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Lecture 50: Male and Female Pelvic Diaphragm

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Posted by lae2 on October 13, 2021 at 17:48:15:

Essay Questions

During childbirth, a 36-year-old female tears her puborectalis and pubococcygeus muscles. Describe the anatomy of the levator ani muscle including relationships, innervation, and function. Account for the role the puborectalis muscle in defecation and fecal continence, and the relationship of pubococcygeus muscle to the perineal body and anococcygeal raphe.

True false Questions

The pelvic inlet is defined by the pubic symphysis, pubic crest, pectin line, arcuate line, ala of the sacrum, and sacral promontory.
The pelvic inlet separates the false pelvis of the abdominal cavity from the true pelvis.
The pelvic outlet is defined by the pubic symphysis, conjoint rami, sacrotuberous ligament, and the coccyx.
The lateral wall of the pelvis superior to the arcus tendineus is bordered by the obturator fascia.
The pelvic diaphragm consists of levator ani and ischiococcygeus, whereas, in turn, the levator ani consists of the puborectalis, pubococcygeus, and iliococcygeus.
Relaxing the levator ani drops the pelvic floor and, thus, facilitates urination and defecation.
The puborectalis muscle circles the proximal anal canal superior to the anococcygeal ligament (body) and inferior to the anococcygeal raphe.
The iliococcygeus muscle arises from the ilium by way of a thickening of obturator fascia known as the arcus tendineus.
Ischiococcygeus takes origin from the internal surface of the ischial spin and the internal surface of the sacrospinous ligament.
The ligaments of the pelvic floor, the pubosacral ligamentous complex, are derived from condensations of visceral pelvic fascia.
The transverse cervical ligament (cardinal, Mackenrodt's) is especially important during pregnancy for supporting the developing fetus.
The pubovesical ligament is important for urinary continence by preventing dropping of the bladder.
The rectouterine pouch of the female and the rectovesical pouch of the male are the most inferior extent of the peritoneal cavity.
The presacral space contains the sacral plexus, inferior hypogastric plexuses, sacral sympathetic trunks, lateral sacral arteries, piriformis muscle, pelvic and sacral splanchnic nerves, and more.
The retropubic space provides surgical access to elevate the pubovesical ligament by suturing to the pectineal ligament as a treatment for urinary incontinence.
The peripheral zone of the prostate can be palpated through the anterior wall of the rectum and the thickened periprostatic fascia know as the fascia of Denonvillier.



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