Pelvis Part I

Front 1

Organs of the pelvis

Back 1

Uterus, ovaries (female), bladder or prostate and seminal vesicles

Front 2

Where is the birth canal located in females?

Back 2

In the pelvis

Front 3

Sacrum is the unification of this many vertebra

Back 3

5

Front 4

Components of the bony wall of the pelvis

Back 4

Sacrum and coccyx

Front 5

These are the two parts of the pelvis and their borders

Back 5

Greater pelvis

Lesser pelvis

Front 6

Another name for the hip bone

Back 6

Os Coxae

Front 7

These three separate bones (at birth) join together at the acetabulum.

Back 7

ilium (superiorly), ischium(posteriorly) and pubis (anteriorly)

They are joined at the acetabulum by cartilage.

Front 8

The time at which the three seperate bones of the ox coxae join together and growth is complete

Back 8

After puberty

Front 9

What encloses the obturator foramen?

Back 9

Rami of the ischium and pubis

Front 10

The pubic bones of either side are joined by this

Back 10

The pubic symphysis

Front 11

What happens at the acetabulum?

Back 11

This is the concave surface for the insertion of the head of the femur.

This is an ossified joint.

Front 12

Origin of the inguinal ligament

Back 12

anterior superior iliac spine

Front 13

Lines on the outside of the iliac bone

Back 13

Gluteal lines for muscle insertion

Front 14

Landmark that is important for the inlet of the lesser pelvis

Back 14

Arcuate line

Front 15

Greater pelvis border

Back 15

Above the pelvic brim (iliopectineal line)

Front 16

Floor of the pelvis is formed by these two things

Back 16

coccygeus and levator ani muscles

Front 17

Which is in the more anterior vertical plane: Anterior superior iliac spine or the pubic tubercles?

Back 17

Trick Q: they are in the same vertical plane because the pelvis is normally tilted in the anatomical position.

Front 18

Another name for the pelvic diaphragm

Back 18

Levator ani

Front 19

An OBGYN will measure these two things and compare to the size of the baby's cranium in order to determine whether or not Cesarian will be needed

Back 19

Size of pelvic inlet and pelvic outlet

Front 20

Functions of the pelvis

Back 20

Attachment for lower limbs, protection of organs and serves as the birth canal in women.

Front 21

Borders of the pelvic inlet

Back 21

posteriorly- promontory of the sacrum and the anterior border of the ala of the sacrum

laterally- arcuate or iliopectineal line of the ilium

anteriorly-pectineal line, the pubic crest and the superior margin of the pubic symphisis

Front 22

Examples of things that cross through the pelvic inlet

Back 22

ureter, gonadal vessels, middle sacral vessels, iliolumbar vessels, lumbosacral trunk, obturator nerve, spermatic cord, round ligament of the uterus, sympathetic trunk, suspensory ligament of the ovary, etc.

Front 23

Borders of the pelvic outlet

Back 23

Posteriorly- sacrum and coccyx

Laterally- ischial tuberosities and sacrotuberous ligaments

Anteriorly- pubic symphisis, arcuate pubic ligament, and rami of the pubis and sacrum

Front 24

Differences between Female and Male Pelvis

Back 24

- Bones of the female pelvis are usually smaller, lighter and thinner than those of the male

-Ala in females are wider (distance between ASISs is larger than between the two points in the female)

-Inlet is transversely oval in the female and heart-shaped in the male

-Outlet is larger in the female than in male due to everted ischial tuberosities

-Cavity is wider and shallower in the female

-Subpublic angle for males is 50-60 degrees; for females, it is 80-85 degrees

-The ischial spines and the sacrum/coccyx point into the cavity more sharply in the male.

Front 25

Coccyx (are/are not) flexible

Back 25

ARE: During birth, the head of the baby can push the coccyx posteriorly.

Front 26

Important dimensions of the boney pelvis: female

Back 26

Inlet of pelvis: minimum 12 cm transverse

Cavity (amplitude): minimum 12 cm oblique

Outlet of pelvis: minimum 9.5-12 cm sagittal

True conjugate diameter: 11 cm

Diagonal conjugate:11.5-12 cm

Front 27

Largest diameter of head of baby

Back 27

The saggittal diameter (anterior-posterior)

The baby's forehead has to be to the left or right and later turn to face more obliquely (in order to match the diameter of the cavity) THEN the head is able to push the coccyx back

Baby must make a 90-degree turn inside of the birth canal

Front 28

What is the diagonal conjugate?

Back 28

A distance from the promontory of the sacrum to the inferior margin of the pubic symphysis, measured manually per vagina or by ultrasonography

Front 29

What would you measure in order to find the true conjugate diameter?

Back 29

Upper surface of pubic symphysis to the sacral promontory

Front 30

The diameter between the two iliac crests; iliac spines (ASIS)

Back 30

Distantia cristarum; distantia spinarum

Front 31

Name the four joints of the pelvis

Back 31

Lumbosacral joint

Sacroiliac joint

Sacrococcygeal joint

Pubic symphysis

Front 32

What kind of joint is the sacroiliac joint?

Back 32

It is synovial. It transmits the weight of the body to the hip bone.

Front 33

The weight of the body pressing down on the lumbar vertebrae would drive the sacrum like a wedge separating the hip bones. Preventing this are the strong and extensive _______________________________.

Back 33

Sacroiliac Ligaments

Front 34

Attaches the pubic bones inferiorly

Back 34

Pubic symphysis

Front 35

The only diameter of pelvic inlet that can be measured clinically

Back 35

Diagonal conjugate

Front 36

Is exposed to large levels of estrogen, this will allow for expansion

Back 36

Pubic symphysis

Front 37

Preventing the sacrum/coccyx to be flipper backwards ate these two ligaments:

Back 37

Sacrotuberous and sacrospinous

Front 38

Sacrotuberous and sacrospinous ligaments + the hipbone form these:

Back 38

Greater and lesser sciatic foramina

Front 39

Sacrospinous ligament runs from what to what:

Back 39

Sacrum to ischial spine

This ligament crosses anteriorly to sacrotuberous ligament.

Front 40

What occupies most of the obturator foramen?

Back 40

Obturator membrane

Front 41

Obturator foramen - obturator membrane =

Back 41

Obturator canal

Front 42

Borders of the greater sciatic foramen

Back 42

sacrotuberous ligament, sacrospinous ligament and iliac bone

Front 43

Muscle arising from the anterior surface of the sacrum (out of the greater sciatic foramen)

Back 43

Piriformis muscle: divides the greater sciatic formamen into two leaving a space above and below

Front 44

Spaces above and below piriformis muscle

Back 44

Suprapiriform hiatus and infrapiriform hiatus

Front 45

Where does the sciatic nerve pass?

Back 45

Through the infrapiriform hiatus

Sciatic nerve is the largest in the body.

Front 46

Floor of the pelvis is also called this:

Back 46

Pelvic diaphragm (levator ani muscle with its fascia)

Front 47

To what is the pelvic diaphragm bound?

Back 47

Lower 1.2 of the hip bones (anteriorly), sacrum and coccyx (posteriorly)

Front 48

Beak of the funnel that is the pelvic floor

Back 48

Anus

Front 49

Two muscles which make up the pelvic diaphragm

Back 49

Levator ani and coccygeus muscles

(fascial coverings are also included in this)

Front 50

When the pelvic diaphragm contracts, which way does it move?

Back 50

The pelvic floor is raised.

Front 51

The pelvic diaphragm will help direct the fetal head toward the birth canal at ____________. (in females)

Back 51

parturition

Front 52

Directly posterior to pubic symphysis in a female pelvic diaphragm, you will find these structures:

Back 52

urethra, vagina and rectum

Front 53

Parts of the levator ani muscle (muscular sections)

Back 53

Pubococcygeus muscle

Iliococcygeus muscle

Puborectalis muscle

Front 54

Vagina and levator ani muscle (are/are not) fused

Back 54

Are not.

Front 55

What is prolapse?

Back 55

Pelvic organ prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall, out of their normal positions. Without medical treatment or surgery, these structures may eventually fall farther into the vagina or even through the vaginal opening if their supports weaken enough.

Front 56

The deepest point of the pelvis- in females

Back 56

Rectouterine pouch (Cul-de-sac of Douglas)

Front 57

Peritoneum partially covers these organs in the pelvis (female)

Back 57

Bladder, uterus, rectum

These are infraperitoneal organs.

Front 58

Rectouterine pouch is also called:

Back 58

Douglas pouch (Cul-de-sac of Douglas)

Front 59

Deepest pouch of the pelvis

Back 59

Rectouterine Pouch (Douglas pouch)

Front 60

Space between bladder and the uterus

Back 60

Vesico-uterine pouch

Front 61

Space just inferior to the cervix

Back 61

Vaginal Fornix (split into anterior and posterior)

Front 62

By palpating through the vagina near the cervix of the uterus, you will be able to feel whether there is fluid accumulation in this:

Back 62

Douglas' pouch (rectouterine pouch)

You can place a needle here for a sample but cannot do so through the rectum

Front 63

Where is the real perineum? (in females)

Back 63

Between vagina and rectum

Front 64

Why is the ischiococcygeus (aka coccygeus) NOT part of the levator ani?

Back 64

It connects two bony portions. It has nothing to do with the floor and associated structures

Front 65

Major components of levator ani (lateral to medial)

Back 65

Iliococcygeus, pubococcygeus, puborectalis

Front 66

What is the perineum?

Back 66

Space between the legs inferior to the pelvic diaphragm

Front 67

What is the position of child birth?

Back 67

Lithotomy

Front 68

What is the shape of the perineum?

Back 68

Diamond which is divided into two triangles: anal and urogenital

Front 69

At what angle is the "diamond" of the perineum hinged?

Back 69

90 degrees

Front 70

Muscles of the perineum- anterior (female)

Back 70

Bulbospongiosus, ischiocarvernosus, superficial transverse perineal muscle, deep transverse perineal muscle

Front 71

Components of the urogenital diaphragm

Back 71

Transverse perineus mm. and fascia

Front 72

The urogenital diaphragm is (deep to/superficial to) pelvic diaphragm

Back 72

Superficial to

Front 73

Space on both sides of rectum deep to the pelvic diaphragm

Back 73

Ischiorectal fossa (space)

OR Ischioanal fossa