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Learning Objectives Pelvic Walls and Floor a. Understand the position, attachments and major divisions of the pelvic diaphragm. b. Define the difference between levator ani muscle and pelvic diaphragm. c. Understand how the pelvic and urogenital diaphragms close the pelvic outlet.
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Learning Objectives Pelvic Walls and Floor a. Understand the position, attachments and major divisions of the pelvic diaphragm. b. Define the difference between levator ani muscle and pelvic diaphragm. c. Understand how the pelvic and urogenital diaphragms close the pelvic outlet. d. Describe the relationship of pelvic organs to the pelvic and urogenital diaphragms. e. Describe the distribution of the branches of the internal iliac artery. f. Describe the arrangement and distribution of pelvic autonomic nerves. g. Describe the pelvic position of the sacral plexus and understand how the major nerves from this plexus exit the pelvic cavity.
Superior fasca UG diaphragm Urethral hiatus Puborectalis m. Anorectalhiatus Iliococcygeus m. Tendinous arch Obturator internus m. Pubococcygeus m. (Ischio)coccygeus m. Piriformis m. Plate 340
Pubococcygeus m. Urethra Iliococcygeus m. Vagina Rectum Tendinous arch Piriformis m. (Ischio)coccygeus m. Plate 338
Piriformis m. Obturator internus m. Tendinous arch Iliococcygues m. (Ischio)coccygues m. Rectum Pubococcygeus m. Urethra Vagina Plate 338
Puborectalis muscle Moore et al; Fig. 3.12
Rectum Obturator internus m. Fat in ischioanal fossa Anal canal Levator ani m. (iliococcyxageus) Pudenal canal with pudendal n, internal pudendal a. and v. Plate 372
Deep dorsal vein of penis Dorsal artery of penis Dorsal nerve of penis Deep artery of penis Urethra Duct of bulbourethral gland Artery of bulb of penis Superficial transverse perineal m. Plate 363 Ischial tuberosity
Sympathetic trunk Gray rami communicantes Pelvic splanchnic nn. Sacral splanchnic nn. (Ischio)coccygeus m. S4 nerve supply to muscles of pelvic diaphragm Netter,Plate 487 Levator ani m.
L. Common iliac a. L. Internal iliac a. Iliolumbar a. Uterine a. Lateral sacral aa. Sup. gluteal a. Obturator a. Umbilical a. Sup. vesical aa. Inf vesical aa. Inf. Gluteal a. Middle rectal a. Internal pudendal a. Plate 382
Rt. Internal iliac a. Ureter Sup. gluteal a. Obturator a. Piriformis m. Umbilical a. Inf. Gluteal a. Internal pudendal a. Middle rectal a. Plate 382 Uterine a.
Uterine artery in transverse cervical ligament Supravaginal part of cervix URINARY BLADDER Ureter Plate 344
Sup. gluteal a. Obturator a. Inf. gluteal a. Umbilical a. I Internal pudendal a. Inf. vesical a. Prostatic venous plexus Plate 383
Prevertebral ganglia (sympathetic) Gray rami communicantes Superior hypograstic plexus Ventral ramus, S1 Pelvic splanchnic nn. Inferior hypogastric plexus Lumbar splanchnic nn. Vesical plexus Pudendal n. Prostatic plexus Left hypogastric n. Plate 390
Lumbar splanchnic nn. Gray ramus communicantes Superior hypogstric plexus Rt. and left hypogastric nn. Inferior hypogastric plexus Sacral splanchnic nn. Plate 392 Pelvic splanchnic n
External iliac nodes Deep ingiunal nodes Superficial inguinal nodes Plate 388