1. Identify the bony walls and ligamentous landmarks of the pelvis. Iliopectineal Line
Sacrotuberous Ligament
Greater Sciatic Foramen
Sacrospinous Ligament
Lesser Sciatic Foramen
Sacrospinous Ligament
Sacrotuberous Ligament Pubic Arch
Pubic Symphysis
Ischial Tuberosity Ant. Sup. Iliac Spine
Pubic symphysis
Pelvic Outlet
Tip of Coccyx Sacrotuberous Ligament Coccyx
Male vs. Female Pelvis Female
Male
Pelvic Inlet
Pelvic Outlet
Pelvic Cavity
Pelvic Arch
Muscular Walls Greater Sciatic Foramen
Piriformis Muscle Sacrotuberous Ligament
Piriformis Muscle
Sacrospinou s Ligament
Sacrotuberous Ligament
Gemellus Superior & Inferior Greater Trochanter Obturator Internus Ischial Tuberosity
Lesser Trochanter
4. Identify the pelvic diaphragm and its components Sphincter Vaginae (or Levator Prostatae)
Pubic Symphysis
Urethra
Pubic Symphysis
Levator Prostatae or Sphincter Vaginae
Vagina Rectum
Puborectalis Pubococcygeus
Puborectalis Perineal Body
Pubococcygeus
Obturator Internus
Coccyx
Iliococcygeus Coccygeus
Iliococcygeus Sacrum
Superior View
Coccyx
Coccygeus
Inferior View
2. Identify the normal position and anatomical relationships of the pelvic viscera
Anteverted
Anteflexed
3. Identify the extent of the peritoneum and its folds and reflections in the male and female pelvis and their relationship to the pelvic contents. Rectovesicle pouch
Infraperitoneal space
•Most pelvic organs are infraperitoneal
Vesicouterine pouch
Rectouterine pouch
Ligaments supporting pelvic organs Peritoneal ligaments
Pelvic visceral ligaments
Fundus
Bladder
Bladder
Lig. Of ovary
Round lig. of uterus
Pubocervical lig.
Uterine tube
Transverse cervical lig.
Broad ligament Suspensory lig.
Cervix Sacrocervical lig. Rectum
Ovarian art.
Lig. Of the ovary
Mesosalpinx Fundus
Round ligament of the uterus
Sacrocervical lig.
Uterine tube
Body
Round lig. of the uterus Uterine art.
Cervix
Lig. Of the ovary Mesometrium
Bladder
Ureter Uterine art.
Pubocervical lig.
Rectum Pelvic diaphragm Transverse cervical lig.
5. Follow the flow of blood into an out of the structures of the pelvis and perineum. Celiac Superior mesenteric Renal Ovarian Common iliac Ext. iliac
Int. iliac
Inferior mesenteric Superior rectal Testicular
Inguinal ligament
Median Sacral Femoral
Rules: 1. All pelvic organs are supplied by branches of the internal iliac artery except the ovaries and the upper third of the rectum. 2. Venous drainage follows the arterial supply, including the portal tributary, the inferior mesenteric vein. 3. Portal caval anastomses are found at the inferior rectal veins.
6. Identify the lymphatic drainage of structures of the pelvis and perienum. Paraaortic
Rules:
•
Lymphatics drain toward lymph nodes along internal iliac veins, except for the ovary (paraaortic nodes), and superior portion of the rectum (inferior mesenteric nodes)
•
Perineum drains to superficial inguinal nodes
External iliac
Superficial Inguinal
Internal iliac
7. Follow the course taken by an ovum through the female reproductive tract and the pathway taken by a spermatozoon through the male reproductive tract. Uterine tube
Fimbria
Ureter
Fundus
Ductus deferens
Inguinal canal Ovary
Uterine cavity Cervix
Body
Bladder Ejaculatory duct
Ampulla
Fornix Vagina
Seminal vesicle Prostate Bulbourethral gland Urethra Ductus deferens Testis
Epidiymis
Innervation of Pelvic Organs