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Pelvis and Perineum
Study
76
Anatomy
Graduate
11/22/2014

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Term
False (Greater) pelvis
Definition
superior region related to upper parts of pelvic bones and lower lumbar vertebrae
Term
True (lesser) pelvis
Definition
related to inferior parts of pelvis bones, Sacrum, Coccyx. Cantains inlet and outlet
Term
Perineum
Definition
inferior to floor of pelvic cavity, contains external genitalia and external opening of urinary and GI systems
Term
Uterus is positioned between what 2 organs anteriorly and posteriorly
Definition
between rectum and bladder
Term
Bony borders of the pelvic wall
Definition
Sacrum,
Coccyx and inferior 1/2 of pelvis
Term
Greater and lesser sciatic notches are made from what two ligaments
Definition
sacrospinous
sacrotuberous
Term
Pelvic walls is made by what 2 muscles
Definition
Piriformis and Obturator internus
Term
Borders of the pelvic outlect
Definition
ventrally - pubic symphysses, ischiopubic rami and ischial tuberosities

posteriorly - by Sacrotuberous ligaments and coccyx
Term
Pelvic Floor if formed by
Definition
levaror ani
coccygeus
Perineal membrane (spans between arms of Pubic arch)
Term
Two triangles creates by an imaginal line between the two ischial tuberosities
Definition
anterior - Urogenital
Posterior - Anal
Term
Pelvis and Perineum is enervated at what level
Definition
Pudendal
S2-4
Term
Pudendal nerve path in the pelvis
Definition
passes through the greater sciatic foramen then goes back through the lesser sciatic foramen
Term
What is the Perineal body
Definition
Fibromuscular node lying in the midline

Muscles converging on to it include:
- levator ani
- Musles of urogental and anal triangles that maintain continence
Term
Pubic symphysis joint ligaments
Definition
superior pubic ligment
inferior pubic ligament
Term
Piriformis O:
Definition
Sacrum and Greater Sciatic notch
Term
Piriformis I
Definition
Greater trochanter
Term
Piriformis A
Definition
Abducts and laterally rotates thigh
Term
Piriformis N
Definition
N to Piriformis (S1-2)
Term
Obturator Internus O:
Definition
Obturator membrane and ischiopubic rami
Term
Obturator Internus I:
Definition
Greater trochanter
Term
Obturator Internus N:
Definition
N to Obturater Internus (L5-S2)
Term
Obturator Internus A:
Definition
Lateral rotation and abduction
Term
What nerves and vessels go through the greater sciatic notch
Definition
Superior gluteal nerve and vessels (Above the piriformis)

Inferior gluteal nerve and vessels
Sciatic nerve
Posterior femoral cutaneous nerve
Quadratus femoris nerve
Pudendal nerve and vessels
Term
What goes through the lesser sciatic notch
Definition
Pudendal nerve and internal pudendal vessels
Nerve to obturator internus
Obturator internus muscle
Term
What goes through the obturator canal
Definition
obturator nerve and vessels
Term
3 muscles of the levator ani
Definition
Pubococcygeous (Middle)
Iliococcygeous (lateral)
Puborectalis (Medial
Term
Pubococygeous O
Definition
Pubic bone
Term
Pubococygeous I
Definition
Coccyx
Term
Pubococygeous N
Definition
S4 via Pudendal Plexus
Term
Pubococygeous A
Definition
Supports and raises pelvis floor
Term
Iliococcygeus O
Definition
Tendinous arch
Term
Iliococcygeus I
Definition
coccyx
Term
Iliococcygeus N
Definition
S4 pudendal
Term
Iliococcygeus A
Definition
supports and raises pelvic floor
Term
Puborectalis O
Definition
Pubic bone
Term
Puborectalis I
Definition
slings around the anus to meet with partner
Term
Puborectalis N
Definition
S4 Pudendal
Term
Puborectalis A
Definition
Supports external sphincter
Term
Coccygeus O
Definition
Spine of Ischium
Term
Coccygeus I
Definition
Coccyx and sacrum
Term
Coccygeus N
Definition
S4-5
Term
Coccygeus A
Definition
Draws coccyx forward and raises pelvic floor
Term
Sphincter muscles (4)
Definition
External Urethral Sphincter (B)

External Urethravaginalis (W)

Urethra Compresor (W)

Deep Transverse Perineal (B)

All are innervated by S4
Term
Rectum
Definition
Continuous with the Sigmoid colon at level S3
Anterior to the Sacrum
Pushed posteriorly by the Puborectalis
Term
Anal Canal
Definition
Surrounded throughout by the internal and external sphincter

serves to keep the anal canal closed
Term
Ureters
Definition
- Anterior to the bifurcation of the common iliac artery
- follows the pelvic inlet from the abdomen into pelvic cavity
- joins blader
- In the pelvis the ureters are crosses by the ductus deferens (M) or Uterine Arteries (W)
Term
Fibromuscular bands that hold bladder in position
Definition
Pubovesical ligaments (W)
Puboprostatic ligaments (M)
Term
Pathway of the Urethra in men (4 parts)
Definition
~20cm
1) Preprosthatic
2) Prosstatic
3) Membranous
4) Spongy part of the urethra
Term
Preprostatic urethra
Definition
1 cm long

- Associated with circular cuff of muscle (internal urethral sphincter)
- Prevents retrograde flow of semen into the bladder during ejaculaition
Term
Prostatic
Definition
3-4 cm long
Surrounded by prostate
Containts opening for Ejaculatory ducts; connection of urinary and reproductive systems occur here
Term
Eppididymis
Definition
Storage for sperm,
continuous with the ductus deferens
Term
Bulbourethral glands
Definition
base of the penus
contribute to lubrication of urethra and pre-ejaculate
Term
Retrovaginal septum
Definition
separates posterior vagina from anterior rectum
Term
Female fascia has three divisions
Definition
anterior- Pubocervical
lateral - Transverse cervical
Posterior - Uterosacral
Term
Broad ligament
Definition
sheet-like fold of peritoneum oriented in coronal plane

Encloses Uterine tube and suspends ovary
Term
Ischioanal fossa
Definition
are wedge-shaped on either side of the anal canal which contain fat and arolar tissue to accommodate the enlargement of the canal during passage of feces. The space is crossed by the inferior rectal vessels and nerve on their way to the anal region
Term
Sphincter ani externus has 3 parts
Definition
Subcutaneous - encircles the anal orifice
Superficial - deep to the subcutaneous part. It anchors the anus to the perineal body anteriorly and to the coccyx posteriorly
Deep - forms a wide encircling band and fuses with levator Ani
Term
Structures Adhering to the Peritoneum in the Male
Definition
1) Rectum
2) Ureter
3) Vas deferences
4) Bladder
Term
Rectropubic space
Definition
A U-shaped space lying between the Pubic symphysis and the Bladder Dorsally it is limited by Retrovesicular fascia which contains vessels of the Bladder and Genital organs. Inferiorly are two ligaments anchoring the neck of the Bladder to the Pubis:

Pubovescical Ligament
Puborpostatic ligament
Term
Retrorectal Space
Definition
S3-5 and Coocyx are covered by the Rectum. Between the Rectum and Sacrum lies the Retrorectal space. The space is limited inferiorly by fascia investing the legator Ani An infection in this space is prone to rupture into the Rectum.
Term
Pelvic Splanchnic nerves
Definition
- originate from ventral rami S2-4
These nerves synapse in the ganglia of the Inferior Hypogastric Plexus
Term
Vessels and nerves that are associated with the Pelvic diaphragm
Definition
Obturator Artery - from the Internal Iliac
Obturator vein - drains into the Internal Iliac vein
Obturater Nerve - L2-4 ventral rami
Term
Arcus Tendineus
Definition
Thickening of Obturator Internus fascia which runs from Ischial spine to the Pubic bone
Term
The Pelvic Diaphragm has the parts
Definition
1) Pubococccygeus
2) Iliococcygeus
3) Coccygeus

1 & 2 form Levator Ani along with Puborectalis
Term
Anteroposterior or Conjuate Diameter -
Definition
a midsagital line connecting the upper end of the Pubic symphysis withe the Sacral Promontory (334)
Term
Transverse Diameter
Definition
Greatest width across the pelvic inlet
Term
Broad ligaments of the uterus
Definition
Thy are formed by 2 layers of the Peritoneum that covers the 2 surfaces of the Uterus as they come together at the margins of the uterus and extend laterally to the side walls of the pelvis.
Term
the four parts of the broad ligament
Definition
Suspensory ligament of the Ovary - Runs laterally from the ovary to the wall of the pelvis and contains the Ovarian vessels

Ligament of the Ovary - Connects the ovary to the Uterus

mesovarium - peritoneal folds that contain and surround the ovary

Mesosalpinx - the peritoneal folds surrounding the uterine tube and superior to the mesovarium
Term
The arteries that supply the Uterus are
Definition
1) Uterine from the Internal Iliac
2) Ovarian- from the Abdominal Aorta
Term
Rectouterine fold
Definition
A fold curving dorsally from the Isthmus of the Uterus and the Rectum to the Sacrum. It forms the brim of the Rectouterine pouch. This fold also contains the Sacrouterine ligament which anchors the Uterus to the Sacrum
Term
Structures Adhering to the Periotoneum in the Female 344
Definition
1) Rectum
2) Bladder
3) Ureter
4) Ovarian (Testicular) ligament
5) Round ligament of the Uterus
Term
Posterior Division of Internal Iliac Artery:
Definition
Iliolumbar
Lateral Sacral
Superior Gluteal
Term
Iliolumbar Artery
Definition
Passes upward to the Iliac fossa where it divides into an Iliac branch (supplying the Ilium and abdominal wall) and a lumbar branch (supplying the Psoas and Quadratus)
Term
Lateral Sacral Atery
Definition
Usually 2 of them which anastomose with Median Sacral Artery. It supplies the contend of the sacral canal and the dorsum o fate sacrum.
Term
Superior Gluteal AA
Definition
Very large and usually appears to be the continuation of the posterior division. It usually passes between the Lumbosacral trunk and the first sacral nerve. It divides into a superficial branch (supplying the Gluteus Max) and deep branch (Supplying the Gluteus Medius and Minimus)
Term
Posterior Division
Definition

Umbilical

Obturator

Internal Pudendal

Inferior Gluteal

Inferior Vescical Uterine (female only)

Vaginal (female)

Middle rectal

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