PELVIS AND PERINEUM.

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Presentation transcript:

PELVIS AND PERINEUM

Bony Pelvis Review bones of pelvic girdle. Pelvic brim: = superior outlet. Boundaries: Sacral promontory. Arcuate lines. Iliopectineal line of pubis. Greater (false) pelvis: = expanded area above pelvic brim.

Bony Pelvis Pelvic outlet: Bounded by: Lesser pelvis: Coccyx, sacrotuberous ligaments, ischial tuberosities, ischiopubic rami, pubic symphysis. Lesser pelvis: Portion of bony pelvis below pelvic brim. Closed below by pelvic diaphragm.

Pelvic Diaphragm Levator ani: Consists of: Puborectalis: forms a sling around anorectal junction. Pubococcygeus. Iliococcygeus.

Pelvic Diaphragm Levator ani: Ischiococcygeus. Forms muscular sling supporting pelvic organs. Incomplete anteriorly to allow for passage of urethra and vagina. Ischiococcygeus.

Urogenital Diaphragm Layer of skeletal muscle between two layers of fascia: Penetrated by membranous urethra (male and female) and vagina. Ischiorectal fossa: Wedge-shaped space between: Anal canal, obturator internus, pelvic diaphragm, skin.

Perineum Diamond-shaped area below pelvic Diaphragm: Same boundaries as inferior pelvic aperture. Divided into two triangles: Anal triangle. Urogenital triangle.

Viscera of Male Pelvis Seminal vesicle. Ductus deferens. Ejaculatory duct. Prostate gland. Urethra: Prostatic. Membranous.

Viscera of Female Pelvis Ovaries. Uterine tube (Fallopian tube; oviduct): Infundibulum. Ampulla. Isthmus. Intramural part. Uterus: Body. Fundus. Cervix.

Viscera of Female Pelvis Ligaments: Broad ligament: Formed by two layers of peritoneum. Contains: Uterine tube. Round ligament of uterus. Ligament of the ovary. Uterine vessels. Vagina.

Arteries of Pelvis Internal iliac artery: Supplies: Arises from common iliac artery anterior to sacroiliac joint. Supplies: Perineum. Gluteal region. Pelvic organs and walls. Divided into anterior and posterior divisions.

Arteries of Pelvis Internal iliac artery: Anterior division: Umbilical artery. Obturator artery. Inferior gluteal artery. Internal pudendal artery. Inferior vesical artery. Middle rectal artery. Uterine arteries. Vaginal artery.

Arteries of Pelvis Internal iliac artery: Posterior division: Superior gluteal artery. Iliolumbar artery. Lateral sacral artery. Other arteries of the pelvis: Ovarian artery. Superior rectal artery. Median sacral artery.