Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
73 Cards in this Set
- Front
- Back
Organs of the pelvis |
Uterus, ovaries (female), bladder or prostate and seminal vesicles |
|
Where is the birth canal located in females? |
In the pelvis |
|
Sacrum is the unification of this many vertebra |
5 |
|
Components of the bony wall of the pelvis |
Sacrum and coccyx |
|
These are the two parts of the pelvis and their borders |
Greater pelvis Lesser pelvis |
|
Another name for the hip bone |
Os Coxae |
|
These three separate bones (at birth) join together at the acetabulum. |
ilium (superiorly), ischium(posteriorly) and pubis (anteriorly)
They are joined at the acetabulum by cartilage. |
|
The time at which the three seperate bones of the ox coxae join together and growth is complete |
After puberty |
|
What encloses the obturator foramen? |
Rami of the ischium and pubis |
|
The pubic bones of either side are joined by this |
The pubic symphysis |
|
What happens at the acetabulum? |
This is the concave surface for the insertion of the head of the femur.
This is an ossified joint. |
|
Origin of the inguinal ligament |
anterior superior iliac spine |
|
Lines on the outside of the iliac bone |
Gluteal lines for muscle insertion |
|
Landmark that is important for the inlet of the lesser pelvis |
Arcuate line |
|
Greater pelvis border |
Above the pelvic brim (iliopectineal line) |
|
Floor of the pelvis is formed by these two things |
coccygeus and levator ani muscles |
|
Which is in the more anterior vertical plane: Anterior superior iliac spine or the pubic tubercles? |
Trick Q: they are in the same vertical plane because the pelvis is normally tilted in the anatomical position. |
|
Another name for the pelvic diaphragm |
Levator ani |
|
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 |
Size of pelvic inlet and pelvic outlet |
|
Functions of the pelvis |
Attachment for lower limbs, protection of organs and serves as the birth canal in women. |
|
Borders of the pelvic inlet |
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 |
|
Examples of things that cross through the pelvic inlet |
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. |
|
Borders of the pelvic outlet |
Posteriorly- sacrum and coccyx
Laterally- ischial tuberosities and sacrotuberous ligaments
Anteriorly- pubic symphisis, arcuate pubic ligament, and rami of the pubis and sacrum
|
|
Differences between Female and Male Pelvis |
- 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. |
|
Coccyx (are/are not) flexible |
ARE: During birth, the head of the baby can push the coccyx posteriorly. |
|
Important dimensions of the boney pelvis: female |
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 |
|
Largest diameter of head of baby |
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 |
|
What is the diagonal conjugate? |
A distance from the promontory of the sacrum to the inferior margin of the pubic symphysis, measured manually per vagina or by ultrasonography |
|
What would you measure in order to find the true conjugate diameter? |
Upper surface of pubic symphysis to the sacral promontory |
|
The diameter between the two iliac crests; iliac spines (ASIS) |
Distantia cristarum; distantia spinarum |
|
Name the four joints of the pelvis |
Lumbosacral joint Sacroiliac joint Sacrococcygeal joint Pubic symphysis |
|
What kind of joint is the sacroiliac joint? |
It is synovial. It transmits the weight of the body to the hip bone. |
|
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 _______________________________. |
Sacroiliac Ligaments |
|
Attaches the pubic bones inferiorly |
Pubic symphysis |
|
The only diameter of pelvic inlet that can be measured clinically |
Diagonal conjugate |
|
Is exposed to large levels of estrogen, this will allow for expansion |
Pubic symphysis |
|
Preventing the sacrum/coccyx to be flipper backwards ate these two ligaments: |
Sacrotuberous and sacrospinous |
|
Sacrotuberous and sacrospinous ligaments + the hipbone form these: |
Greater and lesser sciatic foramina |
|
Sacrospinous ligament runs from what to what: |
Sacrum to ischial spine
This ligament crosses anteriorly to sacrotuberous ligament. |
|
What occupies most of the obturator foramen? |
Obturator membrane |
|
Obturator foramen - obturator membrane = |
Obturator canal |
|
Borders of the greater sciatic foramen |
sacrotuberous ligament, sacrospinous ligament and iliac bone |
|
Muscle arising from the anterior surface of the sacrum (out of the greater sciatic foramen) |
Piriformis muscle: divides the greater sciatic formamen into two leaving a space above and below |
|
Spaces above and below piriformis muscle |
Suprapiriform hiatus and infrapiriform hiatus |
|
Where does the sciatic nerve pass? |
Through the infrapiriform hiatus
Sciatic nerve is the largest in the body. |
|
Floor of the pelvis is also called this: |
Pelvic diaphragm (levator ani muscle with its fascia) |
|
To what is the pelvic diaphragm bound? |
Lower 1.2 of the hip bones (anteriorly), sacrum and coccyx (posteriorly) |
|
Beak of the funnel that is the pelvic floor |
Anus |
|
Two muscles which make up the pelvic diaphragm |
Levator ani and coccygeus muscles (fascial coverings are also included in this) |
|
When the pelvic diaphragm contracts, which way does it move? |
The pelvic floor is raised. |
|
The pelvic diaphragm will help direct the fetal head toward the birth canal at ____________. (in females) |
parturition |
|
Directly posterior to pubic symphysis in a female pelvic diaphragm, you will find these structures: |
urethra, vagina and rectum |
|
Parts of the levator ani muscle (muscular sections) |
Pubococcygeus muscle Iliococcygeus muscle Puborectalis muscle |
|
Vagina and levator ani muscle (are/are not) fused |
Are not. |
|
What is prolapse? |
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. |
|
The deepest point of the pelvis- in females |
Rectouterine pouch (Cul-de-sac of Douglas) |
|
Peritoneum partially covers these organs in the pelvis (female) |
Bladder, uterus, rectum
These are infraperitoneal organs. |
|
Rectouterine pouch is also called: |
Douglas pouch (Cul-de-sac of Douglas) |
|
Deepest pouch of the pelvis |
Rectouterine Pouch (Douglas pouch) |
|
Space between bladder and the uterus |
Vesico-uterine pouch |
|
Space just inferior to the cervix |
Vaginal Fornix (split into anterior and posterior) |
|
By palpating through the vagina near the cervix of the uterus, you will be able to feel whether there is fluid accumulation in this: |
Douglas' pouch (rectouterine pouch)
You can place a needle here for a sample but cannot do so through the rectum |
|
Where is the real perineum? (in females) |
Between vagina and rectum |
|
Why is the ischiococcygeus (aka coccygeus) NOT part of the levator ani? |
It connects two bony portions. It has nothing to do with the floor and associated structures |
|
Major components of levator ani (lateral to medial) |
Iliococcygeus, pubococcygeus, puborectalis |
|
What is the perineum? |
Space between the legs inferior to the pelvic diaphragm |
|
What is the position of child birth? |
Lithotomy |
|
What is the shape of the perineum? |
Diamond which is divided into two triangles: anal and urogenital |
|
At what angle is the "diamond" of the perineum hinged? |
90 degrees |
|
Muscles of the perineum- anterior (female) |
Bulbospongiosus, ischiocarvernosus, superficial transverse perineal muscle, deep transverse perineal muscle |
|
Components of the urogenital diaphragm |
Transverse perineus mm. and fascia |
|
The urogenital diaphragm is (deep to/superficial to) pelvic diaphragm |
Superficial to |
|
Space on both sides of rectum deep to the pelvic diaphragm |
Ischiorectal fossa (space)
OR Ischioanal fossa |