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The pelvis and perineum The pelvis and perineum. Introduction pelvis — bony pelvis pelvic walls pelvic diaphragm pelvic organs blood vessels and nerves.

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Presentation on theme: "The pelvis and perineum The pelvis and perineum. Introduction pelvis — bony pelvis pelvic walls pelvic diaphragm pelvic organs blood vessels and nerves."— Presentation transcript:

1 The pelvis and perineum The pelvis and perineum

2 Introduction pelvis — bony pelvis pelvic walls pelvic diaphragm pelvic organs blood vessels and nerves Introduction pelvis — bony pelvis pelvic walls pelvic diaphragm pelvic organs blood vessels and nerves

3 The bony pelvis: --- hip bones, --- sacrum --- coccyx --- their connections (joints, ligaments and pubic symphysis) The bony pelvis: --- hip bones, --- sacrum --- coccyx --- their connections (joints, ligaments and pubic symphysis)

4 divisions: --- greater pelvis --- lesser pelvis  oblique plane: Promontory of sacrum Arcuate line Pecten pubis Pubic tubercle Pubic crest Superior border of pubic symphysis divisions: --- greater pelvis --- lesser pelvis  oblique plane: Promontory of sacrum Arcuate line Pecten pubis Pubic tubercle Pubic crest Superior border of pubic symphysis

5 The pelvic walls: Post.--- sacrum, coccyx piriformis Ant.--- pubes, pubic symphysis Lat.--- ilium, body of the pubis, ischium ligaments obturator internus The pelvic walls: Post.--- sacrum, coccyx piriformis Ant.--- pubes, pubic symphysis Lat.--- ilium, body of the pubis, ischium ligaments obturator internus

6 The floor of pelvis: --- pelvic diaphragm  levator ani  coccygenus  deep fasciae --- urogenital diaphragm  muscles  deep fasciae The floor of pelvis: --- pelvic diaphragm  levator ani  coccygenus  deep fasciae --- urogenital diaphragm  muscles  deep fasciae

7 The pelvic organs ---The urinary bladder ---The rectum ---The pelvic part of ureter ---The prostate ---The pelvic part of ductus deferens ---The seminal vesicle ---The ejaculatory duct ---The uterus ---The ovaries ---The uterine tubes --- The vagina The pelvic organs ---The urinary bladder ---The rectum ---The pelvic part of ureter ---The prostate ---The pelvic part of ductus deferens ---The seminal vesicle ---The ejaculatory duct ---The uterus ---The ovaries ---The uterine tubes --- The vagina

8 Ⅱ.The urinary bladder 1. Position, shape and relatons It rests against pubis. When it empty, is pyramid has a apex, body and fundus.

9 2. The interior of the bladder  urinary trigone—  ureteric orifices and  internal urethral  orifice position boundaries clinical notes to be susceptical to tuberlosis and tumor.

10 ---The rectum: 1. Position and relations ---The rectum: 1. Position and relations

11 2. The shape of the rectum ~16cm in length parts: pelvic part (ampulla of rectum) anal canal curves in sagittal plane: sacral flexure perineal flexure curves in coronal plane: 2. The shape of the rectum ~16cm in length parts: pelvic part (ampulla of rectum) anal canal curves in sagittal plane: sacral flexure perineal flexure curves in coronal plane:

12 3. The internal features of the rectum transverse folds --- 6~10 anal columns --- anal valves --- anal sinuses --- dentate line ectoderm and entoderm there are differents in epithelial lining, blood and nerve supply and lymphatic drainage --- anal pecten 3. The internal features of the rectum transverse folds --- 6~10 anal columns --- anal valves --- anal sinuses --- dentate line ectoderm and entoderm there are differents in epithelial lining, blood and nerve supply and lymphatic drainage --- anal pecten

13 4.The blood vessels, lymphatic drainage and nerves --- Arteries: superior rectal a. inferior rectal a. anal a. --- veins: internal rectal venous plexus external rectal venous plexus 4.The blood vessels, lymphatic drainage and nerves --- Arteries: superior rectal a. inferior rectal a. anal a. --- veins: internal rectal venous plexus external rectal venous plexus

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15 --- lymphatic drainage:  inferior mesenteric lymph nodes  internal iliac lymph nodes  superficial inguinal lymph nodes --- lymphatic drainage:  inferior mesenteric lymph nodes  internal iliac lymph nodes  superficial inguinal lymph nodes

16 --- The uterus: 1.Position : between the urinary bladder and rectum Anteflection: bent forward between the body and neck Anteversion: bent forward between the uterus and vagina --- The uterus: 1.Position : between the urinary bladder and rectum Anteflection: bent forward between the body and neck Anteversion: bent forward between the uterus and vagina

17 2. relations: ant.--- ant. Abdominal wall, urinary bladder, intestine post.--- rectouterine pouch, rectum inf.--- vagina lat.--- uterine tube, ovary, broad lig., blood vessels sup.--- intestine 2. relations: ant.--- ant. Abdominal wall, urinary bladder, intestine post.--- rectouterine pouch, rectum inf.--- vagina lat.--- uterine tube, ovary, broad lig., blood vessels sup.--- intestine

18 3. The shape: pear-shaped anterior and posterior surfaces lateral borders fundus, body neck: supravaginal part vaginal part isthmus 3. The shape: pear-shaped anterior and posterior surfaces lateral borders fundus, body neck: supravaginal part vaginal part isthmus

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20 4. The ligaments: broad lig. of uterus: mesometrium mesosalpinx mesovarium suspensory lig. of ovary cardinal lig. of uterus round ligament of uterus uterosacral lig. 4. The ligaments: broad lig. of uterus: mesometrium mesosalpinx mesovarium suspensory lig. of ovary cardinal lig. of uterus round ligament of uterus uterosacral lig.

21 5. Blood vessels: The uterine artery---from the internal iliac a. crosses above (or in front of) the ureter lateral to the neck of uterus about 2cm 5. Blood vessels: The uterine artery---from the internal iliac a. crosses above (or in front of) the ureter lateral to the neck of uterus about 2cm

22 6. The lymphatic drainage: Fundus and upper part --- lumbar lymph nodes along the round lig. --- superficial inguinal lymph nodes lower part and neck--- internal and external iliac lymph nodes 7. The nerves 6. The lymphatic drainage: Fundus and upper part --- lumbar lymph nodes along the round lig. --- superficial inguinal lymph nodes lower part and neck--- internal and external iliac lymph nodes 7. The nerves

23 Introduction The Perineum — boundaries divisions anal region urogenital regions in male and female Introduction The Perineum — boundaries divisions anal region urogenital regions in male and female

24 boundaries: --- same boundaries as the outlet of pelvis: inferior border of the pubic symphysis, inferior rami of the pubes, the rami of ischia ischial tuberosities sacrotuberous ligaments boundaries: --- same boundaries as the outlet of pelvis: inferior border of the pubic symphysis, inferior rami of the pubes, the rami of ischia ischial tuberosities sacrotuberous ligaments

25 2. divisions: --- anal region: anal canal --- urogenital region: urethra (male) urethra, vagina (female) 2. divisions: --- anal region: anal canal --- urogenital region: urethra (male) urethra, vagina (female)

26 3. Pelvic diaphragm: --- levator ani --- coccygeus --- superior fascia of pelvic diaphragm --- inferior fascia of pelvic diaphragm 3. Pelvic diaphragm: --- levator ani --- coccygeus --- superior fascia of pelvic diaphragm --- inferior fascia of pelvic diaphragm

27 4.The ischioanal fossa (ischiorectal fossa): med.--- levator ani, sphincter ani externus, inferior fascia of pelvic diaphragm lat.--- ischial tuberosity, sacrotuberous lig., and the fascia of obturator internus 4.The ischioanal fossa (ischiorectal fossa): med.--- levator ani, sphincter ani externus, inferior fascia of pelvic diaphragm lat.--- ischial tuberosity, sacrotuberous lig., and the fascia of obturator internus


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