Q1

Name the parts of the male pelvis on this model.

PROMPT –  What are the skeletal features, organs of the urogenital system, vascular structures?

Model – Male pelvis model (Model No: MS2)

  1. Pubic bone
  2. Sacrum
  3. Coccyx
  4. Urinary bladder (a. apex, b. fundus, e. ureteral orifice, f. trigone)
  5. Prostate
  6. Seminal vesicles
  7. Spermatic duct
  8. Ureter
  9. Urethral corpus cavernosum
  10. Penis
  11. Glans penis
  12. External urethral orifice
  13. Ischio-cavernosus muscle
  14. Testicle
  15. Epididymis
  16. Pampiniform plexus
  17. Testicular artery
  18. Cremaster muscle
  19. Rectum
  20. Common iliac artery
  21. Common iliac vein
  22. Peritoneum
  23. /25 Inguinal ligament
  24. Inguinal ligament
  25. Femoral canal

Pass criteria

  • Bold to pass

Name the parts of the urethra.

Model – Male pelvis model (Model No: MS2)

Name the parts of the urethra

  • Pre-prostatic part (surrounded by internal urethral sphincter)
  • Prostatic part
  • Membranous (intermediate) part (surrounded by external urethral sphincter)
  • Penile (spongy) part

Pass criteria

  • Bold to pass

What is the innervation of the urethra?

Model – Male pelvis model (Model No: MS2)

  • Prostatic nerve plexus to first 3 parts above
  • Dorsal nerve of the penis (from pudendal nerve) to penile part

Pass criteria

  • 1 of 2 bold to pass

 

Bonus - Describe the anatomy of the prostate.

Model – Male pelvis model (Model No: MS2)

  • Surrounds prostatic part of the urethra (about the size of a walnut).
  • Base sits near the neck of the urinary bladder
  • Apex is next to the urogenital diaphragm.
  • Covered in a thick fibrous capsule, which houses the prostatic plexuses of nerves and veins.
  • 5 lobes: anterior, middle, posterior & 2 lateral
  • Arterial supply via inferior vesical, internal pudendal, and middle rectal arteries.
  • Venous drainage via the prostatic venous plexuses, which is located around the base and sides of the prostate.

Q2

Demonstrate the major anatomical features of the pelvis.

  • Pubic symphisis
  • Inferior and superior pubic rami
  • Obturator foramen
  • Acetabulum
  • Iliac crest
  • Sacro-iliac joint
  • Sacrum

Pass Criteria:

  • 6 major features to pass

(a) What is this? (AIIS) What attaches here? (b) What is this? (ASIS) What attaches here?

  • AIIS – Rectus femoris
  • ASIS – Sartorius

Pass Criteria:

  • 3/4 to pass

Describe the course of the iliac arteries.

  • Common iliac origin from aorta L3-5
  • Follows medial border of Psoas to pelvic brim
  • Divides at level of L5/S1
  • Internal iliac artery enters pelvis
  • External iliac artery follows iliopsoas, ends at the inguinal ligament and becomes femoral artery at mid-inguinal point

Pass Criteria:

  • Bold to pass

Q3

?Photo/?Model – L-spine (bone)

What type of vertebral body is this? Outline its features.

PROMPT – How is it different to other vertebra?

  • Lumbar
  • Large kidney shaped body.
  • Transverse processes are long and slender.
  • Vertebral foramen triangular, larger than thoracic/smaller tahn cervical.
  • Spinous process is short, thick, hatchet shaped.
  • Articular processes/facets extend vertically.

Pass Criteria:

  • Bold to pass
  • 2 of 4 to pass

What levels should a Lumbar Puncture be performed at, and what landmarks are used?

  • L3-4, 4-5 or L5-S1
  • Spinal cord ends at L2. Top of iliac crests at L4 spinous process. Hence space above or below this avoids the cord.

Pass Criteria:

  • 2 levels + landmark to pass

What structures does the needle pass through, in order?

  1. Skin
  2. Subcutaneous fat
  3. Supraspinous ligament
  4. Interspinous ligament
  5. Ligamentum flavum
  6. Epidural space
  7. Dura
  8. Subarachnoid space

Pass Criteria:

  • 5 of 8 to pass

Q4

XR: AP Pelvis

Describe the major bony features seen on this x-ray.
Prompt: Which bones can you see? Where do fractures usually occur?

  • Ilium
    • Crest
    • Anterior superior iliac spine
    • Inferior superior iliac spine
    • Anterior inferior iliac spine
    • Acetabulum
    • Sacro-iliac joint
  • Ischium
    • Body
    • Ramus
    • Tuberosity
    • Spine
  • Pubis
    • Symphisis
    • Inferior ramus
    • Superior ramus
    • Tubercle
    • Pectineal line
  • Sacrum
    • Vertebral foramina
    • L5-S1 joint
  • Coccyx
  • Femur
    • Head
    • Neck
    • Greater trochanter
    • Lesser trochanter
  • Acetabulum
  • Obturator foramen

Pass Criteria:

  • 15 features to pass

Demonstrate the bony attachments of the main muscles which flex the hip.

  • Flexors:
    • Iliacus
      • Iliac crest, fossa, ala sacrum, anterior superior iliac ligament to psoas major
    • Psoas major
      • T12-L5 vertebrae, discs, transverse process to lessor trochanter
    • Psoas minor
      • T12-L1 to pectinate line, ilipectoral eminence
    • Rectus femoris
      • Anterior inferior iliac spine, ilium
    • Pectineus
      • Superior ramus of pubis
    • Sartorius
      • Anterior superior iliac spine

Pass Criteria:

  • Iliopsoas and one other

Q5

XR: AP Pelvis

Describe the major bony features seen on this x-ray.
Prompt: Which bones can you see? Where do fractures usually occur?

  • Ilium
    • Crest
    • Anterior superior iliac spine
    • Inferior superior iliac spine
    • Anterior inferior iliac spine
    • Acetabulum
    • Sacro-iliac joint
  • Ischium
    • Body
    • Ramus
    • Tuberosity
    • Spine
  • Pubis
    • Symphisis
    • Inferior ramus
    • Superior ramus
    • Tubercle
    • Pectineal line
  • Sacrum
    • Vertebral foramina
    • L5-S1 joint
  • Coccyx
  • Femur
    • Head
    • Neck
    • Greater trochanter
    • Lesser trochanter
  • Acetabulum
    • Obturator foramen

Pass Criteria:

  • 15 features to pass

Demonstrate the important ligament attachments of the hip joint.

  • Iliofemoral ligament
    • Strong
    • Anterior superios iliac spine
    • Inferior intertrochanteric line
  • Pubofemoral ligament
    • Medial
    • Obturator crest pubis inferior-lateral to merge with capsule deep to iliofemoral ligament
  • Ischiofemoral
    • Posterior
    • Weakest of 3
    • From ischial part of acetabular rim superolaterally to femoral neck
    • Medial to base of greater trochanter
  • Ligament of head of femur
    • From acetabular notch to fovea for ligament of head of femur

Pass Criteria:

  • 2 of 4 to pass

Q6

Photo: Pelvis

Please demonstrate the major anatomical structures in the photo.

  • Aorta
  • Common iliac vessels
  • Internal & external iliac veins & arteries
  • Ureters
  • Bladder
  • Psoas muscle

Pass Criteria:

  • At least 8 to pass

Please describe the innervation of the bladder.

  • Presynaptic sympathetic fibers (T11-L2/3) via Hypogastric plexus
    • Excite internal urethral sphincter
  • Presynaptic parasympathetic fibers
    • Motor to detrusor and inhibitory to internal urethral sphincter (S2-4) via splanchnic nerve and inferior hypogastric nerve
  • These synapse with post synaptic neurone on or near bladder wall
  • Inferior to pelvic line (reflex & pain)
    • Visceral afferent follow parasympathetic fibers retrograde to S2-3 spinal ganglia
  • Superior to pelvic line (pain)
    • Follows sympathetic fibers retrograde to T11-L2/3
  • Somatic to external urethral spinchter, urethra via pudendal nerve (S2-4)

Pass Criteria:

  • To pass: describe the effects of sympathetic and parasympathetic stimulation on the bladder

Bonus question: Please identify any nerves that innervate the bladder.

  • Inferior/superior Hypogastric plexus
  • Left/right Hypogastric nerve
  • Splanchnic nerve

Q7

Media: Model of the pelvis.

Identify the bony landmarks of the pelvis.

  • 3 bones – ilium, ischium, pubis
  • Surface – iliac crest, ASIS, AIIS, ischial tuberosity, ischial spine, PSIS, PIIS, symphysis pubis
  • Joints – SI  joints, acetabulum/femur, symphysis pubis
  • Other – pubic rami (4), ala of ilium, greater/lesser sciatic notches, obturator foramen

Pass Criteria:

  • Bold to pass. 

Identify on the model the ligaments of the hip joint and their attachments.

  • Iliofemoral (AIIS/acetabular rim – intertronchanteric line)
  • Pubofemoral (obturator crest – capsule and iliofemoral ligament)
  • Ischiofemoral (acetabular rim – base of the greater trochanter)

Pass Criteria:

  • Bold to pass. 

Where might you find a pathological fracture on the model?

  • Pubic rami
  • Neck of femur
  • Proximal shaft

Pass Criteria:

  • 1 to pass. 

 

 


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