pelvic area and perineal area Flashcards
bulbospongiosus attachments and actions male
from median raphe and perineal body to surround bulb of penis empties urethra, maintains erection, contracts during ejaculation
ejaculatory ducts
slender tubes that rise from the union of ductus deferns and seminal glands. are on the neck of the bladder and pass anterioinferiorly through middle part of prostate alongside prostatic utricle.
Pelvic cavity functions
contains and supports bladder, rectum, anal canal and reproductive tracts
fundus of bladder
opposite apex, formed by posterior wall
what contributes to semen
sperm from ductus deferens nutrient rich material from ejaculatory duct prostatic juices from prostate fluid from bulbourethral glands
ampulla of ductus deferns
enlargement on posterior side of bladder just before it meets with seminal glands
bulb of vestibule
paired masses of elongated erectile tissues along side vaginal orifice, superior or deep to labia minora and immediately inferior to perineal membrane. homologus to bulb of the penis
dartos fascia
continuous with perineal fascia to cover the penis and scrotum.
Neck of bladder
where the fundus and inferolateral surfaces meet inferiorly on the bladder, just above the urethra.
Apex of bladder
points towards superior edge of pubic symphysis
scrotum
cutaneous fibromuscular sac for tests and associated structures. scrotal raphe separates the two sides and is continuous with penile raphe and perineal raphe. septum dartos muscles
what gland is most posterior in the penis
corpus cavernosum (2) fused
Infundibulum
distal end of the uterine tube that opens into the peritoneal cavity with the fimbriae.
Ischial ramus attachments
ischiocavernosus compressor urethrae m
pudendeal cleft
central depression when thighs are adducted, wihtin which is the labia minora and vestibule
bulbospongiosus m. females action and attachments
perineal body to surround vestibular bulb, vaginal oriface and clitoris constructs vaginal orifice, contributes to erection of clitoris
middle rectal a.
anterior diviision of internal iliac descends in pelvis to inferior rectum supplies inferior rectum, seminal glands, and prostate. @superior and inferior rectal a.
female urethra
short and passes anterioinferely from urinary bladder orifice is located between labia minora
trigone
space on internal part of bladder between the two ureters and urethra rich in receptors that are sensitive to stretching to signal brain of a full bladder.
nerve blocks of pudendal and ilioinguinal
are only somatic nerve blocks and will not block pain from uterine contraction. must do a spinal block at L3-4
pubic symphysis
symphysis joint between pubic bones on either side of pelvis has fibrocartilaginous inter-pubic disc
Obturator internus muscles
covers and pads the lateral pelvic walls from anterolateral wall of pelvis, obturator foramen and obturator membrane through the lesser sciatic foramina to medial surface of greater trochanter innervated by sacral plexus (nerve of obturator internus) bloody supply from obturator and internal pudendal a.
Superior pubic ramis features
pecten pubic obturator groove
inferior vesicle artery
only in males, is replaced by vaginal artery in females off of the internal iliac, inferior gluteal branch origin: anterior internal iliac passes subperitoenally in lateral ligament of bladder suppies inferior male bladder, prostate, seminal glands
ischiocavernosus muscle females att and actions
ischial tuberosity and ramus to aponeurosis surrounding crus of the clitoris compresses crus during erection
Emission
sperm is delivered to prostatic urethra rhythmic contraction of ductus deferens and ejaculatory duct sympathetic L1-2
Dorsal surface of sacrum attachements
erector spinae, gluteus maxiumus m, sacrotuberous and sacrospinous ligament
name for foreskin
prepuce
Pelvic inlet
defined by the ridge of bone from superior sacrum to superior pubic symphysis opening into true previs
Body of the penis
free pendulous part of penis corpus spongiosum glands corpa cavernosum
Erection innervation
Blood dilates cavernous spaces in corpora of penis requires relaxation of smooth muscles in helicine arteries Parasympathetic S2-4 from prostatic plexus This causes blood to fill into helicine a. and compress the dorsal vein so it is pinched off. bulbospongiosus and ischiocavernosus also contract to keep blood in distal portion of penis
Promotory attachments
on top of sacrum attaches to anterior longitudinal ligmanet
Anterior superior Iliac Spine attachment
inguinal ligmanet
Fundiform ligament of the penis
irregular mass of collagena nd elestic fibers that descent in midline from linea alba anterior to pubic symphysis. it splits to surround the penis and then unites and blends with dartos fascia to form scrotal spetum lie superficial to suspensory ligament
tunica albuginea
outer fobrous covering of each cavernous body in the penis
Ureters path
muscular tubes that connect kidney to urinary bladder retroperitoneal cross over bifurcation of common iliac artery and pass over pelvic brim to enter lesser pelvis. Run along lateral walls between pelvic peritoneum and internal iliac arteries. They then curve antero-medially, superior to levator ani and enter urinary bladder obliquely.
what is inferior to pevic outlet
perineal area
Tendinous arch
tendinous arch of levator ani thickening of obturator fascia between pubis and ilium pelvic diaphragm attaches to it covers the obturator internus muscle
Pecten pubic attachments
conjoined tendon, lacunar and pectineal ligaments
glans of clitoris
most outward projection at tip of bodies
Cardinal ligmanet
transverse cervical: extend from supravaginal cervix and later parts of the fornix to the vagina to the lateral walls of the pelvis
Ligament of the ovary
peritoneum fold that tether the ovary to the uterus. This is a remnant of the female gubernaaculum.
Sphincter urethrovaginalis att and actions
from perineal body, surrounds vagina and urethra to meet contralateral muscle inferior to compressor urethra deep to perineal membrane compresses urethra and vagina
Fundus of uterus
superior to where the uterine tubes split off
arterial supply of vulva
internal pudendal arteries.
Obturator fascia
covers the pelvic surface of the obturator internus muscle
Ischial spine attachments
levator ani, coccygeus m. sacrospinous ligament
Perineal membrane
stretches between the two sides of the pubic arch and covers urogential triangle. fills anterior aspect of pelvic diaphgram, but is perforated by urethra and vagina. Has foundation of erectile bodies of the external genetalia of penis and scrotum, and vulva for females. separates the deep pouch from the superficial pouch
Round ligament of the uterus
remnant of the gubernaculum lower part, goes through inguinal ring to attach to the labium majora distally
Interosseous sacroiliac ligmanet
lies deep between the tuberosities of sacrum and ilium between articular surfaces of sarcum and ilium responsible for transferring weight of the upper body from the axial skeleton to the two ilia of appendicular skeleton
sacrospinous ligament
passes from ischial spine to lateral margin of sacrum subdivides foramen into greater and lesser sciatic foramina
lumosacral trunk
L4 and L5 and passes inferiory to ala of sacrum to join sacral plexus
Ovaries
female gonads located usually inferior to the uterine tubes. not covered in peritoneum.
Bulb of penis
enlarged posterior part of the bulb formed by corpus spongeosum gland
what two ligaments support the cervix and uterus
uterosacral ligmanet cardinal ligment
what parts of the uterus are covered by the peritoneum?
all areas anteriorly and superiorly except the cervix.
Median sacral crest
spinous process of sacrum erector spinae gluteus maximus
prepuce of clitoris
foreskin of clitoris that covers up the glans of the clitoris anterior to labia minora
how does urine move through ureters
peristaltic contractions
colliculus semilunaris
rounded eminence of urethral crest in prostatic segment of urethra contains the prostatic utricle
rectouterine pouch
pouch created between uterus and rectum created by peritoneum adhering to posterior vaginal wall and reflecting superiorly on anterior part of rectum
membranous segment of urethra
intermediate part of urethra that goes through the deep perineal pouch
veinous drainage of vagina
vaginal venous plexus which are continous with uterovaginal venous plexus
pelvic outlet
defined by ischial spines, pubis, sacrum and coccyx
ampulla of rectum
lies just superior to and supported by pelvic diaphragm and anococcygeal ligamanet receives and hold fecal matter until defecation
Mesovarium
ligament that surrounds the ovary on posterior side
fimbria
finger like processes at the end of the infundibulum of the uterine tube that spread over the medial surface of the ovary
testicular a. males
origin: abdominal aorta Descends retroperitoneally to transverse the inguial canal and enter scrotum. blood supply to: abdominal ureter, testis, and epididymis anastomeses with cremasteric a and ductus deferens a.
perineal membrane spaces
the perineal membrane is still has open spaces with the anterior recess of the ischioanal fossa and the deep postnatal space.
Greater vestibular gland
located in superficial perineal pouch lie on each side of the vestibule, posterolateral to the vaginal orifice. round or oval and partly overlapped by bulbs of vestibule. secrete mucus during sexual arousal
Deep fascia of the penis
also known as buck fascia continuation of deep perineal fasica srrong membranous covering of corpa caveronosa and spongiosum and binds them together
vesicouterine pouch
formed by peritoneum reflecting on the uterus and posterior superior surface of the bladder
bulbospongiosus muscles
form a constrictor that compresses the bulb of the penis and the corpus spongiosum.
pubis body attachments
levator ani
Lumbosacral joint
symphysis joins 5th lumbar vertebra and base of sacrum
urogential triangle
anterior to the line formed between the ischial tuberosities closed by a thin sheet of tough, deep fascia, the perineal membrane. houses the urethra and vagina (in females)
Pelvic diaphragm
inferior border of the pelvic cavity from pubic symphysis to coccyx and sacrum
Mons pubis
is the rounded fatty eminence anterior to pubic symphysis, pubic tubercles and rami. covered with hair
iliolumbar
posterior division of internal iliac ascends anterior to sacroiliac joint and passes posterior to common iliac vessels and psoas major supplies: psoas, iliacus, QL, cuada equina
Lesser sciatic notch function
transmits obturator internus tendon, pudendeal n., and internal pudendal a and v
Changes in size of uterus
starts small and increases during pregnancy and puberty Post-partum, takes a while to shrink back to normal size (with multiple births it might not shrink back) Menopause, goes back to pre-puberty size
innervation and blood supply of levator ani
pudendal n and S4 inferior gluteal, internal pudendal, inferior rectal, and inferior visceral a
Benign prostate hypertrophy
with advancing age, prostate starts to grow around urethra and compresses on urethra –> difficult and painful urination
anal triangle
formed posterior to the lines between the ischial tuberosities houses the anal canal and its orifice.
Anterior commisure
part of labia major, thickness where they join anteriorly
Urinary Bladder
most anterior pelvic viscera made up of four surface features: apex, fundus, neck, and urachus sac made of detruser msucles
Peritoneum in pelvic cavity
continuous with abdominal cavity but does not reach pelvic floor, instead reflects on pelvic viscera. Only covers completely uterine tubes.
perineal body
deep the skin posterior to the vestibule or bulb of the penis and anterior to anus. site of convergence for interlacing fibers of: bulbospongiosus external anal sphincter superficial and deep transverse perineal muscles
Uterus
thick-walled pear shaped organ. body lies on the urinary pladder and its cervis is between the bladder and rectum made up of: fundus, corpus, and cervix
sphincter ani externus muscles action and attachments
from perineal body to anococcygeal raphe closes anal canal and fixes perineal body
Root of the penis
the attached part has crura and bulb ischiocavernsus and bulbosponiosus muscles found in superficial perineal pouch
perimetrium
out surface of the uterus made of connective tissue
innervation and blood supply of coccygeus
ventral rami S4-5 inferior gluteal, internal pudendal and inferior rectal a.
umbilical artery
Origin: anterior division of internal iliac pass along lateral pelvic wall and ascent to anterior abdominal wall through umbilicial ring into umbilical cord. prenatally: conduct oxygen and nutrient deficient blood to placenta for replenishment after birth, vessels no longer function and become occluded distal to branches to bladder. patent afts from anterioinferely between urinary bladder and lateral wall of pelvis.
sacral canal
houses sacral spinal roots
piriformis m.
most posterior aspect of pelvic cavity from anterolateral sacrum through the greater sciatic foramin to upper border of the greater trochanter deep is the sacral plexus innervation: lumbosacral plexus blood supply: lateral sacral, superior gluteal, internal pudendal a.
pariteal pelvic fascia
membranous layer that lines inner aspect of muscles forming walls and floor of pelvis. contains obturator fascia continous with trasversalis and ilipsoas fascia
male internal reproductive organs
Tests epididymis ductus deferens seminal glands ejaculatory ducts prostate bulbourethral glands bladder, urethra
blood supply to vagina
uterine arteries, vaginal and internal pudendal a.
bulbourethral glands
posteriorlateral to intermediate part of urethra, embedded within the external urethral sphincter. the glands pass through perineal membrane and open through small aperture in spongy urethra in the bulb of the penis.
apex of sacrum
articulates with coccyx
why do the ureters enter obliquely?
to act like a sphincter to prevent backward movement of the urine from the bladder.
uterus position
anteverted and anteflexed flexion: determined by axis between cervix and body of uterus version: between vaginal canal and cervix
spongy segment
urethra within sulbospongy erectile tissue to external urethral orifice.
Cervix
cylindrical, narrow inferior third of the uterus. there is a supravaginal part between the isthumus and the vagina and a vaginal part that protrudes into the vagina.
Internal iliac nodes
drain pelvic visera, perineum, gluteal region
Vestibule of vagina
space surrounded by labia minora with orifices of urethra and vagina, and ducts of greater and lesser vestibular glands.
ductus deferens a.
branch from superior vesicle a. runs subperitoneally to ductus deferens. @ testicular and cremasteric
superior gluteal a.
posterior division of internal iliac exits via great sciatic foramen supplies piriformis, gluteal muscles, TFS
Greater Sciatic Notch
transmits Piriformis m, superior and inferior gluteal a., sciatic n., pudendal, superior and inferior gluteal n.
urogential hiatus
space in between the medial borders of the levator ani muscles that gives passage to the urethra and vagina (in females)
internal pudendal a.
from anterior internal iliac exits pelvis vis great sciatic foraman to enter perineum vis lesser sciatic foramen, passes into uretogential triangle. main artery of perineum, muscles and skin of UG triangle and erectile bodies.
superior vesicle a.
origin: Internal iliac anterior sometimes has ductus deferens branch. passes to superior aspect of urinary bladder.
obturator n.
from L2-4 anterior rami of lumbar plexus. runs along lateral wall of pelvis to obturator canal in obturator membrane. does not supply pelvic structures
arterial supply of the uterine tubes
ovarian a. supply ovary and runs medially along the uterine tube. ascending part of the uterine arteries
prostatic utricle
remnant of embryonic uterovaginal canal
Inferior pubic ramus attachments
ischiocavernosus, compressor urethrae
lateral sacral a.
posterior division of internal iliac runs on anteriomedial aspect of piriformis and sends branches into pelvic sacral foramina supplies piriformis, structures in sacral canal, erector spinae, skin
How does the prostate contribute to semen?
prostatic juices join the urethra through the 20-30 openings called prostatic sinuses
Internal iliac a.
origin: common iliac passes medially over pelvic brim and descens into pelvic cavity to split into anterior and posterior division. supplies blood to pelvic organs, gluteal muscles and perineum.
Female external genitalia
mons pubis, labia majora, labia minora, clitoris, bulb of vestibule, and greater and lesser vestibular glands
prostatic segment
segment of urethra that runs through the prostate contains prostatic sinus and colliculus semilunaris
fascia of the penis
fundiform ligmanet suspensory ligmament superficial deep tunica alberginea
Internal vs external hemorrhoids
prolapse of the internal rectal pelxus, stretches mucosa. Not very painful for internal, but must more painful for external due to somatic innervation.
cardinal ligament
endopelvic fascia thickening passes medially to the uterine cervix and vagina also calle transverse cervical ligmaent
Helicine arteries of the penis
when penis is flaccid these are coiled and restrict blood flow
superior rectal a.
origin: inferior mesenteric a. crosses left common iliac vessels and descens between layers of sigmoid mesocolon to supply superior rectum. @ middle rectal and inferior rectal
uterine artery
branch of inferior gluteal homologous to ductus deferens in males. descends lateral wall of pelvis anterior to internal iliac and masses medialy to reach junction of uterus and vagina at cervix protrusion into vagina. passes superiorly to ureter as it passes medially. “water passes under the bridge” divides into vaginal branch and ovarian branch.
Ventral sacrioiliac ligament
anterior part of the fibrous capsule of the sacroiliac joint
deep arteries of the penis
peirce the crura proximally and run distally near center of corpora cavernosa
Pelvic diaphragm muscles
levator ani coccygeus
Broad ligament of the uterus
mesovarium mesosalpinx mesometrium all made up for peritoneum that extend from the lateral sides of the uterus that to the pelvis.
where is the spongy urethra found
in corpus spongiosum
Perineal membrane
defines the deep boundary of the superficial perineal space and the inferior boundary of the deep perineal space
intramural part of urethra
in the nick of the bladder, contains a sphincter to prevent semen from going into bladder during ejaculation
arterial supply of uterus
uterine arteries and some from ovarian a.
Penis
consists of a root, body, and glans composed of corpora cavernosa (dorsally) and corpus spongiosum (ventrally)
prostatic sinus
bilateral groove in the prostatic segment of the male urethra
three kinds of sacroiliac ligmanets
dorsal, ventral, and interosseous
Vaginal fornices
small spaces formed by the vaginal portion of the cervix and the vaginal wall anteriorly and posteriorly and laterally
Iliopubic eminence attachments
pubofemoral ligament
Ductus Deferens
thick muscular walls and small lumen begins at the tail of the epidiymis, inferior to pole of testis ascents posterior to testis, medial to epididymis runs through inguinal canal Crosses over external iliac vessles passes superior posterior to the bladder, medially around the ureter down the posterior side of bladder towards head of prostate
Medial umbilical ligmanet
formed from occluded part of the umbilical artery. gives rise to medial umbilical fold on anterior abdominal wall.
pectinate line
zip-zag line that has anal columns and valves that release mucus. demarcates difference between tissues that are visceral and somatic.
iliac tuberosity attachments
dorsal sacroiliac, interosseous sacroiliac and iliolumbar ligaments
coccygeus muscle attachments and actions
from ischial spine and sacrospinous ligament to coccyx supports and compresses posterior pelvic floor
Isthmus
the thick walled part of the tube that enters the uterus
Ejaculation
contraction of internal urethral sphincter by sympathetic L1-2 to prevent semen from going into bladder (sympathetic) contraction of urethral muscles (parasympathetic S2-S4) contraction of bulbospongiosus m. by perineal branch of pudendal n. S2-4
Iliac fossa attachment
iliacus muscles
uterosacral ligmanet
ligament from sacrum to uterus cervix endopelvic fascia thickening
Superficial perineal fascia
Colle’s fasia continuous with the superficial fascia of the penis and scrotum; defines superficial boundary of the superficial perineal pouch or space
pelvic floor injuries
may lead to urinary incontinence or prolapse of perineal organs
Pelvic fascial ligaments for women
found inferior to the peritoneum, but superior to the pelvic diaphragm. obturator fascia tendinous arch of levator ani uterosacral ligmanet cardianl ligmaent
isthmus of uterus
narrowing of the uterine body just superior of the cervix demarcates the end of the corpus of the uterus.
Pelvic cavity
there is no muscle or diaphragm barrier superiorly, just the bony landmarks of the pelvic inlet inferior border of the pelvic diaphgram contains elements of urinary, gastrointenstinal and reproductive systems
inferior gluteal a.
anterior division of internal iliac. exits pelvis via great sciatic foramen supplies: pelvic diaphragm, piriformis, quadratus femoris, hamgstrings, gluteus maximus
Dorsal arteries of the penis
run on each isde of deep dorsal vein between corpora cavernosa.
external iliac nodes
drain inguinal nodes, abdominal wall, perineum and lower pelvic visera
Anococcygeal ligmanet
ligament between anus and coccyx, part of the fibrous midline raphe attachment site of levator ani
pudendal canal
a horizontal pathway within the obturator fascia that covers the medial aspect of obturator internus.\ Internal pudendeal a, v, and pudendal n., enter at LSN supply nerves and blood for most of perinuem
obturator a.
anteroinferiorly on the obturator fascia on lateral wall of pelvis and passes between obturator n. and vein. in obturator canal supplies pelvic muscles, head of femur and medial thigh
What gland is most anterior in the penis
corpus spongiosum
Mesosalpinx
forms the free anterior superior edge of the broad ligmanet goes around uterine tubes.
Two types of pelvic fractures
anterior and superior (around pubic symphysis) central fracture of acetabulum
pubic tubercle
rectus abdominis and inguinal ligament
seminal glands function
rich fluid that contributes to the semen to nourish the sperm
Labia Majora
prominent fold of skin that indirectly protect the clitoris, urethra and vaginal orifices subcuteneous tissue and termination of round ligament of uterus. covered with pigmented skin and pubic hair
Iliacus muscle
from iliac fossa to lesser trochanter of femur Stabalizes the hip joint and flexes thigh innervated by femoral nerve and pumbar plexus branches iliolumbar, deep circumflex iliac, femoral and obturator a.
Iliac crest attachments
external oblique, internal oblique, transversus abdominis and quadratus lumborum
sacral plexus
gives rise to the sciatic and pudendal nerves
rectum
continuous with sigmoid colon
Ischial tuberosity attachments
sacrotuberous ligament
compressor urethrae muscles att and action
ischiopubic ramus to midline passing ventral to urethra and inferior to sphincter urethrae in females there are multipe fibers fanning out medially and can replase deep transverse perineus m. compresses urethrae
what is superior to true pelvis?
false pelvis or greater pevlis cecum and descending colon
bulbourethral glands
located adjacent to the membranous part of the urethra just above perineal membrane, with ducts more distal in spongy urethra release mucus like substance to lubricate the urethra
Clitoris
erectile organ where labia minora meet anteriorly. has a corpus, crus, and glans.
ischioanal fossa
distal part of the rectum and anal canal opening. wedge shaped spaces between skin of anal region and pelvic diaphragm. filled with ischioanal fat that supports the rectum. if you don’t have this, it could prolapse
veinous drainage of uterus
uterine venous plexus
Psoas m
from anterior lumbar transverse processes, vertebral bodies and discs to lesser trochanter of femur stabilizes hip joint, flexes thigh ventral rami L1-3 lumbar, iliolumbar, obturator, external iliac and femoral a.
venous drainage of bladder
vesical venous plexus which is continusous with prostatic venous plexus.
Seminal Glands (vesicle) location
elongated structure that lies between the fundus of the bladder and the rectum obliquely superior to prostate with ductus deferns running medially.
Corpus of uterus
the body of the uterus, forming the superior two thirds of the viscera. has two surfaces: vesicle (bladder) and intestinal.
Base of the sacrum
articulates with the 5th lumbar vertebrae
ischiocavernosus m., attachments and actions men
from ischial tuberosity and ramus to aponeurosis surrouding crus of penis compresses crus during erection
Midline raphe
Where the two sides of the pelvic diaphragm attach in the middle
the septum of the scrotum
prolongation of dartos fascia that divides the scrotum into two sides. (internally)
Visceral pelvic fascia
membranous fascia that directly ensheaths pelvic organs
superficial transverse perineus innervation and blood supply
perineal brach of pudendal nerve internal pudendal a.
What attaches to pelvic surface?
piriformis m.
uterosacral ligmanets
pass superiorly and sightly posteriorly from the sides of the cervix to the middle of the sarcum
Prostate
surrounds the prostatic urethra gland and muscle inferior and slightly posterior to the bladder posterior suface is in contact with the rectum.
Suspensory ligament of the ovary
peritoneum that covers the blood vessels that go to the ovaries.
meometrium
connect the uterus to the ovary, very broad stucture
Crura
attaches to the inferior part of the internal surface of corresponding ischial ramus forms due to the fusion of the corpus cavernosa dorsal side of penis
ischiocavernosus m. innervation and blood supply
perineal brach of pudendal n. internal pudendal a.
Arterial supply of bladder
superior vesicle and inferior vesicle (males) and vaginal arteries (females)
labia minora
rounded folds of fat-free hairless skin eclosed in pudendal cleft surround and close over vestibule of vagina and the clitrois
Coccyx attachments
coccygeus muscle
lateral aortic nodes
para-aortic drain kidneys, suprarenal glands, ureter, posterior ab wall, testes, ovaries, uterine tubes, superior uterus, and iliac nodes common iliac nodes external iliac nodes internal iliac nodes
what is the glans of the penis?
formed distally by enlargement of the corpus spongiosum
Pubic crest attachment
rectus abdominis
sacrotuberous ligament
from posterior iliac spine and lateral margin of sacrum to ischial tuberosity transforms sciatic notches of hip bone into the large sciatic foramen
Ureters in males
ductus deferens passes anteromedial to the ureter. ureter enters the bladder just superior to the seminal gland.
Perineum
shallow compartment bounded by pelvic outlet and separated by fascia covering the inferior aspect of pelvic diaphragm formed by levator ani and coccygeus muscles.
frenulum of clitoris
where the medial laminae of the labia minora unite. and also posterily connects (frenulum of labia minora)
endometrium
internal layer marked change during the monthly cycle when it sheds implantation of the embryo.
Pelvic fracture of the pubic symphysis
posterior and anterior fracture causes fracture of pubic symphysis and inferior and superior pubic ramus loss of stability of pubic girdle high risk of injuring pelvic visera
Male Urethra
long with 2 major bends four segments: intramural part, prostatic segment, membranous segment, spongy segment
bulbospongiosus m innervation and blood supply
perineal branch of pudendal n. internal pudendal a.
posterior division of internal iliac
passes posteriorly and supplies pelvic wall and gluteal region
sacroiliac joint
synovial plane between articular surfaces of sacrum and ilium limited mobility transmits most of the weight of the body to the hip bones
what is inside the superficial perineal pouch?
erectile bodies/spongy tissues, skeletal muscles that surround this bodies, openings of urethra and vaginal canal
coccygeus muscle relations to piriformis and levator ani
is anterior to piriformis posteiror to levator ani
Obturator groove function
transmits obturator n., a, and v
Function of pelvic sacral foramina
transmits ventral rami or sacral nerves and lateral sacral artries
posterior commisure
joining of posterior labia majora in nulliparous women. overlies perineal body.
Perineam
inferior to pelvic cavity boundaries form the pelvic outlet contains external genitalia and external openings of genitourinary and gastrointestinal system
urachus
fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord located at tip of apex
Innervation of vulva
Mons pubis and anterior labia (anterior aspect) ilioinguinal, genitofemoral n. posterior: sacral plexus derivatives: posterior cutaneous nerve of the thigh, pudendal nerve. deep branches of perineal nerve supply vagina and superficial muscles dorsal n. of clitoris deep perineal m and clitoris
myometrium
main muscular compartment of the uterus extends and stretches, especially during birth and menstruation.
venous pelexus of the uterus
pampiniform plexus of veins which forms a single ovarian vein.
internal bladder features
urethral orifices ureteric orifices trigone
pudendal n.
main nerve or perineum and external genetalia leaves GSF between piriformis and coccygeus, then hooks around ischial spine and sacrospinous ligament to enter perineum through LSF inferior rectal perineal n. dorsal nerve of clitoris or penis
Broad ligament of the uterus
extends between uterus and lateral pelvic wall separate the paravesicle fossae and pararectal fossae encloses uterine tubes, ovaries, ligaments of ovaries and round ligament of uterus
superficial transverse perineus att and action
from ischial tuberosity to perineal body fixes perineal body
innervation of vagina
only inferior 1/4 is somatic - by deep perineal nerve (branch of pudendal n): sympathic and visceral afferent nerves from hypogastric plexus which has symphatic and parasympathetic and visceral afferent
vaginal artery
homolog in inferior vesical artery divides into vaginal and inferior vesicle branches to supply lower vagina, vestibular bulb and fundus of bladder. @uterine a.
what is inside the deep perineal pouch?
external uretral sphincter, urethra, bulbourethral glands (M), and vaginal canal (F)
venous drainage of vulva
internal pudendal vein
Ampulla
widest and longest part of the tube which begins at the medial end of the infundibulum. fertilization occurs in the ampulla
supravesical fossa
space created by peritoneum reflecting on the superior surface of the bladder.
crus of clitoris
attach to inferior pubic rami and perineal membrane, deep to the labia.
Sphincter urethrae m
surround urethra and is deep to compressor urethrae compresses urethra
Dorsal sacral foramina function
transmits dorsal rami of sacral nerves
ischiocavernosus muscles in male
surround the cura at the root of the penis
levator ani attachements and actions
pubic symphysis, obturator fascia, ischial spine to midline raphe and anococcygeal ligament supports pelvic viscera and compresses rectum and vagina
innervation of ureter
adjacent autonomic plexuses (renal, aortic, hypogastric)
Dorsal sacroiliac ligmanets
from lateral sacral crest to posterior superior iliac spine
Ovarian a.
origin: abdominal aorta descends retroperitoneally to cross the pelvic brim and descends in ligament of ovary supplies abdominal and/or pelvic ureter, ovary, and ampulla of uterine tube @ with uterine a
Corpus of the clitoris
makes up the body of the clitoris on either side of the orifices
common iliac nodes
drain internal and external iliac nodes
Uterine tubes
conduct oocytype discharged monthly extend laterally from uterus and open into the peritoneal cavity superior to the ovaries (usually) divided into four parts: fimbria, infundibulum, ampulla, ithmus
suspensory ligament of the penis
condensation of deep fascia from the anterior pubic symphysis passes inferiorly to splits to form a sling that attaches to deep fascia at junction of root and body. anchors erectile bodies to pubic sympysis
Internal iliac artery
principal artery of the pelvis divides into anterior and posterior division at the superior edge of greater sciatic foramen
how to ejaculatory ducts release into the urethra?
open in the seminal colliculus by tiny, slit like aperture on the prostatic utricle
internal iliac veins
form superior to the greater sciatic foramen and lie posteroinferior to internal iliac arteries. tributaries roughly accompany arteries. no umbilical veins
Vagina in pelvic area
distensible musculomembranous tube that extends from cervix of uterus to vaginal orifice. has two fornices
