DPT 745 Week 5 Lecture Notes Pt. 2

inlet

outlet

Anterior

Lateral

Posterior

Boundaries of pelvic cavity

• Pelvic _____

– Superior opening

• Pelvic _____

– Enclosed by pelvic diaphragm

• _____ pelvic wall

– Bodies of pubic rami & pubic symphysis

• _____ pelvic walls

– Hip bones & obturator internus

• _____ pelvic wall

– Sacrum, coccyx , SI joint and associated ligaments

Heavy

Deep

Narrow

Small

70

Round

Large

Male Pelvis

• General Structure Thick and _____

• Greater pelvis (false pelvis) _____

• Lesser pelvis (true pelvis) _____/deep

• Pelvic Inlet Heart shaped

• Pelvic Outlet _____

• Pubic arch Narrow (<___°)

• Obturator Foramen _____

• Acetabulum _____

Thin

Shallow

Wide

Oval

Large

80

Small

Female Pelvis

• General Structure _____ and Light

• Greater pelvis (false pelvis) _____

• Lesser pelvis (true pelvis) ____/shallow

• Pelvic Inlet _____ and rounded

• Pelvic Outlet _____

• Pubic arch Wide (>___°)

• Obturator Foramen Oval

• Acetabulum _____

Coccygeus

Pelvic Floor

• Formed by the funnel shaped pelvic diaphragm

– Consists of

• Levator Ani

• _____

– The diaphragm stretches from the pubis anteriorly to the coccyx posteriorly

– It also stretches laterally to the walls of the pelvis on both sides

Levator Ani

coccyx

compression

_____ _____

• Most important muscle in the pelvic floor

• Pubococcygeus, Puborectalis and lIiococcygeus

– Origin - body of pubis, obturator fascia, ischial spine

– Inserts - _____

– Innervation - nerve to the levator ani (S3, S4)

• Action

– Forms muscular sling to support abdominopelvic viscera

– Holds pelvic viscera in position

– Assist with abdominoplevic cavity _____, utilized with coughing, sneezing, vomiting, etc.

Pubococcygeus

Puborectalis

lIiococcygeus

pudendal

sacral

Innervation to Pelvic floor

• Some say innervation comes from the _____ n.

– Some sources are now saying branches direct from the _____ plexus innervate the levator ani

• In general, we can say pudendal and branches innervate pelvic floor

– Inferior anal nerve

– Perineal nerve

– Dorsal nerve of the penis/clitoris

Pudendal nerve

Inferior anal nerve

Perineal nerve

Anorectal angle

increase

contracts

Pelvic Floor Function

During Breathing

• Pelvic floor musculature will loosen so it can _____ the space in the pelvic floor while the diaphragm _____ into the pelvic floor during inhalation

Internal Iliac

_____ _____ artery

• Main supply to the pelvic region

• Branches into two divisions

– Anterior branch

• Obturator artery

• Pudendal artery

• Inferior gluteal artery

– Posterior branch

• Superior gluteal artery

• Iliolumbar artery

• Lateral sacral artery

Obturator artery

Pudendal artery

Inferior gluteal artery

• Main supplier of blood to the muscles of the pelvic diaphragm

• Exits through the greater sciatic foramen to supply the gluteal region.

Superior gluteal artery

Iliolumbar artery

Lateral sacral artery

Pelvic inlet

The opening that marks the boundary between the false pelvis (above) and the true pelvis (below)

Pelvic outlet

Lower opening of the true pelvis, crucial for childbirth and containing the lower parts of the urinary, digestive, and reproductive systems.

Saddle parasthesias

Refers to a tingling, burning, or prickling sensation in the saddle area

Pelvic diaphragm

Superior fascia of levator ani

Inferior fascia of levator ani

Anorectal junction

Compressed at rest

Anal sphincter

Common iliac artery

Internal iliac artery Anterior division

Internal iliac artery Posterior division

Internal pudendal artery

Lumbrosacral trunk

Subcostal nerve

Iliohypogastric nerve

Ilioinguinal nerve

Genitofemoral nerve