1. The pelvis
and
perineum

2. 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)

4. 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

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

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

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

11. 2. The shape of the rectum --- 12~16cm in length
--- 2 parts: pelvic part
(ampulla of rectum)
anal canal
--- 2 curves in sagittal plane:
sacral flexure
perineal flexure
--- 3 curves in coronal plane:

12. 3. The internal features of the rectum --- 3 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

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

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

17. ant.--- ant. Abdominal wall,
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

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.

21. The uterine artery---from the internal iliac a.
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

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

24. --- 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)

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

27. 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