Glossary of 4-Pelvis
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- What is the inferoposterior portion of the abdomen that serves as a transition from trunk to lower limb?
- What is the function of the bony pelvis?
- protects distal digestive and urinary tracts and internal reproductive organs, serves as attachment site for spine above and limbs below
- Where is the perineum?
- between thighs and extends from tip of coccyx to pubis
- What does the perineum include in men? women?
- anus, penis scrotum
anus and vulva
- What are the boundaries of the greater pelvis?
- from iliac crests inferiorly to pelvic brim
- What are the boundaries of the lesser pelvis?
- from pelvic brim to pelvic diaphragm
- Describe the location of the pelvic brim or inlet?
- marked by sacral promontory, arcuate line and pectineal line and upper edge of pubic symphysis
- How many bones form the bony pelvis? What are they?
2 os coxi (hip bones), sacrum and coccyx
- What forms the hip bones (os coxi)? When does fusion of these bones occur?
- fusion of three bones-ilium, ischium, pubis
- How many fused vertebrae make up the sacrum?
- What is the sacral promontory? What covers it?
- anterosuperior most portion of the sacrum just below the juntion of the sacrum w/ the 5th lumbar vertebrae
covered w/ broad anterior longitudinal spinal ligament
- What is the clinical significance of the sacral promontory?
- protrudes into the pelvic inlet and is the most limiting dimension of the pelvic inlet (anteroposterior direction)
- What makes up the coccyx?
- fusion of 4 rudimentary vertebrae
- What are 3 ways of measuring the dimensions of the pelvic inlet? What is the common measuring spot in all 3? What varies?
- anatomical, true (obstetric), and diagonal conjugate
-different spots on pubic symphysis
- What part of the pubic symphysis do you measure from when measuring the anatomical conjugate diameter? true (obstetrical)? diagonal?
- -superior surface
- What is an estimate of the true obstetric conjugate?
- diagonal conjugate
- What is a way to estimate the diagonal conjugate?
- trans-vaginal palpation
- What is the anteroposterior diameter of the pelvic outlet?
- inferior surface of pubic symphysis and tip of coccyx
is about 9.5cm
- What is the transverse diameter of the pelvic inlet?
- Where is the sacral hiatus? What marks it on each side?
- on posterior surface at the end of the sacral canal
inferior sacral cornu are on each side
- What covers the sacral hiatus?
- posterior sacrococcygeal ligament
- What is the sacral hiatus used for clinically?
- to gain access to caudal epidural space for injuection
- What level does the dural sac terminate? spinal cord?
- What does the body of the ilium help form?
- acetabulum for the femur head
- What originates at the ASIS?
- inguinal ligament
- What does the ilium articulate with?
- Where is the ischium located with regard to the pelvis?
- posterior inferior, what you sit on
- What part of the ischium helps create the obturator foramen?
- What are the parts of the ischium?
- ramus, ischial tuberosities (2), body, ischial spines
- What parts of the pelvis help form the acetabulum?
- body of ischium and body of ilium and superior ramus of the pubis
- What attaches to the ischial spines?
- sacrospinous ligament
- What is superior to the ischial spine? inferior?
- s-greater sciatic notch
i-inferior sciatic notch
- Where is the pubis located?
- inferior and anterior
- What are the parts of the pubis?
- superior and inferior ramus, body, pubic crest, pubic tubercle
- What helps create the obturator foramen?
- ramus of ischium, and superior and inferior rami of pubis
- What 2 things does the superior ramus of the pubis help create?
- obturator foramen and acetabulum
- Where is the pubic tubercle located? What is it an attachment for?
- lateral edge of pubic crest
attachemnt for inguinal ligament
- What is the subpubic angle? What is the average for men? women?
- angle below the pubic symphysis to the ischial tuberosities
men-60 degrees' women-90 deg
- What are the boundaries of the pelvic outlet?
- anterior-inferior margin of pubic symphysis
anterolaterally-inferior ramus of pubis and ischial tuberosities
posteriorly-tip of coccyx
- In the anatomical position which two parts of the pelvis are vertical?
- ASIS and pubic symphysis
- Describe the difference between the greater pelvis in males vs females. true pelvis?
- men-deeper and narrow
women-shallower and wider
- Describe the shape of the pelvic brim (inlet) in females and males.
- females-oval and rounded
- Is the pelivc outlet lareger in females or males?
- Describe the shape of the sacrum in females and males.
males-more concave anteriorly
- Define gynecoid.
- typical female shaped pelvis
- Define android.
- typical male shaped pelvis
- Define anthropoid.
- pelvis w/ elongated anterior to posterior dimension, similar to man's ancestors
- Define platypelloid.
- broad pelvis w/ a subpubic angle greater than 90 degrees
- What commonly occurs in pelvic fractures?
- displacement of pubic symphysis posteriorly
- Name the 2 pelvic joints.
- lubosacral and sacrococcygeal
- What are the two portions of the lubosacral joint? Name the facet joint.
- intervertebral disc between L5 and sacrum and two posterior zygapophyseal (facet joints)
- What type of a joint is the sacrococcygeal joint?
- What helps to strengthen the sacrococcygeal joint?
- the anterior and posterior sacrococcygeal ligaments
- What type of a joint is the sacroiliac joint?
- both fibrous and synovial
- What does the sacroiliac joint do?
- transfers weight of the vertebral column to the pelvis
- What stabilizes the sacroiliac joint?
- interosseous ligaments and posterior and anterior sacroiliac ligaments
- What type of a joint is the pubic symphysis?
- What helps stabilize the pubic symphysis?
- superior and inferior pubic ligaments
- During pregnancy what hormones are released that help degrade the collagen fibers of the pelvis? What joint is particularly affected?
- progesterone and relaxin
- From where does the pelvic inlet (or brim) extend? Which conjugae diameter does this correspond with? What is the average length?
- internal superior portion of pubic symphysis, posteriorly to sacral promontory
- From where does the pelvic outlet extend? What is the average length?
- anteriorly from the internal inferior portion of the pubic symphysis, posteriorly tot he tip of the coccyx
- What is the average distance of the transverse pelvic inlet in women?
- 13-14 cm
- What makes up the anterior portion of the pelvic wall?
- body and ramus of pubic bone and pubic symphysis
- What is located laterally in the pelvic wall?
- greater pelvis ala of ilium w/ iliacus muscle; true pelvis-obturator internus muscle
- Where does the obturator internus muscle exit the pelvis? What does it attach to? What is its action?
- lesser sciatic foramen
greater trochanter of femur
laterally rotates leg
- What is located in the posterior portion of the pelvic wall?
- sacrum, coccyx, part of ilia, sacroiliac joints and ligaments, piriformis muscle
- Where does the piriformis muscle exit the pelivs? What does it attach to? What is its action?
- greater sciatic foramen
anterior surface of sacrum and greater trochanter of femus
lateral rotation of leg
- What forms the pelvic diaphragm?
- levator ani and coccygeus muscle
- The pelvic diaphragm stretches from the _____ anteriorly to the _____ posteriorly and is laterally attached to ________.
- a-pubic symphysis
l-obturator internus muscle
- What are the three parts of the levator ani?
- pubococcygeus, puborectalis, iliococcygeus
- What is the largest part of the levator ani? What does it attach to?
- pubococcygeus, attached from body of pubis to coccyx (bone to bone)
- What is the puborectalis attached to?
- medial body of pubis, forms a U-shaped muscular sling around the anorectal junction
- What is the slimmest portion of the levator ani? What does it attach to?
from tendinous arch of fascia on top of obturator internus and ischial spine to the coccyx
- What does the coccygeus muscle attach to? What is it innervated by?
- from ischial spine to distal sacrum and coccyx
S4 (some S3 or 5)
- What is the function of the pelvic diaphragm?
- maintains proper positioning of pelvic organs, essential for maintaining abdominal and thoracic pressure during micturation, defecation, parturition, and heavy lifting
- What muscle aids in maintaining fecal continence?
- What muscle is contracted during Kegal exercises?
- Which muscle can be torn while giving birth? Compromised functions of this muscle can lead to what?
urinary stress incontinence, can contribute to uterine prolapse
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