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Pelvic Anatomy
Anatomy
| Question | Answer |
|---|---|
| Ligaments of pelvis | Sacro-iliac joints (ant/post sacro-iliac ligs); pubic symphysis; Sacrotuberous lig & sacrospinous lig form greater/ lesser sciatic foramina |
| Pelvic cav mx’s: Lateral wall | Obturator internus; Piriformis; Both mx’sact on lower extremity; Piriformis attach to ant body of sacrum & runs out foramen |
| Pelvic cav bounded superiorly/inferiorly by: | superiorly by abd cav; inf by pelvic floor |
| Inguinal ligament attaches: | ASIS to pubic tubercle |
| Obturator mx's attach to: | obturator membrane, which is closing the obt foramen |
| Characterize pelvic ligaments | S-I joint = synovial; pubic symph = cartilaginous pad (not really ligament) |
| sacrotub lig attaches: | sacrum to ischial tuberosity |
| sacrospinous lig attaches: | sacrum to (coccyx and) to ischial spine |
| Females pelvis: | Ilium more flared; Pelvic inlet circular; Wider sub-pubic angle |
| Males pelvis: | Ilium more upright; Heart shaped pelvic inlet; acute sub-pubic angle |
| False pelvis (=inferior abdomen) vs. true pelvis | False pelvis (=inferior abdomen): btw iliac blades; True: inferior; sep’d by the pelvic inlet (pelvic brim) |
| Weakness or damage to pelvic floor mx (& urethral & anal sphincters) can result in: | Urinary or fecal incontinence (multifactorial symptom) |
| Female external genitalia (vulva) | Mons pubis; Labia majora; Labia minora; Prepuce of clitoris; Glans of clitoris |
| Levator ani mx attachments: | Ileococcygeus & pubococcygeus end in coccygeus; puborectalis forms sling around anal aperture and attach antly to (pubic bone?) |
| Perineal membrane | Inf to pelvic diaphragm; attachment for external genitalia; openings for urethra and vagina |
| Position of uterus | Body of uterus is anteverted over bladder; laterally continues & forms fallopian tubes |
| Stretching of broad ligaments during childbirth can contribute to: | Prolapse of uterus through the vaginal canal |
| Contents of Spermatic cord: | Testicular a.; Pampiniform plexus of veins; Ductus deferens; Lymphatics and nerves to testes |
| Hydrocele= | Abnormal accumulation of fluid in the tunica vaginalis; a few poss causes (e.g., incomplete devt of parietal (scarpus fascia?) |
| Erectile tissues: male vs female | Erectile tissues covered by ischiocavernosus (corpora cavernosa), and bulbospongiosus (bulbs of vestibule/ corpus spongiosum) muscles |
| Erectile Tissues- Arterial Supply | Dorsal a. penis/clitoris; deep a. of p/cl; a. of bulb of penis (vestibular bulb) |
| NS ctrl: erection/ejaculation/orgasm | Erection = parasymp ctrl (venous supply shut off); ejaculation/orgasm = symp ctrl |
| Path of sperm flow | Testes -> Epididymis -> Ductus deferens -> Ampulla of ductus deferens -> (Seminal vesicle joins at) -> Ejaculatory ducts -> (Prostate joins at) -> Prostatic urethra -> Penile urethra |
| mx of pelvic cav: Lateral wall | Obturator internus; Piriformis |
| mx of pelvic cav: Floor (pelvic diaphragm) | Levator ani: 3 parts; Coccygeus |
| Mx forms most of pelvic diaphragm: | Levator ani |
| Levator ani mx form 3 parts: | ileococcygeus; pubococcygeus; puborectalis |
| Perineal membrane attaches to: | post surface of pubic arch |
| perineal mem attach to: | post surface of pubic arch (but not attach to ...) |
| Perineal body = | post attachment of perineal mem; what is cut during episiotomy |
| Urogenital triangle | Roots of external genitalia; Openings for urogenital system |
| Urogenital triangle formed by: | pubic symph & ischial tuberosities |
| Anal triangle includes: | Anal aperture |
| Anal triangle formed by: | coccyx & ischial tuberosities |
| Parietal peritoneum drapes over: | pelvic viscera |
| Sacral Plexus: level/type: | L4 - S4 spinal levels; All are ventral rami |
| Sacral Plexus Innervates: | Pelvic floor/wall muscles |
| Sacral Plexus Major branches: | Sciatic n. (Leg, foot); Gluteal nerves; Pudendal n. (Perineum) |
| Pelvic splanchnic nerves | Parasymp to hindgut, bladder, genitalia; S2-S4 spinal levels |
| Clin sig of pudendal n. | site of nerve block during childbirth |
| Lymph drainage: Pelvic cavity | Internal/ external iliac nodes -> lateral aortic nodes |
| Lymph drainage: Ovaries/ Testes: | Drain directly to lateral aortic nodes |
| Female external genitalia collectively referred to as: | the vulva |
| Female Erectile Tissues | Corpora cavernosa; Bulbs of the vestibule; Glans clitoris |
| Corpora cavernosa | Crura of clitoris = erectile tissue (pair) |
| Crura of clitoris attach: | along pubic arch |
| Bulbs of vestibule: | Anchored to perineal membrane; surround vaginal opening, either side |
| Female repro organs | Vagina, Cervix; Uterus; Uterine tubes; Ovaries |
| Round ligament of uterus = | remnant of gubernaculum in female |
| Vagina: Anterior wall contacts: | bladder |
| Vagina: Posterior wall contacts: | rectum |
| Vagina: Blood Supply: | Vaginal a./v. |
| Vagina: Innervation: | Upper 2/3 visceral sensory; |
| Cervix: parts | External os; Cervical canal; Internal os |
| Vagina: surgical approach to abdomen via: | posterior fornix |
| Cervix = actually part of the: | uterus |
| Uterus: parts | Body; Fundus |
| 3 layers of tissue in uterine fundus | Perimetrium; Myometrium; Endometrium |
| Uterine Blood Supply: | Uterine a./v. |
| Ovarian blood supply | ovarian a.; ovarian v. (R drains to IVC; L to L renal v.) |
| Uterine tubes (aka fallopian tubes): parts | Isthmus; Ampulla; Infundibulum; Fimbrae |
| Most fertilizations occur in: | ampulla of uterine tube |
| Some ectopic PGs can result in: | ruptured uterine tube (v dangerous) |
| Sites of poss ectopic PG | see S22 |
| Broad Ligament = | Peritoneum draped over uterus, uterine tube, and ovary |
| Ovaries: size | approx 3cm long |
| Ovaries: location | On lateral wall of true pelvis; Suspended by broad ligament |
| Ovarian ligament: | Remnant of gubernaculum; Attaches ovary to uterus |
| Penis: parts | shaft; glans |
| Scrotum: function | Houses spermatic cord and testes |
| R/L compartments of scrotum divided by: | median septum |
| Spermatic cord: layers from: | anterior abdominal wall |
| Testes = | 4 cm long; Covered by tunica albuginea |
| Tunica albuginea fn: | Keeps seminiferous tubules together |
| Testes partly covered by: | tunica vaginalis |
| Tunica vaginalis = | remnant of processus vaginalis |
| Testes contain: | seminiferous tubules |
| Testes: surrounded by: | surrounded (on one side) by the epididymis |
| Testes: Connected to urethra via: | ductus (vas) deferens |
| 2 spongy erectile tissues of penis: | Corpus spongiosum (1); Corpora cavernosa (2) |
| Corpus spongiosum is (ventral/dorsal) & contains: | ventral; urethra |
| Corpora cavernosa is (ventral/dorsal)? | dorsal |
| Penis: visible | Half; root (not visible) = in perineal region |
| Penis covered by: | loose skin (prepuce) that covers the glans |
| Attached part of corpus cavernosum = | Crus (of penis/clitoris) |
| Prostate | 25-30% semen vol; at base of bladder, surrounding urethra |
| Seminal vesicles | 60% semen volume; joins ductus deferens at ejaculatory ducts |
Created by:
Abarnard
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