Lecture 12 Pelvis
How many muscles compose the floor of the pelvic diaphragm?
4 Levator ani has three parts: -puborectalis -pubococcygeus -Iliococcygeus one coccygeus (ischial spine to coccyx)
How long is the female urethra?
4 cm (less than 2 inches)
The ilium, ischium, and pubis make up the socket of the hip bone called? This fuses at the age of 25
Acetabulum
is a thick, triangular arch of ligamentous fibers, connecting together the two pubic bones inferiorly.
Arcuate pubic ligament
Secrete an alkaline fluid into spongy urethra during sexual excitement (prior to ejaculation)
Bulbo-urethral gland
which gland contains 1% of semen
Bulbo-urethral gland
It is also known as the vas deferens, begins at inferior pole of testis, it is the tail of the epididymus, ascends to spermatic cord, passes through inguinal canal, crosses over external iliac vessels into pelvis and ends by joining duct of the seminal gland
Ductus Deferens
T/F: The obturator internus is part of the obturator nerve?
False
Which nerve is the obturator internus innervated by
L5-S1-S2
reflects across the superior aspect of pelvic structures.
Peritoneum of pelvis
Walnut sized, lies inferior to the bladder, can be palpated during rectal exam, rest on Levator ani muscle
Prostate gland
which nerve innervates the levator ani and coccygeus
S3 and S4
the angle that is formed just below the pubic symphysis by the meeting of the inferior ramus of the pubis a. pubic symphysis b. ilium c. sacral promontory d. subpubic angle
Subpubic angle also narrower in males and wider in females.
What is a common procedure for benign prostatic hyperplasia?
TURP- Transurethral Resection of the Prostate
a thickened portion of the obturator fascia on the medial aspect of the obturator internus (muscle) that extends in an arching line from the pubis posteriorly to the ischial spine and gives origin to part of the levator ani muscle
Tendinous arch of levator ani
the expanded portion of the cavity situated above and in front of the pelvic brim. (Practically the Ala of the ilium)
The greater pelvis (false pelvis)
How many fold does are there in the umbilical fold?
Three 1. lateral umbilical fold 2. medial umbilical fold 3. median umbilical fold
T/F: the ovarian tubes and urinary bladder are intraperitoneal?
True
T/F: the seminal vesicle does not store sperm
True
What forms the Trigone?
Uretic orifices (ureters) and urethral orifice
Its overall shape is round, shallow, and open. Flat spines triangular inlet. in males only a. Android b. Gynecoid c. Anthropoid d. platypelloid
a. Android
Formed by bodies and rami of pubic bones and symphysis pubis Bladder rests against anterior wall a. anterior pelvic wall b. lateral pelvic wall c. posterior pelvic wall d. floor pelvic diaphragm
a. anterior pelvic wall
the distance from the undersurface of the pubic arch to sacral promontory a. diagonal conjugate b. pelvic inlet c. pelvic outlet
a. diagonal conjugate
Contains urinary bladder, many reproductive organs, rectum, inferior portion of ureter a. pelvic cavity b. pelvis c. perineum
a. pelvic cavity
also called the inferior pelvic aperture, defines the lower margin of the lesser (true) pelvis. a. pelvic outlet b. pelvic inlet c. perineal region d. pelvic axis e. pelvic brim
a. pelvic outlet
Passes through Prostate Gland a. prostatic urethra b.membranous urethra c. penile/ spongy urethra
a. prostatic urethra
Tube that carries urine from bladder to environment a. urethra b. urinary bladder c. ureters
a. urethra
might ask to label
anterior sacrum
The angle of the female pubic arch is wide and round. normal spines round inlet. a. Android b. Gynecoid c. Anthropoid d. platypelloid
b. Gynecoid
Which is the bone compresses on the butt as you sit on a flat surface? a. ilium b. ischium c. pubis d. sacral promontory
b. ischium
Formed by hip bones (os coxae); obturator internus covers obturator foramen and membrane Obturator nerve and artery and other branches of internal iliac artery are medial to obturator internus a. anterior pelvic wall b. lateral pelvic wall c. posterior pelvic wall d. floor pelvic diaphragm
b. lateral pelvic wall
a planar surface which defines the boundary between the pelvic cavity and the abdominal cavity a. pelvic outlet b. pelvic inlet c. perineal region d. pelvic axis e. pelvic brim
b. pelvic inlet
Trunk inferior to the abdomen a. pelvic cavity b. pelvis c. perineum
b. pelvis
stores urine a. urethra b. urinary bladder c. ureters
b. urinary bladder
Passes through Pelvic Diaphragm a. prostatic urethra b.membranous urethra c. penile/ spongy urethra
b.membranous urethra
Where is the fundus of the bladder located?
base-posterior surface
pelvis is narrow and deep. Prominent spines anterior-posterior oval inlet in males a. Android b. Gynecoid c. Anthropoid d. platypelloid
c. Anthropoid
Bony ring that connect spine to femurs a. pubic symphysis b. ilium c. pelvic girdle d. subpubic angle
c. pelvic girdle
Passes through entire length of Penis to Meatus a. prostatic urethra b.membranous urethra c. penile/ spongy urethra
c. penile/ spongy urethra
the region between the thighs, bounded by the scrotum and anus in males and by the opening of the vagina and the anus in females a. pelvic outlet b. pelvic inlet c. perineal region d. pelvic axis e. pelvic brim
c. perineal region
Between thighs and buttock; coccyx to pubis a. pelvic cavity b. pelvis c. perineum
c. perineum
Formed by sacrum, coccyx, and SI joints; piriformis attaches to sacrum and exits through greater sciatic notch Sacral plexus is anterior to piriformis a. anterior pelvic wall b. lateral pelvic wall c. posterior pelvic wall d. floor pelvic diaphragm
c. posterior pelvic wall
The base of the sacrum, the broadest and uppermost part. an important landmark for labour and delivery a. pubic symphysis b. ilium c. sacral promontory d. coccyx
c. sacral promontory
Tubes that carry urine from the kidney to bladder a. urethra b. urinary bladder c. ureters
c. ureters
Formed by Levator ani and coccygeus muscles. Helps support external anal sphincter and external urethral sphincter a. anterior pelvic wall b. lateral pelvic wall c. posterior pelvic wall d. floor pelvic diaphragm
d. floor pelvic diaphragm
A hypothetical curved line joining the centre point of each of the four planes of the pelvis, marking the centre of the pelvic cavity at every level a. pelvic outlet b. pelvic inlet c. perineal region d. pelvic axis
d. pelvic axis
In females. a flat spine pelvis. Tarnasverse oval inlet. This is the least common type. It's wide but shallow, and it resembles an egg or oval lying on its side. a. Androiod b. Gynecoid c. Athropoid d. platypelloid
d. platypelloid
the edge of the pelvic inlet. It is an approximately Mickey Mouse head-shaped line passing through the prominence of the sacrum, the arcuate and pectineal lines, and the upper margin of the pubic symphysis. a. pelvic outlet b. pelvic inlet c. perineal region d. pelvic axis e. pelvic brim
e. pelvic brim
begins at union of the seminal gland and the vas deferens, near the neck of the bladder and pass through the posterior part of the prostate, ends at the prostatic urethra
ejaculatory duct
What is the action of the obturator internus and piriformis
externally rotate hip
T/F: In the pelvic girdle there is a lot of movement occurring at the joints.
false, it is a solid bony ring.
Which pelvic inlet is the image showing. male of female?
female
Which subpubic angle is a the image showing. A male of female?
female
Who has a wider pelvis?
females, greater than 90 degrees of pubic arch
The anterior aspect of the pelvic girdle which connects the right pubis and left pubis it is called the pubis symphysis. Which type of joint connects these bones?
fibrocartilaginous
Which ligament is attaches from the iliac crest to transverse process of L5
iliolumbar ligament
Which line is formed from the arcuate line (back) and pecten pubic (pectineal line) (front)
iliopectin line (it is sharp)
Might ask to label
ilium parts landmarks
Which bones make the connection for the sacroiliac joint?
ilium to sacrum
Pelvic Floor anterior view
image
Which is the red oval labeling?
inferior pubic ramus
Lies deep to the posterior ligament, and consists of a series of short, strong fibers connecting the tuberosities of the sacrum and ilium.
interosseous sacroiliac ligament
which bone contributes to the inferior pubic ramus?
ischium
might ask to label
ischium landmarks
Which pelvic inlet is the image showing. male of female?
male
Which subpubic angle is a the image showing. A male of female?
male
who has a narrower pelvis?
males
what is the smallest part of the male urethra
membranous urethra
Through which canal does the obturator nerve comes through?
obturator canal
a small opening in the superior aspect of the obturator foramen that connects the pelvis to the medial compartment of the thigh.
obturator canal
Which tendon passes through the lesser sciatic notch and inserts at the greater trochanter of femur?
obturator internus
The landmark showing on the image is
obturator internus tendon
Which membrane cover the obturator foramen?
obturator membrane
arises from the lumbar plexus and provides sensory and motor innervation to the thigh. (medial compartment muscles)
obturator nerve
Space that allows bladder fill and expand.
peritoneum of pelvis
Tendon that passes through greater sciatic notch and inserts at greater trochanter of femur?
piriformis
the sacroiliac joints in composed of what type of joint?
plates of hyaline cartilages
might ask to label
posterior sacrum
produces 20 to 30 % of semen
prostate gland
which gland is common to enlarge as men age?
prostate gland
The inferior pubic ramus is a connection between which two bones?
pubic and ischium
might ask to label
pubis
might ask to label
pubis landmarks
What are the three part of the male urethra?
- prostatic urethra -membranous urethra - penile/ spongy urethra
Which bone to inject
-----
Which organs are part of the pelvic viscera
-rectum -urinary tract -reproductive system
What are the contents of the male internal genital organs
1. Ductus(Vas) deferens 2. seminal glands 3. Ejaculatory duct 4. prostate gland 5. bulbo-urethral gland (SEP-B)
What are the 5 hypospadias in the urethral meatus.
1. glanular 2. coronal 3. penile 4. scrotum 5. perineal
What are the notches called in the pelvic bone/os coxa?
1. greater sciatic notch 2. lesser sciatic notch
Which are the three crest of the sacrum?
1. lateral sacral crest 2. median sacral crest 3. intermediate sacral crest
Which ligament is attached from the sacrum to the ischial spine
sacrospinous ligament
secrete a thick alkaline fluid that mixes with sperm
seminal gland
Which gland provides 65% of semen?
seminal gland/vesicle (during sympathetic and parasympathetic)
Note
sigmoid colon and small intestine are mostly considered to be part of the abdominal structures
ligament that connects together the two pubic bones superiorly.
superior pubic ligament
The posterior aspect of the pelvic girdle is connected by the sacroiliac joint. What type of joint is this?
synovial joint
T/F: The trigone is the same for males and females
true
When the bladder is full it squeezes on ________ to prevent urine from backing up to the kidney.
ureters, if blocked by kidney stone it can be very painful
lies anterior to the vaginal opening (only in females)
urethra
Which three bones make up the pelvic Girdle?
1. right os coxa 2. left os coxa 3. sacrum and coccyx (containing ilium, ischium, pubis)
know these ligaments from the anterior view of the sacroiliac joint
1. sacroiliac ligament 2. sacrospinous ligament 3. sacrotuberous ligament
know these ligaments from the posterior view of the sacroiliac joint
1. sacroiliac ligament 2. sacrospinous ligament 3. sacrotuberous ligament
Which nerve innervates the piriformis
ventral rami S1, S2
Which contents are part of the pelvic outlet?
1. urinary bladder 2. colon 3. internal reproductive organs
How long is the male urethra?
18 cm (7 inches)
How many sacroiliac ligaments are there?
2, anterior and posterior
At what age do the three pelvic girdle bones completely fuse into one?
25 years