Posted by Murphy on September 10, 2011 at 15:55:58:
In Reply to: Questions for the Pelvic Musculature and Fascia posted by lae2 on September 09, 2011 at 16:48:02:
1. The sacrotuberous ligament is anterior to the sacrospinous ligament. False- it is posterior.
2. The urogenital hiatus includes the urethra as an effluent but not anal canal. False- the hiatus includes the urethra, vagina, and anus in females.
3. The piriformis muscle originates from the posterior surface of the sacrum. False- internal surface of S2, S3 and S4
4. The ischiococcygeus (coccygeus) takes origin from the internal surface of the sacrospinous ligament. True
5. The puborectalis muscle attaches to the anococcygeal raphe and, thus, is tethered to the coccyx. False- this makes a ‘sling’ around the anal canal
6. The inferior fascia of the pelvic diaphragm blends with the superior fascia of the urogenital diaphragm at the urogenital hiatus. True- mostly filled by pubococcygeus
7. An equation; the pelvic diaphragm minus the ischiococcygeus equals the levator ani. True- composed of iliococcygeus, pubococcygeus, and puborectalis
8. Contraction of the ischiococcygeus raises the pelvic floor (push upward on the pelvic floor from the ischiorectal fossa in the laboratory).
9. The iliac crest contributes the superior boundary of the true pelvis. False- false pelvis
10. The sacral promontory contributes to a boundary of the true pelvis. True!
11. The arcuate line contributes a boundary of the true pelvis. True- the arcuate line is the line along the superior
12. The ischial spines in the female are oriented more laterally than in the male. True- during labor a baby exits oriented anteriorly/posteriorly through the pelvic outlet. However, to enter the pelvic inlet the baby is transversely oriented.
13. The fifth lumbar vertebra couples the weight of the upper body to the sacrum. True- the sacrum then transfers this weight to those laterally placed ischial tuberosities
14. The topography of the female, pelvis relative to the male pelvis, accounts for the higher incidence of femoral hernias in the female. True- we have wider pelvis
15. The puborectalis muscle is inferior the to the pubococcygeus muscle. True-
16. The puborectalis, when contracted, enforces an angle at the anorectal junction that contributes to continence. True
17. The urethral crest is a raised part of the anterior membranous urethra. False- prostatic urethra, posterior portion that holds the utricle medially and laterally the ejaculatory ducts
18. The bulbourethral glands drain into the prostatic sinuses. False. These sit in the deep perineal pouch but actually drain into the superficial pouch.
19. The bulbourethral glands drain into the membranous urethra. False, the superificial perineal space is the spongy urethra.
20. The arcus tendineus is a specialization of the obturator externus muscle that provides a site of attachment for the iliococcygeus muscle. False- this is the obturator internus muscle.
21. The transversalis fascia of the pelvis, know as parietal pelvic fascia, is applied to the superior fascia of the pelvic diaphragm. True. It medial to the thick arcus tendineous.
22. The parietal pelvic fascia covers the inferior fascia of the pelvic diaphragm and lines the walls of the ischiorectal fossa. False- The ischio rectal fossa is lined superiorly by the thin inferior fascia of the pelvic diaphragm which is investing fascia of the levator ani muscle
23. The prostatic ducts are lateral to the ejaculatory ducts at the urethral crest. True- although the ducts are located in the prostatic sinus.
24. The ejaculatory ducts are lateral to the utricle. True
25. The seminal colliculus of the urethral crest is medial to the prostatic sinuses. True
26. The utricle and and the ejaculatory ducts, but not the prostatic ducts, are topographies of the seminal colliculus. True- the ducts are located in the prostatic sinus
27. The fascia of Denonvilliers' is a thickening of parietal visceral fascia. False- pelvic visceral fascia.
28. The perivisceral fascia of the rectum is opposed to the fascia of Dennonvilliers'. True- the rectal fascia blends anteriorly with the retrovesical fascia of Denonvillier.
29. The rectum has a convexity with the outside wall toward the right side.
30. There is one transverse rectal fold on the right and two transverse rectal folds on the left. True- the one on the right is the one you get
31. The convexity to the right of the rectum provides a mnemonic for which side has two transverse rectal folds and which side has one rectal fold.
32. The location of the descending colon on the left provides a mnemonic for knowing that the rectum has a convexity to the right.
33. The venous drainage of the rectum is partly to the portal system and mostly to the caval system. True- the superior rectal vein drains to the portal system via the inferior mesenteric vein, joining with the splenic vein posterior to the pancreas and inferior to the splenic artery.
34. The levator ani muscle blends with the internal anal sphincter muscle.False. It does blend with the deep portion of the external anal sphincter.
35. The pectinate line is located at the inferior margin of the anal valves. True- this divides the portion of the anus that came from the cloaca (endoderm) vs. proctadeum (ectoderm derived- cranially, ectoderm of the stomatodeum is the primitive ‘mouth’)
36. Internal hemorrhoids, more so the external hemorrhoids, may develop during portal hypertension. True- external hemorrhoids form as a result of increased pressure in the internal pudendal