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.

Anorectal hiatus Urethral hiatus Tendinous arch Piriformis m. (Ischio)coccygeus m. Iliococcygeus m. Puborectalis m. Pubococcygeus m. Obturator internus m. Plate 340 Superior fasca UG diaphragm

Plate 338 Urethra Vagina Rectum Piriformis m. Tendinous arch Pubococcygeus m. Iliococcygeus m. (Ischio)coccygeus m.

Plate 338 Rectum VaginaUrethra Piriformis m. Obturator internus m. Tendinous arch (Ischio)coccygues m. Iliococcygues m. Pubococcygeus m.

Puborectalis muscle Moore et al; Fig. 3.12

Plate 372 Fat in ischioanal fossa Obturator internus m. Levator ani m. (iliococcyxageus) Pudenal canal with pudendal n, internal pudendal a. and v. Rectum Anal canal

Plate 363 Superficial transverse perineal m. Urethra Deep artery of penis Dorsal artery of penis Deep dorsal vein of penis Dorsal nerve of penis Duct of bulbourethral gland Artery of bulb of penis Ischial tuberosity

Netter,Plate 487 Levator ani m. (Ischio)coccygeus m. Pelvic splanchnic nn. Gray rami communicantes Sympathetic trunk Sacral splanchnic nn. S4 nerve supply to muscles of pelvic diaphragm

Plate 382 L. Common iliac a. L. Internal iliac a. Uterine a. Obturator a. Umbilical a. Sup. vesical aa. Inf vesical aa. Middle rectal a. Internal pudendal a. Inf. Gluteal a. Sup. gluteal a. Lateral sacral aa. Iliolumbar a.

Plate 382 Rt. Internal iliac a. Sup. gluteal a. Piriformis m. Inf. Gluteal a. Internal pudendal a. Middle rectal a. Uterine a. Umbilical a. Obturator a. Ureter

Plate 344 Supravaginal part of cervix Ureter URINARY BLADDER Uterine artery in transverse cervical ligament

Plate 383 Obturator a. Umbilical a. Prostatic venous plexus Inf. vesical a. I Internal pudendal a. Inf. gluteal a. Sup. gluteal a.

Plate 390 Pelvic splanchnic nn. Ventral ramus, S1 Gray rami communicantes Superior hypograstic plexus Lumbar splanchnic nn. Inferior hypogastric plexus Prostatic plexus Vesical plexusPudendal n. Prevertebral ganglia (sympathetic) Left hypogastric n.

Plate 392 Rt. and left hypogastric nn. Superior hypogstric plexus Inferior hypogastric plexus Sacral splanchnic nn. Pelvic splanchnic n Lumbar splanchnic nn. Gray ramus communicantes

Plate 388 Superficial inguinal nodes Deep ingiunal nodes External iliac nodes

Plate 386