Pelvic Organs Anatomy Notes PDF

Pelvic Organs  Peritoneum o Males  Anterior abdominal wall -> superior surface of bladder -> anterior surface of rectum  Forms rectovesical pouch o Fe...

Pelvic Organs  Peritoneum o Males  Anterior abdominal wall -> superior surface of bladder -> anterior surface of rectum  Forms rectovesical pouch o Females  Anterior abdominal wall -> superior surface of bladder -> anterior -> superior -> posterior surface of uterus -> upper posterior vagina -> anterior surface of rectum  Forms vesicouterine pouch b/w bladder & uterus  Forms rectouterine pouch (of Douglas)  Rectum o Pierces pelvic diaphragm, continuous w/ anal canal o Junction b/w anal canal & rectum ~80o  Due to puborectalis m. of levator ani m. o Upper part has peritoneum o Lower part does not  Anal canal o Located in posterior perineum (anal triangle) o Relations  Posterior  Anococcygeal lig.  Lateral  Fat in ischiorectal fossa  Anterior  Males = perineal body, bulb of penis  Females = perineal body, lower part of vagina o Upper part  Distal hindgut  Epithelium from endoderm (simple columnar)  Supplied by superior rectal a.  Drained by superior rectal v.  Cause internal hemorrhoids  Lymph drain into internal iliac lymph nodes  Receives autonomic innervation  Internal sphincter  Circular smooth m. layers o Lower part  Ectodermal depression  Epithelium from ectoderm (stratified squamous)  Supplied by inferior rectal a.  Drained by inferior rectal v.  Cause external hemorrhoids  Lymph drain into superficial inguinal lymph nodes  Receives somatic innervation  From inferior rectal n. (of pudendal n.)  External sphincter   Skeletal m. fibers  Bladder o Empty is in pelvic cavity, as it fills, rises into hypogastric region o Parts  Apex  Anterior  Connected to umbilicus via median umbilical lig.  Fundus (base)  Posterior  Body  1 superior surface  Covered w/ peritoneum  2 inferolateral surfaces  Related to obturator internus & levator ani mm.  Neck  Inferior, has urethra o Detrusor m. covers bladder  PS innervation S2-S4  Males o Urethra  Within pelvic cavity  Preprostatic  Prostatic  Passes through prostate  Posterior wall has urethral crest, forms seminal colliculus  Ejaculatory ducts open here  Prostatic sinuses  Grooves on each side of urethral crest & seminal colliculus  Openings of prostatic glands  Within perineum  Membranous  Shortest part  Surrounded by external urethral sphincter m.  Voluntary, skeletal m.  Spongy  Bulbourethral glands open into proximal part here  Lubrication of urethra & pre-ejaculate part here o Ductus deferens  Carries sperm from epididymis to ejaculatory duct  Part of spermatic cord at beginning  Joins seminal vesicle to form ejaculatory duct o Seminal vesicle  Relations  Anterior  Base of bladder  Posterior   Rectum  Medial  Ampulla of ductus deferens  Inferior  Joins ductus deferens to form ejaculatory duct  Contains fructose, nutrients for spermatozoa o Prostate  Ejaculatory ducts run through posterior part, becomes prostatic urethra  Relations  Superior  Neck of bladder  Inferior  Sphincter urethrae m.  Anterior  Pubic symphysis  Posterior  Rectum  Lateral  Levator ani m.  Fluids from here are part of seminal fluid, helps neutralize acidity in vagina  Zones  Central  Around ejaculatory ducts  Transitional  Around proximal prostatic urethra  Peripheral  MC site of prostatic carcinomas  Anterior (isthmus)  Fibromuscular tissue, no glandular tissue o Ejaculatory duct  Runs through posterior part of prostate  Females o Urethra  From internal urethral orifice (neck of bladder) to external (space b/w labia minora)  Surrounded by external urethral sphincter m.  Voluntary, skeletal m. o Ovary  Smooth before puberty  Corpora lutea gets progressively scarred  Before 1st pregnancy  Ovary located in ovarian fossa  After 1st pregnancy  Ovary pulled up into abdominal cavity, takes up variable position in pelvis  Function  Produce ova & estrogen/ progesterone   One pole connected to pelvic brim via suspensory lig. & peritoneal fold  Other pole connected to uterus via proper ovarian lig. o Fallopian tube  Located at upper part of broad lig.  Mesosalpinx b/w fallopian tube & ovary  Function  Receives ovum  Place where fertilization occurs  Parts  Infundibulum  Contains fimbriae  Ampulla  Site where fertilization occurs  Isthmus  Intramural (uterine)  Orifice  Abdominal ostium (lateral)  Uterine ostium (medial) o Uterus  Parts  Fundus  Cervix  Supravaginal part  Vaginal part  Circular in nulliparous women  Transverse slit in parous women  Body  Angles  Version of uterus  Angle b/w vagina & cervix  Flexion of uterus  Angle b/w body & cervix  Normal  Anteversion & anteflexion  Ligaments  Broad lig.  Lateral uterus -> lateral pelvic wall  (proper) ovarian lig.  Ovary -> uterus  Represents proximal part of gubernaculum  Round lig.  Anterior from uterus -> deep inguinal ring -> through inguinal canal  Represents distal part of gubernaculum  Broad & round ligs. both pretty lax and don’t support uterus that much o Vagina  Vaginal fornix   Upper part of vaginal lumen, surrounds cervix  Vaginal orifice  In virgin closed by hymen  Relations  Anterior  Base of bladder & urethra  Posterior  Rectouterine pouch, rectum, perineal body, anal canal  Lateral  Ureter, levator ani m.  Lymph o External iliac nodes o Internal iliac nodes o Sacral nodes o Common iliac nodes