lumbrosacral joint

Front 5

Which three ligaments support the sacroiliac joint?

Back 5

1. The anterior sacroiliac ligament 2. The posterior sacroiliac ligament 3. The interosseus ligaments

Front 6

List five ways the pelvis differs between women and men

Back 6

1. In women, the bones of the pelvis are smaller, lighter, and thinner 2. In women, the sacrum is broader and shorter 3. In women, the suprpubic arch and the greater sciatic notch are wider 4. In women, the pelvic inlet is ovoid, while in men it is heart-shaped 5. In women, the ischial tuberosities are everted, thereby enlarging the pelvic outlet

Front 7

Which muscles comprise the urogenital diaphragm?

Back 7

1. The deep transverse perineal muscles, running transversely anteriorly and posteriorly 2. The sphincter urethrae muscle (and the sphincter vaginae muscle in women)

Front 8

The superior fascia of the urogenital diaphragm is continuous with which fascial layer?

Back 8

The obturator internus (pelvic parietal) fascia

Front 9

What is the origin of the obturator internus muscle?

Back 9

The pelvic surface of the obturator internus fascia and the surrounding parts of the ilium and pubis

Front 10

What is the insertion of the obturator internus muscle?

Back 10

The greater trochanter of the femur

Front 11

What is the innervation of the obturator internus muscle?

Back 11

The obturator nerve (from the sacral plexus)

Front 12

What is the action of the obturator internus muscle?

Back 12

Lateral rotation of the thigh when the hip joint is extended

Front 13

What structure covers the obturator internus muscle?

Back 13

The obturator internus fascia

Front 14

What structure is formed by the obturator internus (pelvic parietal) fascia?

Back 14

The pudendal canal, which transmits the pudendal nerve, artery, and vein

Front 15

What is the anorectal angle?

Back 15

The angle between the rectum and the anal canal; contraction of the puborectalis muscle holds the anorectal junction anteriorly, preventing the passage of feces from the rectum into the anal canal

Front 16

What is the origin of the coccygeus muscle?

Back 16

The lateral pelvic surface of the ischial spine and the sacrospinous ligament

Front 17

What is the insertion of the coccygeus muscle?

Back 17

The medial and lateral margin of the coccyx and vertebra S5

Front 18

What is the innervation of the coccygeus muscle?

Back 18

Branches of the spinal nerves S4 and S5

Front 19

What is the action of the coccygeus muscle?

Back 19

Assists the levator ani muscle group in supporting the pelvic viscera; supports and pulls the coccyx anteriorly

Front 20

The pelvic fascia is consistent with which fascial layer of the abdominal wall?

Back 20

The transversalis fascia

Front 21

The common iliac artery divides into the external and the internal iliac arteries at which vertebral level?

Back 21

L5-S1

Front 22

What is the first branch of the internal iliac artery?

Back 22

The iliolumbar artery

Front 23

How does the internal iliac artery terminate?

Back 23

By dividing into the anterior and posterior branches

Front 24

What are the three branches from the posterior internal iliac artery?

Back 24

1. Iliolumbar artery 2. Lateral sacral artery 3. Superior gluteal artery

Front 25

How does the superior gluteal artery leave the pelvis?

Back 25

Through the superior part of the greater sciatic foramen (i.e. the part above the piriformis muscle)

Front 26

What are the eight branches from the anterior internal iliac artery?

Back 26

1. Umbilical artery 2. Superior vesical arteries 3. Uterine artery 4. Vaginal artery (women) or inferior vesical artery (men) 5. Middle rectal artery 6. Obturator artery 7. Internal pudendal artery 8. Inferior gluteal artery

Front 27

How does the obturator artery leave the pelvis?

Back 27

Through the obturator foramen

Front 28

How does the inferior gluteal artery leave the pelvis?

Back 28

Through the inferior part of the greater sciatic foramen

Front 29

What are the two terminal branches of the internal pudendal artery?

Back 29

The deep and dorsal arteries of the penis (men) or the clitor (women)

Front 30

Where do the ovarian arteris arise?

Back 30

Anteriorly from the abdominal aorta, just inferior to the renal arteries

Front 31

Where do the testicular arteris arise?

Back 31

Anteriorly from the abdominal aorta, just inferior to the renal arteries

Front 32

What is the drainage of the pelvic lymph nodes (i.e. the external iliac and internal iliac nodes)?

Back 32

The common iliac nodes

Front 33

Which two major nerves are dericed from the sacral plexus?

Back 33

The sciatic nerve and the pudendal nerve

Front 34

The pudendal nerve follows the course of which artery?

Back 34

The internal pudendal artery

Front 35

What are the two distal branches of the pudendal nerve?

Back 35

1. The perineal branches 2. The dorsl nerve of the penis or clitoris

Front 36

The pudendal nerve carries which sensory fibers?

Back 36

Those that supply the external genitalia and perianal region

Front 37

The pudendal nerve carries which motor fibers?

Back 37

Those that supply the external anal sphincter and muscle associated with ejaculation

Front 38

Which branch of the pudendal nerve supplies the external anal sphincter?

Back 38

The inferior rectal nerve

Front 39

Which nerves contribute to the inferior hypogastric plexus?

Back 39

1. Parasympathetics, via the pelvic splanchinic nerves (derived from spinal segments S2-S4) 2. Sympathetics from the superior hypogastric plexus and pelvic sympathetic trunk

Front 40

Afferent fibers sensing bladder fullness are carried by which nerves?

Back 40

The pelvic splanchnic nerves

Front 41

Visceral efferents to the detrusor muscle and internal sphincter of the bladder are carried by which nerves?

Back 41

Parasympathetics

Front 42

Which nerves supply motor innercation to the smooth muscle of the prostate, the seminal vesicle, the ejaculatory ducts, and the ductus deferns?

Back 42

Sympathetics

Front 43

Which autonomic nerves coordinate erection?

Back 43

Parasympathetics

Front 44

Which autonomic nerves coordinate ejaculation?

Back 44

Sympathetics

Front 45

How does the ductus deferens travel relative to the ureter

Back 45

The ductus deferens travels anterior to the ureter (as the ureter enters the bladder) to join with the duct of the seminal vesicle

Front 46

Where do the ejaculatory ducts open into the urethra?

Back 46

At the sminal colliculus, lateral and inferior to the porstatic utricle (a remant of the mullerian duct)

Front 47

Where do the bulbourethral glands (of Cowper) open into the urethra?

Back 47

At the spongy urethra

Front 48

Where do the prostatic ducts open into the urethra?

Back 48

At the prostatic sinuses (grooves alongside the urethral crest)

Front 49

What is the normal position of the uterus?

Back 49

Anteflexed and anteverted

Front 50

What is the vesicouterine pouch?

Back 50

The intraperitoneal space between the bladder and the uterus

Front 51

What is the Pouch of Douglas (rectouterine pouch)?

Back 51

The intraperitoneal space between the uterus and the rectum

Front 52

What are the five parts of the fallopian tube?

Back 52

1. Infundibulum 2. Ampulla 3. Isthmus 4. Intramural region 5. Fimbriae

Front 53

Which ligament runs antero-inferiorly from the uterus within the broad ligament?

Back 53

The round ligament of the uterus

Front 54

Where do the ends of the round ligament of the uterus attach?

Back 54

One end attaches to the anterolateral fundic region of the uterus; the other attaches in the labium majus

Front 55

Which veins drain the rectum?

Back 55

The inferior and middle rectal veins (part of the systemic venous system) and the superior rectal vain (part of the portal venous system)

Front 56

What is the dentate (pectinate) line?

Back 56

The division between the superior and inferior anal canal

Front 57

Where is the dentate line located?

Back 57

Approximately two thirds of the way down the anal canal

Front 58

What are the three main components of the anal triangle?

Back 58

1. Anal canal 2. External anal sphincter 3. Ischioanal fossae

Front 59

Describe the location and shape of the ischioanal fossae

Back 59

The ischioanal fossae are wedge-shaped areas located on each side of the anus

Front 60

What are the three major borders of the ischioanal fossae?

Back 60

The base of the wedge is formed by the skin overlying the anal triangle on each side of the anus. The lateral walls are formed by the obturator internus muscle and fascia. The medial walls are formed by the levator ani muscle group (i.e. the pelvic diaphragm)

Front 61

Which two nerves traverse the ischioanal fossa?

Back 61

1. Inferior rectal nerve 2. Perineal branch of the femoral cutaneous nerve

Front 62

What are the three major parts of the external anal sphincter?

Back 62

Subcutaneous, superficial, and deep

Front 63

With which muscle does the deep part of the external anal sphincter blend?

Back 63

The puborectalis muscle

Front 64

Which nerve innervates the external anal sphincter?

Back 64

The inferior rectal nerve

Front 65

How does control of the external anal sphincter differ from that of the internal anal sphincter?

Back 65

Control of the external anal sphincter is voluntary, whereas control of the internal anal sphincter is involuntary

Front 66

Which sphincter must relax for defectation to occur?

Back 66

External and internal sphincters

Front 67

What structure is at the apex of the urogenital triangle?

Back 67

The symphysis pubis, (i.e. imaginary lines connecting the symphysis pubis to each ischial tuberosity form the two sides of the triangle, and an imaginary line between the ischial tuberosities forms the bottom)

Front 68

Where are the deep arteries of the penis located?

Back 68

Within the corpora cavernosa

Front 69

Where is the deep dorsal vein of the penis located?

Back 69

Between the tunica albuginea and Buck's (deep) fascia (like the dorsal arteries)

Front 70

What are the three anatomic divisions of the male urethra?

Back 70

1. Prostatic urethra 2. Membranous urethra 3. Spongy urethra

Front 71

What is the innervation of the scrotum?

Back 71

The scrotum is innervated by the ilioinguinal, genitofemoral, perineal, and posterior femoral cutaneous nerves

Front 72

What is the lymphatic drainage of the scrotum

Back 72

Superficial inguinal lymph nodes

Front 73

What is the lymphatic drainage of the testis?

Back 73

The aortic and retroperitoneal lymph nodes

Front 74

Into which vein does the testicular vein drain on the left?

Back 74

The left renal vein

Front 75

Into which vein does the testicular vein drain on the right?

Back 75

Inferior vena cava

Front 76

From which artery does the left ovarian/testicular artery arise?

Back 76

The aorta

Front 77

From which artery does the right ovarian/testicular artery arise?

Back 77

The aorta

Front 78

Into which vein does the left ovarian/testicular vein drain?

Back 78

The left renal vein

Front 79

Into which vein does the right ovarian/testicular vein drain?

Back 79

Directly into the inferior vena cava

Front 80

What are the three branches of the posterior internal iliac artery

Back 80

1. Iliolumbar artery 2. Lateral sacral artery 3. Superior gluteal artery

Front 81

Which arteries supply the rectum?

Back 81

1. The superior rectal artery, the direct continuation of the inferior mesenteric artery 2. The middle rectal artery, a branch of the internal iliac artery 3. The inferior rectal artery, a branch of the internal pudendal artery

Front 82

Which veins drain the rectum?

Back 82

The inferior, middle, and superior rectal veins

Front 83

Which rectal veins are systemic

Back 83

The inferior and middle rectal veins

Front 84

Which rectal veins are portal

Back 84

The superior rectal vein

Front 85

What is the origin and path of the pudendal nerve in the pelvis?

Back 85

The pudendal nerve, a branch of the sacral plexus, accesses the gluteal region by exiting the pelvis through the greater sciatic foramen; it then reenters the pelvis through the lesser sciatic foramen to travel in the pudendal canal

Front 86

Which three nerves arise from the pudendal nerve?

Back 86

1. Inferior rectal nerve 2. Perineal nerve 3. Dorsal nerve of the penis (in men) or clitoris (in women)