DR1- Answers.docx

DR1: Pelvic Region (Answers) Below are the explanations and answer to questions asked it the practical session. The questions relating to pins are not included as they are not useful outside of the lab. Station 1 Make sure you can identify the 3 bones that form the innominate. What are their boundar...

DR1: Pelvic Region (Answers) Below are the explanations and answer to questions asked it the practical session. The questions relating to pins are not included as they are not useful outside of the lab. Station 1 Make sure you can identify the 3 bones that form the innominate. What are their boundaries? Can you identify and name the joints of the pelvis? What are their classifications? Sacroiliac joints – Synovial and fibrous joint Pubic symphysis – Secondary cartilaginous joint Station 2 Study the pelvic inlet and outlet. List the components that form these apertures. Pelvic inlet – Promontory, Ala of sacrum, Terminal line (arcuate line, lectin pubis, pubic crest). Pelvic outlet – Coccyx, Sacrotuberous ligament, Ischiopubic ramus, Pubic symphysis Define the greater and lesser pelvis. List what structures are typically in these regions. Greater pelvis area of the pelvis above the pelvic inlet contains: small intestines, sigmoid colon, cecum, appendix Lesser pelvis area of the pelvis below the pelvic inlet contains: viscera of pelvic cavity, sacral plexus, branches of internal iliac artery, sacral sympathetic chain, hypogastric nerve, inferior hypogastric plexus, pelvic and sacral splanchnics. Station 3 Name the muscular components that form the pelvic floor. Pelvic floor = Coccygeus (ischiococcygeus) + Levator ani Levator ani = Puborectalis, Pubococcygeus, Iliococcygeus Review the motor innervation to these muscles. Coccygeus and Levator ani are supplied primarily by nerve to levator ani (S4). Levator ani receives some contribution inferiorly from the Pudendal nerve (S2,3,4) Station 5 Please review the lecture slide for labelling of these pins. Station 6 Which arteries are formed by the bifurcation of the aorta? Common iliac arteries Which vertebral level does this bifurcation typically occur? L4 The internal iliac artery becomes which artery as it passes inferior to the inguinal ligament? Femoral artery Station 7 List the layers of the abdominal wall. Lateral region (Superficial to deep) Skin, Camper’s fascia, Scarpa fascia (inferiorly), External oblique muscle/aponeurosis, Internal oblique muscle/aponeurosis, Transversus abdominis muscle/aponeurosis, transversalis fascia, parietal peritoneum, peritoneal cavity. Anterior paramedian position (Superficial to deep) – above arcuate line Skin, Camper’s fascia, Scarpa’s Fascia (inferiorly), Anterior rectus sheath, rectus abdominis muscle, posterior rectus sheath, transversalis fascia, parietal peritoneum, peritoneal cavity. Anterior paramedian position (Superficial to deep) – below arcuate line Skin, Camper’s fascia, Scarpa’s Fascia (inferiorly), Anterior rectus sheath, rectus abdominis muscle, transversalis fascia, parietal peritoneum, peritoneal cavity. Which additional layers are needed to pass through to reach the uterus? Visceral peritoneum Station 8 Sympathetic outflow from the spinal cord arises from which vertebral levels? Thoracolumbar outflow (T1-L2) Parasympathetic outflow arise from which regions of the CNS? Craniosacral outflow Cranial nerve with parasympathetic outflow are CN III (oculomotor), CN VII (facial), CN IX (glossopharyngeal), CN X (vagus). Sacral outflow is from S2-4. Station 9 Which landmarks and features define the boundaries of the urogenital and anal triangles? What forms the boundaries of the ischioanal fossae? Laterally – Obturator internus muscle and fascia Medially – Levator ani Inferiorly – perineal skin.