Pelvis osteology, arthrology. Pelvic cavity and viscera

inferoposterior

The pelvis is apart of the trunk _______ to the abdomen.

surrounded by the pelvic girdle

The pelvis is a area of transition between the trunk and lower limbs and is surrounded by what?

part of the appendicular skeleton of the lower limbs (LL)

what skeleton is the pelvic girdle in?

Pelvic cavity

What is the inferiormost part of the abdminopelvic cavity?

surrounded by the superior pelvic girdle and is occupied by inferior abdominal viscera

What is the greater pelvis surrounded by? what is it occupied by?

surrounded by the inferior pelvic girdle and is occupied by the pelvic cavity and perineum

What is the lesser pelvis surrounded by? what is it occupied by?

inferior part of AAW

What is the Anterior external boundary of the pelvis?

gluteal region of the LL

What is the posterolaterally external boundary of the pelvis?

perineum, which is separated from the pelvic cavity by the pelvic diaphragm (floor)

What is the Inferior external boundary of the pelvis?

ring of bones that connects the vertebral column to the 2 femurs

What is the pelvic girdle? what does it connect to?

1. Bear the weight of the upper body while sitting and standing

2. Transfer weight from axial skeleton to the LL for standing or walking

3. Provide attachment for the muscles of locomotion and posture, and those of the abdominal wall

4. Contain and protects inferior abdominal and pelvic viscera

5. Provides attachment for the muscles of the external genitalia

What are the functions of the pelvic girdle? (5)

ilium, ischium, and pubis and the sacrum

The pelvic girdle is formed by the fusion of what 3 hip bones?

Triradiate cartilage

What cartilage separates the 3 hips bones during childhood at the acetabulum?

Pubic symphysis (cartilaginous joint)

What is the place where the 2 hip bones are joined anteriorly?

Articulates posteriorly with the sacrum at the sacroiliac joints

What does the pelvic girdle articulate with posterity with at what joint?

Ilium

What is the superior fan-shaped part of the hip bone?

spread of the fan

What is the Ala of ilium?

handle of the fan that forms the acetabulum externally

What is the Body of the ilium what does it form externally?

rim of the fan

What is the Iliac crest?

formed by the anteromedial concave surface of the ala

What is the Iliac fossa formed by?

muscle attachment

What are the Anterior and posterior superior iliac spines for?

muscle attachment

what are the Anterior and posterior inferior iliac spines for?

Auricular surface and Iliac tuberosity

what are the two Sacropelvic surface of ilium?

forms synovial articulation with sacrum

What does the auricular surface of the ilium form?

forms syndesmotic articulation with sacrum

What does the Iliac tuberosity of the ilium form?

helps form the acetabulum

What does the body of the ischium help form?

forms part of the obturator foramen

What does the Ramus of ischium form part of?

large posteroinferior protuberance

What is the Ischial tuberosity?

small posteromedial projection, near the junction of body and ramus

what is the Ischial spine? what is it near?

helps form the acetabulum

What does the superior ramus of the pubis help form?

helps form the obturator foramen

what does the inferior ramus of the pubis help from?

anterior thickening of the body of pubis

what is the pubic crest?

prominence on the body of pubis, lateral to the pubic crest

What is the Pubic tubercle? what is it lateral to?

cup-shaped socket that fits the head of femur

What is the acetabulum of the pelvic girdle?

covered partially by the obturator membrane. Passage for the obturator nerve, artery, and vein

What is the obturator foramen covered partially by? what is it a passage for? (3)

between the posterior inferior iliac spine and ischial spine

What is the greater sciatic notch between

greater sciatic notch + sacrospinous ligament + sacrotuberous ligament = greater sciatic foramen

What three structures form the Greater Sciatic Foramen?

between ischial spine and ischial tuberosity

What is the lesser sciatic notch between?

lesser sciatic notch + sacrotuberous ligament = lesser sciatic foramen

What two structures make up the Lesser sciatic foramen?

1. Ala of sacrum

2. Arcuate line: on inner surface of ilium

3. Pecten pubis: oblique ridge on the lateral aspect of the superior pubic ramus

What is the pelvic inlet bounded by? (3)

1. Pubic arch: formed by the ischiopubic rami comprises the anterior boundary

2. Ischial tuberosities: lateral boundary

3. Sacrotuberous ligaments: between coccyx and ischial tuberosity forms the posterolateral boundary

4. Tip of coccyx: posterior boundary

What is the pelvic outlet bounded by? (4)

bony edge defining the pelvic inlet

What is the Pelvic brim?

1. Synovial joint

2. Syndesmosis

What are the two Sacroiliac joints that link the axial skeleton and inferior appendicular skeleton (LL)?

anterior between auricular surfaces of ilium and sacrum

What is the Synovial joint (Sacroiliac joint) between?

posterior between the tuberosities of ilium and sacrum

What is the Syndesmosis joint (Sacroiliac joints) between?

mediates the transfer of body weight from the axial to the LL skeleton

What does the Anterior, interosseous, and posterior sacroiliac ligament transfers body weight?

between ilium, sacrum, and L5 vertebra

The is the iliolumbar ligament between?

from posterior ilium and lateral sacrum and coccyx to ischial tuberosity

What is the Sacrotuberous ligament extend from (3) and to (1)?

from lateral sacrum and coccyx to ischial spine

What does the Sacrospinous ligament extend from (2) and to (1) ?

cartilaginous joint formed by the interpubic disc and ligaments

What type of joint is the pubic symphysis? what is it formed by?

connect the pubic bodies and interpubic disc superiorly and inferiorly

What does the Superior and Inferior pubic ligament connect?

Reinforce the pubis symphysis joint anteriorly.

What does the Rectus abdominis and external oblique tendons reinforce?

1. terminal ureters

2. urinary bladder

3. rectum

4. pelvic genital organs

5. loops of small (ileum) intestines

6. large (appendix, cecum, and sigmoid colon) intestines

What is the content of the pelvis? (6)

body and rami of pubic bones & pubic symphysis

What is the Anteroinferior wall of the pelvis?

Obturator internus muscle and obturator membrane. Covers and pads most of the lateral pelvic walls

What is the Lateral wall of the pelvis? what does it cover?

Nerve to obturator internus (L5, S1 – S2)

rotates thigh laterally

What is the Obturator internus muscle innervated by? What is its function?

sacrum, coccyx, ligaments, and piriformis muscle

What is the posterior wall of the pelvis? (4)

Occupies most of the Greater sciatic foramen

What does the piriformis muscle occupy most of?

anterior rami of S1 – S2

rotate thigh laterally, abducts thigh

What is the Piriformis muscle innervated by? What is its function?

formed by the pelvic diaphragm

What is the floor of the pelvis formed by?

1. Coccygeus muscle

2. Levator ani muscle

o Puborectalis: medial

o Pubococcygeus: intermediate

o Iliococcygeus: posterolateral

What muscles form the pelvic diaphragm (floor)? (2)

branches of S4 and S5 spinal nerves

What is the Coccygeus muscle innervated by?

1. Nerve to levator ani (S4)

2. inferior anal nerve

3. coccygeal plexus

What is the Levator ani muscle innervated by? (3)

oPuborectalis: medial

o Pubococcygeus: intermediate

o Iliococcygeus: posterolateral

What are the three parts of the levator ani muscle?

1. Anorectal hiatus: rect

2. Urogenital hiatus: urethra and vagina (female), urethra (male)

What are the two perforations of the floor of the pelvis (pelvic diaphragm)?

because it reflects onto the pelvic viscera

The Parietal peritoneum continues inferiorly into the pelvic cavity, but does NOT reach the pelvic floor because

Ovaries and uterine tubes are the only structures (in M or F).

What are the only structures ensheathed by the peritoneum and lying inferior to it?

reflection of peritoneum from AAW onto the superior surface of the bladder

The supravesical fossa is a peritoneal reflection from AWW onto what?

1. Rectovesical pouch

2. Pararectal fossae

3. Ureteric fold

What are the MALE peritoneal reflections? (3)

reflection of peritoneum between the posterior surface of the bladder and the anterior surface of the rectum

The Rectovesical pouch (M) is a reflection of peritoneum between what?

depressions on each side of the rectum

Where are the Pararectal fossae (M) at?

peritoneal ridge formed by the ureters

What is the Ureteric fold (M) formed by?

1. Vesicouterine pouch

2. Rectouterine pouch

3. Pararectal fossae

4. Rectouterine folds

5. Broad ligament of uterus

6. Ureteric fold

What are the FEMALE peritoneal reflections? (6)

reflection of peritoneum between the bladder and the uterus

The Vesicouterine pouch (F) is a reflection of peritoneum between what?

reflection of peritoneum between the uterus and the rectum

The Rectouterine pouch (F) is a reflection of peritoneum between what?

lateral extensions of the rectouterine pouch on each side of the rectum

The paratectal fossae (F) is lateral extenstions of what? where are they found?

peritoneal ridges formed by underlying fascial ligaments that demarcate the lateral boundaries of the pararectal fossae

What are the Rectouterine folds (F) formed by? where do they demarcate?

double peritoneal fold extending between the uterus and the lateral pelvic wall on each side. Contains the uterine tubes, ovaries, ligaments of the ovaries, and round ligaments of the uterus

The Broad ligament of uterus (F) is a double peritoneal fold extending between what? What does it contain? (4)

peritoneal ridge formed by the ureters

What is the Ureteric fold (F) formed by?

1. Common iliac artery: divides at L5 – S1 level

2. External iliac artery

- Femoral artery: forms deep to inguinal ligament. Lower limbs

- Inferior epigastric artery: ascends along AAW

What are the arteries that supply the pelvis?

Internal iliac artery

- medial to external iliac vein and obturator nerve

- divides at greater sciatic notch

What is the main artery of the pelvis? What is it medial to and where does it divide?

1. Umbilical artery

2. Superior vesical artery

3. Obturator artery

4. Inferior vesical artery (M)

5. Vaginal artery (F)

6. Uterine artery (F)

7. Middle rectal artery

8. Internal pudendal artery

9. Inferior gluteal artery

What are the ANTERIOR division arteries of the pelvis? (9)

from fetus to placenta

What is the umbilical artery of the anterior division of the pelvis supply?

bladder and ductus deferens

What is the Superior vesical artery of the anterior division of the pelvis supply? (2)

runs on lateral wall, between obturator nerve and vein

What does the Obturator artery of the anterior division of the pelvis run on and between?

bladder, ureter, seminal vesicle, prostate

What is the Inferior vesical artery (M) of the anterior division of the pelvis supply? (4)

vagina and cervix. Sometimes off uterine artery

What is the Vaginal artery (F) of the anterior division of the pelvis supply? (2)

ovaries, uterus, superior vagina

What is the Uterine artery (F) of the anterior division of the pelvis supply? (3)

inferior part of rectum, seminal glands, prostate (vagina)

What is the Middle rectal artery of the anterior division of the pelvis supply? (3)

Internal pudendal artery

What is the MAIN artery of the Perineum?

S: muscles and skin of anal and urogenital triangles

passes through GSF and LSF to the urogenital triangle

What is the Internal pudendal artery of the anterior division of the pelvis supply? What does it PASS through?

supplies muscles and skin of buttock

Exits pelvis through GSF between anterior rami of S1 and S2

What is the Inferior gluteal artery of the anterior division of the pelvis supply? What does it EXIT through and between?

1. oIliolumbar artery

2. Lateral sacral artery

3. Superior gluteal artery

What are the POSTERIOR division arteries of the pelvis? (3)

posterior abdominal and pelvic walls

What is the Iliolumbar artery of the Posterior division of the pelvis supply?

posterior sacrum and overlying muscles

What is the Lateral sacral artery of the Posterior division of the pelvis supply?

terminal branch, muscles of buttock

What is the Superior gluteal artery of the Posterior division of the pelvis supply?

pelvic venous plexus: veins surrounding pelvic viscera.

drain in internal iliac vein

forms superior to GSF and is posteroinferior to internal iliac artery

What are the veins of the plevis? what do they drain into? What does it form Superior to? what is it posteroinferior to?

innervated mainly by sacral and coccygeal spinal nerves and pelvic part of autonomic nervous system

What is the pelvis mainly innervated by? (3)

Coccygeus and piriformis muscles

What two muscles form a bed for the sacral and coccygeal plexus?

medial thigh muscles

What does the Obturator nerve (L2 – L4) innervate?