Flashcards in Pelvis Deck (89)
1
How is bony pelvis divided and what are regions
Superior peliv aperture (pelvic inlet)
False (greater) pelivs above
True (lesser) pelvis between inlet and outlet
2
Bony boundary of pelvic inlet
Pevlic brim
3
Position for pelvis exam
Lithotomy position
4
Pelvic outlet is also called
Inferior pelvic aperture
5
Midpelvic (tranverse) diameter
Line between ischial spaces
Smallest line that baby must pass through
6
Obstetric (true) conjugate
Line from the sacral promentory to the pubic symphysis
Shorter than diagonal
7
Diagonal conjugate and how to measure
Palpate sacral promontory...line extends to the inferior aspect of pubic symphysis...line will be longer than true conjugate
8
Sacrotuberous ligament attachments
Extends from sacrum to medial margin of ischial tuberosity
9
Sacrospinous attachments
From medial margin of lower sacrum to ischial spine
10
Obturator membrane closes off
Allows passage of
Most of obturator foramen
Obturator artery, vein, and nerve
11
Innfer surface of pelvis, hip bone, and sacrum, largerly covered by
Piriformis
Obturator internus
12
Pelvic diagphragm
Sling-like muscular structure covering pelvic floor
13
Posterior part of pelvic diaphragm and relative location to sacrospinous
Coccygeus
Deep
14
Anterior part of pelvic floor
Levator ani muscles
15
What do levator ani muscles arise from
Tendinous arch
16
What is tendinous arch
Thickening of fascia covering obturator internus muscle
Gives rise to levator ani muscles
17
Puborectalis muscle and what it is important for
Fibers of levator ani that loop around rectum
Maintaining fecal continenence
18
Levator ani muscle innervation
Sacral plexus
19
Perineum
Region below pelvic diaphragm
20
Deep pouch of the perineum composition and function
Composed of muscle, connective tissue, and neurovascular structures
Supports urogenital organs
21
Where does deep pouch not extend
Posteriorly past the ischial tuberosities to support the rectum
22
Perineal body
Midline know of fibrous connective tissue connecting pelvic floor and deep pouch of perineum
23
Damage to peliv floor, perineal body, or deep pouch can lead to
Incontinence, prolapse of the bladder or prolapse of the uterus through the vagina
24
3 systems of pelvic anterior to posterior
Urinary, reproductive, digestive
25
Rectum is continuation of what and begins where?
Sigmoid colon
Pelvic brim
26
Lumen of rectum exhibits what?
3 permanent transverse folds
27
Smooth muscle over rectum formed from
Taeniae coli of the colon
28
When is rectum renamed anal canal?
Region of perineum
29
Arterialy supply of rectum and origins
Superior rectal (from inferior mesenteric)
Middle rectal (from internal iliac)
Inferior rectal (from internal pudendal from internal iliac)
30
Venous return of rectum and where they drain to
Superior rectal vein (portal venous system)
Middle rectal vein (to internal iliac vein to IVC)
Inferior rectal vein (to internal pudendal vein to internal iliac vein to IVC)
31
Portocaval anastomosis
Connects superior, middle, and inferior regions of rectal venous plexus...means if superior is blocked, will drain to middle and inferior)
32
Hemorrhoids formed from
Longitudinal venous channels that are dilated...result of portocaval anastomosis
33
Rectal venous plexus also anastomsis with what (cancer)
Urinary bladder, prostate, uterovaginal plexus)
34
Parasympathetic innervation of rectum
S2-4 and joins pelvic splanchnics (ganglion in wall of target organ)
35
Sympathetic innervation of recum
Comes from lower regions of the IML to collateral ganglion in lubrosacral plexus
36
Lumbrosacral plexus also innervates
Anal sphincter
37
Somatomotor and somatosensory innervation of the rectum
Pudendal - both
38
What does pudendal nerve also innervate?
External anal sphincter
39
Types of nerve fibers of rectum
Para
Symp
Somatomotor and sensory
40
As rectum enters the pelvis____
Fixed to the body wall
41
What seals the rectum
Kinking mechanism
42
Why is inferior anal canal immobile?
External anal sphincter
43
Anorectal angle
Region of rectum passing through pelvic diaphragm
Pretty immobile
44
Puborectalis
Loops around the rectum at the anorectal angle
45
Contrction of puborectalis
Will draw rectum anteriorly, cuasing the tube to fold...analogous to kinking a garden hos e
46
What makes fold even more secure
Intraabdominal pressure
47
Where do ureters pass pelvic brim?
Bifurcation of common iliac arteries
48
In the female/Male, ureter is crossed superiorly by
Uterine artery
Ductus deferens
49
Detrusor muscle
Main muscle of the bladder
50
Interior walls of bladder exhibit
Mucosal folds EXCEPT in the trigone
51
When empty, bladder lies _____, when ballooned it lies -____
True pelvis...ab cavity
52
Apex of bladder
Continuous with the medial umbilical ligament (urachus) of the anterior ab wall
Most anterior corner
53
Superior surface of bladder
Covered by peritoneum and expands when filled
54
Base of the bladder
Most inferior and least distensible part
55
Ureters enter the bladder
At upper corner of the base
56
Uterovesical junctions
Prevent backflow of urine during bladder contraction
57
Trigone location
Smooth portion of bladder wall
Tapers toward neck
58
Internal urethral sphincter adjacent to what in male and female
Prostate gland
Deep pouch of perineum
59
Bladder blood supply
Internal iliac artery --- superior and inferior vesicles aa
60
Detrusor muscle innervation
Parasympathetic
S2-S4
61
Internal urethral sphincter innervated by
Sympathetic fibers
62
In order to fill bladder, detrusor muscle and sympathetic fibers
Detrusor relaxes and sympathetic fibers elicit contractio of internal sphincter
63
TO empy bladder
Visceral affarent fibers carry to S2-S4 that elicit a parasym response...contracts detrusor AND ALSO inhibits internal urethral sphincter
64
Atonic or flaccid bladder
Inability to empty completely
May be because of neurological lesions of parasympathetic (sacral cord)
65
Spastic bladder (over active bladder)
Inability to fill the bladder
May be due to neurologic lesions to sympathetic portion (above sacral level)
66
Urethra connects (in males)
Urinary bladder and testis to genitalia
67
Prostatic urethra
Passes through prostate where ejaculatory ducts deposit contents
68
Membranous urethra
Passes through deep pouch of perineum
Surrounded by external urethral sphincter
Most easily ruptured during catheter placement
69
Spongy urethra
Longest portion
Surrounded by corpus spongiosum of penis
70
Upper portion of female urethra lies
Between bladder and UG diaphragm
71
BPH
Bening prostatic hypertrophy
Enlarged prostate prevents flow of urine through prostatic urethra
72
Uterus orientation
Anteverted - anterior lies superior
Anteflexed - slightly bent forward
73
How are ovaries attached to posterior body wall?
Suspensory ligaments - also provides route for artery and vein
74
Proper ovarian ligament
Attaches uterus to lower pole of ovary
75
Infundibulum
Has hair like appendages called fimbriae that engulf egg
76
Ampulla
Mid region and site of fertilization
77
Isthmus
Narrowest part of tube that joins uterus
78
Mesosalpinx of broad ligament
Covers and supports uterine tubes
79
Pouches of peritoneum found in men and women
Rectouterine and vesicouterine pouch (female)
Rectovesical pouch (male)
80
Broad ligament
What peritoneum renamed when it drapes over sides of female reproductive structures
Double layered
81
Mesometrium
Directly apply to uterus
82
Mesosalpinx
Covers uterine tube and attaches tube to mesometrium
83
Mesovarium
Supports ovary
84
Larger majority of ovary in infundibulum covered by ______
germinal epithelium
85
Pelvis fascia type
Investing
Endopelvic fascia (covers walls and organs)
Subserous fascia (loose adipose tissue packing material)
86
Transverse cervical ligament (or cardinal ligaments)
Support the uterus or vagina
***Uterine artery/vein will pass through this
87
Pubocervical ligament
Support bladder and cervix
88
Uterosacral ligaments
Stabilize uterus and rectum
89