Lecture Notes - Pelvis & Pelvic Viscera

Bony Structure

• 2 hip bones: ilium, pubis, ischium
• 1 sacrum
• 1 coccyx

Ligaments - hold/bind bony pelvis together and hold pelvis in proper orientation to resist forces
• sacrotuberous
• sacrospinous
• sacroiliac
Orientation - NOT a basin!!! Tilt to ~80° angle
• Pubic tubercles and ASIS in vertical line

Peritoneum

Falls short - does not reach pelvic floor/diaphragm
• Pouches
  • Female - vesicouterine & rectouterine
  • Male - rectovesical
• Broad Ligament - mesosalpinx, mesovarium, & mesometrium

Viscera

Rectum
• peritoneal covering - top 1/3 on front and sides, middle 1/3 on front, inferior 1/3 none
• transverse rectal folds
• passes through pelvic diaphragm to become anal canal
• blood supply and venous return - portocaval anastomosis
Anal Canal
• internal anal sphincter - thickened circular (smooth) muscle
• external anal sphincter - skeletal muscle
• anal columns, valves, and sinuses - what forms columns?
  • Pectinate Line - functional significance??
Reproductive Organs
• Female:
  • Uterus
    • fundus, body, isthmus, cervix (internal and external os)
    • round ligament (anterior)
    • uterine artery OVER ureter
    • anteverted vs. anteflexed
  • Uterine Tube
    • isthmus, ampulla, infundibulum, fimbriae
  • Ovary
    • suspensory ligament (contains ovarian vessels)
    • proper ovarian ligament
    • (ovarian + round ligaments = gubernaculum)
  • Vagina
    • from cervix to vestibule
    • vaginal fornices - recess around cervix (anterior, posterior, lateral)
• Male:
  • Testis
    • seminiferous tubules
    • epididymis - head, body, tail
  • Spermatic Cord
    • ductus deferens
    • testicular artery
    • pampiniform plexus of veins
  • Ejaculatory Ducts
    • ampulla of ductus deferens + seminal vesicles
    • through prostate to join urethra at seminal colliculus
  • Prostate
    • base of bladder
    • median lobe = uvula
Bladder
• apex, fundus, body, neck
• trigone = ureteric orifices + internal urethral orifice
• urethra
  • male: prostatic, membranous, penile (spongy)
  • female: membranous