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Pelvic Anatomy


Ligaments of pelvis Sacro-iliac joints (ant/post sacro-iliac ligs); pubic symphysis; Sacrotuberous lig & sacrospinous lig form greater/ lesser sciatic foramina
Pelvic cav mx’s: Lateral wall Obturator internus; Piriformis; Both mx’sact on lower extremity; Piriformis attach to ant body of sacrum & runs out foramen
Pelvic cav bounded superiorly/inferiorly by: superiorly by abd cav; inf by pelvic floor
Inguinal ligament attaches: ASIS to pubic tubercle
Obturator mx's attach to: obturator membrane, which is closing the obt foramen
Characterize pelvic ligaments S-I joint = synovial; pubic symph = cartilaginous pad (not really ligament)
sacrotub lig attaches: sacrum to ischial tuberosity
sacrospinous lig attaches: sacrum to (coccyx and) to ischial spine
Females pelvis: Ilium more flared; Pelvic inlet circular; Wider sub-pubic angle
Males pelvis: Ilium more upright; Heart shaped pelvic inlet; acute sub-pubic angle
False pelvis (=inferior abdomen) vs. true pelvis False pelvis (=inferior abdomen): btw iliac blades; True: inferior; sep’d by the pelvic inlet (pelvic brim)
Weakness or damage to pelvic floor mx (& urethral & anal sphincters) can result in: Urinary or fecal incontinence (multifactorial symptom)
Female external genitalia (vulva) Mons pubis; Labia majora; Labia minora; Prepuce of clitoris; Glans of clitoris
Levator ani mx attachments: Ileococcygeus & pubococcygeus end in coccygeus; puborectalis forms sling around anal aperture and attach antly to (pubic bone?)
Perineal membrane Inf to pelvic diaphragm; attachment for external genitalia; openings for urethra and vagina
Position of uterus Body of uterus is anteverted over bladder; laterally continues & forms fallopian tubes
Stretching of broad ligaments during childbirth can contribute to: Prolapse of uterus through the vaginal canal
Contents of Spermatic cord: Testicular a.; Pampiniform plexus of veins; Ductus deferens; Lymphatics and nerves to testes
Hydrocele= Abnormal accumulation of fluid in the tunica vaginalis; a few poss causes (e.g., incomplete devt of parietal (scarpus fascia?)
Erectile tissues: male vs female Erectile tissues covered by ischiocavernosus (corpora cavernosa), and bulbospongiosus (bulbs of vestibule/ corpus spongiosum) muscles
Erectile Tissues- Arterial Supply Dorsal a. penis/clitoris; deep a. of p/cl; a. of bulb of penis (vestibular bulb)
NS ctrl: erection/ejaculation/orgasm Erection = parasymp ctrl (venous supply shut off); ejaculation/orgasm = symp ctrl
Path of sperm flow Testes -> Epididymis -> Ductus deferens -> Ampulla of ductus deferens -> (Seminal vesicle joins at) -> Ejaculatory ducts -> (Prostate joins at) -> Prostatic urethra -> Penile urethra
mx of pelvic cav: Lateral wall Obturator internus; Piriformis
mx of pelvic cav: Floor (pelvic diaphragm) Levator ani: 3 parts; Coccygeus
Mx forms most of pelvic diaphragm: Levator ani
Levator ani mx form 3 parts: ileococcygeus; pubococcygeus; puborectalis
Perineal membrane attaches to: post surface of pubic arch
perineal mem attach to: post surface of pubic arch (but not attach to ...)
Perineal body = post attachment of perineal mem; what is cut during episiotomy
Urogenital triangle Roots of external genitalia; Openings for urogenital system
Urogenital triangle formed by: pubic symph & ischial tuberosities
Anal triangle includes: Anal aperture
Anal triangle formed by: coccyx & ischial tuberosities
Parietal peritoneum drapes over: pelvic viscera
Sacral Plexus: level/type: L4 - S4 spinal levels; All are ventral rami
Sacral Plexus Innervates: Pelvic floor/wall muscles
Sacral Plexus Major branches: Sciatic n. (Leg, foot); Gluteal nerves; Pudendal n. (Perineum)
Pelvic splanchnic nerves Parasymp to hindgut, bladder, genitalia; S2-S4 spinal levels
Clin sig of pudendal n. site of nerve block during childbirth
Lymph drainage: Pelvic cavity Internal/ external iliac nodes -> lateral aortic nodes
Lymph drainage: Ovaries/ Testes: Drain directly to lateral aortic nodes
Female external genitalia collectively referred to as: the vulva
Female Erectile Tissues Corpora cavernosa; Bulbs of the vestibule; Glans clitoris
Corpora cavernosa Crura of clitoris = erectile tissue (pair)
Crura of clitoris attach: along pubic arch
Bulbs of vestibule: Anchored to perineal membrane; surround vaginal opening, either side
Female repro organs Vagina, Cervix; Uterus; Uterine tubes; Ovaries
Round ligament of uterus = remnant of gubernaculum in female
Vagina: Anterior wall contacts: bladder
Vagina: Posterior wall contacts: rectum
Vagina: Blood Supply: Vaginal a./v.
Vagina: Innervation: Upper 2/3 visceral sensory;
Cervix: parts External os; Cervical canal; Internal os
Vagina: surgical approach to abdomen via: posterior fornix
Cervix = actually part of the: uterus
Uterus: parts Body; Fundus
3 layers of tissue in uterine fundus Perimetrium; Myometrium; Endometrium
Uterine Blood Supply: Uterine a./v.
Ovarian blood supply ovarian a.; ovarian v. (R drains to IVC; L to L renal v.)
Uterine tubes (aka fallopian tubes): parts Isthmus; Ampulla; Infundibulum; Fimbrae
Most fertilizations occur in: ampulla of uterine tube
Some ectopic PGs can result in: ruptured uterine tube (v dangerous)
Sites of poss ectopic PG see S22
Broad Ligament = Peritoneum draped over uterus, uterine tube, and ovary
Ovaries: size approx 3cm long
Ovaries: location On lateral wall of true pelvis; Suspended by broad ligament
Ovarian ligament: Remnant of gubernaculum; Attaches ovary to uterus
Penis: parts shaft; glans
Scrotum: function Houses spermatic cord and testes
R/L compartments of scrotum divided by: median septum
Spermatic cord: layers from: anterior abdominal wall
Testes = 4 cm long; Covered by tunica albuginea
Tunica albuginea fn: Keeps seminiferous tubules together
Testes partly covered by: tunica vaginalis
Tunica vaginalis = remnant of processus vaginalis
Testes contain: seminiferous tubules
Testes: surrounded by: surrounded (on one side) by the epididymis
Testes: Connected to urethra via: ductus (vas) deferens
2 spongy erectile tissues of penis: Corpus spongiosum (1); Corpora cavernosa (2)
Corpus spongiosum is (ventral/dorsal) & contains: ventral; urethra
Corpora cavernosa is (ventral/dorsal)? dorsal
Penis: visible Half; root (not visible) = in perineal region
Penis covered by: loose skin (prepuce) that covers the glans
Attached part of corpus cavernosum = Crus (of penis/clitoris)
Prostate 25-30% semen vol; at base of bladder, surrounding urethra
Seminal vesicles 60% semen volume; joins ductus deferens at ejaculatory ducts
Created by: Abarnard



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