Term
| The human pelvis is the intricate lower region of the __, located between the __ and the __. |
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Definition
| trunk; abdomen; lower limbs |
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Term
- The skeletal structure of the pelvis, often referred to as the __, is comprised of 4 bones: Two __ (or __), the __, and the __.
- Each hip bone (also known as the __ or __ bone) is a large, relatively flat and irregularly shaped bone. Each forms a ball-and-socket joint with one of the two __ bones of the lower limb.
- Another notable aspect of the bony pelvis is the ring-like structure highlighted in this illustration. This is known as the __, which marks the upper limit of and the entrance to the pelvic cavity. |
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Definition
- hip bones (ox coxae); sacrum; coccyx
- innominate; coxal bone; femur
- pelvic inlet |
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Term
Bony Pelvis
-Located between the articulating surfaces of the sacrum and each of the two attaching ilium bones, the __ serve to interlock these three bones. These weight-bearing synovial joints move together and are therefore known as __.
- Another important joint is the __, located where the __ of the left and right pubic bones meet. Unlike the sacroiliac joints, this joint is __, and is made of a __ that is more flexible, especially in females, when childbirth requires expansion of the pelvic inlet through which the fetus will pass. |
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Definition
- sacroilliac joints; bicondylar joints
- pubic symphysis; superior rami; non-synovial; fibrocartilage disk |
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Term
Pelvis
-The three portions of the hip bone are more clearly seen in this isolated hip bone illustration. The superior component is known as the __, with its upper edge referred to as the __
-The __ is found just below the ilium. Fused to both the ilium and ischium is the third component of the hip bone known as the __.
-The fusion of the three components of the hip bones form a large, bowl-shaped structure known as the __, located near the middle of the outer surface of the hip bones. This is where the head of the __ articulates with the pelvis at the hip joint. |
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Definition
- ilium; iliac crest
- ischium; pubis
- acetabulum; femur |
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Term
pelvis
- On the three major bodies that comprise each hip bone, several bony processes exist that serve as points of attachment for muscles and ligaments.
- The first of these major landmarks is the __, located on the superior edge of the Ilium, (which is the origin of the iliacus muscle). Next is the __, which is a prominent structure protruding from the ischium posteriorly. Finally, the __ is a rounded prominence that extends outwards from the ischium, just inferior to the ischial spine (when we sit our weight is resting on the ischial tuberosities).
- Also notable is the opening formed by the union between the pubis and ischium, just inferior to the acetabulum. This is known as the __, through which the obturator nerve and other structures travel down to the lower limbs. This opening will be closed off by a muscle called the __ |
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Definition
- iliac crest; ischial spine; ischial tuberosity
- obturator foramen; obturator internus |
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Term
pelvis - ligaments
- The gaps between bones of the pelvis leave much empty space, which must be closed off in order to support the __. The ligaments of the pelvis begin to close off these spaces, and form attachments for muscles of the __.
- Often, the names of joints and ligaments are derived from the proximal processes of their attachment sites. For example, the __ is a ligament formed between the sacrum and the ilium, hence it’s name.
- Other important ligaments (which will be discussed more soon) include the __ and __ ligaments, the __, and the __. |
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Definition
- pelvic viscera; pelvic floor
- sacroilliac joint
- sacrotuberous; sacrospinous ligaments; inguinal ligament; obturator membrane |
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Term
pelvis - ligaments
- The __, found just superior to the ischial spine, is a key feature that is converted into a foramen (opening) by the __, which we will discuss on the following slide.
- Immediately below the ischial spine is a slightly smaller groove known as the __. This lesser notch is also transformed into a foramen by two additional ligaments (seen on the next slide). Several important structures enter or exit through both of these converted openings. |
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Definition
- greater sciatic notch; sacrospinous ligament
- lesser sciatic notch |
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Term
pelvis - ligaments
- By adding in the ligaments of the lateral wall of the pelvis, it is possible to see how both the greater and lesser sciatic notches are closed off to form two distinct __
- The __ extends from the medial side of the sacrum, crossing over to the ischial spine. The __ travels from the posterior/dorsal sacrum to attach to the ischial tuberosity |
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Definition
- passageways (foramen)
- sacrospinous ligament; sacrotuberous ligament |
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Term
ligaments of the pelvis
- By looking at a posterior view of the bony pelvis, these key ligaments can be seen more clearly. As we just discussed, the __ is located on the lower, posterior part of the pelvis. Roughly triangular in shape, it travels from the __ to the __.
- The __ lies just anterior to the sacrotuberous, and connects the ischial spine to the lateral margins of the sacrum and coccyx. Together with the sacrotuberous, this ligament converts the greater and lesser sciatic notches into distinct __. These ligaments will be colored in pink and green in all subsequent slides. |
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Definition
- sacrotuberous ligament; sacrum; ischial tuberosity
- sacrospinous ligament; foramina |
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Term
pelvic muscles - lateral wall
- As we just learned, the greater and lesser sciatic foramina are formed as a result of the presence of both the __ and __. The bony inner surface of the pelvis wall is primarily covered by two muscles.
- The __ muscle originates on the anterior surface of the sacrum, passing through the greater sciatic foramen to attach to the greater trochanter of the femur. The piriformis muscle fills the space of the __.
- The __ attaches to the bony parameter of the obturator foramen and moves toward the __, and attaches along with the piriformis to the __. |
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Definition
- sacrospinous; sacrotuberous ligaments
- piriformis muscle; greater sciatic foramen
- obturator internus; lesser sciatic foramen; greater trochanter of the femur |
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Term
pelvic muscles - lateral wall
- By viewing this image of the posterior wall of the pelvis, we can see the __ as it exits the pelvis, traveling laterally towards its attachment to the greater trochanter of the femur. Also visible is the __, which exits the pelvis to attach to the greater trochanter as well.
- This posterior view also allows us to see the separating effect that both the __ and __ have in creating the greater and lesser sciatic foramen (not shown). These ligaments will serve as reference points when looking at the pelvis from various viewpoints. |
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Definition
- piriformis muscle; obturator internus muscle
- sacrospinous; sacrotuberous ligaments |
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Term
muscles of the lateral wall & pelvic floor
- the muscles of the pelvic floor include the __ muscles and __
- the __ muscles include __, __, and __
-- these muscles form the __ and support __
- the other muscle of the pelvic floor, the __, supports the ___
- the muscles of the lateral wall include the __ and __
-- the __ connects the sacrum to the apex of the greater trochanter of the femur and contributes to the __
-- the __ connects the __ to the __ |
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Definition
- levator ani muscles; coccygeus
- levator ani; puborectalis; pubococcygeus; iliococcygeus
-- pelvic diaphragm; pelvic viscera
- coccygeus; pelvic viscera
- piriformis; obturator internus
-- piriformis; lateral wall of the pelvis
-- obturator internus; obturator membrane; medial side of the greater trochanter of the femur |
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Term
pelvic organs
- The ___ (seen as the portion above the dashed line) is the final segment of the large intestine. Although the diameter is roughly equal to that of the sigmoid colon at it’s beginning, the rectum soon dilates near it’s termination, forming a fecal storage site known as the __. The rectum is supported by the pelvic floor, most notably by the __. Once it pierces this floor (signified by the dashed line), the rectum then becomes known as the __.
- In the diagram on the upper left, it is possible to see the location of the rectum as being just anterior to the __. In the larger illustration, the anterior wall of the rectum has been removed, allowing us to see the various structures within from an anterior view.
- The rectal wall has a series of muscular folds that serve to compartmentalize the rectum. These include the __, the __, and the __. |
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Definition
- rectum; rectal ampulla; levator ani muscles; anal canal
- sacrum
- superior transverse fold; middle transverse fold; inferior transverse fold |
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Term
muscular control of the rectum
-Voluntary control of defecation (and to some degree in urination) is aided by muscles that form a type of sling, or hammock-like structure around the rectum.
-The fibers of the __, one of the muscles that composes the __ muscle, originate from the lower, inferior side of the pubis, on either side of the __. As fibers from one side of the symphysis travel at a slight downward angle to wrap around the posterior side of rectum, they join with muscle fibers traveling from the other side.
-During relaxation of the __, the angle between the rectum and the anal canal is __. This angle reduction combined with the relaxation of the internal and external sphincters allows for defecation to occur. |
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Definition
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- puborectalis muscle; levator ani; pubic symphysis
- puborectalis; reduced |
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Term
pelvic organs - the anus
- The human anus serves as the external opening of the rectum. The muscular control of the closure (and relaxation) of the anus is controlled by two muscles, the __ and the __.
- The __ is a muscular ring that surrounds the __. It is formed from the circular smooth muscle that composes the wall of the rectum, therefore the action of this sphincter is completely __.
- The __ is a flat elliptical plane of muscular fibers that are intimately associated with the __ surrounding margins of the anus. It is formed from skeletal muscle fibers of the __ as the rectum passes through the pelvic floor, and is therefore under __ control. It keeps the anal canal closed, and helps fix the central point of the __. |
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Definition
- internal anal sphincter; external anal sphincter
- internal anal sphincter; anal canal; involuntary
- external anal sphincter; integument; levator ani; voluntary; peritoneum |
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Term
muscles of the pelvic floor
- The muscles that span the area just underneath the pelvis form a collective set of structures known as the __. This muscular __ forms a partition that both separates the pelvic cavity from the perineal region just below, and supports the rectum, prostate and urethra in males, and the urethra and vagina in females.
- The posterior portion of the pelvic floor is comprised of the __, which arises from the ischial spine and inserts into the lower sacrum just superior to the sacrospinous ligament.
- The anterior portion of the pelvic floor is formed by the __, which is a broad, thin muscle that fills the majority of the pelvic outlet . The structural integrity of the pelvic floor is primarily attributed to these muscles. The levator ani is anatomically divided into 3 parts: the __, __, and __, all of which are suspended from the thick connective tissue of the __, also known as the __. |
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Definition
- pelvic floor; diaphragm
- coccygeus
- levator ani; iliococcygeus; pubococcygeus; puborectalis muscles; obturator internus; tendinous arch of obturator internus |
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Term
urinary system
-The structure and location of the __ is different in the male versus the female body, primarily due to the presence of the female reproductive organs such as the uterus. The __ is the organ that collects urine excreted by the kidneys before it is disposed during urination. The bladder is a hollow, muscular, and elastic organ that sits on the pelvic floor.
- In males, the base of the bladder lies between the __ and the __. It is superior to the __.
- In females, the bladder sits inferior to the __ and anterior to the __. Due to it’s position, the maximum capacity of the female bladder is __ than in males. |
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Definition
- bladder; bladder
- rectum; pubic symphysis; prostrate
- uterus; vagina; lower |
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Term
urinary system
- The __ is the organ that serves to collect urine excreted by the kidneys prior to its disposal through urination. The bladder is a hollow, muscular organ, with highly elastic properties, and it sits on the __. Entering the bladder from the ureters through the two __, urine is then excreted through the __. The smooth triangular region found on the internal bladder wall is known as the __. This area is highly sensitize to stretching when the bladder reaches full capacity, and once stretched it signals the brain to begin urination. The triangular shape of the trigone is formed by the two ureteral orifices and the point of transition where the urethra exits the bladder through the __, as seen in the illustration on the right. |
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Definition
| - urinary bladder; pelvic floor; ureteral orifices; urethra; trigone of the bladder; internal urethral orifice |
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Term
urinary system - female
-In both males and females, the __ is a tube that connects the urinary bladder to outside the body. As the final part of the urinary system, the purpose of urethra is to provide a passageway for the removal of fluids from the body.
-The __ is shorter than in males and is approximately 4-5 cm long. Located just behind the __, the female urethra is embedded in the anterior wall of the __ as it travels obliquely downward. |
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Definition
- urethra
- female urethra; pubic symphysis; vagina |
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Term
male bladder
- The male bladder is fundamentally different from the female bladder, primarily due to the presence of accessory organs that contribute to the male reproductive system.
- From this posterior view of the male bladder, we can see the two __ as they descend from the kidneys and drain into the bladder.
- A major difference between the male and female is presence of the __ in males. Also notable are the tubes known as the __, which are long muscular tubes that function in transporting sperm from the testes in anticipation of ejaculation.
- Note the __, seen here just posterior to the bladder and inferior to the vas deferens. Prior to ejaculation, sperm traveling through the vas deferens joins with fluids from the seminal vesicles when both are deposited in the prostatic urethra. We will discuss the vas deferens and seminal vesicles in more detail when we cover the male reproductive organs. |
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Definition
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- ureters
- prostrate gland; vas deferens
- seminal vesicles |
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Term
urinary system
-The __ is a tube that connects the urinary bladder to the outside of the body for the removal of fluids (urine) from the body. In males, the urethra travels through the penis. It provides an exit for both urine and semen, and is divided into three parts, the __, __, and __.
-The portion of the male urethra that is encased in the prostate gland is known as the __, seen in the diagram on the right as the region shaded in pink.
-Approximately 3 centimeters long, the prostatic urethra runs almost straight downwards through the __. |
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Definition
- urethra; prostatic; membranous; spongy urethra
- prostatic urethra
- prostrate |
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Term
urinary system
- The male urethra can be divided into three distinct regions, based largely on their relationship to nearby structures.
-As we just saw, the portion of the male urethra surrounded by the prostate gland is known as the __.
-Immediately after exiting the prostate that surrounds it, the short portion of the urethra between the inferior prostate and the beginning of the __ of the penis is known as the __.
-Finally, the last portion of the male urethra found encased within the corpus spongiosum of the penis is known as the __. The male urethra ends at the ___ found at the end of the penis. |
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Definition
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- prostatic urethra
- corpus spongiosum; membranous urethra
- spongy urethra; external urethral orifice |
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Term
| the female reproductive system is a major component of the female __ |
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Definition
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Term
female reproductive system
-Before we begin discussing the various pelvic viscera that make up the female reproductive system, it is important to note the structures that stabilize these organs in the pelvic cavity.
- The __ of the uterus is a wide fold of __ that connects the lateral sides of the uterus to the abdominal wall and the floor of the pelvis. It has anterior and posterior portions. The __ is the largest portion of the broad ligament that is found on the body of the uterus . The __ is the portion of the broach ligament associated with the uterine tubes. The __ is a small portion of the broad ligament, that attaches to the undersurface of the ovaries only. |
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Definition
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- broad ligament; peritoneum; mesometrium; mesosalpinx; mesovarium |
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Term
- The __ are a pair of egg-producing organs found in the female pelvis, located in the lateral wall of the pelvis. The male counterpart of the ovaries are the __.
- Attaching the ovaries to the uterus are a pair of fibrous ligaments known as the __. Each ovarian ligament attaches its respective ovary to the lateral surface of the __.
- Also visible is the __, which is found on the opposite pole of the ovary from the ovarian ligament. Its function is to attach the ovary to the __, and carries within it the __ and __ |
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Definition
- ovaries; testes
- ovarian ligaments; uterus
- suspensory ligament; pelvic wall; ovarian artery; vein |
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Term
-A pair of tubular structures known as the __ (also known as the __ or __) serve as passageways for eggs from the ovaries to the uterus. __ also occurs in these tubes. Lined with __, the tubes are situated just superior to each ovary.
- As seen in this close up view of left uterine tube, each tube is broken down into several regions as it travels from ovary to uterus.
- The opening at the lateral end of each tube is known as the __, which is composed of __ that “sweep” the eggs inward once they are released from the ovary. From here, the uterine tubes are composed of an __ and an __ region prior to their connection with the uterus at the __. |
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Definition
- uterine tubes; (fallopian tubes; oviducts); fertilization; ciliated epithelium
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- infundibulum; mobile fimbriae; ampulla; isthmus; utero-tubular junction |
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Term
-The __ (commonly referred to as the womb) is a major female reproductive organ. It is here that a fetus develops throughout the __ period, and the lining of the uterus is intimately involved in the __ process.
-The uterus is located within the __ immediately dorsal to the urinary bladder and ventral to the rectum, and is roughly pear-shaped. It is divided into three sections: the __, the __, and the ___. The ___ is the portion of the uterus found above the uterine tubes.
-The __, which is the lower, narrow 1/3 portion of the uterus, protrudes downward into the vagina. At the junction between the cervix and the vagina, an opening allows for sperm and menstrual fluid to pass through. During labor, the dilation of the cervix is often used as a reference point for how far along a mother is in the labor process. |
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Definition
- uterus; gestation; menses
- pelvic cavity; fundus; body; cervix; fundus
- cervix |
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Term
-The __ has several key functions, and is an integral structure involved in menstruation, intercourse, and during childbirth. As such, it is important to understand the internal structures that comprise the cervix and how they pertain to these various functions.
-As we can see in this expanded view of the cervix, the cervix is the junction between the __ and the __, and has both a uterine portion and a vaginal portion (where it protrudes through the anterior vaginal wall).
-Two openings are present in the cervix that serve to either allow for or prevent the passage of fluids. The first of these is the __, which is a narrowing of the uterine cavity.
-Further down in the vaginal portion of the cervix is the ___, which is a somewhat circular aperture that exits into the vaginal canal. We will see more about the structure of the external os on the following slide. |
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Definition
- cervix
- uterus; vagina
- internal os
- external os |
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Term
-By looking at the anterior wall of the vagina it is possible to view the internal structure of the vaginal canal. In the enlarged coronal section on the right, we can see the entire length of the anterior vaginal wall as it travels obliquely downward from the ___ to the female external genitalia.
-The vaginal portion of the cervix serves as the junction between the uterus and the vagina. An opening in the cervix, known as the ___, allows for fluids to move in either direction between the vagina and uterus. A ___ is normally found in the cervix; however during ovulation this mucous thins out so that sperm can more easily travel up through the uterus and to the uterine tubes where fertilization occurs.
-The inner surface of the vaginal canal is covered in ribbed folds known as the ___. As seen here, these rugae run along the entire length of the vaginal canal from the cervix down to the external genitalia. |
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Definition
- cervix
- external os; mucous plug
- vaginal rugae |
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Term
-The __ is a term that refers to the general surface region of the male and female pelvis which includes the perineal membrane and structures associated with it.
-In general, the perineum is confined to the area bounded by the __ anteriorly, the __ posteriorly, and the ___ laterally. It is located between the __ just below the __. |
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Definition
- perineum
- pubic symphysis; coccyx; ischial tuberosities; lower limbs; pelvic diaphragm |
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Term
-Prior to our discussion of the external genitalia of both genders, it is important to first examine the region of the pelvis that is inferior to the pelvic diaphragm and between the legs. This region, known as the __, is the point of attachment of both the male and female external genital structures.
-The perineum is composed of an anterior and a posterior division. The anterior portion of the perineum is referred to as the __. The posterior portion is known as the __.
-Over the course of the next several slides, we will discuss the structures found in both the urogenital and anal triangles of the perineum, with a specific focus on the differences in content between males and females. Our discussion of the perineum will begin with an introduction to the spatial relationship between both triangles on the next slide. |
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Definition
- perineum
- urogenital triangle; anal triangle |
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Term
| There is an __ relationship between the urogenital triangle and the anal triangle, in that while the urogenital is level from posterior to anterior, the anal triangle travels posteriorly and superiorly away from the urogenital triangle. In this superior/lateral view of the pelvis, we can see the __ that represent their orientation when standing in anatomical position |
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Definition
| angular relationship; angle between the triangles |
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Term
-The __ is the anterior of the two triangular regions of the perineum. The base of the triangle is formed between each of the two __ of the __. The anterior point of this triangle is located on the __.
-In this parasagittal section of the pelvic cavity, we can see the muscular structure of both the pelvic floor and some of the muscular components found in the urogenital triangle.
-Seen in cross-section on the bottom of this diagram, the __ arises between the inferior rami of the ischium bones. This muscle forms the majority of the urogenital triangle and is often referred to as the __. The posterior edge of this muscle marks the imaginary line between the __ that separates the two perineal triangles (refer to the inset at the upper right corner see the junction between the urogenital and anal triangles).
-The deep fascia that is located above and below the deep transverse perinei muscle is given a specific name. These fascial layers are referred to as the __ and the __ (the inferior fascia is also known as the __) of the deep perinei muscle. The inferior fascia will be referred to as the perineal membrane in subsequent slides. |
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Definition
- urogenital triangle; ischiopubic rami; pelvic bone; pubic symphysis
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- deep transversus perinei muscle; urogenital diaphragm; ischial tuberosities
- superior fascia; inferior fascia; (perineal membrane)
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Term
-By viewing the urogenital triangle from below and posteriorly, we can more clearly see the ___ muscle as it spans between the ischial tuberosities. The top illustration shows this region in males and the lower is the corresponding region in females.
-In these illustrations, we can see the right side of the __ colored in white (left half removed). Deep to this membrane is the __.
-The muscle responsible for voluntary control of urination is the __. This muscle surrounds the membranous urethra of both sexes as they pierce the deep transversus perinei muscle. Thus, the sphincter urethrae muscle forms a __ for the bladder because it is skeletal muscle. In females, the vagina also passes through this region and in males, the bulbourethral glands. |
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Definition
- deep transversus perinei
- inferior fascia (perineal membrane); deep transverus perinei muscle
- sphincter urethrae muscle; voluntary sphincter |
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Term
-Both the male and the female external genitalia are intimately associated with the __. Before we begin our discussion of the external genital structures found in both males and females, it is important to recognize the role of the perineal membrane as an attachment for these structures and as a conduit for their vasculature and innervation.
-In males, the __ is attached to the perineal membrane just below the __. As this illustration indicates, the erectile tissues that comprise root of the penis originate from the posterior side of the perineal membrane. They then move slightly upwards and anteriorly prior to transitioning into the external portion of the penis (the body). |
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Definition
- perineal membrane
- root of the penis; pubic symphysis |
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Term
-Our discussion of the male reproductive system begins with the two structures known collectively as the __, which are the male’s homologous structure to the female’s ovaries. The primary function of the testes is the production of both __ and __, primarily __.
-Unlike egg-production in the ovaries, __ in the testes is temperature sensitive, and works best in an environment that is slightly cooler than the core body temperature.
-As such, the testes are externally located inside the __, which is a double-chambered protuberance of skin and muscle tissue that contains both testicles. The scrotum, located between the base of the penis and the anus, is homologous to the __ of the female external genitalia |
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Definition
- testes; sperm; hormones; testosterone
- spermatogenesis
- scrotum; labia majora |
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Term
-The testicles are separated inside the scrotum by a __, and their vasculature, innervation, and lymphatics are distinct from the scrotum itself. The exterior surface of each testicle is covered by a layer of white connective tissue called the __.
-The __ is an anastomosing network of tubules at the hilum of the testicle, where sperm from __ collect. These sperm then move into the initial portion of the __ via a series of __.
-A prominent structure associated with each testicle is a narrow, tightly-coiled tube known as the __. Each one is divided into three anatomical sections: a __, __, and __. Each epididymis connects the efferent ducts from the posterior side of the testes to their respective __.
-Sperm leaving the testes enter the __, where they continue to develop and are stored in anticipation of ejaculation. When ejaculation does occur, sperm now located in the lower portion of the epididymis are transported to the __ via peristaltic action of the muscular walls of the __. |
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Definition
- septum; tunica albuginea
- rete testis; seminiferous tubules; epididymis; efferent ductules
- epididymis; head, body, tail; vas deferens
- epididymis; prostatic urethra; vas deferens |
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Term
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Definition
| seminiferous tubules > efferent ductules > epididymis > vas deferens > prostatic urethra |
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Term
-Both the formation of sperm cells and the pathway that these newly formed cells take in exiting the testes is intimately associated with the complex network of the ___. These tubules are located within each testicle. By looking at an isolated view of the seminiferous tubules of a single testicle, we can see the comparative location of these tubes throughout the structure of the testes.
-There are two different types of seminiferous tubules: __ and __. The network of convoluted tubules are bunched into __ that are found in between testicular septa. These partitions or septa are created from the invagination of the fibrous __. As the tubes of each lobule move medially towards the hilus of the testicle, they transition to __ as they exit the testes. The straight tubules move through passageways called the __. Think of the rete testis as the holes in swiss cheese and the cheese itself is the framework of the tunica albuginea surrounding these passageways (rete testes).
-Once the straight seminiferous tubules join with the __, sperm then move into the continuous __ that eventually becomes the __. |
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Definition
- seminiferous tubules
- convoluted; straight; lobules; tunica albuginea; straight tubules; rete testes
- efferent ductules; epididymus; vas deferens |
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Term
-In order to produce semen during ejaculation, sperm must travel from their storage sight in the __ upwards toward the __, via a pair of muscular ducts known as the __. Each epididymis has a corresponding vas deferen tube connecting it with the prostate. Once deposited in the prostatic urethra, sperm are then mixed with deposits from the male accessory sex glands.
-The first of these accessory glands is the __, a pair of tubular glands located just posterior and inferior to the male bladder. As each of the vas deferens enters the prostate gland, it is joined with an excretory duct from its respective seminal vesicle. Each vesicle secretes fluids that join with the sperm in the prostatic urethra, contributing to the formation of semen |
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Definition
- epididymis; prostatic urethra; vas deferens
- seminal vesicles |
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Term
-In this diagram of the viscera of the male urogenital system, we can see the inner structures of the prostate gland, most importantly the __ and the junction between the it and the vas deferens.
-In the enlarged illustration showing a cross-section of the prostate gland, the __ is visible just superior to the upper portion of the prostate. This structure is an enlargement of the vas deferens that occurs just prior to their junction with the prostate.
-The tubular structures that connect the vas deferens/seminal vesicle with the male urethra are known as the __. these are a pair of ducts, each of which forms from the union of each __ with the duct of the __.
-The ejaculatory ducts empty sperm and seminal vesicle secretions into the prostatic urethra through an opening known as the __, which we will see on the following slide |
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Definition
- prostatic urethra
- ampulla of the vas deferens
- ejaculatory ducts; vas deferens; seminal vesicle
- semina colliculus |
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Term
-By taking a coronal section of the prostate gland, it is possible to see the prostatic urethra. The __ is an opening through which sperm from the vas deferens and glandular secretions from the seminal vesicles enter the prostatic urethra.
-The __ also contributes to the composition of semen, and is therefore considered a male accessory sex gland. Fluid deposits secreted by the prostate make up approximately 20%-30% of the volume of semen.
-The final male accessory glands includes a pair of small exocrine glands located posteriorly and lateral to the __, called the __. Found near the base of the penis, these glands secrete a viscous fluid known as __ that both lubricates and buffers the spongy urethra, allowing sperm to travel through more easily during ejaculation. |
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Definition
- seminal colliculus
- prostrate gland
- membranous urethra; bulbourethral glands; pre-ejaculate |
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Term
-The male primary sex organ, the __, serves both as a reproductive organ during intercourse and as the pathway for urination. The erectile tissue that constitutes the penis includes two layers. The innermost layer, the __, is a cylindrical layer of tissue that surrounds the male urethra, stretching from the bulbourethral glands down to the the expanded end of the penis known as the __. The corpus spongiosum has two structural modifications. One is the __, which attaches to the perineal membrane, and the other feature is the __.
-The second layer of erectile tissue is known as the __. This exists as a pair of tissues that run laterally along the length of the penis from the pubic bones to the head of the penis.
-The posterior fourth of each of the corpus cavernosa is an extended, tapering process known as the __. Each of these extensions are connected to the ischium of the pelvis. At the end of the glans penis lies the termination of the urethra, known as the __. |
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Definition
- penis; corpus spongiosum; glans penis; bulb of the penis; glans penis
- corpus cavernosum
- crus of the penis; external urethral orifice |
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Term
-The innermost layer of __ that surrounds the urethra has been peeled to the right, showing the conjoined pair of outer erectile tissue, the __.
-The penis has two anatomical divisions; these are known as the __ and the __. The root of the penis refers to the portion that lies in the __. More specifically, the root is suspended from the __. The root contains the diverging __ (one on either lateral side) as well as the __.
-The __ muscle can be seen surrounding the bulb of the penis (shown on the right side only). Also note the presence of the __ muscle, which surrounds the crura of corpus cavernosum. Working together, these muscles provide the contraction necessary to propel sperm through the reproductive tract. |
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Definition
- corpus spongiosum; corpus cavernosum
- root of the penis; body; perineum; perineal membrane; crura; bulb of the penis
- bulbospongiosus; ischiocavernosus |
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Term
-In the illustration on the upper left, we can see a cross-section of the root of the penis. The image more clearly shows the three erectile tissue components that exist in the root. The pair of __ regions lie superior to __, which is the layer of erectile tissue surrounding the male urethra. Immediately above the bands of corpus cavernosum is a __ that runs the length of the penis.
-The lower illustration shows a cross-section of the penis further down in the region of the body. At this point, the two cylinders of corpus cavernosa are separated by the __, a fibrous division that runs the median plane of the penis.
-As we saw in the testes, both compartments of erectile tissue are bounded by a membranous structure referred to as __. However, the layer of __ surrounding the corpus spongiosum is __ than that around the corpus cavernosum. The erectile tissue in both compartments expands during erection (due to increased bloodflow). The thinner tunica albuginea around the corpus spongiosum prevents the urethra from being pinched shut during this time |
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Definition
- corpus cavernosum; corpus spongiosum; neurovascular bundle
- penile septum
- tunica albuginea; tunica albuginea thinner |
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Term
-Just as we saw with the male external genitalia, the homologous female structures are also intimately associated with the __ that spans the space between each ischial tuberosity.
-Unlike in males, the perineal membrane of the female pelvis has a pair of perforations (orifices) that allow for passage of the internal female reproductive structures. The first of these is the __, which as its name implies is the conduit for the female urethra. Just below this opening is the __.
-Similar to the male genitalia, the __ originate just below the pubic symphysis along the perineal membrane. |
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Definition
- perineal membrane
- urethral orifice; vaginal orifice
- roots of the femal genitalia |
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Term
-The external genitalia of the female, collectively referred to as the __, consists of several anatomical structures that have both sexual and protective functions.
-Lying just above the pubic bone and anterior to the pubic symphysis is a deposit of adipose (fatty) tissue known as the ___. This tissue then divides into two longitudinal cutaneous folds known as the __, found on either side of the __. These labia majora surround the inner structures of the vulva.
-Just medial to each labia majora are two additional cutaneous flaps on either side of the vaginal opening, known as the __. The upper portion of each labia minora meet just above the __, forming a fold over it called the __.
-Found between the labia minora is the __, which contains both the vaginal opening as well as the point of exit for the female urethra, known as the ___. |
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Definition
- vulva
- mons pubis; labia majora; pudendal cleft
- labia minora; clitoris; prepuce
- vestibule; external urethral orifice |
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Term
-As we just saw, the ___ is the point of attachment for the tissues that make up the root of the external genitalia of both genders. Here we can see the deep muscles (left half) as they relate to the female external reproductive organs, as well as the superficial muscles (right side of dashed line). The black dashed line divides the image into sides displaying either superficial and deep muscles.
-The __ of the pelvic floor (found in the anal triangle) can be seen in the lower half of this illustration.
-In the female urogenital triangle, the __ muscle cov ers the a pair of erectile tissue bodies known as the __, which are homologous to the bulb of the penis (these are shown on the left side of the diagram). Note how the __ covers the crura of the clitoris. The __ (seen in the close-up view of the boxed in region), is found at the apex of the labia minora. This structure is homologous to the glans penis in males. So to review, the female has erectile tissue in the __ and the __ (which has __ and a __) . This erectile tissue is covered by skeletal muscle just as in the male. |
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Definition
- perineal membrane
- levator ani muscles
- bulbospongiosus muscle; vestibular bulbs; ischiocavernosus; glans of the clitoris; vestibular bulbs; clitoris (crura; glans) |
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Term
homologous
penis = __
testes = __
scrotum = __
bulb of the penis = __ |
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Definition
clitoris
ovaries
labia majora
vestibular bulbs |
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Term
-The __, which is the primary source of blood supply in the pelvis, gives off __ parietal branches and __ visceral branches. We will begin with a discussion of the parietal branches of the internal iliac.
-Shortly after the internal iliac artery arises from the common iliac, it gives off it’s first branch known as the __. this quickly turns upward, just behind the obturator nerve, on its way toward the medial border of psoas major.
-The largest branch of the internal iliac is the __, which is essentially a continuation of the internal iliac’s posterior trunk. Running posteriorly between the lumbosacral trunk and the 1st sacral nerve (which we will discuss shortly), the superior gluteal artery and it’s branches supply the __, __, and __ muscles of the posterior abdominal wall.
-The 3rd branch off the internal iliac is the __, seen here as it branches off the internal iliac and gives off it’s own branches. These branches pass through the sacral foramina on their way to supply the skin and muscles dorsal to the sacrum and coccyx. |
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Definition
- internal iliac artery; five; four
- iliolumbar artery;
- superior gluteal artery; iliacus; piriformis; obturator internus
- lateral sacral artery |
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Term
-Further down the internal iliac, the __ branches off and passes forward and inferiorly on the lateral walls of the pelvis on its way to exit the pelvis via the obturator foramen. While in the pelvic cavity however, it functions in supplying the __.
-The final parietal branch of the internal iliac is the __. As the larger of the two terminal branches of the internal iliac’s anterior trunk, the inferior gluteal artery is primarily directed towards the buttock region and the posterior thigh.
-As it exits the pelvis by passing through the greater sciatic foramen, the inferior gluteal artery passes downward along the __ muscle, just behind the ___. |
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Definition
- obturator artery; iliacus
- inferior gluteal artery
- piriformis; internal pudendal artery |
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Term
-With the exception of the __, the arteries of the pelvis are all branches of the internal iliac artery. Note that this image shows a posterior view, which is different than the medial view shown on the previous slide.
-The __ is a continuation of the __. It descends into the pelvis by passing between mesentery and the sigmoid colon.
-Also supplying the rectum are the __. this artery arises from the internal iliac artery as it travels medially to supply the middle portions of the rectum.
-Like the middle rectal arteries, the __ also branches off of the internal iliac. It descends along the hip bone before it transitions into what’s known as the ___. As its name implies, this branch supplies the most inferior portions of the rectum. |
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Definition
- superior rectal artery
- superior rectal artery; inferior mesenteric artery
- middle rectal artery
- internal pudendal artery; inferior rectal artery |
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Term
-The sympathetic nerves associated with the pelvic viscera have their cell bodies in the __ cell column (lateral horn) of the lower thoracic and upper lumbar regions. Preganglionic fibers pass through the __ (without synapsing) toward the aortic plexus of nerves. At the bifurcation of the aorta, the nerves continue downward as the __.
-The superior hypogastric plexus subsequently divides into the right and left __ (also known as the Pelvic Plexuses). Contributors to these paired plexuses include the presynaptic sympathetic fibers and __ (carrying preganglionic parasympathetic fibers). |
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Definition
- intermediolateral; sympathetic chain ganglia; superior hypogastric plexus
- inferior hypogastric plexuses; pelvic splanchnic nerves |
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Term
-Parasympathetic innervation associated with the pelvis arises entirely from __. Visceral efferent parasympathetic fibers reach the pelvic viscera and the external genitalia via the __. These nerves arise from the sacral spinal levels __.
-The __ is a part of the __, and it emerges from the sacral vertebrae __. Although largely associated with innervating the posterior thigh and lower leg, direct branches from the sacral plexus do provide __ innervation to the piriformis and the obturator internus muscles of the posterior abdominal wall. These branches are named according to the muscles they innervate. We will study more nerves associated with the sacral plexus when we move into the lower limb. |
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Definition
- S2-S4; pelvic splanchnic nerves; S2-S4
- lumbosacral trunk (L4/L5); sacral plexus (S1-S4); S2-S4; somatomotor |
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Term
-The primary nerve associated with the urogenital diaphragm and the external genitalia is the __. this nerve is from __ so it is a nerve of the sacral plexus, and contains somatomotor and somatosensory fibers.
-The __ supplies sensory innervation to the external genitalia and the anal region, as well as motor innervation to the muscles of the urogenital diaphragm. Motor innervation is also provided to the muscles of the penis and the clitoris via the pudendal nerve. |
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Definition
- pudendal nerve; s2-s4
- pudendal nerve |
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Term
-Lymphatic drainage of the male and female reproductive organs and external genitalia are provided by a collection of lymph vessels that travel throughout these viscera. These vessels drain into paired groups of glands found in the __ regions.
-The __ are located just medial to the femoral veins (both the right and left sides). There are roughly 3-5 deep lymph nodes found in these areas. The most superficial of these deep nodes lies just under the inguinal ligament. These glands drain superiorly into the external iliac nodes, and from there lymph is collected by the __.
-Immediately below the inguinal ligament is a “chain” of lymph glands known collectively as the __. Located in what’s known as the __, these nodes drain to the deep inguinal lymph nodes that we just mentioned. Lymph from the skin of the penis, the scrotum, perineum, buttock, and the anus is all received by these nodes. |
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Definition
- inguinal
- deep inguinal lymph nodes; pelvic lymph nodes
- superficial inguinal lymph nodes; femoral triangle |
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Term
-The __ is a major hip extensor and is innervated by the ___. It is the largest and most superficial of the three gluteal muscles. As such it comprises the most significant portion of the shape and appearance of the buttocks.
-The __ abducts and medially rotates the hip joint and is innervated by the __. This broad, thick muscle is covered mostly by the gluteus maximus. |
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Definition
- gluteus maximus; inferior gluteal nerve
- gluteus medius; superior gluteal nerve |
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Term
-The __ also abducts and
medially rotates the hip joint and is innervated by the __
The five muscles displayed, excluding the gluteus minimus, are __ of the hip and are found deep to the three larger gluteus muscles are __, __, __, __
-These muscles rotate the femur __ and oppose the medial rotation of the gluteus medius and minimus.
-These five lateral rotator muscles are innervated by direct branches of the __ (i.e. nerve to the obturator internus, etc).
-Note __ attaches to the area between the greater and lesser trochanter of the femur; it adducts the thigh at the hip joint. |
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Definition
- gluteus minimus; superior gluteal nerve
- lateral rotator; piriformis; superior gemullus; inferior gemullus; obturator internus
- laterally
- sacral plexus
- quadratus femoris |
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Term
-The __ provides motor and sensory nerves to some of the pelvis (i.e. pudendal nerve), the posterior thigh, and entire leg and foot. The sacral plexus emerges from the __.
-A prominent nerve of the lower limb is the __ (from the sacral plexus) which is both the longest and widest nerve found in the human body. It innervates the posterior thigh and entire leg and foot. |
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Definition
- sacral plexus (L4-S4); sacral vertebrae (S1-S4)
- sciatic nerve |
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Term
-The lower limb is subdivided into three regions: __, __, and __.
-These regions comprise the entire lower limb, which is attached to the body at the __. |
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Definition
- thigh, leg, foot
- pelvic girdle |
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Term
-The lower limb is very similar to the upper arm in many ways, yet it has a more restricted __ than that of the upper limbs. While the arm is built for movement, the leg is built to be more suited for stability.
-We will begin by covering the surface anatomy of only skeletal structure found in the thigh, the long bone known as the __. Understanding the features of this bone will provide the foundation for learning about the rest of the thigh. |
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Definition
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Term
-The femur is the longest bone in the human body and is responsible for bearing the most weight. The proximal end of the femur consists of two major features, a __ and its hemispherical __ where it articulates with the pelvis in a ball-and-socket joint.
-The anterior processes and bony ridges on which the powerful muscles of the hip attach, include the __ and __ and __.
-Recall that many of the gluteal muscles attached distally to the __ and __ (next slide). |
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Definition
- constricted neck; head
- greater; lesser trochanters; intertrochanteric line
- greater trochanter; intertrochanteric crest |
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Term
-On the posterior portion of the femur is the __ (the distal attachment for the quadratus femoris).
-The __ is also slightly viewable from the posterior side of the femur. It is at this pit that the Ligament of the of the Head of the Femur attaches the femur to the hip. A portion of the blood supply to the femoral head is also delivered to this area. |
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Definition
- intertrochanteric crest
- fovea captis |
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Term
-The __ is located at the intersection of three bones that fuse between the ages of 14 to 16. These three bones include the __, __ and __. It is at this point that the femur articulates with the hip and is connected by multiple ligaments.
-The __ is a ring of cartilage that surrounds the acetabulum. |
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Definition
- acetabulum; illium; ischium; pubis
- acetabular labrum |
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Term
| Like the shoulder joint, the hip joint is a __ joint. There are a many more __ reinforcing the hip compared to the shoulder because the hip is responsible for keeping the body in an upright position while standing. This increase in number of ligaments makes the hip more stable in comparison to the shoulder, yet with a smaller range of motion. |
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Definition
| ball and socket; ligaments |
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Term
-The hip joint is encapsulated by a synovial membrane and held together by 4 ligaments. Three of the four ligaments are __ and one is __.
-The extracapsular ligaments include the __, __ and __ which are attached to proximally to the ilium, ischium and pubis respectively.
-The intracapsular ligament (not shown) attaches the __ of the femur to the __ and is identified as the __. |
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Definition
- extracapsular; intracapsular
- ilifemoral ligament; ischiofemoral ligament; pubofemoral ligament
- fovea captis; acetabulum; transverse ligament of acetabulum |
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Term
| The __ is the strongest ligament in the body and keeps the torso in an upright position while standing without the need of muscular contraction. The __ is most posterior, and the __ is found anterior to it |
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Definition
| iliofemoral ligament; ischiofemoral ligament; pubofemoral ligament |
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Term
-The femoral head receives oxygenated blood from two key arteries. The first of these is the __, which delivers blood to the head of the femur. this artery originated from its branch point off the __.
-The __, which is a branch off of the femoral artery, also delivers blood to the head of the femur. We will discuss this vessel in more depth later in this module. |
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Definition
- obturator artery; internal iliac artery
- deep femoral artery |
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Term
| One of the femur’s predominant posterior features is the __, which is a bony ridge that splits the femur. Proximally, the above creates the __ (spiral line) and the __ (where part of the gluteus maximus inserts). |
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Definition
| - linea aspera; pectineal line; lesser gluteal tuberosity |
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Term
-The distal end of the femur articulates with the __ of the leg and is connected to the smaller __
-The __ and __ are joined at a surface known as the __, then split posteriorly.
-The __ of the femur is a bony protrusion located on the medial side of the bone’s distal end. The __, which is smaller, serves as an attachment to the __ of the knee joint (to be discussed later). |
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Definition
- tibia; fibula
- medial; lateral condyles; patellar surface
- medial epicondyle; lateral epicondyle; fibular collateral ligament |
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Term
-The distal end of the femur has 3 points in which it articulates with other bones. The two __ both articulate with the __ at the knee joint. The __ articulates with the patella.
-The __ is not involved in the knee joint and does not make direct contact with the femur yet there is a ligament that attaches to the femur and fibula that helps to stabilize the knee joint (discussed later). |
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Definition
- condyle (medial and lateral); tibia; patellar surface
- fibula |
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Term
-In this illustration of a cross-section of the thigh, it’s important to remember that all cross-sections must be viewed as if looking up through the patients leg from the foot of their bed.
-The fascia extends inward to separate the thigh into __, __ and __ compartments.
-The anterior compartment consists of the __. The posterior compartment consists of the __. The medial compartment consists of the __. |
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Definition
-
- anterior; posterior; medial
- thigh flexors; thigh extensors; thigh adductors |
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Term
-The muscles of the thigh are divided into an anterior and a posterior section. The anterior section consists mostly of __ innervated by the __, including the __ and the __.
-The __ is the lateral edge of what is known as the femoral triangle (discussed later). It rests on top of the adductor canal and is commonly used in surgical practice as a guide to locating the __. It serves to flex, aBduct and externally rotate the hip joint and flex and internally rotate at the knee joint. It’s this internal flexion and rotation that aids in sitting cross-legged.
-The __ muscles allow for flexion at the hip joint and extension at the knee joint as when juggling (bouncing) and kicking a soccer ball. These muscles are very important in running and are exercised while performing squats. |
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Definition
- thigh flexors; femoral nerve; sartorius; quadriceps femoris
- sartorius; femoral artery
- quadriceps femoris |
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Term
-The quadriceps femoris is a collection of four muscles including the __ and the 3 __ muscles (__, __ and __). The __ runs along the femur to the tibia and aids the __ in flexion of the thigh as well as extension of the leg.
-These four muscles merge at the __, at the point in which it embeds the __ then continues downwards towards the foot, taking on the name __.
-When testing reflexes of the lower spine, it is the __ that is tapped and the __ contracted. |
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Definition
- rectus femoris; vasti; (lateralis; medialis; intermedialis); rectus femoris; iliopsoas
- quadricep femoris tendon; patella; patellar ligament
- patellar ligament; quadriceps femoris |
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Term
-In this close up of the anterior knee, we can see two important ligaments. Just above the knee we see the insertion of the rectus femoris muscle via the __.
-Inferior to the knee is a strong and flat ligament that is the central portion of the common tendon of quadriceps femoris, the __. This is continued from the patella on to the tuberosity of the __. |
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Definition
- petalla tendon
- patellar ligament; tibia |
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Term
-The main function of the posterior region of the thigh is to extend the thigh and flex the leg. The muscles that accomplish this include the __, __ and __. These four muscles are collectively known as the __. Note the boxes highlighting the distal attachments of the hamstrings, which show how they function in flexing the knee..
-As antagonists to the anterior quadriceps femoris and sartorius, the muscle actions of the posterior compartment are opposite to those in the anterior compartment. These actions include extending and stabilizing the hip and flexing and externally rotating the leg at the knee joint. The biceps and semitendinosus tendons form the lateral and medial sides of the __, located on the backside of the knee. |
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Definition
- biceps femoris (long and short head), semimembranosus; semitendinosus; hamstrings
- popliteal fossa |
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Term
-The muscles found in the medial thigh primarily aDduct the thigh. The superficial muscles in this region include the __, __, __ and __. Note that the __ is deep to __. All four muscles originate on the pubic bone and all except for __ insert on different parts of the femur. The gracilis reaches around the knee and inserts on the tibia of the leg.
-Innervation is supplied by both the __ and __ branching from the __. A condition commonly experienced by horseback riders , called “rider’s leg”, results from overuse of thigh adductors, causing discomfort. This muscular pain is caused by ossification in the distal tendon of the adductor longus muscle.
-Note that these muscles are found both on the right & left, but have been shown on one or the other in this illustration. Their proximal attachments on the pubic bone are highlighted by the black rectangle. |
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Definition
- pectineus; adductor longus; adductor brevis; gracilis adductor brevis; adductor longus; gracilis
- femoral; obturator nerves; lumbar plexus (L2-L4) |
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Term
-The deep layer of medial thigh muscles include the __, __ and __.
-These three muscles also __ the thigh at the hip joint. They also play an important role in stabilizing the pelvis. The __ acts as both an adductor of the thigh where it attaches to the __ of the femur and an extensor of the thigh where it attaches to the adductor tubercle.
-Note the empty space between the distal end of the __ and the __. This space is called the __. It is here that the __ travels through and moves from an anterior position to a posterior position behind the knee. In this posterior position behind the knee, the femoral artery is renamed the __ (this will be illustrated in the vasculature section of this module). |
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Definition
- obturator externus; adductor minimus; adductor magnus
- adduct; adductor magnus; linea aspera
- femur; adductor magnus tendon; adductor hiatus; femoral artery; popliteal artery |
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Term
-The Femoral Triangle is a specific region of the upper thigh. The triangular boundaries are formed by the __ superiorly, the __ medially, and the __ laterally.
- this can be remembered by the phrase ___
-The importance of the femoral triangle is its wide array of vasculature, innervation, and lymphatics, all of which will be discussed in detail on the following slide. |
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Definition
- inguinal ligament; adductor longus muscle; sartorius muscle
- i am sal |
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Term
The femoral triangle
-The major blood supply to the lower limb travel through this region as well as the femoral nerve, which innervates the anterior compartment of the thigh.
-This includes the __, __, and __. All three pass under the __ then travel down the middle third of the thigh through the __.
-The contents of the neurovascular bundle of the femoral traingle can be remembered (lateral to medial) by the acronym __
-The femoral artery and vein are found within the __ while the __, wanting to avoid compression, is located outside the sheath. The pulsations of the femoral artery are easily felt. |
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Definition
-
- femoral artery; femoral vein; femoral nerve; inguinal ligament; adductor canal
- NAVEL (femoral Nerve; femoral Artery; femoral Vein; Empty space that contains; Lymph)
- femoral sheath; nerve |
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Term
- The __ is the largest branch of the __ and enters into the thigh behind the __.
- the nerve innervates the following muscles of the thigh: |
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Definition
- femoral nerve; lumbar plexus (L2-L4); inguinal ligament
- Sartorius; quadraceps femoris: Rectus femoris, vastus medialis, vastus lateralis, vastus intermedius |
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Term
-The __ exits the spine at __, passes through the __ and enters the thigh.
-The nerve innervates the following muscles of the medial compartment of the thigh: |
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Definition
- obturator nerve; L2-L4; obturator formen
- PAAGAAO; pectineus; adductor longus; adductor brevis; gracilis; adductor magnus; adductor minimus; obturator externus |
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Term
-The __ is the largest nerve in the human body, branches from the __ regions and runs down the posterior region of the thigh. It divides just proximal to the popliteal fossa into the __ and __ divisions.
-The __ branch of the sciatic nerve innervates the following muscles of the thigh: |
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Definition
- sciatic nerve; L4-S3; fibular; tibial
- tibial; adductor magnus; long head of biceps femorus; semimembranosus; semitendinosus |
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Term
The __ is fused in the thigh and splits just proximal to the popliteal fossa. Its two divisions are the __ and the __.
-The common fibular branch of the sciatic nerve innervates the following muscle in the thigh:
-Note how the short head of the biceps femoris originates at the __ of the femur and attaches to the head of the fibula. The __ is unable to extend the hip like the other hamstrings, as it does not cross the hip joint. Instead its only responsibility is flexing the knee joint. |
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Definition
- sciatic nerve; tibial nerve; common fibular nerve
- biceps femoris short head
- linea aspera; biceps femoris |
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Term
-The abdominal aorta branches into two __ in the lumbar region; these common branches divide into an __ and __. The __ is the primary blood supplier of the thigh (internal iliac supplies structures inside the pelvis).
-From there the external iliac artery passes through the __ and transitions into the __. Within the femoral triangle, the femoral artery branches into a __ and __. The __ has branches that supply deeper muscles of the thigh. |
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Definition
- common iliac arteries; internal; external branch; external iliac artery
- inguinal ligament; femoral artery; large; smaller branch (deep femoral artery); deep femoral artery |
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Term
-The __ and __ branch from the deep femoral artery to supply blood to the deep adductors and posterior muscles of the thigh. Branches of the circumflex arteries are primarily responsible for supplying blood to the hip joint.
-The larger branch is labeled simply as the __. this artery travels through the adductor hiatus and becomes known as the __. This artery travels behind the knee, branches, changes names and continues down the posterior region of the leg towards the foot (will be discussed in leg module). |
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Definition
- medial; lateral circumflex arteries
- femoral artery; popliteal artery |
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Term
-The main vein responsible for superficial drainage of the thigh is the __. This vein originates at the dorsal venous arch of the foot and travels up the length of the lower limb.
-In the region of the femoral triangle, the vein merges with the __ and __. The __ and __ join the __ before it converges with the __ and dumps into the __.
-The deep veins (including the femoral, deep femoral, and circumflex branches) run parallel to the deep arteries, and drain separately from the superficial drainage of the thigh. The __ for the great saphenous vein is the point where it dives deep in order to join the femoral vein. |
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Definition
- long (great) saphenous vein
- femoral vein; deep femoral vein; medial; lateral circumflex veins; deep femoral; external iliac vein
- hiatus |
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Term
-The red arrows pictured on the left show the general flow of lymph. Notice that the flow of lymph follows the same direction as the venous drainage of the thigh. Lymphatic fluid drains from __ tissues, inward to __ tissues.
-The __ receive drainage from the leg and foot.
-Drainage from the skin, abdominal wall, lower back, gluteal region, bowel, anal region and external genitalia drain to the __.
-The __ receive drainage from the deep portions of the lower limb. Remember superficial drainage ultimately drains to deep nodes before returning to the thoracic duct and to the heart. |
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Definition
- superficial; deep
- popliteal lymph nodes
- superficial inguinal lymph nodes
- deep iliac lymphatic nodes |
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Term
| The femoral triangle has a major collection of __ and __ lymph nodes in which the lymph collected from the lower limb passes before heading back towards the heart. |
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Definition
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Term
-Moving distally from the thigh, the next region of the upper limb spans from the knee joint down to the ankle, and is referred to as the __. Although the entire lower limb is commonly called this, for our purposes the word leg refers only to this particular region.
-Only two bones are found in the leg, the large long bone called the __, with the smaller __ running parallel alongside it.
-The mobility of the leg is much more constricted than the range of motion of the thigh. The primary function of the muscles in the leg is movement of the bones in the foot. Bound together by the __, the tibia and fibula are virtually immobile. We will begin exploring the structures of the leg by covering the surface anatomy of the fibula and tibia. |
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Definition
- leg
- tibia; fibula
- interosseous membrane |
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Term
| The proximal end of the tibia has a __ and a __ that articulate with the __ and __ of the knee. Highlighted in red to the left is the __, found on the anterior side of the proximal tibia. Note that the center portion of the quadriceps femoris tendon, which is known as the __ ligament, spans between the patella and the tibial tuberosity. |
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Definition
| - lateral; medial condyle; medial; lateral menisci; tibial tuberosity; patellar ligament |
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Term
-The __ articulates with the __ of the femur and is capable of fractures. The __ is a prominent ridge found on the posterior side of the tibia and serves as an attachment point for muscles and fascia of the posterior compartment of the leg, including insertion of the __ and orgin of the __, __ and __ (discussed further in the following slides).
-The __ is a fibrous fascia, like that found between the radius and ulna, connecting the two bones. This membrane divides the leg into posterior and anterior compartments. Also visible is an opening in the membrane, which allows for passage of blood vessels. It is at this opening that the __ passes from a posterior to an anterior position. |
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Definition
- intercondylar eminence; intercondylar notch; soleal line; popliteus; soleus; flexor digitorum longus; tibialis posterior
- interosseous membrane; anterior tibial artery |
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Term
-The distal end of the tibia and fibula make up the __, formally known as the __ and __. The __ is found on the distal end of the fibula, while the __ is on the same end of the tibia. To the left we see an anterior view of the distal leg bones, while the picture below looks down these bones from their distal ends (the red arrow on the bottom right indicates the direction viewed in the below image).
-The ___ is a non-cartilaginous joint formed by the tibia and fibula. Many ligaments attach at this point, stabilizing the ankle joint. Syndesmosis sprains are common and if severe enough, may require temporary screws (shown in grey) for immobilization and healing. |
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Definition
- ankle bones; lateral; medial malleolus; lateral malleolus; medial malleolus
- tibiofibular syndesmosis |
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Term
-The distal end of the fibula and tibia articulate with the __ of the foot at the __. The ankle is a synovial joint.
-One useful tip when trying to figure out the orientation of images of the leg bones is to remember that the __ is always found on the lateral side in both the right and left lower limbs.
-Knowing this we can quickly tell that this image is a posterior view of the right leg. Also by noting the lateral and medial malleolus we can tell that this is the distal end of the leg bones (since the proximal end would have the lateral & medial condyles). |
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Definition
- talus; ankle joint
- fibula
- |
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Term
-The muscles in the leg region are grouped into one of 3 compartments that are named by their location. Facia extends inward and around the muscle groups. This __ separates the leg into an __, __, and a __ compartment.
-The posterior compartment, commonly referred to as the __, makes up the majority of the leg, and their action results in __ of the foot.
-The anterior and lateral compartments are responsible for __, supination and pronation (aka eversion) of the foot.
-In the center of this cross-section are several muscles that are not highlighted. These are the deep muscles in the posterior compartment of the leg, and will be covered later on in this module. |
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Definition
- investing fascia; anterior; posterior; lateral compartment
- calf muscles; plantar flexion
- dorsiflexion (extension)
- |
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Term
-The four muscles of the anterior compartment are the __, __, __ and __. As suggested by the names, the muscles of the anterior compartment are __ that extend the digits of the toes and act on the ankle to __ the foot as a whole.
-These muscles originate on the tibia and fibula of the leg and insert on the bones of the foot. Due to this setup, there are two band-like thickenings of fascia, referred to as __, that restrain the muscles at the ankle in order to avoid bowstringing during dorsiflexion. |
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Definition
- tibialis anterior; extensor hallucis longus; extensor digitorum longus; fibularis tertius; extensors; dorsiflex
- retinacula |
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Term
-The lateral compartment contains the __ and __ muscles.
-Both of the these fibularis muscles are responsible for __ of the foot at the ankle. this refers to the movement of the sole of the foot away from the median plane. Essentially, these muscles act as helpful balancing tools keeping our center of gravity towards the body’s midline while walking or while standing in place.
-To illustrate the effect of eversion, imagine standing on one foot. When we do so, our body feels as though our center of gravity is shifting medially. In response to this the fibularis muscles contract, causing the medial portion of your foot to push downward. This causes the leg we aren’t standing on to be pushed down and medially inward, restoring balance by shifting our center of gravity back towards the body’s midline. An image of eversion of the foot can be seen to the right. |
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Definition
- fibularis longus; fibularis brevis
- eversion
- |
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Term
-The superficial portion of the posterior compartment of the leg contains the __, __ and __ muscles. Gastrocnemius and soleus, referred to together as the __, share a common tendon, the __, which is the strongest tendon in our body. On the left we can see both the medial and lateral head of gastrocnemius in purple, and soleus/plantaris on the right with gastrocnemius removed.
-Contraction of the posterior compartment muscles results in __ of the foot, which “pushes” a person forward while walking or upwards when jumping. Most of the force is exerted on the ball of the foot.
-One common mistake by anatomy students involves mistaking the tendon of plantaris for a nerve. Students so often misidentify the tendon that its jokingly referred to as the “freshman’s nerve.” |
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Definition
- gastrocenemius; soleus; plantaris; triceps surae; calcaneal (achilles) tendon
- plantar flexion
- |
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Term
-The __, __, __ and __ muscles make up the deep portion of the posterior compartment of the leg. The __ acts as a stabilizor for the knee while the other three muscles assist the superficial posterior compartment with plantarflexion of the foot and flexion of the toes.
-Due to the arrangement of the deep muscle tendons to the foot in comparison to the Achilles’ tendon of the superficial muscles, the deep muscles contribute a very small amount to the overall force applied when flexion occurs. |
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Definition
| - tibialis posterior; flexor digitorum longus; flexor hallucis longus; popliteus; popliteus |
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Term
- the tarsal tunnel can be remembered, in the order they come upon, can be remembered by:
-In this image we can see that this arrangement of tendons, nerves, and arteries travels posterior to the __. The muscles and tendons found here originate from the deep portion of the posterior compartment of the leg. Note this DOES NOT include the gastrocnemius, soleus, or plantaris muscles. |
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Definition
- Tom Dick And Very Nervous Harry; Tibialis posterior muscle, flexor Digitorum longus muscle, posterior tibial Artery, posterior tibial Vein, tibial Nerve, flexor Hallucis longus muscle
- medial malleolus |
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Term
-Innervation to the structures of the leg originates from fibers of the __. On the left we can see the network of highlighted nerves forming the plexus. The most notable structure leaving the plexus is the __, which is the longest and widest nerve in the body. Comprised of fibers from the anterior & posterior division of this plexus, it supplies nearly all the skin of the lower limb, as well as the posterior thigh muscles, and muscles of the leg and foot. After passing through the gluteal region, it gives off both __ and __ branches.
-The muscular branch of the sciatic nerve gives off both the __ and the __ around the knee joint. The __ travels down to innervate most muscles in the foot (will be discussed in the foot module).
-All muscles in the leg region are supplied by the __. Descending between the biceps femoris and lateral head of gastrocnemius, it goes on to divide into the __ and a __. We will discuss these nerves and the structures they supply over the next few slides. |
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Definition
- lumbosacral plexus; sciatic nerve; articular; muscular
- tibial nerve; common peroneal nerve; tibial nerve
- common peroneal (fibular) nerve; superficial fibular; deep fibular nerve |
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Term
-The __ innervates the lateral compartment of the leg. It is one of two branches of the __
-In the illustration to the left we can clearly see the superficial path taken by the superficial fibular nerve. Fibers from this nerve go on to innervate the __ and __. |
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Definition
- superficial fibular nerve; common fibular nerve
- fibularis longus; fibularis brevis |
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Term
-The __ (seen as a yellow dashed line to the left) innervates the structures of the anterior compartment of the leg. Both the __ and __ are branches from the common peroneal (fibular) nerve.
-The deep fibular n. supplies the following muscles:
-If the deep fibular nerve is damaged, Injury to this nerve can result in an inability to dorsiflex the foot. This condition, known as __, causes the affected foot to drag since the anterior muscles can no longer lift the anterior foot enough to clear the ground when walking |
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Definition
- deep fibular nerve; deep fibular; superficial fibular nerve
- tibialis anterior; extensor hallucis longus; extensor digitorum longus; fibularis tertius
- foot drop |
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Term
-Along with innervating muscles of the posterior thigh, the __ is in charge of innervating the entire posterior compartment of the leg. It branches directly from the sciatic nerve at variable distances above the popliteal fossa.
- this nerve innervates the following muscles: |
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Definition
- tibial nerve
- gastrocnemius; soleus; plantaris; tibialis posterior; flexor digitorum longus; flexor hallucis longus; popliteus |
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Term
-The arterial supply to the leg begins with the large __, which begins on the anterior side before moving through the __. Once it passes posteriorly through this opening and travels behind the knee, the femoral artery becomes the __.
Further down the leg, the popliteal gives off a branch called the __, while the continuation past this branch point becomes the __. This artery then gives off a branch called the __. This artery supplies the lateral compartment of the leg (although it isn’t located in the lateral leg).
As their names imply, the __ is the primary blood supply for the posterior leg, while the __ supplies the anterior compartment. These arteries continue to travel down into the foot, where they terminate into capillary beds, and provide nutrients and oxygen to the structures of the foot. |
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Definition
- femoral artery; adductor hiatus; popliteal artery
- anterior tibial artery; posterior tibial artery; fibular artery
- posterior tibial artery; anterior tibial artery |
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Term
-As with most regions of the body, there are networks of both deep and superficial veins that drain the tissues of the leg. Deep veins travel parallel to the arteries of the same name.
-The three notable deep veins in the leg can be seen in the image on the left. These include the __, the __, and __.
-The prominent superficial vein of the leg is the __, which drains superficial venous blood (in the skin) deep to the popliteal vein. |
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Definition
-
- posterior tibial; anterior tibial; fibular veins
- short saphenous vein |
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Term
-The red arrows on the right show the general flow of lymph in the leg. The direction of flow follows that of the veins.
-Lymph from the superficial and deep lymphatic vessels of the leg drain into the __ and __ respectively. From there, the flow continues on to the __ located in the femoral triangle of the upper thigh. |
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Definition
-
- superficial; deep popliteal lymph nodes; deep inguinal lymph nodes |
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Term
-It is important to note that the innervation and arterial blood supply to the joints throughout the body is provided by the nerves & blood vessels that pass directly over/around them.
-The ankle joint receives blood and innervation from several sources that travel around it. Oxygenated blood from the __, and fibers from the __ supply the structures of this joint.
-In addition, blood from the __ and innervation from the __ are given off as they pass anterior to the ankle. Recall that the deep fibular nerve is a branch of the common fibular n., and is found between tibialis anterior and extensor hallucis longus in the anterior compartment of the leg. |
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Definition
-
- posterior tibial artery; tibial nerve
- anterior tibial artery; deep fibular nerve |
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Term
-Three major ligaments of the ankle joint include the __, __ and __ (which is named after its attachment to the calcaneus bone in the foot). Note that the __ is itself a grouping of four small ligaments, which collectively help stabilize the ankle by keeping the foot from moving too far medially during eversion.
-In most cases, one or more of these 3 ligaments are damaged due to excessive eversion or inversion of the foot. They are commonly injured or torn which leads to painful bruising and swelling, a condition known as an ankle sprain. Below we see the locations of these ligaments, shown here in images of the ankle from 3 viewpoints |
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Definition
| - deltoid ligament; posterior tibiofibular ligament; calcaneofibular ligament; deltoid ligament |
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Term
-The __ is the most weight baring region of the entire body, and therefore it is constructed in a way that allows it to withstand a great amount of pressure, while also allowing us to maintain balance while standing or walking.
-The skeletal structures in the foot can be divided into three sections: the __, __ and __. The bones in each of these 3 regions are analogues to the carpal bones, metacarpals and phalanges of the hand. |
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Definition
- foot
- tarsus; metatarsus; forefoot |
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Term
-The tarsus of the foot includes seven bones: the __, __, __, __, and __
-The __ is the bone in which articulates with the tibia and fibula, forming the ankle joint. The talus receives all the wait of the body and disperses it to the other bones of the foot through multiple joints in the foot.
-The __ forms the heel of the foot and is the first to hit the ground when walking. It articulates with the talus and cuboid.
-The __ articulates with the three cuniform bones and the talus. It is named this because of its resemblance to a small boat. |
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Definition
- talus; calcaneus; cuboid; navicular; three cuneiforms (lateral, intermediate, and medial)
- talus
- calcaneus
- navicular |
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Term
-the metatarsus of the foot includes the __
- the bones are numbered __ to __
- these bones are similar to the __ bones of the hand
- the __ and __ metatarsal are fixed while walking and because of this can easily experience a stress fracture after prolonged use. |
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Definition
- metatarsal 1-5
- medial; lateral
- metacarpal
- second; third |
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Term
-The forefoot consists of the __. These bones construct the visible digits of the foot and are able to flex, extend, abduct and adduct.
-The phalanges are very similar in __ yet differ in __.
-Notice that there is no middle philanx in __. |
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Definition
- phalanges (proximal, middle, distal)
- shape; size and length
- digit one |
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Term
-The foot is made up of __ individual bones and __ joints in which they articulate.
-The __ is located in the tarsus of the foot and is made up of the __ and __.
-Amputation of the foot at this joint is referred to as a Chopart Amputation. |
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Definition
- 26; 33
- transverse tarsal joint; talonavicular joint; calcaneocuboid joint |
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Term
-The bones of the foot are connected by many ligaments, the major ones consisting of the __ (spring ligament), __ and the __.
-The __ extends from the talus to the navicular and helps with the transfer of weight from the talus while walking, giving support and helping to maintain the arch. A lax ligament would be evident in a collapsing arch or the extreme, known as “flatfoot” (lacking an arch).
-The __ runs from the calcaneous to the cuboid and metatarsals 3, 4 and 5, creating a tunnel where the __ passes through.
-The __ runs from the calcaneous, alongside the flexor digitorum brevis muscle, and attaches to the phalanges. Its sole purpose is to maintain the arch of the foot |
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Definition
- plantar calcaneonavicular ligament; long plantar ligament; plantar aponeurosis
- plantar calcaneonavicular ligament
- long plantar ligament; fibularis longus tendon
- plantar aponeurosis ligament |
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Term
-The intrinsic muscles of the dorsum include the two muscles __ and __. These muscles are responsible for extending the the 1st through 4th toe.
-The __ attaches to the base of the middle philanges of the 2nd to 4th toe while the __ attaches to the proximal philanx of the 1st toe at the dorsal aponeurosis.
-Muscles labeled __, attach at a joint (i.e. metatarsophalangeal joints and proximal interphalangeal joints). Muscles labeled __ attach to the tip of the joint. |
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Definition
- extensor digitorum brevis; extensor hallucis brevis; extending
- extensor digitorum brevis; extensor hallucis brevis
- brevis; longus |
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Term
-The superficial intrinsic muscles of the sole are found on the underside of the foot, originating at the __ and attaching at different points on the phalanges. These muscles include the __, __ and __.
-These muscles are primarily responsible for __ of the foot, but additionally help support the longitudinal arch. As suggested by their names, the abductor hallucis and abductor digiti minimi muscles are responsible for abduction of the 1st and 5th toes, respectively.
- this layer is known as the __ of the foot |
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Definition
- calcaneal tuberosity; abductor hallucis; flexor digitorum brevis; abductor digiti minimi
- flexion
- abductors |
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Term
-The second layer of muscles are the main __ of the toes. The __ originates on the calcaneal tuberosity and inserts on the __, redirecting the pull of the tendon. There is no homolog to the quadratus plantae muscle in the hand.
-The four __ of the foot connect the flexor digitorum longus tendon to toes 2 through 5. They attach more proximally than the flexor digitorum longus tendon and therefore flex the toes to a lesser degree. They are also capable of adducting toes 2 through 5 towards the big toe |
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Definition
- flexors; quadratus plantae; flexor digitorum longus tendon
- lumbricles |
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Term
-The third layer of muscles also flex the toes at the __ joints of the foot. These muscles include the __, __ and __.
-The __ has two heads, one medial and one lateral, both responsible for flexing the MTP joint and supporting the longitudinal arch.
-The __ has two heads as well, a transverse and an oblique head. Both act primarily on the big toe, flexing and adducting. The transverse head helps in supporting the transverse arch while the oblique head aids in longitudinal arch support.
-__ runs along the 5th metatarsal and is responsible for flexing the MTP joint of the little toe. |
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Definition
- metatarsophalangeal joints; flexor hallucis brevis; adductor hallucis; flexor digiti minimi brevis
- flexor hallucis brevis
- adductor hallucis muscle
- flexor digiti minimi brevis |
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Term
-The fourth layer of the sole includes the seven __ and __.
-There are __ muscles located on toes 3, 4 and 5, laterally to the respective dorsal interossei. These three muscles flex, extend and adduct the 3rd to 5th toes.
-There are __ muscles originating on all 5 metatarsals and effecting phalanges 2 through 4. These four muscles are capable of flexing, extending toes 2 through 4, and abducting only the 3rd and 4th toes. |
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Definition
- plantar; dorsal interossei
- 3 plantar interossei
- four dorsal interossei |
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Term
-The __ innervates the two intrinsic muscles of the dorsum.
-These muscles include the __ and the __. |
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Definition
- deep fibular nerve
- extensor digitorum brevis; extensor hallucis brevis |
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Term
| -The __ and __ provide innervation to all the muscles of the plantar side of the foot. The medial plantar nerve innervates the __, __, __ and __. All other intrinsic muscles of the foot are innervated by __. |
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Definition
| - lateral; medial plantar nerves; first lumbrical; flexor hallucis brevis; abductor brevis; flexor digitorum longus; lateral plantar nerve |
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Term
-The __ is the major blood supplier to the dorsal region of the foot. It terminates as the __
-The __ carries oxygenated blood to the muscles of the posterior compartment of the leg, as well as the plantar surface of the foot.
-Originating from the posterior tibial artery and traveling through the tarsal tunnel (Tom, Dick And Very Nervous Harry), the __ and __ provide sufficient nutrients to the plantar surface of the foot.
-After branching of the popliteal artery, the __ travels parallel to the medial & plantar nerves, as does the posterior tibial deep vein. |
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Definition
- anterior tibial artery; dorsalis pedis artery
- posterior tibial artery
- lateral; medial plantar arteries
- posterior tibial artery |
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Term
-The veins of digits 2 through 5 converge to form two arches known as the __ and __.
-The dorsal venous arch gives rise to the __. Digit one drains into the __. Similarly, the plantar venous arch contributes venous drainage to the __. Together, the medial & lateral plantar veins both drain back to the __
-Note that deep veins typically travel parallel to the arteries with the same name. |
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Definition
- dorsal venous arch; plantar venous arch
- long great saphenous vein; medial plantar vein; lateral plantar vein; posterior tibial vein |
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Term
-The lymph fluid collect in the feet must first travel from the __ region to the __ region of the foot.
-From here, it then gets drained upwards towards the leg and collects in the __.
-As we have seen in our study of lymphatics from other regions, lymph fluid typically follows the general direction as venous blood flow.
-As the red arrows in both these images indicate, lymph drains first anteriorly, then superiorly towards the leg. |
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Definition
- plantar; anterior
- popliteal lymph nodes
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