Gross Anatomy Gross Anatomy Reproductive System 1Reproductive System 1

Harold J. Sheedlo, Ph.D.Department of Cell Biology and Genetics

Arteries of Pelvis and Perineum

Abdominal Aorta Common iliac arteries (L4)

External iliac artery Inferior epigastric artery Deep circumflex iliac artery

Arteries of Pelvis and Perineum

Abdominal Aorta Common iliac arteries

Internal iliac artery Posterior division

Iliolumbar artery Superior gluteal artery Lateral sacral arteries

Arteries of Pelvis and Perineum

Internal iliac artery Anterior division

Obturator artery Umbilical artery Vaginal/uterine artery Inferior vesical artery Middle rectal artery Internal pudendal artery Inferior gluteal artery

Muscles of Pelvis

Piriformis muscle Obturator internus muscle Coccygeus muscle Levator ani muscles

Iliococcygeus muscle Pubococcygeus muscle Puborectalis muscle

Muscles of Perineum

Ischiocavernosus muscle Bulbospongiosus muscle Sphincter urethrae muscle Deep transverse perineal muscle Superficial transverse perineal muscle

Ligaments of Pelvis

Sacrotuberous ligament Sacrospinous ligament Suspensory ligament of ovary Proper ligament of ovary Broad ligament

Mesometrium Mesovarium Mesosalpinx

Ligaments of Pelvis

Round ligament of uterus Cardinal ligament - uterine vessels

Nerves of Pelvis and Perineum

Lumbosacral trunk (L4, L5) Sacral plexus - ventral rami of S1, S2, S3 and

S4 Pudendal nerve (S2, S3, S4)

Perineal nerve Inferior rectal nerve Dorsal nerve of clitoris or penis

Obturator nerve (L3, L4) Inferior gluteal nerve (L5, S1, S2) Superior gluteal nerve (L4, L5, S1)

Veins of Pelvis and Perineum

Inferior vena cava (L5) Common iliac veins Internal iliac veins External iliac veins (femoral vein) Testicular or ovarian veins (left or right)

Female Organs

Infundibulum of uterine tube Fimbriae Ampulla of uterine tube Isthmus of uterine tube Uterine part Uterus

Fundus Body Internal os

Female Organs

Cervix Internal os External os

Vagina Fornices Vestibule

Vulva

Male Organs Scrotum

Skin Superficial (Dartos’) fascia External spermatic fascia Cremaster muscle Internal spermatic fascia

Testis Tunica vaginalis - parietal and visceral

layers Epididymis Tunica albuginea - seminiferous tubules

Male Organs

Ductus (vas) deferens Seminal vesicles Prostate

Ejaculatory ducts Lobes

Middle - benign prostatic hypertrophy (BPH)

Posterior - cancer prone

Male Organs

Corpus caverosum (corpora cavernosa) Corpus spongiosum Prostatic urethra Membranous urethra Spongy urethra

Male and Female Pelvis

Sacrum Ischial tuberosities Shape of pelvic inlet Pelvic inlet to pelvic outlet Pubic arch Size of pelvic cavity

Perineum

Boundaries Anal triangle Urogenital triangle

Urinary Bladder

Posterior of retropubic space Apex is anterior Ureters enter bladder posteroinferior Trigone - orifices of ureters and uvula of

bladder Interureteric crest Vesicouterine pouch - female Rectovesical pouch - male

Rectum

Arterial supply Superior rectal artery Middle and inferior rectal arteries

Venous drainage Superior rectal vein Middle and inferior rectal veins

Anus Anal columns Anal valves Pectinate line

Upper half and lower half of anal canal joins Differences

Epithelium (SCE, SSE) Anal columns Nervous innervation Arterial supply (SRA, IRA) Venous drainage (SRV, IRV) Lymphatic drainage

Examinations Rectal examination

Male - prostate, seminal vesicle Female - cervix

Bimanual examination in female Uterus Uterine tube Ovary

Clinical Hemorrhoids

Internal - srv External - irv

Hysterectomy Uterine artery Ureter

Vasectomy Episiotomy Pudendal nerve block

Practical Examination 25 gross anatomy and 10 histology Gross anatomy

1 x-ray (computer) 1 cross section (computer) 9 second order

Practical Examination Gross anatomy

3 arteries 2 nerves 3 veins 8 structures or organs 4 regions 1 muscle 2 bones

Practical Examination Gross anatomy

7 female structures 6 first order 1 second order

7 male structures 4 first order 3 second order

Histology (computer) 5 female and 5 male 5 first order 5 second order