pelvis

Question 1

Pelvis region

Answer 1

1. area of transition between trunk and lower limbs

2. enclosed by bones, ligaments, muscles

Question 2

sexual differences in pelves (4)

Answer 2

1. xy- pelvic inlet xx- oval (not heart shaped)
2. pelvic outlet; larger pelvic outlet; everted ischial spines
3. pelvic cavity; shallower greater & lesser pelves
4. pubic arch; rounded & wider subpubic angle

Question 3

pelvic cavity

Answer 3

• funnel shaped space bound by bones of the pelvis
  
  • greater pelvis: btw ala of ilium & p. inlet
  • lesser p: btw p. inlet & p. outlet
• continuous with abdominal cavity
• contains urinary bladder, terminal parts of ureters, pelvic genital organs, rectum

Question 4

perineum
two parts
male/XX

Answer 4

• triangular area of trunk btw thighs and buttocks extending from pubis to coccyx
• seen best in lithotomy position-diamond shape
• separated from pelvic cavity by the pelvic diaphragm (pelvic floor)
• 2 parts: urogenital triangle, anal triangle
• males: penis, scrotum, anus
• females: vulva, clitoris, vagina, anus

Question 5

OIAN Obturator internus

Answer 5

O: ilium, superior pubic ramus & ischium (anterolateral wall of oelvis minor)
I: greater trochanter of femur
A: none
N: nerve to obturator internus

Question 6

Piriformis OIAN

Answer 6

O: 2-4th sacral segments
I: greater trochanter of femur
A: none
N: S1-2

Question 7

Muscles making up pelvic diaphragm
function of pelvic diaphragm

Answer 7

• levator ani muscle + coccygeus muscle
• form floor of pelvis, suporting abdominopelvic organs
• aids in urinary and fecal continence
• raises pelvic floor during urination, vomiting, coughing, weight lift
• during parturition, supports the fetal head while the cervix dilates for delivering the baby

Question 8

Three names that make up the levator ani

Answer 8

1. puborectalis
2. pubococcygeus
3. Iliococcygeus

Question 9

Tendinous arch of levator ani

Answer 9

• thickened fascia of obturator internus muscle

- attachment for levator ani muscle

Question 10

Iliococcygeus (one of three muscle making up the levator ani OIAN

Answer 10

O-tendinous arch of obturator fascia
I-perineal body, coccyx
A-support pelvic viscera
N-S4, inferior rectal nerve, cocygeal plexus

Question 11

OIAN of puborectalis (levator ani)

Answer 11

O-inferior ramus of pubis
I-rectum, prostate in males, vagina in female
A-support pelvic viscera
N-S4-5

Question 12

OIAN of pubococcygeus

Answer 12

O-inferior ramus of pubis tendinous arch of obturator internus
I-coccyx
A-support pelvic viscera
N-S4-5

involve in episiotomy. Injury may lead to stress incontinence.

Question 13

OIAN coccygeus

Answer 13

O-ischial spine
I-inferior end of sacrum, coccyx
A-supports pelvic viscera and flexes coccyx
N-S4-5

Question 14

Pudendal nerve

Answer 14

-supplies sensory innervation to perineum

Question 15

walls of pelvic cavity
posterior-
anterior-
lateral-
inferior-
superior-

Answer 15

posterior-sacrum, piriformis m.
anterior- pubic rami, pubic symphysis
lateral- obturator internus
inferior- levator ani m. (iliococcygeus, pubococcygeus, puborectalis)
superior-open to abdominal cavity

Question 16

Arteries in pelvis

Answer 16

1. aorta
   - common iliac a
   
   • external iliac a–>femoral a
   • internal iliac a
     
     • iliolumbar a
     • lateral sacral a
     • superior gluteal a
     • inferior gluteal a
     • internal pudendal a
     • middle rectal a
     • superior vesical a
     • inferior vesical a
     • umbilical a

Question 17

male/female peritoneal recesses

Answer 17

Male: rectovesical pouch
Female: rectouterine pouch (of Douglas)
vesicouterine pouch

Question 18

Urinary components (3)

Answer 18

1. ureters carry urine from kidney
2. urinary bladder temporarily stores urine
3. urethra conducts urine from urinary bladder to exterior

Adult: urinary bladder in retropubic space within lesser pelvis.
Children: bladder is in abdomen
enters greater pelvis at 6 yo, lesser pelvis at 16

Question 19

1. What is the muscle that makes the bladder?
2. What does the urethral sphincters do?
3. Symp innervation
4. para innervation

Answer 19

1. detrusor m.- internal (involuntary), external (voluntary)
2. help maintain urinary continence, internal sphincter prevent semen from entering bladder during ejaculation
3. T11-L2, maintain continence by contraction of internal sphincter
4. S2-4, allows urination by relaxing internal sphincter and contracting detrusor m.

Question 20

Four parts of male urethra

Answer 20

1. intramural part
2. prostatic urethra
3. intermediate part
4. spongy urethra

Question 21

Male pelvic viscera (8 structures)

Answer 21

1. ductus deferens-takes pathway superior then posterior to bladder transmit sperm from epididymis of testis to prostatic urethra. Toward the end, ductus joins duct of seminal gland to form ejaculatory duct
2. urianry bladder
3. ureter
4. seminal gland (vesicle)
5. rectum
6. prostate gland
7. epididymis
8. testis

Question 22

1. seminal glands
2. prostate gland
3. ejaculatory duct
4. bulbourethral glands

Answer 22

1. 50-70% semen made of fluid secreted by seminal gland
2. 20% semen made of secretion from prostate gland
3. ejaculatory duct bring seminal fluid & sperm through prostate into prostatic urethra
4. bulbourethral glands secrete a lubricating fluid during sexual arousal

Question 23

Penis structures

Answer 23

• corpus cavernosum outside
• corpus spongiosum
• erectile tissues fill with blood to become turgid
• spongy urethra runs through corpus spongiosum
• at base of penus corpus cavernosum is called crus of the penis
• corpus of spongiosum is call bulb of the penis
• at the tip of penis corpus spongiosum expands into glans of the penis

Question 24

What are the two muscles at the base of penis? and the nerve

Answer 24

1. ischiovavernosus muscle covers crus of penis
2. bulbospongiosus muscle covers bulb of penis
3. innervated by pudendal nerve
   - erectile tissues covered by thin muscles that help maintain erection

Question 25

Female pelvic viscera

Answer 25

- short urethra - vaginal canal lies btw urethra and bladder anteriorly and anal canal and rectum posteriorly - vaginal canal ends in an expanded fornix that surrounds the cervix of the uterus

Question 26

female pelvic structures:

Answer 26

``` -ureter ovarian a and v. uterine tube ovary proper ligament of ovary uterus urinary bladder urethra clitoris labia minora/majora cervix rectum vagina levator ani m. anus vaginal orifice ```

Question 27

What is the function of broad ligament and what suspend there? what does the uterine tube do? what causes prolapsed uterus?

Answer 27

1. secure everything to the lateral pelvic walls 2. uterus, uterine tubes, ovaries in the double layer of peritoneum 3. uterine tube receives and conveys the ovum from the ovary to the uterine cavity 4. prolapsed uterus results when the uterus descends abnormally into the vagina

Question 28

Erectile tissue homology

Answer 28

penis=clitoris crus of clitoris/glands of clitoris=crus of penis, glands of penis bulbs of vestibule=bulb of penis

Question 29

Structure in female genitalia

Answer 29

- ischocavernous m. covers crus of clitoris | - bulbospongiosus m. covers bulbs of vestibule (the vestibule is the region btw the labia minora)

Question 30

innervation of pelvis and perineum (symp/para) 1. sexual function 2. defecation and urination

Answer 30

1. para- spinal cord S2-4 -erection relaxation of smooth muscles in walls of arteries, allowing blood to fill erectile tissue 2..symp L1-2 -ejaculation in males contraction of smooth muscles in walls of the ductus deferens, seminal vesicles, prostate and urethra -orgasm in females rhythmic contractions of smooth muscles in walls of vagina 3. para S2-4 -relaxation smooth muscle internal sphincters of bladder and rectum, contraction smooth muscle in walls of these organs -symp L1-2 -contraction of smooth muscle internal sphincters to maintain continence -voluntary somatic control S2-4 contraction of striated muscle external sphincters to maintain continence.