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Ch 16 Female Pelvis
Curry & Tempkin Ch 16 Female Pelvis
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Medical
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01/15/2011

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Cards

Term
What organs are contained within the female pelvis?
Definition

Uterus

Vagina

Uterine or fallopian tubes

Ovaries

Urinary bladder

Pelvic colon

Term
What forms the outer boundaries of the pelvic cavity?
Definition
Osseous pelvis
Term
What lies deep to the boney osseous pelvis?
Definition
The skeletal muscles that line the pelvic cavity
Term
What do the urogenital folds from embrionic development contain?
Definition
Gonad & mesonephros
Term

Where are the gonads originally located?

When do they move?

Where do they move?

Definition

In cephalad position

Descend during fetal development

Into true pelvis

 

Term
What is the precursor to the mesonephros, urogenital sinus, Wolffian or mesonephric ducts & Mullerian or paramesonephic ducts?
Definition
The mesonephros
Term
What fetal structures become the urinary system?
Definition
Mesonephros & urogenital sinus
Term
What fetal structure becomes the male genital tract?
Definition
The Woffian or mesonephric ducts
Term
What fetal structure becomes the female genital tract?
Definition
Mullarian or paramesonephic ducts
Term
What happens to the Wolffian or mesonephic ducts & Mullerian or paramesonephic ducts in female development?
Definition

The Wolffian ducts degenerate.

The Mullerian ducts fuse at midline to form the vagina, the uterus & fallopian tubes.

Term
What is the most common malformation of the female genital tract?
Definition
Bicornuate uterus (heart shaped)
Term
How is a bicornuate uterus recognized sonographically?
Definition
Two endometrial canals that usually conect at the level of the cervix
Term
Which view best to visualize a bicornuate uterus?
Definition
Short axis or transverse view
Term
What are examples of congenital ovarian malformations?
Definition

Unilateral Mullarian or paramesonephic duct anomaly

Gonadal dysgenisis

Acessory, lobulated or supernumerary ovaries

 

Term
What congenital ovaian malformation appears as uterus-like paraovariam mass characterized by a thick smooth muscle wall?
Definition
Unilateral Mullarian or paramesonephic duct anomaly
Term
What congenital ovaian malformation is characterized by the absence of both ovaries?
Definition
Gonadal dysgenesis
Term
Is unilateral ovarian dysgenesis common?
Definition
No, it is rare
Term
Are accessory, lobulated or supernumerary ovaries common or rare?
Definition
They are among the most rare of gynecologic malformations
Term
Where is the pelvic cavity located?
Definition
The part of the paritoneal cavity that extends from the iliac crests superiorly to the pelvic diaphram inferiorly
Term
What are the 3 descriptive regions in the pelvis?
Definition

R Iliac

L Iliac

Hypogastic region

 

Term
What are the 2 structurally continuous regions that comprise the pelvic cavity?
Definition
True & false pelvis
Term
What arbitrary line divides the true & false pelvis?
Definition
The linea terimalis
Term
What landmark determines where the linea terminalis lies?
Definition
Sacral promintory posteriorly and the pubic symphysis anteriorly
Term
Which direction does the pelvis tilt?
Definition
Inferoposterioraly
Term
What is another name for the false pelvis?
Definition
Major or greater pelvis
Term
Where does the false pelvis lie?
Definition
The more superior aspect of the pelvic cavity which extends fromt he iliac crests superiorly to the linea terminalis inferiorly
Term
What is another name for the true pelvis?
Definition
Minor or lesser pelvis
Term
Where does the true pelvis lie?
Definition
The more inferior aspect of the pelvic cavity which extends from the linea terminalis superiorly to the pelvis diaphram inferiorly
Term
What are situated within the true pelvis?
Definition
Urinary bladder, various loops of small bowel, genital tract & ovaries
Term
Where is the nonpregnant uterus situated?
Definition
In the hypogastic region of the peritoneal cavity in the true pelvis between the urinary bladder anteriorly and the rectum posteriorly
Term
Where is the cervix located?
Definition
At right angles to the vagina
Term
Where is the vagina located?
Definition
In the hypogastic region of the peritoneal cavity between the urniary bladder & uretha anteriorly and the rectum posteriorly
Term
How does the vagina extend?
Definition
Superior to inferior from the uterus to the external genitalia
Term
Where is the exterior orifice of the vagina located?
Definition
Posterior to the urethral orifice between the labia minora
Term
Where do the uterine or fallopian tubes extend?
Definition
From the uterus to the ovaries
Term
Where do the uterine or fallopian tubes course?
Definition
Within the peritoneal folds of the broad ligaments
Term
Where do the uterine or fallopian tubes lie in relation to the uterus?
Definition
Posterolateral
Term
Where do the uterine or fallopian tubes lie in relation to the ovaries?
Definition
Anteromedial
Term
Where do the uterine or fallopian tubes lie in relation to the urinary bladder?
Definition
Posterior
Term
What is the adnexa?
Definition
Peritoneal cavity spaces located posterior to the broad ligaments.
Term
Even though the ovary position is variable, they never move where?
Definition
Anterior to the uterus or broad ligaments
Term
During a pregnancy it is common for what to happen to the ovaries?
Definition
They become displaced & never return to their original position
Term
The ovaries in a nulliparous woman lie where?
Definition
Craniocaudal long axis direction on the iliopsoas muscle bewteen the external iliac vessels anteriorly and the interior iliac vessels & ureters posteriorly
Term
Where is the urinary bladder fixed?
Definition
Anchored to the pelvis by the pubovesical & lateral ligaments.  It is fixed anteriorly at its base in the true pelvis posterior to the public symphysis and anterior to the uterus & vagina
Term
What is the location of the superior portion of the urinary bladder?
Definition
It varies depending upon the amount of urine in the bladder.  It can extend into the false pelvis, displacing movable pelvic organs & loops of small bowel.
Term
What parts of the colon are contained within the pelvis?
Definition
Sigmoid colon & rectum
Term
The sigmoid colon lies within which part of the pelvis?
Definition
True pelvis
Term
The sigmoid colon is continuous with which part of the colon?  In which abdominopelvic cavity?
Definition
Descending colon in the LLQ
Term
What loosely attaches the sigmoid colon to the posterior pelvic wall?
Definition
The Mesocolon
Term
What ligaments provide rigid support for the uterine cervix?
Definition
The cardinal ligaments
Term
What ligaments extend from the cornua to the anterior wall of the pelvis?
Definition
Round ligaments
Term
What ligaments maintain the anterior bend of the normal anteverted uterus?
Definition
Round ligaments
Term
The sigmoid colon descends towards the rectum & the infroposterior aspect of the pelvis at the level of the _______ sacral vertebra.
Definition
3rd
Term
The rectum is situated _______ to the vagina,  is in a fixed postion & is largely retroperitoneal.
Definition
Posterior
Term
What bones does the pelvic skeleton contain?
Definition
Sacrum, coccyx & inominate bones
Term
What bones constitute the distal segment of the verterbral spine & form the posterior border of the pelvic cavity?
Definition
Sacrum & coccyx
Term
What bones encircle most of the pelvic cavity, forming it's lateral and anterior margins?
Definition
Inominate bones
Term
What are the inominate bones comprised of?
Definition
Ilium, ishium & pubis
Term
Where do the inominate bones join?
Definition

Posteriorly at the sacrum & coccyx 

Anteriorly at the pubis or pubic symphysis

Term
What two external palpable landmarks aid in evaluating the pelvis?
Definition

Iliac crests of inominate bones superiorly

 

Pubic symphysis

Term
What are the prominate paired muscles that extend across the posterior wall of the posterior pelvic cavity?
Definition
Psoas muscles
Term
Where do the psoas muscles originate & where do they course?
Definition
Lateral aspect of the of the lower thorasic vertebra and the course anterolaterally in their descent to the iliac crest.
Term
What are the names of the false pelvis muscles?
Definition
Iliopsoas, Rectus abdominus, & Transversus abdominus
Term
What bundles does the joining of the psoas major muscle and iliacus muscle form?
Definition
Iliopsoas bundles of the false pelvis
Term
Where does the iliopsoas course & insert?
Definition
Courses anteriorly along the linea terminalis to travel over the pelvic brim & insert intot he lesser trochanter of the femur
Term
What muscle forms much of the anterior wall of the abdominopelvic cavity?  It extends from the 6th rib & xyphoid process to the pubic symphysis.
Definition
Rectus abdominus
Term
These paired muscles are intersected by transverse tendonous bands and are wrapped in a muscular sheath that fuses with transversus abdominus muscles to form the linea alba.
Definition
Rectus abdominus muscles
Term
These muscles fuse with the rectus sheath to form the linea alba.
Definition
Transversus abdominus muscles
Term
The midline structure that forms by the fusing of the transverus abdomninus muscles & the rectus sheath.
Definition
Linea Alba
Term
This forms anterolateral borders of the abdominopelvic cavity.
Definition
Transversus abdominus muscles
Term
This muscle group lies deep to the internal & external oblique muscles.
Definition
Transversus Abdominus muscles
Term
What are the muscles of the true pelvis?
Definition

Obturator Internus

Piriformis

Pelvis diaphram (which consists of the pubococcygeus & iliococcygeus or levator ani muscle & the coccygeus)

Term
What muscles originate along the arcuate line of the inominate bones & course parallel to the lateral walls of the true pelvis?
Definition
Obturator inturnus muscles
Term
What triangular muscles narrow inferiorly to pass through the lesser sciatic notch?
Definition
Obturator internus muscles
Term
What muscle is secured to the medial aspect of the greater trochanter?
Definition
Obturator internus muscles
Term
The internal surface of which muscle is covered by a tough membranous layer called the obturator fascia?
Definition
Obturator internus muscles
Term
What muscle originates at the most posterior aspect of the true pelvis along the lower portion of the sacrum, posterior to the uterus?
Definition
Piriformis muscle
Term
Where does the piriformis travel and where does it attach?
Definition
Travels anterolateraly narrowing to pass through the greater sciatic notch & attaches at the superior aspect of the greater trochanter
Term
What is the group of skeletal muscles lining the floor of the true pelvis & supporting the pelvic organs?
Definition
Pelvic diaphram
Term
This muscular floor is composed of 3 paired muscles:  the pubococcygeus, the iliococcygeus & coccygeus
Definition
Pelvic diaphram
Term
The most medial & anterior muscle pair of the pelvic diaphram that eztends from the pubic bones to the coccyx, encircling urethra, vagina & rectum
Definition
Pubococcygeus muscles
Term
These paired muscles are located lateral to the pubococcygeus muscles & extend from the obturator fascia & ischial spine anteriorly to the coccyx posteriorly
Definition
Iliococcygeus muscles
Term
What muscles form a hammock across the floor of the true pevis & are termed the levator ani muscles?
Definition
Pubococcygeus & iliococcygeus muscles
Term
What muscles provide primary support of the pelvic viscera & aid in the contraction the vagina and rectum?
Definition
Levator ani muscles (pubococcygeus & iliococcygeus muscles)
Term
What muscles are the most posterior muscle pair of the pelvic diaphram & extend from the ishial spine to the sacrum & coccyx?
Definition
Coccygeus muscles
Term
Name the pelvic ligaments
Definition
Cup, broil, cardinal, uterosacral, pubovesicle, broad, round, ovarian, infundibulopelvic & lateral ligaments
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