Anatomy, Pelvis - Lecture 1

Front 1

What do the superior and inferior rami projections of the pubis go towards?

Back 1

Acetabulum and the Ischium

Front 2

Which 4 tissues/ligaments support the interpubic disc of the pubis bones?

Back 2

external oblique, rectus abdominus aponeuroses, superior and inferior pubic ligaments.

Front 3

What structure resists displacement of the fifth lumbar vertebra relative to the sacrum?

Back 3

iliolumbar ligament.

Front 4

What two structures prevent upward tilting of the lower part of the sacrum when it forced down from load bearing (aka prevent jacknifing and keep your back upright)?

Back 4

The sacrotuberous and sacrospinous ligaments, which both come from the lateral surface of the sacrum and go to the ischial tuberosity and spine, respectively.

Front 5

Which ligaments close the greater and lesser sciatic foramens?

Back 5

sacrospinous and sacrotuberous, respectively.

Front 6

What phase of respiration do all muscles of the pelvis participate in?

Back 6

the QUIET INSPIRATORY phase of respiration. This has been mentioned 3+ times in her lectures. Also note that this is part of an increase in intra-abdominal pressure.

Front 7

What is the only structure that punctures the peritoneal cavity of the pelvis?

Back 7

The opening of the uterine tube.

Front 8

What 4 structures define the "pelvic brim", AKA the superior region of the true pelvis AKA the pelvic inlet AKA the superior pelvic aperture?

Back 8

pectineal line of the pubis, arcuate line of the ileum, sacral promontory, and the margin of sacral ala.

Front 9

what borders the pelvic OUTLET?

Back 9

anteriorly: pubic arch
posteriorly: sacrum and coccyx
laterally: ischial tuberosities
posterolaterally: sacrotuberous ligaments

Front 10

The pelvic bowl is characteristically slanted, but two landmarks in its structure are in the same vertical plane. Which are they?

Back 10

The anterior superior iliac spine and pubic tubercle.

Front 11

When comparing females to males, FEMALES have ______ pubic rami, ______ subpubic angles, _______ greater sciatic notches, ________ shaped pelvic inlets, and ________ sacra than males.

Back 11

Females have:
LONGER pubic rami
WIDER subpubic angles
WIDER greater sciatic notch
OVAL pelvic inlets vs heart shaped
BROADER and LESS CURVED sacra

bonus: women also have a larger pelvic outlet, for obvious reasons.

Front 12

Why are men's pelvic inlets heart shaped instead of oval?

Back 12

anterior projection of the sacral promontory.

Front 13

Which muscle contributes most to the lateral pelvic walls? Where does it pass through to reach the greater trochanter? What supplies blood and innervation to it?

Back 13

obturator internus, obturator foramen

inferior/superior gluteal arteries + internal pudendal artery

obturator internus, L5-S2 nerves.

Front 14

Which muscle handles less majorly, the posterolateral walls of the pelvis? Where does it pass through in the pelvis to reach the greater trochanter? What supplies blood and innervation to it?

Back 14

piriformis, greater sciatic foramen

inferior/superior gluteal arteries + internal pudendal artery

S1-S2 nerves.

Front 15

What two muscles compose the pelvic diaphragm?

Back 15

Levator ani and coccygeus

Front 16

Where do the levator ani muscles insert?

Back 16

The anococcygeal ligament, which inserts into the coccyx

Front 17

Which muscle forms the majority of the levator ani, and where does it insert? What forms the thinnest part of the levator ani, and where does it insert? What is the name of the 3rd muscle?

Back 17

Pubococcygeus forms the majority, and inserts on the posteromidline of the coccyx. Iliococcygeus is the thinnest and most posterior muscle, and inserts onto the anococcygeal ligament behind puborectalis.

Front 18

What two structures does the coccygeus muscle attach to?

Back 18

Ischial spine and coccyx.

Front 19

What tissue is the superior fascia of the pelvic diaphragm continuous with?

Back 19

Transversalis fascia of the abdomen.

Front 20

What nerves innervate levator ani muscles?

Back 20

pudendal nerve of S2-4, ventral ramus of S4

Front 21

What nerves innervate the coccygeus muscle?

Back 21

ventral rami of S3-S4

Front 22

What effect does childbearing have on levator ani muscles?

Back 22

They become stressed and less contractile, which is why after pregnancy, females experience urinary stress incontinence. AKA, if you make them laugh, they will pee uncontrollably.

Front 23

All of the parts of the urinary system are intraperitoneal or retroperitoneal? Which part is secondary retroperitoneal? Which parts are not included?

Back 23

The urinary system is retroperitoneal. The uterus is secondary INTRAperitoneal, forced out of the posterior by the broad ligament. The ovaries and uterine tubes remain, and are intraperitoneal.

Front 24

Why is it safer to pass instruments through the abdominal wall of the bladder when it is full/distended?

Back 24

As the bladder fills, it forces the peritoneum upward so that it is no longer situated between the bladder and anterior abdominal wall. You can therefore insert a needle or other surgical instrument through without disrupting the peritoneum.

Front 25

What is the clinical significance of the rectouterine pouch? How would you sample from it?

Back 25

It is the inferiormost point of the peritoneal cavity in females, therefore puss, blood, cancer cells, or whatnot will collect there. To sample, you would take a needle, travel to the fornix of the vagina and pierce through.

Front 26

The broad ligament of the uterus has 3 divisions. Which is the largest? Which is most superior and what does it connect to? What does the remaining structure connect to?

Back 26

Largest: mesometrium
Superiormost and connects to uterine tubes: mesosalpinx
Mesovarium: ovaries

Front 27

What does the gubernaculum become in the adult female?

Back 27

proper ovarian ligament, round ligament