Bony pelvis and pelvic viscera
• By
• Hussein Abdellatif
• Asst. Prof. Human and Clinical Anatomy
• Sultan Qaboos University
IL0s:
Describe the bones, joints and ligaments of the pelvic girdle
Demonstrate the orientation of the pelvic girdle
Understand the division of pelvic cavity into true and false pelvis
Trace the boundaries of the pelvic inlet and outlet
Describe the structure of the walls and floor of the pelvic cavity
List the differences between male and female pelvises.
the major pelvic viscera in the male and female and their relations to each
Describe
other.
Describe the parts and relations of the urinary bladder in the male and female
Describe the general topography of the uterus and fallopian tubes
Understand the subdivisions of the perineum into anal and urogenital triangles
Pelvic girdle :
• The pelvic girdle is a ring-like bony structure, located in
the lower part of the trunk. It connects the axial
skeleton to the lower limbs.
• The bony pelvis consists of the two hip bones, the sacrum
and the coccyx.
• There are four articulations within the pelvis:
• Sacroiliac joints (x2) – between the ilium of the hip
bones, and the sacrum
• Sacrococcygeal symphysis – between the sacrum and the
coccyx.
• Pubic symphysis – between the pubis bodies of the two
hip bones.
• Ligaments attach the lateral border of the sacrum to
various bony landmarks on the bony pelvis to aid stability.
Hip bones:
Functions of pelvis:
Transfer of weight from the upper axial skeleton to the lower appendicular
components of the skeleton, especially during movement.
Provides attachment for a number of muscles and ligaments used in
locomotion.
Contains and protects the abdominopelvic and pelvic viscera.
Greater and Lesser Pelvis:
• Greater pelvis (false pelvis) – located
superiorly, It has little obstetric relevance.
• Lesser pelvis (true pelvis) – located
inferiorly. Within the lesser pelvis reside
the pelvic cavity and pelvic viscera.
• The junction between the greater and
lesser pelvis is known as the pelvic inlet.
• The outer bony edges of the pelvic inlet
are called the pelvic brim.
posterior
- > anterior
Pelvic Inlet:
all of line pectined
Sacral
promontory >
- sacrum-arcuate >
- line >
- Public symphysis
• The pelvic inlet marks the boundary
-
between the greater pelvis and lesser
-
-
als of
Sacram
pelvis.
-
L
• The borders of the pelvic inlet:
• Posterior – sacral promontory (the
arcuate
superior portion of the sacrum) and line
sacral wings (ala).
Pectineal &
line
-
• Lateral – arcuate line on the inner
surface of the ilium, and the pectineal
Pectineal
line on the superior pubic ramus.
line
--
--
• Anterior – pubic symphysis.
Pelvic Outlet: anterior >
-
publich arch-
>
Posterior
ischiopublic ramus >
- Ischial
tuberosity
- > Sacrotuberous > tip
ligament -
of
coacyx
• The pelvic outlet is located at the end of the -
-
lesser pelvis, and the beginning of the pelvic
-
-
wall.
• Borders:
• Posterior: The tip of the coccyx
projection
• Lateral: The ischial tuberosities and the
inferior margin of the sacrotuberous ligament
• Anterior: The pubic arch (the inferior border
of
- tip
coccyx
2
of the ischiopubic rami).
between
2 hupic bone
• The angle beneath the pubic arch is known as
-
the sub-pubic angle and is of a greater size in
-
women.
-
-
Difference between male and female pelvis:
>
- broader + lighter narrower
+ heavier
E for birth
under effect of female sex hormones
because
dilatation
+ we have lots ligament to allow
Sacral
during birth
& promontory
more
prominent
in make
- -
G G
- -
Pelvic walls:
• Anterior: formed by post. Surface of pubic
bones and pubic rami and symphysis pubis
• Posterior: Large formed of sacrum and
coccyx, piriformis and pelvic fascia piriformis
• Lateral: Part of hip bone, Obturator internus
with its covering fascia; sacrotuberous and
sacrospinous ligaments sacrospinous
- obturator s
S
Sacrotuberous
separate the 2 hip bones from the down area (perineum)
• Inferior (Floor): pelvic diaphragm, stretches
&=8
across the pelvis and divides it into:
• Main (true) pelvis above contains -
pelvis
viscera
-
• Perineum below that carries external genital -
organs
-
to pelvic diaphragm
* Cutting the Pelis and
looking from above
Pelvic floor: Diaphragm
Floor mus&
cles
E
Pelvic
pelvic diaphragm
• Levator ani: consist of
inside it, there a re important
puborectalis, organs) they
organs (pelvic and
need support
of & pubocoygens
ex · in cases
weight or
pregnancy to support them
from Sphictor Vagina/levator prostate
pubococcygeus &
being down
(support pelvic organs from
Puborectalis
below)
↑
↑ surrounded and support the pubocycygeus proper
iliococcygeus
hiatus
❑ Supplied by perineal -
branch of pudendal
- - - Female :Sphinctor Vagina
-
surround the rectum
&
- - male : levator prostate
nerve & S4 spinal -
we have
3 openings
-
-
nerve lavator
ani
• Coccygeus:
-
(Ischeococcygeus ): S4 &
S5 -
Or
ischeocoygens
Female pelvis
externretatio & anal
canal
urethra is d
Shorter than make
perineal body
G & fibromuscular body
& (perineal body)
Organization of pelvic viscera in male and in female:
Anatomy of the urinary bladder:
Urinary > normal -
- > Pelvic organ
bladder
full >
- abdominopelvic organ
• Apex – located superiorly, pointing towards the pubic
symphysis. It is connected to the umbilicus by the
median umbilical ligament (a remnant of the urachus).
• Body – main part of the bladder, located between the
apex and the fundus
• Fundus (or base) – located posteriorly. It is
triangular-shaped, with the tip of the triangle pointing
backwards.
• Neck – formed by the convergence of the fundus and
-
the two inferolateral surfaces. It is continuous with
the urethra.
-
• Urine enters the bladder through the left and right
-
-
-
ureters and exits via the urethra.
-
-
- -
• Internally, these orifices are marked by the trigone –
a triangular area located within the fundus.
-
base
J
-
male
When it's
Full ,
itascends
upward
dotted line Cabdomino
&
-
pelvic organ (
=
-
peritoneum
Full
-- covering t h e
Superior border bladder
and making a pouch superior
surface
interolateral neck
Surface surrounded
prostate)
Crethra
by
&
Female
>
- upper part of Vagina
Coronal Section through the bladder
trigone >
- devoid of mucosal rugae /because
of its different development place
than the other parts of bladder
(that's why it's structure is different *
*
than other parts of bladder)
ureteric
- devoid of submucosal &
orifice
· mucosa su muscolosa
Interior of Urinary exist
the
between
three
Bladder
*
move Female
ene
Recn
Upper is related
to coiles of small
↓
intestine
Behindedito
-
rectum
anteriorly related
public symphysis
to
↑ and anal cance
and separated
in the space of retzius
by recto-vesical -
Anterior 87 &
( fa t ) pouch
&
- public symplysis +
Space of retzius
behind :
&
sur face of uterus +
upper border of Vagina
anterior
wall of
Vagina
Relations of urinary bladder:
Male and Female
retention of urine introduce catheter (drainage device) >
- introduce it through space of retzius
cause it devoid of perineum (supra-
public catheter
L
Anatomy of
the uterus:
Anatomy of the uterus:
• The uterus is a secondary sex organ.
• The uterus is a thick-walled muscular organ capable of
expansion to accommodate a growing fetus. It is
connected distally to the vagina, and laterally to the
uterine tubes.
• The uterus has three parts;
• Fundus – top of the uterus, above the entry point of
the uterine tubes.
• Body – usual site for implantation of the blastocyst.
• Cervix – lower part of uterus linking it with the vagina.
This part is structurally and functionally different to
the rest of the uterus.
What is the uterus
making
in this position ?
round ligament- Pulling the
uterus forward
Anatomical position:
Sacrouterine ligament -> pulling the
uterus backward
• In the normal adult uterus is
described as anteverted with respect
to the vagina, and anteflexed with we have 2
angles
respect to the cervix: -
antiverted antiflexed
↓ ↓
why axis of body
• Anteverted: Rotated forward, towards
body of uterus
of uterus +
- Axis of cervix
Axis of Vagina 130 .
the anterior surface of the body. .
90
• Anteflexed: Flexed, towards the
anterior surface of the body.
• Thus, the uterus normally lies
immediately posterosuperior to the
bladder, and anterior to the rectum.
Abnormal positions of uterus:
• The three-common abnormal
positions are: ①
• Excessively anteflexed
-
>
-
Forward
85
25 >
- Is
• Anteflexed and retroverted
-
-
↑
normal -
abnor mal
vagina i
=,
-
• Retroflexed and retroverted
- -
>
- can cause
infertility
abnormal abnormal
• These abnormal arrangements do
80j -
0JJ
&
0
not inherently cause any medical
problems.
Fallopian (Uterine) tubes:
• The uterine tubes (or fallopian tubes, oviducts,
salpinx) are muscular ‘J-shaped’ tubes, found in the
female reproductive tract.
• They lie in the upper border of the broad ligament,
extending laterally from the uterus, opening into the
abdominal cavity, near the ovaries
• Function:
• Assist in the transfer and transport of the ovum from
the ovary, to the uterus.
• Through:
• The inner mucosa is lined with ciliated columnar
-
epithelial cells
-
• Smooth muscle layer contracts
--
to assist with
transportation of the ova and sperm.
-
Anatomical structure: (Length: 4 inches)
• The fallopian tube is described as
having four parts (lateral to medial);
~ picking up
• Fimbriae – finger-like, ciliated
projections which capture the ovum
from the surface of the ovary.
• Infundibulum – funnel-shaped opening
near the ovary to which fimbriae are
attached.
ampulla
• Ampulla – widest section of the uterine
tubes. Fertilization usually occurs here.
• Isthmus – narrow section of the
uterine tubes connecting the ampulla
to the uterine cavity.
Anatomy of perineum:
public
Symphysis
• Glossary: peri: around, ineo: discharge,
evacuate
• Location: it lies below the pelvic diaphragm,
between the upper parts of the thighs.
Horizontal line
ischial
through ishial
tuberosity
↑
rberosity
• Boundaries >
- I5
-
Outlet tip of
• Anteriorly: Inferior margin of symphysis
coccyX
pubis.
• Posteriorly: Tip of coccyx.
• Anterolateral: Fused rami of pubis and
ischium and ischial tuberosity.
• Posterolateral: Sacrotuberous ligaments.
Subdivisions of perineum:
• By a line joining the anterior
-
-
parts of the ischial tuberosities ,
the perineum is divided into O
two
C
triangles :
• Anteriorly: Urogenital triangle
containing
>
- external
genitalic
-
• Posteriorly: Anal triangle
-
Urogenital and anal triangles:
