Anatomy - Peritoneum

1. Transverse - F > M
2. AP (True conjugate) - sacrovertebral angle to pubic symphsis M > F
3. Oblique diamater - Inf SIJ to

Female has wider pubic arch and transverse diamater. Ovoid shape
Male has longer True conjugate. Pubic tubercles closer. Heart shaped

Greater = false = above and in front of the pelvic brim
Lesser = true = part of pelvic cavity

1. Sacroiliac
2. Sacrospinous - spine of ischium
3. Sacrotuberous - PSIS to sacrum to ishcial tuberosity

Superior and inferior pubic ligaments

Piriformis - posterior wall. Scarum to GT
Obturator Internus - lateral wall. Pubis to intertrochanteric line. Both appear to insert of the tendinous arch

Coccygeus
Levator Ani: iliococcygeus, pubococcygeus, puborectalis

Pubococcygeus - Controls urine flow and contracts during orgasm
Puborectalis - Forms sling around rectum, relaxes to allow defacation

O. spine of ischium and SS lig
I: coccyx
N: S3-S5
F: Pulls coccyx forward after defacation

Not part of pelvic cavity - always in state of tonic contraction. Relaxes to allow defacation

Part of levator ani (puborectalis) - partly responsible for fecal continence

U shaped cut out in the mm of the pelvic floor that allows for the passage of the urethra, rectum, and Va J J

CT that extend between teh coccyx and anus - where the mm of the anterior pelvic floor unite !

S2, S3, S4

Cushion for the pushin'
Fat filled area ANT to the urethra that prevents the bladder from falling out of your body and onto the ground

ANT division: obturator, inf. gluteal, umbilical, uterine (F) or deferential (M), Superior vesical, Int pudenal a., obturator
POS division: Iliolumbar, lateral sacral, superior gluteal

Iliolumbar, lateral sacra, superior gluteal

R to L: Umbilical, superior vesicle, obturator, uterine, internal pudenal, inf gluteal

SUP: portal vein
MID and INF: Inf vena cava
Portocaval anastomosis

IIA to Umbilical to Sup vesical aa.
IIA to inf. vesical a. (M) or uterine a. (F)
IIA to rectal artery

Lateral sacral a. and iliolumbar a ... both branches of the pos division of the IIA

Internal pudenal a (to ext. genitalia)
Inf. rectal a. (to lower half an anal canal)

Obturator a
Superior gluteal a.
Inferior gluteal a.

From abdominal aorta

Pelvic floor = levator ani, coccygeus, and fascia covering them
Lateral - Obterator internus
Anterior - Pubic rami and symphysis
Posterior - piriformis and SIJ ligs

Limits the pelvic cavity inferior
It is like a bowl b/c it is suspended above the pelvic outlet
Made up of coccygeus m, levator ani, and fascia
It forms the roof of the perineum

Shallow compartment bounded by pelvic outlet and separated from pelvic cavity by the pelvic diaphragm
Bounded ANT by pubic symphysis and POS by tip of coccyx and LAT by ischial tuberosities

Urogenital triangle (contains vagina) and anal triangle

Fat, Peduenal n., Int pudenal a. and v.

Ductus deferencs, testicular a., pampiniform plxus of veins

Continuation of the duct of the eipididymis. Epididymus stores sperm that testicle makes. Ductus carries it (in spermatic cord) around to ampulla of ductus deferens and then to ejaculatory duct

Tunica albuginea and tunica vaginalis

Seminiferous tubules and Rete testis carry it to efferent ductules to epididymis to store and mature.
No PT implications.

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いつ, いつ(つ)

Spincter urethrae
Sphincter urethrovaginalis
Bulbourethral glands
Deep transverse perineal mm

SUP: erectile tissue and associated mm
DEEP: fat, glands, urethral mm

spongiosum: inner layer; prevents urethra from pinching closed
cavernosum: sponge like region of erectile tissue that fills with blood.
Surrounded by deep (Buck's) fascia

Seminal vesicle and Ampulla of vas deferens

Prostate: inferior to bladder
Seminal vesicle: Posterior to bladder
Bulbourethral gland: Inferior to prostate

S2-S4, pelvic splanchic nn, in charge of micturation, defacation, and erection
Bladder and rectum: relax internal sphincters, contract mm in wall

T11-L2, Least and Lumbar Splanchnic nn, in charge of ejaculation
Bladder and rectum: relax mm in wall and tighten internal sphincters
Vagina: stimulate contraction of wall during orgasm

Sperm production, ovulation, and uterine contractions

Travels mostly with parasympathetics to SC (S2-S4)
Also with sympathetics to higher levels from gonads and uterus

Somatic motor to control external sphincters, mm of pelvic floor and
Somatic sensory to distal 1/5th of Va J J

Connects side of uterus to walls and floor of pelvis. Surrounds fallopian tubes, uterus and ovary
Meosvarium: ovaries
Mesosalpinx: fallopian tubes
Mesometrium: uterus

Attatch to uterine horns, leveas pelvis via deep inguinal ring, passes thru inguinal canal and attatches of labia majora

Ligament of ovary: Ovary to uterus - holds ovary in place
Suspensory: Ovary, goes lateral to wall of pelvis

Attatches cervix to lateral pelvic wall. Contains uterine a. and v.

Where fertilization takes place

Infundibulum with fimrae
Ampulla
Isthmus

Uterine a. has a vaginal branch
Internal pudenal a. goes to the more "exterior" parts
Ascending branch of the uterine a. travels up to get the uterus
Ovarian a. come right of the abdominal aorta

1. Perimetrium - outer serous coat
2. Myometrium - smooth mm = prego contractions
3. Endometrium - inner layer, involved with Ross' menstrual cycle

Rectouterine: between rectum and uterus
Vesicouterine pouch - Between rectum and bladder

Anteversion is normal position, retroversion is when it "stands up"

Deepest portion of the Va J J

Erectile tissue that contains most of the blood in superficial perineal pouch (M and F)

Internal part of the clitoris - erectile tissue in superficial perineal pouch

Inf and lateral to the Va J J - secretes fluid

Between Va J J and anus
Important site of mm attatchment

Surgical incision of the perineum and inferoposterior vaginal wall.
Made to enlarge the vaginal orifice, with the intention of decreasing excessive traumatic tearing. Perineal body is usually incised.

Median and median-lateral
Its toward teh external anal spinchter and additional tearing may occur.
Contributes to loss of mm associated with perineal and pelvic floor support

1. Prolapse: of bladder, uterus, urethra, rectum, intesitnes/colon
2. Incontinence: by stress, urgency, overflow, fecal
Most common in females

Ejaculation in men and contraction of smooth mm in walls of ductus def, seminal vesicles, prostate, urethra, internal vesical sphincter
Rhythmic contrctions of the smooth mm in wall of Va J J during Orgasm

S2-S4, erection and relaxation of smooth mm in walls of arteries feeding erectile tissue
Relaxation of smooth internal sphincters of bladder and rectum during defecation and urination. Contraction of the smooth mm in the walls of these organs

Innervates external anal sphincter and sphincter urethrae. Also levator ani and puborectal sling

Innervates bulbospongiosus and ischiocavernosus mm (superificial pouch)

In peritoneal cavity - between bladder and rectum that allows for expansion of these two structures

Internal pudenal a. (comes off Ant division of IIA) branches to: inferior rectal a., dorsal a. of the penis (clitoris), and perineal a (has scrotal branches)

Uterine a (Ant branch if IIA)

Only in males, branch off IIA to supply prostate, seminal vesicle, and inferior bladder. (Males ahve this instead of uterine a.)

Inferior mesenteric artery (not iliacs)

perineal membrane