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29 Cards in this Set
- Front
- Back
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1.Describe the pelvic fascia and its subdivisions. |
-continuous w/ endoabdominal fascia (CT btwn parietal peritoneum & pelvic muscles)
-subdivisions: 1. parietal pelvic fascia- lines walls & floor of pelvis named according to muscle covered forms tendinous arch of pelvic fascia (from pubis to sacrum, along pelvis from, on both sides of viscera) 2. visceral pelvic fascia- covers & supports pelvic viscera |
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2. Define pelvic ligaments |
-condensed fibrous regions of parietal pelvic fascia
-supports pelvic viscera |
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2. Identify the pelvic ligaments in the female pelvis. |
-pubocervical ligament (cervix to ant. pelvic wall)
-transverse cervical/cardinal/lateral cervical/Mackenrodt ligament (cervix to lat. pelvic wall) -uterosacral ligament (cervix to post. pelvic wall) |
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3.Describe the disposition of the parietal peritoneum of the pelvis |
-continuous w/ parietal peritoneum of abdomen
-drapes over pelvic organs at midline, forming pouches, folds, & ligaments |
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3.Describe the formation of the peritoneal spaces/recesses (pouches). |
-spaces between adjacent organs created by peritoneum draping over contours of organs
-infection & fluids may accumulated in these spaces (in the lowest one) |
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What pouch is the lowest portion of the abdominopelvic cavity in the supine position?
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Rectouterine pouch (of Douglas)
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3.Describe the formation of the pelvic folds and ligaments. |
-folds of peritoneum formed between pelvic organs & walls
-includes broad ligament (created as peritoneum covers uterus & fallopian tubes) & suspensory ligament of the ovary (contains ovarian arteries) (female) |
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4. Describe the arteries of the pelvis |
-internal iliac arteries
(from common iliac a.) *most important blood supply of pelvis -superior rectal artery (continuation of inf. mesenteric a.) -median sacral artery (from aorta @ L4 (bifurcation into common iliacs)) -ovarian/testicular artery (from aorta @ L1) |
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Describe Posterior Divisions of the Internal iliac artery
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-iliolumbar artery
passes sup. across pelvic inlet -lateral sacral artery ant. to sacral plexus -superior gluteal artery exits pelvis through greater sciatic foramen, sup. to piriformis m, btwn lumbosacral trunk & S1 |
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Describe Anterior Divisions of the Internal iliac artery
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-obturator artery
(exits pelvis through obturator foramen, into obturator canal, supplies thigh adductors) -umbilical artery gives rise to sup. vesical arteries proximally, supplying upper urinary bladder & branching into artery to ductus deferens (males only), distal portion obliterated as medial umbilical ligament -uterine artery (females only) crosses ureter* ant., anastomoses w/ vaginal & ovarian arteries -vaginal artery (females only, same as inf. vesical in males) supplies vagina & base of bladder -inf. vesical artery (males only) supplies prostate, seminal vesicles, & base of bladder -middle rectal artery supplies lower rectum -int. pudendal artery passes through greater sciatic foramen w/ pudendal nerve -inf. gluteal artery below piriformis btwn S1 & 2 or 2 & 3 |
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4. Describe the veins of the pelvis |
-veins accompany arteries of same name
-internal iliac vein is main drainage--> joins external iliac vein-->forming common iliac vein-->2 common iliacs form IVC @ L5 |
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4. Describe the lymphatic supply of the pelvis |
nodes are arranged along main vessels & drain into:
-external & internal iliac nodes -common iliac nodes *most drains into internal iliac nodes *lymph drainage is same as blood supply |
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Which pelvic ligament provides the main passive support of the uterus?
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Transverse cervical ligament
(cardinal/lateral cervical/Mackenrodt ligament) |
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In males, the puboprostatic ligaments support the urinary bladder. What ligaments serve this function in females?
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pubovesical ligaments
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W/i the upper part of the transverse cervical ligament, the _________ artery passes toward the cervix above the ureter.
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uterine artery
*at risk during hysterectomy |
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Name the pelvic pouches in males & females
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males-
rectovesical pouch (btwn rectum & bladder) females- vesicouterine pouch (btwn bladder & uterus) rectouterine pouch (btwn rectum & uterus) |
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The ___________ artery is at risk from injury during repair of a femoral hernia as it crosses the femoral ring, superior to the femoral canal
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obturator artery
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The obturator artery may be aberrant or replaced, or joined by an accessory, both of which are usually branches from what artery?
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inferior epigastric artery
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Pelvic veins form communicating plexuses of veins around pelvic organs, which are mainly drained by the internal iliac veins. Some veins also drain through what vein & plexus?
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inferior mesenteric vein & vertebral venous plexus
*vertebral venous plexus provides pathway for pelvic cancer to metastasize to spinal cord & brain |
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4. Describe the sympathetic nerves of the pelvis |
sympathetic nerves:
-lumbar splanchnic nerves (carry preganglionic fibers to inf mesenteric & sup hypogastric plexus) -sacral splanchnic nerves (carry postganglionic fibers to inf hypogastric plexus) -supply pelvic organs, blood vessels, sphincters -ganglia connect to sacral spinal nerves by gray rami communicantes |
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4. Describe the parasympathetic nerves of the pelvis |
Pelvic splanchnic nerves (S2-4):
-arise from cell bodies in spinal cord corresponding w/ IMLCC @ higher levels -exit anterior rami of S2-4 -convey preganglionic parasympathetic fibers to inf. hypogastric plexus -synapse w/ ganglia in plexus or wall of viscera |
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The pelvic pain line signifies the point where pain conduction above & below differs in course. Where is this line?
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line corresponds to inferior limit of the peritoneum
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What is the pathway for GVA fibers to conduct pain from the pelvic viscera above & below the pelvic pain line?
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above- travel w/ abdominopelvic splanchnic nerves (sympathetic) to DRG of T10-L2
below- travel w/ pelvic splanchnic nerves (parasympathetic) to DRG of S2-S4 |
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T/F
Abdominal & Pelvic Nerve Plexuses contain sympathetic fibers only |
FALSE!!!!
contain BOTH sympathetic & parasympathetic fibers!!!!! |
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The superior & inferior hypogastric plexus are connected by __________________ nerves
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R & L hypogastric nerves
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Terminal branches of the (inferior/superior) hypogastric plexus penetrate the pelvic floor to innervate the erectile tissues of the penic & clitoris in the perineum as ____________ nerves
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inferior hypogastric plexus
cavernous nerves |
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What nerve mainly supplies the perineum?
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pudendal nerve (S2-4)
(somatic) |
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What 2 nerve plexuses provide somatic nerve supply pelvic muscles & viscera, perineum, & lower limbs?
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sacral & coccygeal nerve plexus
* on ant. surface of piriformis, leaves pelvis through greater sciatic foramen |
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What nerves from the anterior rami of S2-S4 connect w/ the inferior hypogastric plexus?
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Pelvic splanchnic nerves
*gray rami communicantes connect w/ ant rami carrying postganglionic sympathetic fibers to limbs |