Pelvis Anatomy Notes

Pelvis

• Male and Female Pelvis

Female Pelvis Viscera

• Viscera within the Female Pelvis:
  • Rectum
  • Urinary Bladder
  • Fundus, Uterus
  • Ovary
  • Uterine Tube
  • Round Ligament of the Uterus
  • Mesosalpinx, Broad Ligament of the Uterus
  • Sigmoid Colon
  • Body, Uterus
  • Mesometrium, Broad Ligament of the Uterus

Uterus and Ovary Anatomy

• Key Structures:
  • Ureter
  • Ovarian Artery and Vein
  • Uterine Tube
    • Ampulla
    • Fimbria
  • Suspensory Ligament of the Ovary
  • Cervix, Uterus
  • Fundus, Uterus
  • Body, Uterus
  • Vaginal Artery
  • Uterine Artery and Vein
  • External Os
  • Internal Os
  • Ligament of the Ovary
• Uterus Layers:
  • Perimetrium
  • Myometrium
  • Endometrium
• Uterus Parts:
  • Fundus
  • Body
  • Cervix
• Ovary
• Broad Ligament
• Uterine Tube Parts:
  • Infundibulum
  • Isthmus
• Round Ligament

Female Pelvis Supporting Ligaments

• Suspensory Ligament of the Ovary (Infundibulopelvic Ligament):
  • Peritoneal passageway for the Ovarian Artery and Vein
• Ovarian Ligament:
  • Binds the Ovary to the Uterus
  • Remnant of the Gubernaculum
• Round Ligament of the Uterus:
  • Binds the Uterus to the Anterior Abdominal Wall
  • A Remnant of the Gubernaculum
  • Passes through the Inguinal Canal and attaches to the Labia Majora
• Broad Ligament of the Uterus:
  • Mesentery that extends from the Uterus and associated structures, binding them to each other and the Pelvic Wall
  • Parts:
    • Mesovarium: Binds Ovary
    • Mesosalpinx: Binds Uterine Tube
    • Mesometrium: Binds the Fundus of the Uterus

Female Pelvis Anatomy

• Cervix
  • Posterior Fornix
  • Anterior Fornix
• Rectouterine Pouch “Pouch of Douglas”
• Uterovesical Pouch
• Uterus
  • Fundus
  • Body
• Vaginal Canal
• Urinary Bladder
  • Base
  • Apex
• Urogenital Diaphragm
• Pelvic Diaphragm
• Urethra

Uterus Review

• Review the parts of the uterus using a real example.

Female Pelvis Innervation and Blood Supply

• Ovary
  • Blood Supply:
    • Ovarian arteries arise from the abdominal aorta.
  • Lymphatics:
    • Follows the ovarian arteries and veins to the para-aortic nodes at the level of the 1st lumbar vertebrae.
  • Innervation:
    • Ovarian plexus, accompanying the ovarian vessels.
• Uterine Tube
• Uterus
  • Blood Supply:
    • Uterine arteries, from the internal iliac arteries, and ovarian arteries.
  • Lymphatics:
    • From fundus into para-aortic nodes
    • From body and cervix into internal and external iliac lymph nodes
    • From round ligament into inguinal lymph nodes.
  • Innervation:
    • Parasympathetics (S2-S4) and sympathetics (T10-L1) from inferior hypogastric plexus.

Male Urogenital Tract

• Key Structures:
  • Testicle
  • Epididymis
  • Ductus Deferens
  • Seminal Vesicle
  • Ejaculatory Duct
  • Prostate Gland
  • Bulbourethral Gland
  • Urinary Bladder
  • Median Umbilical Ligament
  • Glans, Penis
  • Shaft, Penis

Male Pelvis Viscera

• Ductus Deferens
• Seminal Vesicle
• Prostate Gland
• Urinary Bladder
• Ureter
• Internal Urethral Orifice

Male Pelvis Innervation and Blood Supply

• Prostate Gland and Seminal Vesicles
  • Blood Supply: inferior vesicle and middle rectal arteries
  • Prostatic venous plexus receives the deep dorsal vein of the penis and drains into the internal iliac veins.
  • Lymphatics: internal iliac lymph nodes
  • Innervation: inferior hypogastric plexuses. Sympathetics stimulate ejaculation.
• Ductus Deferens
  • Blood Supply: deferential arteries, from the superior vesicle arteries
  • Lymphatics: external iliac nodes
  • Function:
    • Seminal vesicles form most of the ejaculate (sucrose + coagulating enzyme) and contract during ejaculation.
    • Prostate gland secretes a highly alkaline based fluid of citric acid and acid phosphatase to neutralize the acidity of the vaginal canal.
  • Function: carries spermatozoa to the seminal vesicles
  • Innervation: inferior hypogastric plexuses.

Common Viscera Between Sexes

• Urinary Bladder
  • Apex
  • Base
  • Ureteric Orifice
  • Interureteric Ridge
  • Trigone
  • Uvula Vesicae
  • Median Umbilical Ligament
  • Ureter
  • Blood Supply: via superior and inferior vesicle arteries
  • Lymph: drain to the internal and external iliac nodes.
  • Innervation:
    • inferior hypogastric plexus
    • Sympathetics (T11-L2)
    • Parasympathetics (S2-S4)
    • Detrusor muscle
• Rectum
  • Anal Columns
  • Internal Anal Sphincter
  • External Anal Sphincter
  • Puborectalis
  • Line of Hilton
  • Hemorrhoid
  • Anorectal flexure at the tip of the coccyx
  • Rectosigmoid Junction S3

Rectal Arteries

• Superior Rectal Artery
• Inferior Rectal Artery
• Middle Rectal Artery

Rectum and Anus Innervation

• Superior Hypogastric Plexus
• Inferior Hypogastric Plexus
• Pelvic Splanchnic Nerves (preganglionic parasympathetics)
• Pudendal nerve (somatic motor and sensory)
• Inferior Rectal Nerves