ANHB 2212 – 2008 Avinash Bharadwaj The Pelvis ANHB 2212 – 2008 Avinash Bharadwaj

Bony Pelvis Hip bones Sacrum Joints and ligaments

Hip Bone

Ligaments Sacrospinous Sacrotuberous Notches  Foramina Other ligaments

The walls Pelvis as a container Muscles Vessels and nerves Piriformis Obturator muscles (Internus/externus) Membrane Vessels and nerves

The Floor Pelvic diaphragm Pubis  sacrum (coccyx) Obturator fascia

The Floor Pelvic diaphragm Perineum Levator ani Coccygeus (ischio-) Puborectalis Pubococcygeus Iliococcygeus Coccygeus (ischio-) Perineum Urogenital region …diaphragm Anal region

Urogenital Region Male urethra Penis Comparable female structures Corpus spongiosum and corpora cavernosa Muscles Comparable female structures

The Pelvis – “True” and “False” Iliac fossae The pelvic brim Pelvic cavity

Contents Urinary system Repoductive system Digestive system Bladder and urethra Repoductive system Male / female Digestive system Rectum – anal canal Peritoneum…

Urinary Bladder Muscular wall Reservoir Sphincters Internal – smooth External – urogenital diaphragm - skeletal Variation in size, shape and location… Empty – Tetrahedral, Pelvis Full – ovoid, partly abdominal

Urogenital Organs - Male Prostate Seminal vesicles Ductus deferens

Female Reproductive Organs Uterus Fundus, body, cervix Vagina Angles Fornix Ovary and the tube

Female Reproductive Organs Uterus Fundus, body, cervix Non-pregnant Pelvic Pregnant Pelvic  12 weeks Abdominal 20 weeks – umbilicus 36 weeks - xiphisternum

Female Reproductive Organs Ovaries Descent Stops in the pelvis Ligaments Round ligament Ovarian artery From aorta

Female Reproductive Organs Uterine tubes Parts Also note Ovarian artery Uterine artery Ligaments

Rectum and Anal Canal The junction Developmental correlation Venous anastomoses Nerves and lymphatics Mucosa and sphincters Internal sphincter – smooth muscle External sphincter - skeletal

Rectum and Anal Canal Lower part Ectodermal Systemic veins “Modified skin”

The Pelvis – Birth Canal Is it adequate? How do we know? Sexual dimorphism Variations and types

Pelvic Dimensions Inlet Midcavity Outlet A-P Transverse Oblique

Types of Female Pelvis Gynaecoid Android Antrhopoid Platypelloid Abnormalities