Tag: Pelvis Musculature

Pelvis Musculature

PELVIS MUSCULATURE

Q. 1

Muscles that can cause external rotation of the hip include all of the following except:

 A

Sartorius

 B

Obturator internus

 C

Obturator externus

 D

Gluteus minimus

Q. 1

Muscles that can cause external rotation of the hip include all of the following except:

 A

Sartorius

 B

Obturator internus

 C

Obturator externus

 D

Gluteus minimus

Ans. D

Explanation:

Ans:D.)Gluteus Minimus.

Many of the muscles of the gluteal region are external rotators of the hip. These muscles include the gluteus maximus, piriformis, obturator internus, obturator externus, quadratus femoris, superior gemellus, and inferior gemellus. The sartorius is a flexor and external rotator of the hip. The gluteus minimus is an abductor and internal rotator of the hip.


Q. 2

All are sphincters of lower genito urinary tract of female except?

 A

Pubovaginalis

 B

External urethral sphincter

 C

Internal urethral sphincter

 D

Bulbospongiosus

Q. 2

All are sphincters of lower genito urinary tract of female except?

 A

Pubovaginalis

 B

External urethral sphincter

 C

Internal urethral sphincter

 D

Bulbospongiosus

Ans. C

Explanation:

Internal urethral sphincter 

There is no ‘internal urethral sphincter’ in females. It is present in males at the bladder neck and proximal urethral. Its function is to prevent retrograde ejaculation of semen into the bladder during the time of ejaculation.

In males the detrusor muscle fibers of the bladder at the region of bladde neck and proximal urethra are organized into internal urethral sphincter which is under involuntary control.

External urethral sphincter is present in both males and females.

  • Vaginal sphincter is formed by the fibres of pubococcygeus known as pubovaginalis.
  • There are other muscles also which contribute in compressing the vaginal orifice.

Q. 3

Pelvic diaphragm is formed by the following muscles:

 A

Pubococcygeus

 B

Iliococcygeus

 C

Pubovaginalis

 D

All of the above

Q. 3

Pelvic diaphragm is formed by the following muscles:

 A

Pubococcygeus

 B

Iliococcygeus

 C

Pubovaginalis

 D

All of the above

Ans. D

Explanation:

The pelvic diaphragm forms a broad muscular sling and provides substantial support to the pelvic viscera.

This muscle group is comprised of the levator ani and the coccygeus muscle. 

 
The levator ani is composed of the pubococcygeus, puborectalis, and iliococcygeus muscles.

The pubococcygeus muscle now is preferably termed the pubovisceral muscle and is subdivided based on points of insertion and function.

These include the pubovaginalis, puboperinealis, and puboanalis muscles, which insert into the vaginal, perineal body, and anus, respectively.
 
Ref: Leveno K.J., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 2. Maternal Anatomy. In K.J. Leveno, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.

Quiz In Between


Q. 4

Urogenital Diaphragm is made up of all of the following, EXCEPT?

 A

Colle’s fascia

 B

Sphincter urethrae

 C

Perineal membrane

 D

Deep transverse Perineal muscle

Q. 4

Urogenital Diaphragm is made up of all of the following, EXCEPT?

 A

Colle’s fascia

 B

Sphincter urethrae

 C

Perineal membrane

 D

Deep transverse Perineal muscle

Ans. A

Explanation:

Urogenital diaphragm is a triangular musculofascial diaphragm situated in the anterior part of perineum, filling in the gap of the pubic arch. It is formed by the sphincter urethrae, deep transverse perineal muscles enclosed between superior and inferior layer of fascia of urogenital diaphragm. Inferior layer of fascia is called perineal membrane.

The closed space contained between the superficial and deep layers of fascia is called deep perineal pouch.

Q. 5

Superficial perineal muscles include‑

 A

Iliococcygeus

 B

Ischiococcygeus

 C

Bulbospongiosus

 D

Levator ani

Q. 5

Superficial perineal muscles include‑

 A

Iliococcygeus

 B

Ischiococcygeus

 C

Bulbospongiosus

 D

Levator ani

Ans. C

Explanation:

Superficial muscles of perineum (lie in superficial perineal pouch) are ischiocavernosus, bulbospongiosus and superficial transverse perinei.

Deep muscles (lie in deep perineal pouch) are splincter urethrae, deep transverse perinei, and in females, compression urethrae and sphincter urethravaginalis.


Q. 6

Lateral border of ischeorectal fossa is formed by‑

 A

Gluteus maximus

 B

Perineal membrane

 C

Pelvic diaphram

 D

Obturator internus

Q. 6

Lateral border of ischeorectal fossa is formed by‑

 A

Gluteus maximus

 B

Perineal membrane

 C

Pelvic diaphram

 D

Obturator internus

Ans. D

Explanation:

Ans. is ‘d’ i.e., Obturator internus

Boundries of ischeoanal (ischeorectal) fossa are :-

i) Anteriorly :- Posterior border of perineal membrane .

ii) Posteriorly :- Gluteus maximus muscle, sacrotuberous ligament.

iii) Laterally :- Ischial tuberosity and obturator internus.

iv) Medially :- Sphincter ani externus (external anal sphincter) and pelvic diaphragm (levator ani).

Quiz In Between


Q. 7

True statement about anatomy of an organ marked  by a “red box” in the picture below is? 

 A

Puborectalis is essential to maintain continence.

 B

Internal sphincter is skeletal muscle.


 C

Internal sphincter remains in the state of tonic contraction.

 D

Both A and C.

Q. 7

True statement about anatomy of an organ marked  by a “red box” in the picture below is? 

 A

Puborectalis is essential to maintain continence.

 B

Internal sphincter is skeletal muscle.


 C

Internal sphincter remains in the state of tonic contraction.

 D

Both A and C.

Ans. D

Explanation:

Ans;D)Both A and C.

The organ marked by a “red box” in the picture above represents the anal canal.

In the anal canal Puborectalis is essential to maintain continence and Internal sphincter remains in the state of tonic contraction.


Q. 8

Structures crossing dorsal surface of the given structure marked by a “red arrow” are ?

 A

Internal pudendal vessel.

 B

Pudendal nerve.


 C

Obturator nerve.

 D

Nerve to obturator internus.

Q. 8

Structures crossing dorsal surface of the given structure marked by a “red arrow” are ?

 A

Internal pudendal vessel.

 B

Pudendal nerve.


 C

Obturator nerve.

 D

Nerve to obturator internus.

Ans. C

Explanation:

Ans;C).Obturator nerve

The structure marked by a red arrow represents the ischial spine.

ISCHIAL SPINEa thin pointed triangular eminence that projects from the dorsal border of the ischium and gives attachment to the gemellus superior on its external surface and to the coccygeus, levator ani, and pelvic fascia on its internal surface

  • The structure crossing dorsal surface of ischial spine is the Obturator nerve.
  • Psoas major, iliacus & pectineus muscles, femoral vessels and nerve, femoral branch of genitofemoral nerve, lateral cutaneous nerve of thigh and lymphatics pass below inguinal ligament.
  • ‘PIN’ structures i.e. Pudendal nerve, Internal Pudendal vessels, Nerve to obturator internus come out of greater sciatic foramen, cross the dorsal surface of ischial spine & enter into lesser sciatic foramen.
  • From the posterior border of the body of the Ischium there extends backward a thin and pointed triangular eminence, the ischial spine, more or less elongated in different subjects.

Surfaces

external surface gives attachment to the Gemellus superior
internal surface gives attachment to the CoccygeusLevator ani, and the pelvic fascia
pointed extremity the sacrospinous ligament is attached.

Clinical significance

It can serve as a landmark in pudendal anesthesia.



Q. 9

All of the following structures forms the boundary of the triangle as shown in the picture below, EXCEPT ? 

 A

Pubic rami.

 B

Ischial tuberosity.

 C

Ischio cavernosus muscle.

 D

Superficial transverse perineal muscle.

Q. 9

All of the following structures forms the boundary of the triangle as shown in the picture below, EXCEPT ? 

 A

Pubic rami.

 B

Ischial tuberosity.

 C

Ischio cavernosus muscle.

 D

Superficial transverse perineal muscle.

Ans. C

Explanation:

The triangle shown in the picture above represents Urogenital triangle.

The perineum is divided by an arbitrary line joining the ischial tuberosities into urogenital triangle and anal triangle. The urogenital triangle is bounded by pubic rami superiorly, the ischial tuberosities laterally, and the superficial transverse perineal muscle posteriorly.

Perineal membrane further divides anterior triangle into superficial and deep spaces. The perineal membrane attaches laterally to the ischiopubic rami, medially to the distal third of the urethra and vagina, posteriorly to the perineal body and anteriorly to arcuate ligament of the pubis.
 

Quiz In Between


Q. 10

All of the following are true about sphincter urethrae except?

 A

Voluntary

 B

Supplied by pudendal nerve

 C

Arises from ischiopubic ramus

 D

Located at bladder neck

Q. 10

All of the following are true about sphincter urethrae except?

 A

Voluntary

 B

Supplied by pudendal nerve

 C

Arises from ischiopubic ramus

 D

Located at bladder neck

Ans. D

Explanation:

Ans. d. Located at bladder neck


Q. 11

Support of prostate is ‑

 A

Pubococcygeus

 B

Ischiococcygeus

 C

Ilioccygeus

 D

None of the above

Q. 11

Support of prostate is ‑

 A

Pubococcygeus

 B

Ischiococcygeus

 C

Ilioccygeus

 D

None of the above

Ans. A

Explanation:

Ans. is ‘a’ i.e., Pubococcygeus 

  • Levator ani muscle is divisible into following parts :­1) Puboccygeus part
  • Anterior fibers of this part closely surround the prostate, in males, to form, levator prostatae. In the female these fibres surround the vagina and form sphincter vaginae. In both cases these anterior fibres are inserted into the perineal body.
  • Middle fibers constitute the puborectalis. They partly form a loop or sling around the anorectal junction; and are partly continuous with longitudinal muscle coat of the rectum.
  • Posterior fibers are attached to anococcygeal ligament and tip of coccyx.
  • Iliococcygeus part
  • This is inserted to anococcygeal ligament and last two pieces of coccyx.
  • Ischiococcygeus part (or coccygeus)
  • It forms posterior part of pelvic floor.

Q. 12

Superficial perineal space contains ‑

 A

Sphincter urethrae muscle

 B

Ischiocavernosus muscle

 C

Deep transverse perinei muscle

 D

Bulbourethral gland

Q. 12

Superficial perineal space contains ‑

 A

Sphincter urethrae muscle

 B

Ischiocavernosus muscle

 C

Deep transverse perinei muscle

 D

Bulbourethral gland

Ans. B

Explanation:

Ans. is ‘b’ i.e., Ischiocavernosus muscle 

Quiz In Between



Pelvis Musculature

PELVIS MUSCULATURE


 PELVIC MUSCULATURE:

The pelvic muscles of importance in gynaecology are those of the pelvic floor grouped into three layers:

LAYER MUSCLE
Pelvic Diaphragm 2 levator ani muscles

  • Pubococcygeus
  • Iliococcygeus
  • Ischiococcygeus
Obturator internus
Puborectalis
Urogenital Diaphragm Sphincter urethra

Deep transverse Perineal

Compressor urethra

Superficial Layer Superficial transverse Perineal

Ischiocavernous

bulbospongiosus

The external
sphincter muscle of the anus

Muscle Origin Insertion
Pubococcygeus Post. Pubic bone Anococcygeal raphe and coccyx
Iliococcygeus white line of the pelvic fascia coccyx.
Ischiococcygeus ischial spine coccyx
Obturator internus Pelvic aspect of ischium & ilium

Obturator membrane

 Greater trochantor of femur
Puborectalis  Posterior surface of pubis   Midline sling posterior to rectum
Sphincter urethra   Circular anatomical sphincter  Fuses with deep transverse perinei
Compressor urethra  ischiopubic ramus Blends with its partner on the other side

anterior to urethra

below external urethral sphincter

Superficial transverse Perineal  Ischial tuberosity   Perineal body
Ischiocavernous   Ischial tuberosity  Clitoris
bulbospongiosus  Central point of  perineum  symphysis pubis
Deep transverse Perineal  Ramus of ischium  Perineal body
The external
sphincter muscle of the anus
Central point of the perineum Surrounds the anus

ACTION OF MUSCLES:

The roles of the pelvic floor muscles are:

  • Support of abdominopelvic viscera (bladder, intestines, uterus etc.) through their tonic contraction.
  • Resistance to increases in intra-pelvic/abdominal pressure during activities such as coughing or lifting heavy objects.
  • Urinary and fecal continence.The muscle fibers have a sphincter action on the rectum and urethra. They relax to allow urination and defecation.Puborectalis is essential to maintain continence

Exam Important

  • Muscles that can cause external rotation of the hip include Obturator internus
  • Pubovaginalis, External urethral sphincter & Bulbospongiosus are sphincters of lower genito urinary tract of female 
  • Pelvic diaphragm is formed by Pubococcygeus,Iliococcygeus & Pubovaginalis
  • Urogenital Diaphragm is made up of Sphincter urethrae , Perineal membrane & Deep transverse Perineal muscle
  • Superficial perineal muscles include Bulbospongiosus
  • Lateral border of ischeorectal fossa is formed by Obturator internus
  • Puborectalis is essential to maintain continence
  • Sphincter urethrae is Voluntary, Arises from ischiopubic ramus and are Supplied by pudendal nerve
  • Pubococcygeus supports prostate
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