Pelvis/Urinary Organs

inferior portion of the trunk that supports urinary and reproductive organs:

pelvis

bones of the pelvic girdle:

ilium, ischium, pubis, sacrum, coccyx

functions of pelvis:

support the abdominopelvic viscera, supports weight of the body when sitting, provides attachment for muscles

invisible structure that separates the pelvic cavity and abdominal cavity

pelvic inlet

invisible structure that separates the pelvic cavity and perineum:

pelvic outlet

greater pelvis

ends at terminal parts of the colon

lesser pelvis

holds urinary organs/reproductive organs

what shape is the inlet on a female pelvis?

oval shaped

what shape is the inlet on a male pelvis?

heart shaped

joints of pelvis:

lumbosacral joing, sacroiiac joint, sacrococcygeal join, pubic symphysis

how many sacroiliac joints are on the pelvis?

2

which joint articulates between L5 vertebra and the base of the sacrum? which movement does it allows?

lumbosacral joing, flexion, extension, lateral rotation

which joint of the pelvis allows for the most movement?

lumbosacral joint

which joint(s) lie between the ring of the sacrum and ilium? what kind of movement does it allow for?

sacroiliac join, minimal gliding

which joint is located between the apex of the sacrum and base of the coccyx?

sacrococcygeal joint

what kind of movement does sacrococcygeal allow?

passive movement, minor flexion/extension through childbirth

which joint widens during childbirth?

pubic symphysis

function of ligaments of the pelvis:

stabilizes pelvic girdle

inflammation of the SI joint which can be secondary to osteoarthritis and mimics lower back bain:

sacroiliitis

which fracture has a high mortality rate due to lots of highly vascularized organs within this structure?

pelvic fracture

the pelvic cavity is continuous with the abdominal at the:

pelvic inlet

superior and inferior boundaries of the pelvic cavity:

superior: pelvic inlet, inferior: pelvic floor

muscles of pelvic floor:

coccygeus, levator ani muscles, fascia

which border of the pelvic cavity is formed by the pubic bones and pubic symphysis

anteriorinferior wall

what forms the lateral walls of the pelvic cavity?

left and right hip bone, obturator foramen, obturator internus

what forms the posterior wall of the pelvic cavity?

sacrum and coccyx, piriformis is the main muscle

what are the two main arteries supplying the pelvis?

common iliac artery, internal iliac artery

common iliac artery in the pelvis pranches into:

external and internal (R/L) iliac arteries

which artery supplies most of the blood to the pelvic viscera and the musculoskeletal part of the pelvis?

internal iliac artery

which veins drain majority of the pelvis?

internal iliac veins

flow of venous drainage from the pelvis:

internal iliac vein > right and left common iliac > inferior vena cava

which dx is a common cause of pelvic pain in women of reproductive age that is due to incompetency of the internal iliac veins or ovarian veins?

pelvic congestion syndrome

where does somatic motor and sensory innervation to the pelvis come from?

lumbar, sacral and coccygeal plexuses

where does autonomic sympathetic and parasympathetic innervation to the pelvis come from?

lumbar and sacral splanchnic nerves, pelvis splanchnic nerves

organs of the urinary system lie in the ______, what are they?

pelvis, ureters, urinary bladder, urethra

bilateral tubular structures that provide a connection between each kidney and the bladder:

ureters

ureter meets bladder to form the:

ureterovesicular juntion

where does the kidney meet the ureter:

ureteropelvic junction

path of ureter from ureteropelvic junction to bladder:

pass over anterior surface of psoas major > enters pelvis at common iliac bifurcation > enters posterior and lateral aspect of bladder

muscular sac that lies central in pelvis, holds urine:

urinary bladder

organ that transports urine out of the body:

urethra

what supplies the proximal end of the ureter?

renal artery

which artery supplies the middle part of the ureters?

ovarian/testicular arteries, ureteral branches of aorta

which arteries supply the distal portion of the ureters?

superior and inferior vesical arteries

sensory fibers that innervate the ureters originate from:

T11-L2

contraction of the ___________ results in micturition:

detrusor muscle

3 openings of the trigone in the bladder:

2 ureteric orifices, internal ureteric orifice

which opening senses dystention of bladder?

internal ureteric orifice

arterial and venous supply to urinary bladder:

superior vesical artery/vein

which nervous system acts of the bladder?

both autonomic and somatic

micturition is stimulated in response to:

stretch of bladder wall

which nerve innervates the external urethral sphincter that provides control over micturition? which part of the nervous system is it?

pudendal nerve, somatic

where is the female urethra located?

vestibule of vagina, anterior to vaginal opening

what does the male urethra transport? about how much longer is it than the female urethra?

urine and semen, 4x longer (15-20 cm)

why are females more susceptible to UTIs?

female urethra is shorter and closer to the rectum

which anatomical region is known as the groin? which organs does it contain?

inguinal region, abdominal and pelvic organs

which ligament is comprised of connective tissue that runs from ASIS to pubic bone and forms the superior boundary of the femoral triangle?

inguinal ligament

what forms the walls of the inguinal canal?

roof: muscles

anterior: aponeurosis

floor: ligaments

posterior: tendon

which muscles form the roof of the inguinal canal?

transversus abdominis/internal oblique

rings of inguinal canal:

internal ring (deep), external ring (superficial)

where is the internal ring found?

where is the external (superficial) ring found?

which nerves innervate both the male and female inguinal canal?

ilioinguinal nerve, genitofemoral nerve

contents in the male inguinal canal:

spermatic cord

contents in female inguinal canal:

round ligament

what is one of the most common reasons that primary care clinicians refer patients to surgery? list any classifications of them:

groin hernias, inguinal hernia, femoral hernia

which hernias are more common in males?

inguinal hernia, more common in general

which is the most common hernia in females?

femoral hernies, less common in general

which hernia has an increased risk of strangulation?

femoral hernias

location of femoral hernia

which hernia sits above and medial to pubic tubercle:

inguinal hernia

which hernia sits below and lateral to pubic tubercle:

femoral hernia

what are the 2 categories of groin hernias?

indirect or direct hernias

indirect inguinal hernia

goes through superficial inguinal ring.

direct inguinal hernia

skips inguinal ring and goes through posterior wall