Pelvis

• What does not change during child birth with relaxin?

  Obstetrical conjugate (diameter)
• Disruption of perineal body on pelvic floor?

  Prevalent in 24% or 1/4
• Widening of the vagina in order to make child birth easier

  Episiotomy
• Pelvic girdle protects?

  the pelvic viscera and the inferior abdominal viscera
• Pelvic Inlet boundaries?

  Sacral promontory (posterior)

  Arcuate lines (lateral)

  Pubic symphysis (anterior)
• Pelvic outlet boundaries


  Tip of coccyx (posterior)

  Sacrotuberous ligament (posterolateral)

  Ischial tuberosities (anterolateral)

  Pubic symphysis (anterior)
• Female and Male Pelvic differences

  Male:

  heart shaped, narrow pubic arch

  Female:

  Shallow greater and lesser pelvis

  wide pubic arch

  larger pelvic outlet
• Circumference increases or decreases the lesser pelvis?

  Increases
• Sacroiliac and pubic symphysis joints contribute to 10-15%

  increase the

  transverse and interspinous diameters
• Obstetrical diameter during childbirth remains?

  unaffected
• Coccygeus attachments

  inschial spine, coccyx
• Pelvic diaphragm structures?

  Levator ani muscles and coccygeus
• Levator ani attachments

  O: Pubic bone (puborectalis, pubococcygeus) , ischial spine (iliococcygeus) , obturator fascia

  I: Coccyx, perineal body, walls of pelvic viscera
• Action of levator ani?

  Supports pelvic viscera
• Innervation of levator ani?

  Nerve to levator ani (S4 branches), inferior rectal nerve, coccygeal plexus
• Posterior division of the internal iliac artery supplies?

  supplies posterior abdominal wall and gluteal region
• Anterior division of internal iliac artery supplies?

  supplies bladder, reproductive organs, and pelvic floor
• What carries urine to the urinary bladder?

  Muscular ducts
• Left gonadal vein drains to left renal v, while the right renal vein drains to?

  Inferior vena cava
• Constrictions of the kidney and adrenal gland?

  junction of the renal pelvis, crossing the pelvic brim (ext iliac a), and through the wall of the urinary bladder
• What passes between the ureter and the peritoneum?

  Ductus deferens
• Ureters cross what artery to enter the pelvis?

  common iliac artery (near the bifurcation)
• Parasympathetic innervation to the bladder

  contraction of detrussor muscle and inhibition of internal sphincter to promote urination
• Sympathetic innervation to the bladder

  relaxation of detrussor muscle and contraction of internal sphincter to inhibit urination
• Internal urethra sphincter does what kind of control?

  involuntary, sympathetic nervous system
• What kind of control does the external urethra sphincter do?

  Voluntary, parasympathetic nervous system
• External urethra sphincter is innervated by?

  pudendal nerve
• Seminal vesicle duct joins with ductus deferens?

  Ejaculatory duct
• 2/3 of prostate is called?

  Glandular
• 1/3 of the prostate is called?

  fibromuscular
• The right and left lobes of the prostate are separated posteriorly by?

  a longitudinal furrow
• The middle lobe of the prostate is subject to?

  Hypertrophy
• Enlargement of the lobes of the prostate is?

  Benign prostatic hyperplasia
• Sympathetic fibers make up what plexus?

  testicular plexus
• A surgical method of birth control?

  Ligation of the uterine tubes
• How does tubal continuity interrupt fertilization?

  By blocking sperm from traveling up the uterine tubes to the egg
• Anteverted + anteflexed is what position of the uterus?

  Normal
• What ligament contains the ovarian vessels?

  Suspensory ligament
• Borders of the vagina?

  superior: middle cervix

  inferior: vaginal orifice
• Vaginal blood supply?

  branches of uterine and internal pudendal arteries