Pelvic Structures

The bony pelvis consists of the —

sacrum, coccyx, and innominate bones

The posterior border of the pelvic cavity is marked by the —

sacrum and coccyx

The innominate bones consist of the —

ilium, ischium, and pubic symphysis

The boundaries of the female pelvis are considered to be from the iliac crest to a group of muscles known as the —, located at the base of the pelvis.

pelvic diaphragm

The pelvis can further be divided into a true pelvis (lesser pelvis) and false pelvis (major pelvis) by an imaginary line known as the —

linea terminalis

The false pelvis is located more — than the true pelvis,

superiorly

The true pelvis contains the —

urinary bladder, small bowel, sigmoid colon, rectum, ovaries, fallopian tubes, and uterus.

Relationship of the abdominal cavity to the true and false pelvis.

Muscles visualized on a sonogram include the

rectus abdominis muscles, the iliopsoas muscles, obturator internus muscles, piriformis muscles, and a group of muscles known as the pelvic diaphragm, which is composed of the levator ani and coccygeus muscles

The pelvic diaphragm muscles provide

support to the pelvic organs

The weakening of the pelvic diaphragm, which includes the levator ani muscles, can lead to

prolapse of the uterus.

Organs of the female pelvis in the sagittal section.

The broad ligaments and suspensory ligament of the ovary are actually

double folds of peritoneum

In addition to providing support, the — of the ovary contains the ovarian artery, ovarian vein, lymphatics, and ovarian nerves.

suspensory ligament

cardinal ligaments house the

vasculature of the uterus

The vesicouterine pouch, or anterior cul-de-sac, is located —

anterior to the uterus and posterior to the urinary bladder

The rectouterine pouch, located between the —, may also be referred to as the posterior cul-de-sac or pouch of Douglas

rectum and uterus

— is considered the most dependent part of the peritoneal cavity, making it the most likely place for fluid to collect in the pelvis

The rectouterine pouch

Between the anterior wall of the urinary bladder and symphysis pubis lies the —

space of Retzius, or retropubic space

the space of Retzius, or retropubic space is an area that contains

extraperitoneal fat.

Rectus abdominis muscle (2) location

anterior

Iliopsoas muscles (2) location

Lateral and anterior to iliac crest

Obturator internus (2) location

Lateral to ovaries

Piriformis (2) location

Posterior

Pelvic diaphragm (levator ani and coccygeus muscles) location

Inferior near the vagina in transverse

The most dependent part of peritoneal cavity is the —, making it the most likely place for free fluid to collect in the pelvis.

posterior cul-desac or pouch of Douglas

The abdominal aorta supplies blood to —

the female genitalia.

The paired right and left uterine arteries are branches of the —

internal iliac arteries.

The paired right and left uterine arteries supply blood to the uterus, the fallopian tubes, and the ovaries, and course along the —

lateral aspect of the uterus within the folds of the broad ligaments

Sagittal scan of the psoas major (Ps) and the iliac muscle (Ilc).

Transverse scan of the pelvis reveals the urinary bladder (UBl), uterus (Ut), and left iliopsoas muscle (arrows).

Transverse scan at the level of the vagina (Va), urinary bladder (UBl), and rectum (R) demonstrating the levator ani (La) muscle group (solid white arrows) and the obturator internus muscle (open arrows).

Branches of the uterine artery include the —, which may be visualized with Doppler interrogation along the lateral aspect of the myometrium

arcuate arteries

The arcuate vessels progress further within the uterus and eventually become the —, which supply blood to the deeper layers of the myometrium.

radial arteries

The radial arteries then divide into the —

straight arteries and spiral arteries

The spiral arteries are the tiny, coiled vessels that supply blood to the —

functional or decidual layer of the endometrium

The ovarian arteries originate from the —

lateral aspect of the abdominal aorta

Each ovary receives its nourishment from an —

ovarian artery and a branch of the uterine artery

broad ligament supports

• uterus

• tubes

• ovaries

broad ligament location

Extends from the lateral aspect of the uterus to the side walls of the pelvis

round ligaments support

uterus (fundus)

round ligaments location

Extends from uterine cornua to labia majora between the folds of the broad ligaments

the suspensory ligament of the ovaries (infundibulopelvic) supports

ovaries and tubes

the suspensory ligament of the ovaries (infundibulopelvic) location

Extends from the ovaries to the pelvic side walls

ovarian ligaments support

ovaries

ovarian ligaments location

Extends from ovary to lateral surface of the uterus

cardinal ligament supports

cervix

caerdinal ligament location

Extends from the lateral surface of the cervix to the lateral fornix of vagina

uterosacral ligament supports

uterus

uterosacral ligament location

Extends from uterus to sacrum

Broad ligament outlined by ascites. The bilateral broad ligaments (short arrows), outlined by ascites, are clearly noted in this transverse image. The longer arrow is identifying the uterus.

All venous structures mirror their arterial counterparts with the exception of the left ovarian vein, which instead of returning blood to the inferior vena cava, drains directly into —

the left renal vein