The Pelvic Wall Anatomy
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| show | False (greater): above pelvic brim, portion of abdomen between iliac fossa. True Pelvis: below pelvic rim
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| show | Pelvic inlet: pubic symphisis and crest, iliopectineal lines, sacral promontory (1st sacral vertebra). Pelvic outlet: pubic symphisis , ishiopubic ramus, ischial tuberosities, sacrotuberous ligaments, coccyx
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| show | The Pelvic Diaphragm
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| show | Pubic bone, pubic symphisis
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| What structures form the lateral wall of the pelvis? | show 🗑
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| What structures form the posterior wall of the pelvis? | show 🗑
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| show | Fibrous sheet, almost completely encloses obturator foramen, but leaves a small gap (obturator canal) for the passage of obturator nerve and vessels
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| This ligament extends from the lateral part of the sacrum and coccyx to the ischeal tuberosity | show 🗑
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| show | Sacrospinous ligament
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| What are the functions of the sacrotuberous and the sacrospinal ligaments? | show 🗑
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| What muscles comprise the pelvic diaphragm? | show 🗑
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| What structures pass through the diaphragm? | show 🗑
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| show | Incomplete anteriorly at the urogenital hiatus to allow for the passage of the urethra (males and females) and the vagina (females)
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| What nerve supplies the pelvic diaphragm? | show 🗑
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| show | Parietal pelvic fascia, visceral pelvic fascia, and superitoneal fascia
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| Describe the parietal pelvic fascia | show 🗑
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| show | Thickening of the obturator internus fascia; important as the origin of a large portion of the levator ani muscle
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| show | Looser connective tissue investing the pelvic viscera (bladder, vagina, uterus, rectum)
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| Describe the subperitoneal pelvic fascia | show 🗑
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| show | bifurcates at the pelvic rim in front of the sacroiliac joint into external and internal arteries
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| Describe the path of the external iliac artery | show 🗑
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| Describe the path of the internal iliac artery | show 🗑
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| show | OA (branch of the abdominal aorta), SRA (terminal branch of the inferior mesenteric artery), and MSA (branch of the abdominal aorta
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| show | Divides into posterior and anterior divisions, though there is a lot of variation.
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| show | Ascends along lumbosacral trunk in front of ala of sacrum; often separates lumbosacral trunk from obturator nerve medial to the psoas major m., supplies iliacus and psoas major m.
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| show | iliolumbar artery, lateral sacral artery, superior gluteal artery
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| Describe the path of the lateral sacral arteries | show 🗑
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| show | Usually separates the lubosacral trunk from the ventral ramus of S1; leaves greater sciatic foramen above the piriformis muscles
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| show | Umbilical artery, obturator artery, inferior vesical artery, middle rectal artery, uterine artery, vaginal artery, internal pudental artery, inferior gluteal artery
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| Describe the path of the umbilical artery | show 🗑
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| Describe the path of the obturator artery; what is an anomalous obturator artery and why is it significant? | show 🗑
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| show | Gives off artery to the ductus deferens
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| Describe the areas supplied by the middle rectal artery | show 🗑
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| show | passes medially within cardinal ligament below the root of the broad ligament; passes above the ureter near the lateral fornix of the vagina
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| Describe the path and area supplied by the vaginal artery | show 🗑
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| show | Exits the pelvis between the piriformis and coccygeus muscles running with the pudental nerve
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| Describe the path and area supplied by the inferior gluteal artery | show 🗑
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| show | Correspond closely with the arteries; tirbutaries of internal iliac vein communicated freely with each other and others outside of their territory of drainage-->vertebral venous plexus and internal iliac vein anastomose, often leading to metastases
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| What nerves comprise the sacral plexus | show 🗑
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| Where do the sacral plexus branches exit through? | show 🗑
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| What is the lumbosacral trunk? | show 🗑
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| show | (S2-S4) and internal pudental vessels: exit via greater sciatic foramen below the piriformis m., hooks around sacrospinous ligament; enters perineum via lesser sciatic forament and enters pudental canal along wall of ischiorectal fossa
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| show | Preganglionic parasympathetics from S2 - S4
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| Where does the obturator nerve originate from? | show 🗑
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| Describe the path of the pelvic sympathetic trunk | show 🗑
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