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What 3 bones make up the hip bone?
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Where do the 3 hip bones meet?
Acetabulum: Deep fossa for the head of the femur
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What are the 4 joints of the pelvis?
- Lumbosacral
- Sacrococcygeal
- Sacroiliac
- Symphysis Pubis
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What ligaments unite the L5 vertebrae to the iliac crest/sacrum? What is their function?
- Iliolumbar ligaments
- Limit axial rotation of L5 on sacrum and stabilize the lumbosacral joint
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What ligaments make up the sacroiliac joint and what is the joint's function?
- Ligaments: Dorsal sacroiliac, iterosseous sacroiliac, sacrotuberous, sacrospinous ligaments
- Function: Transmitting the weight of the body to the hip bones
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What ligaments form the greater and lesser sciatic foramina?
- Sacrotuberous
- Sacrospinous
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What outlines the pelvic brim?
- Promontory and alae of sacrum
- Arcuate line of ilium
- Pectineal line
- Pubic crest
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What diameters are measured of the superior pelvic aperture? Where are the measurements made?
- Anteroposterior/conjugate diameter: Pubis symphysis to sacral promontory
- Transverse diameter: Greatest width of superior pelvic aperture
- Oblique diameter: Iliopubic eminence to opposite sacroiliac joint
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What is the pelvic outlet formed by?
- Pubic symphysis
- Ischiopubic rami
- Ischial tuberosities
- Sacrotuberous ligaments
- Coccyx
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Origin, insertion, innervation of the obturator internus? Path?
- Origin: Obturator membrane, margin of obturator foramen
- Path: Through lesser sciatic foramen
- Insertion: Greater trochanter of femur
- Innervation: Nerve to obturator internus and superior gemellus (L5,S1,2)
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Origin, insertion, innervation of the piriformis? Path?
- Origin: Anterior surface of sacrum
- Path: Through greater sciatic foramen
- Insertion: Greater trochanter
- Innervation: Nerve to the piriformis (S1,2)
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What passes through the urogenital hiatus?
Urethra, vagina and anal canal
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What are the 3 parts of the levator ani?
- Pubococcygeus
- Puborectalis
- Iliococcygeus
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Origin, insertion of the pubococcygeus (levator ani main part)? Where do the anterior fibers sweep?
- Origin: Pubis
- Insertion: Coccyx and anococcygeal ligament
- Anterior fibers: Behind prostate/vagina as levator prostatae and pubovaginalis
- Ends in perineal body
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Origin, insertion of the iliococcygeus?
- Origin: Tendinous arch and ischial spine
- Insertion: Coccyx and anococcygeal ligament
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What is the origin, insertion, innervation and function of the cocygeus?
- Origin: Ischial spine
- Insertion: Sacrum and coccyx
- Innervation: N to the levator ani and coccygeus
- Function: Pull coccyx anteriorly and raise the pelvic floor
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What are the contents of the anal triangle?
- Anus
- External anal sphincter
- Anal canal
- Ischioanal fossae
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What are the parts of the external anal sphincter? Where are they located? Innervation?
- Subcutaneous
- Superficial: Coccyx/anococcygeal ligaments to perineal body
- Deep parts
- Innervation: Inferior rectal branches of pudendal nerve (S2,3,4)
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What does the pectinate line indicate?
Site of seperation of vascular, lymphatic and neural supply of anal canal due to dual embryological origin
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What is found superior to the pectinate line? What is its embryological origin?
- Formed from: Endodermal hindgut
- Contains: Superior rectal vessels, lymphatics of internal iliac nodes, autonomic innervation (GVA,GVE)
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What is found inferior to the pectinate line? What is its emrbyological origin?
- Formed from: Ectodermal proctodeum
- Contains: Inferior rectal vessels, lymphatics of sueprficial inguinal nodes, somatic innervation (GSA, GSE)
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Describe the sensitivity of the anal canal superior and inferior to the pectinate line?
- Superior: Stretching only
- Inferior: Pain, touch, temeprature
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What are the boundaries of the ischioanal fossae?
- Base: Perineal skin
- Vertical lateral wall: Obturator internus and ischial tuberosity
- Superomedial wall: Levator ani and anal canal
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How do the ischioanal fossae communicate?
Anococcygeal ligament
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What is the location, derivation, contents and function of the pudendal canal?
- Location: Lateral wall of ischioanal fossae
- Derivative: Fascia of obturator internus
- Contents: Internal pudendal vessels and pudendal nerves
- Function: Supplies external anal sphincter, inferior part of anal canal and perianal skin
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What usually fractures on the pelvis?
Pelvic rim parts like the pubic rami
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What muscles are easily damaged during childbirth?
Levator ani muscles - especially the pubococcygeus
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What is the ischioanal fossa usually a site of?
Site of infection
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