Glossary of Anatomy Pelvis
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- In a child what hold the 3 components of the Os coxae together?
- the Triradiate cartilage
- State whether the following is male or female:
1. Greater pelvis: Deep/shallow
2. General structure: thick & heavy/think & light
3. Lesser pelvis: wide & shallow/narrow & deep
4. Pelvic outlet: comparatively larg
- 1. Greater pelvis: Male-Deep/Female-shallow
2. General structure: Male-thick & heavy/ Female-think & light
3. Lesser pelvis:female-wide & shallow/ Male-narrow & deep
4. Pelvic outlet: female-comparatively large/ female-comparitively small
5. Pubic arch: male-narrow/ female-wide
6: acetabulum: female-small/l male-large
- Weight is transferred from the axial skeleton to the ilia and then to the femurs during standing. where is the weight transferred to (instead of the femors when sitting?
- the ischial tuburosities
- When is the shape and size of the pelvic inlet important?
- during childbirth (it is the birth canal)
- Indicate which is the male and which is the female pelvic characteristic:
3. larger pelvic inlet
5. larger pelvic outlet
- 1. heavier
2. thinner: male
3. larger pelvic inlet: female
4. thicker: male
5. larger pelvic outlet: female
- What type of joint is the pubic symphysis?
What ligament joins the pubic bones?
Is it thicker in men or women?
- secondary cartilaginous joint
the superior and inferior pubic ligaments
- What hormone permits freer movements in the pelvis and lumbar region?
- Give the following for the OBTURATOR muscle:
- Innervation: obterator internus (L5-S2)
Blood supply: Obturator artery (a branch of the posterior division of the Internal iliac artery
Action: Rotate thigh laterally and hold head of femor in the acetabulum
- Where does the obturator muscle attach on the pelvis?
- the ilium and ischium
- What makes up the lateral pelvic wall?
- the hip bones and the obturator membrane/obturator muscle
- What type of hernia will effect the blood supply of the obturator atery?
When does this happen
- Femoral hernia
When the obturator artery comes off of the inferior epigastric as opposed to the anterior division of the internal iliac.
- What makes up the anterior wall of the pelvis?
- the bodies and the rami of teh pubic bones and the pubic symphysis
- What makes up the lateral wall of the pelvis?
- the hip bones, and the obturator membrane and muscle
- What make up the posterior pelvic wall?
- the sacrum and the coccy (and parts of the ilia and ligaments)
- What 5 things make up the posterior pelvic wall?
- the sacrum and the coccyx, parts of the ilia and ligaments, and the piriformis muscl
- What makes up the pelvic floor (the pelvic diaphragm)?
- the levator ani, the coccygeus muscles and their fascia covering (both the superior and inferior aspects of these muscles.)
- What is the innervation for the following?
1. piriformis m.
2. levator ani m.
3. coccygeus m.
- 1. piriformis m.: anterior rami of S1-S2
2. levator ani m.: S4 via pudendal
3. coccygeus m. S4-S5
- What is the cause of uterine prolapse in older women?
- divarcation (division) of the levator ani by multiparity
- What nerve innervates teh coccygeus?
- Branches of S4-S5
- what is the tendenous arch?
- * thickened fascia of obturator internus muscle.
*attachments: ischial spine and pubic bone.
* Serves as a lateral attachment to the iliococcygeus m.
- Besides resisting increases in abdominal pressure, what 3 things does the levator ani do?
- 1. voluntary control of urination
2. voluntary control of defication
3. support of the uterus
- Which boundaries make up the Pelvic Inlet?
- Anterior: superior margin fo teh pubic symphysis adn posterior border of the pubic crest.
Lateral: pecten pubis and arcuate line of teh ilium
Posterior: anterior border of the ala of teh sacrum and the sacral promontory
- Compare the pubic angles of men and women?
- women :>80%
- Compare the pelvic inlet shape difference between men and women
- Men: heart shaped
Women: rounded oval
- At what levels do you find the skin dimples over the PSIS?
- S2 adn the middle of the sacroiliac joints
- At what level would one be at if they drew a line across the two highest point of the iliac crests?
Why is this clinically relevant?
This is the level of the lumbar puncture
- what type of tissue do external hemorrhoids arise?
- perianal skin
- What is the natal cleft?
- the midline sulcus between the buttock
- What structures does the pudendal nerve innervate?
Which sacral nerves compose the pudendal nerve?
- 1. Bladder, rectum and external genitalia
2. S2, S3, S4
- What separates teh greater and the lesser pelvis?
- the pelvic inlet (the pelvic brim)
- What limits the movement of the sacroiliac joints?
- the interlocking of the articulating bones and teh interosseous and posterior sacroiliac ligaments... thus movement is limited to sliding and rotatating
- What limits the upward movement of the sacrum?
- the sacrotuberous and sacrospinous ligaments
- What type of joint ist he pubic symphysis?
- secondary cartilaginous joint (w/ a fibrocartilaginous interpubic disc)
- Which hormone accounts for the relaxation of teh pelvic joints and ligaments during childbirth?
- Answer the following for the "Obturator Internus" muscle:
- 1. innervation: nerve to the obturator inturnus (L5-S2)
2. Action: rotates thigh laterally, and hold femor in the acetabulum
- Answer the following for the "Periformis" muscle:
- 1. innervation: Anterior rami of S1-S2
2. Action: rotates thigh laterally, holds femur in the acetabulum
- Answer the following for the "Levator Ani" muscle:
1. innervation (3 each)
- 1. innervation: nerve to the levator ani (branches of S4), interior anal, & coccygeal plexus.
2. Action: helps support the pelvic viscera and resists incerasese in intra-abdominal pressure
- Answer the following for the "coccygeus" muscle:
- 1. innervation: branches of S4-S5 nerves
2. Action: supports pelvic viscera
- Which muscle plays an important role in the voluntary control of urination, and fecal continance as well as the suppor tof the uterus?
- levatator ani
- Which nerves are most pelvic structures innervated by?
- Sacral (S1-S4) and coccygeal nerves of the ANS
- What is the source of the lumbosacral trunk?
Where does it pass when entering the sacrum
what does it join when in the pelvis?
- L4 and L5
inferior/anterior to the ala of the sacrum
- Which nerves is the sciatic nerve formed by?
Where do these nerves converge to form the sciatic nerve?
Which foramen does the sciatic nerve pass through to go the ______region?
They converge on the anterior surface of the piriformis
it passes through the greater sciatic foramen --> inferior to the piriformis to enter the gluteal (buttocks) region
- What is the main nerve of the perineum and chief sensory nerve of teh external genitalia?
What is the origin of this nerve?
What artery accompanies this nerve?
How does this nerve enter the perineum?
- Pudendal nerve
Origin: anterior division of the anterior rami of S2-S4
Accompanying artery: pudendal artery
Enters the perineum by hooking around the sacrospinous ligament and finally passes through the lesser sciatic forament to enter the perineum
- What specifcially does the pudendal nerve innervate?
Where does the pudendal nerve end?(hint: male v. female)
- the skin /muscles of the perineum:
Male: dorsal nerve of the penis
Female: nerve of the clitoris
- Where does the superior gluteal nerve arise from?
How does it exit the pelvis:
What 2 muscles and "tensor" does it supply?
- 1. posterior divisions of the anterior rami of L4-S1
2. exits through the greater sciatic foramen superior to the piriformis muscle
3. gluteus medius and minimus... as well as the tensor of the fascia lata
- Where does the inferior gluteal nerve arise from?
How does it exit the pelvis:
What muscle does it innervate
Which artery accompanies this nerve?
- 1. posterior divisions of the anterior rami of L5-S2
2. greater sciatic foramen
3. gluteus maximus
4. inferior gluteal artery
- Where does the "obturator" nerve arise from?
Where does it divide into anterior and posterior branches?
What muscle(s) does it innervate?
- 1. Lumbar plexus (anterior divisions of the the anterior rami of L2-L4) in the abdomen.
2. the obturator canal
3. medial thigh muscles
- During childbirth a mother's pelvic plexus is compressed and produces pain.
1. Which nerve is vulnerable to injury
2. What are the clinical consequences of the injury to this nerve?
- 1. obturator nerve
2. spasms to the adductor muscles of the thigh... and sensor deficits in the medial aspects of the thigh
- What is the origin of the sacral sympathetic trunks?
2. How many ganglia do they usually have?
3. where do they converge?
- they are a continuation of the lumbar sympathetic trunks
2. 4 ganglia
3. ganglion impar
- What is the primary function of the sacral sympathetic trunks?
- provide postsynaptic fibers to the sacral plexus for sympathetic innervation of the lower limbs
- What is the relationship between the following?
a. superior hypgastric plexus
b. hypogastric nerves
c. inferior hypgastric plexuses
2 Where does the superior hypogastric plexus arise from?
- superior hypgastric plexus --> Right/ left: hypogastric nerves --> leads to inferior hypgastric plexuses
2. intermesenteric plexus (which also receives the L3 and L4 splanchnic nerves.
- What do the inferior hypogasatric nerves innervate? (hint: males, female, both)
- Both: parts of the rectum and bladder
male: prostate and seminal glands
female: cervix and lateral parts of the fornix
- Do the inferior hypogastrics have sympathetic or parasympathetics?
- What are the 4 main arteries of the pelvis?
What are the 5 main veins of the pelvis?
1. internal iliac arteries (main)
3. median sacral
4. superior rectal
1. internal iliacs (main)
2. superior rectal veins ( important in collateral drainage)
3. median sacral
- From the Common Iliac name:
1. the first bifurcation
2. second bifurcation of the internal branch?
- 1. internal and external iliac
2. posterior and anterior branches of the internal iliac
- Name 4 branches of the posterior branch of the internal iliac.
- 1. iliolumbar
2. lateral sacral
3. superior gluteal
4. inferior gluteal
- Name ? branches of the anterior branch of the internal iliac.
- are the ureters retroperitoneal?
- what artery supplies the ureters while they run through the pelvis?
- iliac arteries
- In females what is the most "constant arterial supply of the ureters?
In males what is the most "constant arterial supply of the ureters?
Where do these arteries arise?
- uterine arterise
inferior vesical arteries
anterior branch of the internal iliac
- What is the autonomic nerve supply of the ureters?
What route do the afferent (pain) fibers for the ureters follow?
- autonomic plexuses of teh renal , aortaic and superior and inferior hypogastric
they follow the sympatheic fibers retrograde and spinal cord segments T11 -L2
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