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Anatomy Pelvic Wall, Vessels, Nerves
KYCOM Block 2
162
Anatomy
Graduate
09/20/2012

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Term
what are the functions of the pelvis
Definition
transmit weight of body from vertebral column to lower limbs, support protect pelvic viscera, attachment for lower limb and trunk muscles
Term
what are the components of the pelvis
Definition
two hip bones, sacrum, coccyx
Term
what do the hip bones articulate with
Definition
eachother anteriorly at publc symphysis, posteriorly with sacroiliac joint
Term
what do the sacrum and coccyx articulate with
Definition
sacrococcygeal joint
Term
what type of joint is the sacroiliac joint
Definition
synovial
Term
what is the extent of the scaroiliac joint movement
Definition
limited
Term
what is the function of the sacroiliac joint
Definition
transmit weight of body from vertebral column to hop bone
Term
what are the articular surfaces of the sacroiliac joint
Definition
ilium and sacrum
Term
what is the difference in the sacroiliac joint between adults and infants
Definition
flat in infants, reciprocally irregulat in adults
Term
what does the reciprocally irregular configuration of the sacroiliac joint do to adult movement
Definition
restricts it and contributes to strength
Term
what happens to the sacroiliac joint with age
Definition
fibrous adhesions, gradual obliteration, earlier in males
Term
what ligaments are associated with the sacroiliac joint
Definition
interosseous sacroiliac ligament, posterior sacroiliac ligaments (short and long), anterior sacroiliac ligament, sacrotuberous ligament, sacrospinous ligament, iluolumbar ligament,
Term
what does the interosseous sacroliliac ligament connet
Definition
sacrum and ilium tuberosities
Term
what space does the interosseous sacroiliac ligament full
Definition
irregular space posteroir to the scaroiliac joint
Term
what is the posterior sacroiliac ligament posterior to
Definition
interosseous sacroiliac ligament
Term
what does the posterior sacroiliac ligament connect
Definition
posterior sacrum intermediate and lateral sacral crests to posterior ilium
Term
what is the anterior sacroiliac ligament formed by
Definition
thickening of anterior and inferior aspects of joint capsule
Term
what shpe is the sacrotuberous ligament
Definition
triangular
Term
what direction does the sacrotuberous ligament run
Definition
inferior and laterally
Term
what does teh sacrotuberous ligament connect
Definition
posterior ilium and lateral sacrum and occyx to medial argin of ischial tuberosity
Term
what shape is the sacrospinous ligament
Definition
triangular
Term
what does the sacrospinous ligament connect
Definition
lateral margin of sacrum and coccyx to ischial spine
Term
what is the sacrospinous lgiament anterior to
Definition
sacrotuberous ligament
Term
what is another name for the iliolumbar ligament
Definition
accessory ligament of the sacroiliac joint
Term
what does the iliolumbar ligament connect
Definition
medial transverse process L5/4 to posterior iliac crest
Term
what attaches to the iliolumbar ligament
Definition
quadratus lumborum
Term
what are the accessory ligaments of the sacroiliac joint
Definition
sacrotuberous and sacrospinous ligaments
Term
what is the function of the accessory ligaments of the scaroiliac joint
Definition
stabilize sacrum, prevent rotatory movement, weight of trunk rotates scarum so the upper end moves inferior and lower end moves superior
Term
what do the accessory ligaments of the sacroiliac joint turn into
Definition
it changes the greater and less siatic notches into greater and lesser sciatic foramina
Term
where is the greater sciatic foramen
Definition
opening between pelvic cavity and gluteal region
Term
where is the lesser sciatic foramen
Definition
opening between gulteal region of perineum
Term
what kind of joint is the publc symphysis
Definition
cartilaginous joint
Term
what connects the pubic bones
Definition
fibrocartilaginous discs (interpubic disc)
Term
what is the interpubic disc reinforced by and on what side
Definition
superior publc ligament (superior) and acurate public ligament (inferior)
Term
what kind of jount is the sacrococcygeal joint
Definition
cartilaginous joint
Term
what forms the sacrococcygeal joint
Definition
apex of sacrum and base of coccyx
Term
what is the sacrococcygeal joint reingorced
Definition
sacrococcygeal ligaments
Term
when in anatomical position what two markers should be in the same plane
Definition
ASIS and pubic tuberosity
Term
what direction does the posterior surface of the pubic symphysis face
Definition
posterior and superior
Term
what direction does the anterior surface of the sacrum face
Definition
anterior and inferior
Term
what divides the two parts of the pelvis
Definition
pelvic brim (linea terminalis)
Term
what are the components of the pelvic brim posterior to anterior
Definition
sacral promontoryy, anterior border of ala of sacrum, acurate line, pectineal line, pubic crest, superior border of pubic symphysis
Term
what are the two aperatures of the lesser (true) pelvis
Definition
pelvic inlet (superior pelvic aperature, pelvic outlet (inferior pelvic aperature)
Term
what is the pelvic cavity
Definition
space between pelvic inlet and pelvic putlet
Term
what binds the pelvic inlet
Definition
pelvic brim
Term
what is the shape of the pelvic outlet
Definition
diamond
Term
what is the boundries of the pelvic ooutlet
Definition
anterior publc symphysis, posterior coccyx, lateral ischeral tuberosities
Term
what is the anteriorlateral border of the pelvic outlet
Definition
ischiopubic rami
Term
what makes up the ischiopubic ramus
Definition
inferior ramus of pubis, ramus of ischium
Term
what is the posterolateral border of the pelvic outlet
Definition
sacrotuberous ligaments
Term
which wall of the pelvic cavity is shorter
Definition
anterior wall
Term
what makes up the anterior wall of the pelvic cavity
Definition
pubic symphysis and bodies of pubic bones
Term
what makes up the posterior wall of the pelvic cavity
Definition
sacrum, coccyx, piriformis muscles, sacrotuberous, sacrospinous ligaments
Term
what makes up the lateral wall of the pelvic cavity
Definition
hip bone inferior to pelbic brim, obturaror membrane, obturator internus muscle
Term
what makes up the inferior wall of the pelvic diaphragm
Definition
(pelvic floor) formed by levator ani and coccygeus muscles
Term
which direction is the pelvic diaphragm orientated
Definition
concave superior
Term
what does the pelvic diaphragm divide
Definition
pelvis into pelvic cavity (superior) and perineum (inferior)
Term
where is the urogenital hiatus
Definition
anterior on pelvic diaphragm
Term
what passes through the urogenital hiatus
Definition
urethra or urethra and vagina
Term
what is the origin of the levator ani
Definition
posterior body of pubis, tendinous arch of levator ani, ischial spine
Term
what is the tendinous arch of the levator ani composed of
Definition
thickening of the obturator internus fascia
Term
which way do the fibers of the levator ani run
Definition
posterior, inferior, medial
Term
where is the insertion of the levator ani
Definition
perineal body, prostate or vagina, rectum and anal canal, anococcygeal ligament, coccyx
Term
what are the three parts of the levator ani
Definition
puborectalis, pubococcygeus, iliococcygeus
Term
what innervates the levator ani
Definition
ventral rami of S2-S4 via direct muscular branches and the pudendal nerve
Term
what is the shape of the coccygeus (ischiococcygeus)
Definition
triangle
Term
what is the coccygeus anterior to
Definition
sacrospinous ligament, it partially blends with it
Term
what is the origin and insertion of the coccygeus
Definition
ischial spine to lateral margin of lower sacrum and coccyx
Term
what innervates the coccygeus
Definition
direct muscular branches of the ventral rami of S3-S4
Term
what are the functions of the pelvic diaphragm
Definition
support and maintain pelvic viscera prevent it from prolapse, contract with abdominal muscles to increase pressure, spinchteric action
Term
what is prolapse
Definition
viscera sliding out from pelvic cavity
Term
what is the pelvic cavity the space between
Definition
pelvic inlet and pelvic outlet
Term
which way does the sacrum want to move
Definition
inferior tip of saccrum wants to rotate posterior
Term
what prevents the sacrum from rotating
Definition
sacrotuberous and sacrospinous ligament
Term
what is the space above the pelvic brim called
Definition
greater or false pelvis
Term
what is the space below the pelvic brim called
Definition
lesser or true pelvis
Term
what does the lesser pelvis enclose
Definition
pelvic cavity and perinerum
Term
what does the greater pelvis form
Definition
lower abdominal cavity
Term
what muscle makes up the pelvic diaphragm
Definition
levator ani
Term
what is inside the ischial tuberosity
Definition
obterator membrane and muscle
Term
does the coccygous help hold the pelvic diaphragm
Definition
not really
Term
do the urethra and vagina share a hiatus in the pelvic diaphragm
Definition
no, they are next to eachother but seperate
Term
what is the relationship between pubolactalis and the rectum
Definition
it forms a sling around it making a spinctor
Term
where is the pyraformis located
Definition
above the coccygeous
Term
describe male vs female (in that order) structure of the pelvis: general structure
Definition
thick and heavy, thin and light
Term
describe male vs female (in that order) structure of the pelvis: greater pelvis
Definition
deep, shallow
Term
describe male vs female (in that order) structure of the pelvis: lesser pelvis
Definition
narrow and deep, wide and shallow
Term
describe male vs female (in that order) structure of the pelvis: pelvic inlet
Definition
heart shaped, oval and round
Term
describe male vs female (in that order) structure of the pelvis: pelvic outlet
Definition
smaller, larger
Term
describe male vs female (in that order) structure of the pelvis: pubic arch and subpubic angle
Definition
narrow, wide
Term
describe male vs female (in that order) structure of the pelvis: obturator foramen
Definition
round, oval
Term
describe male vs female (in that order) structure of the pelvis: acetabulum
Definition
large, small
Term
where does the ovarian artery originate
Definition
paired visceral branch of abdominal aorta
Term
what does the ovarian artery run along
Definition
pelvic brim
Term
where does the superior rectal artery originate
Definition
terminal branch o the mesenteric a
Term
what does the superior rectal artery supply
Definition
rectum and upper anal canal
Term
where does the median sacral artery originate
Definition
unpaired parietal branch of abdominal aorta
Term
where does the internal iliac artery originate
Definition
terminal branch of common iliac a
Term
describe the path of the internal iliac artery
Definition
descends into pelvis to upper margin of the greater sciatic foramen where ir branches
Term
what does the internal iliac artery branch into
Definition
anterior and posterior
Term
what does the internal iliac artery supply
Definition
pelvic viscera and walls, perineum, proximal parts of lower limbs
Term
what are the branches of the anterior internal iliac artery
Definition
umbulucal, obturator, inferior vesical, middle rectal, internal pudenal, inferior gluteal, uterine, vaginal
Term
what are the branches of the posterior internal iliac artery
Definition
superior gluteal, iliolumbar, lateral sacral
Term
what does the umbilical artery branch into
Definition
proxially the superior vesical srtery, distal the obliteraed umbilical artery (umbilical ligament)
Term
what does the superior vesical artery supply
Definition
upper bladder, lower ureter
Term
where does the obturator artery run
Definition
on lateral pelvic wall with obturator vein and nerve towards the upper obrurator foramen, leaves via obturator canal and enters again medial compartment of thigh
Term
where does the obturator occasionally originate from
Definition
inferior epigastric a
Term
in which gender is the inferior vesical artery in
Definition
males
Term
what artery is the female version of the inferior vesical artery
Definition
vaginal a
Term
what does the inferior vesical artery supply
Definition
lower bladder, prostate, and smeinal vesicles
Term
how does the middle rectal artery originate
Definition
usually by a common trunk with inferior vesical artery
Term
what does the middle rectal artery supply
Definition
lower rectum
Term
how does the middle rectal artery end
Definition
anastomose with superior and inferior rectal arteries
Term
describe the path of the internal pudendal artery
Definition
leaves pelvic cavity and enters gluteal region through greater sciatic foramen, curves around ischial spine, enters perineum via lesser sciatic foramen,
Term
what is the greater sciatic foramen inferior to
Definition
piriformis muscle
Term
what is the main artery of the perineum
Definition
internal pudendal artery
Term
describe the path of the inferior gluteal artery
Definition
descends anterior to sacral plexus and piriformis and posterior to internal pudendal artery, passes between ventral rami of S1/S2 or S2/S3, enters gluteal region through greater sciatic foramen inferior to piriformis muscle
Term
describe the math of the uterine artery
Definition
runs medially towards uterus, crosses ureter superiorly, ascends along lateral margin of uterus, turns laterally and follows uterine tube towards ovary,
Term
how does the uterine artery end
Definition
anastamose with ovarian a
Term
what does the uterine artery supply
Definition
uterus, uterine tube, upper vagina
Term
where does the vaginal artery originate
Definition
uterine artery
Term
what does the vaginal artery supply
Definition
vagina, adjacent parts of bladder and rectum
Term
what is the largest branch of the internal iliac
Definition
superior gluteal a
Term
what is the continuation of the posterior trunk
Definition
superior gluteal a
Term
describe the path of the superior gluteal artery
Definition
passes between lumbosacral trunk and ventra rami of S1 or between S1/S2, leaves pelvis and enters gluteal region via sciatic foramen superior to piriformis muscle
Term
describe the path of the iliolumbar artery
Definition
ascends towards psoas pahow, anterior to lumbosacral trunk, then divides
Term
what does the iliolumbar divide into
Definition
iliac and lumbar
Term
what does the iliac branch of the iliolumbar artery supply
Definition
iliacus muscle, ilium
Term
what does the lumbar branch of the iliolumbar supply
Definition
psoas major and quadratus lumborum and vertebral column
Term
how many lateral sacral arteries are there
Definition
3, superior and inferior
Term
what do the lateral sacral arteries supply
Definition
sacral vertebra and contents of sacral canal
Term
describe the path of the lateral sacral artery branches
Definition
through posterior sacral foramina to supply skin and muscle posterior to sacrum
Term
what is the internal iliac vein between
Definition
lateral pelvic wall and internal iliac artery
Term
what does the internal iliac vein join
Definition
common iliac vein to external iliac v
Term
what dumps into the internal iliac vein
Definition
all the internal iliac a correspondents except umbilical vein
Term
what is the intervertebral venous plexus
Definition
comminication of beins passing through the anterior sacral foramina, intrnal iliac vein tributaries
Term
why are the internvertebral venous plexus dangerous
Definition
malignant cells from the pelvi tumors (prostate) may pass through these beins and lodge in vertebral column
Term
where is there a protal systemic anastomoses in the internal iliac vein
Definition
wall of rectum and anal canal
Term
what is the sacral plexus formed by
Definition
lumbosacral trunk: ventral remi of L5, some of L4 and S1-S4
Term
what does the sacral plexus divide into
Definition
anterior and posterior
Term
what nervous system is the sacral plexus
Definition
somatic
Term
what does the sacral plexus supply
Definition
mesucles and part of skin of gluteal region, muscles and skin of posterior thigh, muscles and skin of entire leg and foot except skin on medial aspect of leg and foot, muscles of skin of perineum
Term
what is the sacral sympathetic trunk a continuation of
Definition
inferior continuation of the lumbar sympathetic trunk
Term
where does the sacral sympathetic trunk run along
Definition
anterior sacrum medial to anterior sacral foramina, right and left trunks my join at tip of occyx in a single ganglion
Term
what is the ganglion at the bottoom of the sacral sympathetic trunk
Definition
ganglion impar
Term
how many ganglia are in the sacral sympathetic trunk
Definition
3-5
Term
what are the branches of the sacral sympathetic trunk, where do they go
Definition
gray comminucating rami go to all spinal nerves, visceral sacral splanchnic nerve branches join inferior hypogastric plexus
Term
what do gray communicating rami of the sacral sympathetic trunk contain
Definition
postganglionic smpathetic fibers
Term
what do the sacral splanchnic nerves contain
Definition
preganglionic sympathetic and visceral sensory fibers
Term
what is the main autonomic plexus of the pelvis
Definition
inferior hypogastric (pelvic) plexus
Term
what type of innervation does the inferior pelvic plexus provide
Definition
motor and sensory
Term
what bring autonomic fibers to the rectum and ovary, without using the hypogastric plexus
Definition
superior rectal and ovarian plexuses
Term
what is the inferior hypogastric plexus formed by
Definition
union of hypogastric and pelvic splanchnic nerves and some sacral splanchnic nerves
Term
what is the superior hypogastric plexus a direct extension of
Definition
aortic plexus below aortic bifurcation
Term
how does the inferior hypogastric plexus end, where
Definition
divides into right and left hypogastric nerves at sacral promontory
Term
what type of fibers does the superior hypogastric plexus and hypogastric nerves contain
Definition
preganglionic, post ganglionic sympathetic, small ganglia, visceral sensory, no or few parasympathetic
Term
what is the pelvic sympathetic outflow
Definition
pelvic splanchnic nerves
Term
where does the pelvic sympathetic outflow originate
Definition
ventral rami of S1-S4 join inferior hypogastric plexus
Term
what type of fibers does the pelvic outflow contain
Definition
preganglionic parasympathetic fibers and visceral sensory
Term
where do the preganglionic fibers of the pelvic outflow synapse
Definition
in ganglia within the inferior hypogastric plexus or in the walls or organs they innervate
Term
where is the inferior hyopgastric plexus located
Definition
against lateral pelvic wall, medial to branches of internal iliac vessels and lateral to pelvic viscera
Term
what are the subsitiary plexuses of the inferior hypogastric plexus
Definition
middle rectal, uterovaginal, vesical
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