11. Abdominal _ 3 Pelvis Viscera 630 S 09 %28Macintosh-6%27s conflicted copy 2010-06-29%29

8/8/2019 11. Abdominal _ 3 Pelvis Viscera 630 S 09 %28Macintosh-6%27s conflicted copy 2010-06-29%29

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Pelvic Viscera!Urinary Bladder!Renal anatomy!

HSC 630 Regional Anatomy!Summer 2010!

Dr. Salt!Ovaries!Prostate Gland!Rectum and anis!

Greater pelvis---false!

Lessor !Pelvis true!

Pelvic !brim!

Pelvic cavity vs abdominal pelvic cavity!

Pelvic inlet!

Pelvic outlet!

Boundaries of pelvic cavity!

Anteriorinferior pelvic wall!(Pubic synthesis-rami of pubic bones)!

Lateral pelvic wall!(Obturator foramen/obturator membrane/

obturator internis m.)!Posterior-lateral wall and roof!(sacrum/coccyx/piriformis m./sacral plexus)!Pelvic floor!(pelvic diaphragm (coccygeus and levator

ani m.)!


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Urogenital !diaphragm!

Obturator Internis m.!Levator ani m.!

Pelvic (floor)diaphragm!= levator ani!& coccygeus m.!

Pubic synthesis!

Sacrum!Piriformis m.!

Coccygeous m.!Iliococcygeus!

Pubococcygeous!

Ischiococcygeus!

Ischial spine!

Obturator internis!m/membrane !

Pelvis floor muscles:!Levator ani m.!

Puborectalis!Pubococcygeous!Iliococcygeus!

Coccygeous m. (Ischiococcygeus)!

Pelvic Floor) diaphragm!female!

Puborectalis!

Female: inferior view!

Pelvis floor!Levator ani m.!

Puborectalis!Pubococcygeous!Iliococcygeus!

Coccygeous m. (Ischiococcygeus)!Coccygeous m. (Ischiococcygeus!

Pubococcygeous!

Iliococcygeus!

Puborectalis!

Superior! Inferior!

p!c!il!

Male pelvic floor!

PC!

PR!


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Birth control!

Peritoneal relationships of the pelvis-female !Sub peritoneal! Peritoneal relationships of the pelvis-male!


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1. Thoracic aorta!2. Abdominal aorta!3. Common iliac a.!4. Internal iliac a.!Numerous branches!

Review: General Blood supply to the !pelvic organs!

Blood supply to the pelvis!

Common !iliac a.!External iliac a.!

Internal iliac a.!

Blood supply to the pelvis!

Internal iliac a. (ant-post branches)!Ant. Division! Umbilical a. (urinary bladder)!

Superior vesical a. (urinary bladder)!Medial umb. Lig.!

Obturator a. (pelvic and adductor m.)!Uterine (uterus)!Internal pudendal a. (perineum)!

Middle rectal (rectum, prostste, vagina) !Inferior gluteal a. (glut maximux m.) !

Post Division!Superior gluteal a. (gluteals, piriformis)!Lateral sacral a. (sacral canal)!

Sup rectal a. from IMA!

Nerves of the pelvis (Somatic)!Sacral plexus L4-S4! Lumbosacral Trunk!Sacral plexus!

Superior gluteal!Nerve to piriformis!Inferior gluteal!Nerve to quadratus femoris!Nerve to obturator internis!Nerve to Superoior gemellus!Nerve to Levator ani!Nerve to Coccygeus!


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Nerves of the pelvis!Sacral plexus!L4-S4!

Nerves to pelvic floor with muscles!

Levator ani m.!Coccygeus m.!

Obturator internis m.!

Piriformis m.!

Nerves to pelvis (ANS)!

Fig. 3.23!

Inferior hypogastric p!Pelvic splanchnics (Para)!Sacral splanchnics!Sacral sym trunk !

Blood supply!

Nerve blood vessel landmarks!

*Superior gluteal (between L5 and S1!

*

Inferior gluteal (between S1 and S2!


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Review of the muscles of the pelvic floor!

Location of bladder and relationships!TRIGONEURETERAL OPENINGSINTERNAL URETHRAL ORIFICEINTERNAL SPHINCTEREXTERNAL SPHINCTER (UG Dia)

HISTOLOGY (FOUR COATS)MUCOSA (Transitional Epithelium) -RUGAESUBMUCOSA CONNECTIVE TISSUE

MUSCULARIS DETRUSOR MUSCLESEROSA Parietal peritoneum

URINARY BLADDER Anatomy


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INTERNAL URETHRAL ORIFICEINTERNAL SPHINCTEREXTERNAL SPHINCTER (UG Diaphragm)

Blood supply, to the bladder! Internal iliac a!Anterior division!

Sup vesical a.!And others!


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Parasympathetic:!Motor to detrusser m. and inhibitory to the !internal sphincter via pelvic splanchnic!

Stim!

Inhib!

ANS reflex!Micturation!

Micturition !reflex!

Ureters!

Kidney stones!

Blood, nerve and lymph drainage of ureter!

Common iliac a.!Internal iliac a.!Gonadal a.!

Plexus:!Renal!Aortic!Sup/inf hypogastric!


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Ovary and Uterus!Basic anatomy!

Ovary!Uterine tubes!Uterus!Vagina!Rectouterine pouch!Vesicouterine pouch!

ROUND LIGAMENT OF THE UTERUSOVARIAN LIGAMENTSUSPENSORY LIGAMENT OF THE OVARYBROAD LIGAMENTUTEROSACRAL LIGAMENTCARDINAL LIGAMENTS

Uterine tube (Fallopian tube)! Infundibulum! Fimbriae! Ampulla! Isthmus! Epithelium (columnar)Uterus

FundusBodyCervix-external os (cervical)Cervical canalFornx

EndometrimMyometrium

Perimetrium

Mesovarium mesentary of ovary!Mesoalpinx mesentary of fallopian tube!

Ovaries and uterus


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Blood supply to the ovary and uterus !

Ovarian a. from aorta!Uterine a. from Internal iliac a.!

Spinal-In L3-L4 vert!!(Inferior waist)!Pudendal-In perineum!

!(S2-S4)-perinuum!Caudal- (epidural) In sacral canal!!(S2-S4)!

Nerve supply to the female pelvis (new)!

Fig 3.47!L3-L4!

S2-S4!


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Prostrate, seminal vesicals and Bulbourethral galnds!Ductus deferens and ampulla!Ejactulary duct!

Male pelvic genital organs!

More on the prostate!BPH!

Blood: inferior vesiclar a.!Nerve- Sym pre- T12-L3!! Para pre S2-S3 pelvic splanchnics!


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Urinary organs and relationships Location of Kidneys!

Relationships!

Location ofKidneys 2-Retroperionteal

Location of Kidneys 3---Retroperionteal!

SkinSUBCUTANIOUS FASCIAMUSCLE lat. and QuadratuslumborumPARARENAL FATRENAL FASCIA ANT/POSTPERIRENAL FATCONTACT WITHCAPsuleRenal CAPSULEKIDNEY


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KIDNEYS!EXTERNAL ANATOMY HILUS RENAL SINUS

RENAL CAPSULE ADIPOSE CAPSULE

RENAL FASCIA

INTERNAL ANATOMY CORTEX

RENAL COLUMNS

MEDULLA RENAL PYRAMIDS

RENAL PAPILLAE

RENAL PELVIS

MAJOR CALYCES

MINOR CALYCES

Blood supply to and from kidneys!

BLOOD SUPPLY TO KIDNEY!AORTA--RENAL ARTERY ! MANY BRANCHES! !

NEPHRON filter ! RENAL VEIN ! INFERIOR VENA CAVA!

AFFERENT ARTERIOLE

GLOMERULUS

GLOMERULAR (BOWMANS)CAPSULE

EFFERNT ARTERIOLE

PERITUBULAR CAPILLARYNETWORK

PROXIMAL CONVOLUTED TUBULE

LOOP OF HENLE

DESCENDING LIMB

ASCENDING LIMB

DISTAL CONVOLUTED TUBULE

COLLECTING DUCT (TUBULE)

PAPILLARY DUCT

How and who does filtering!Of the blood!


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Renal corpusle!

Functional !anatomy!

Filtration!

reabsorption!

Secretion!

Waste to calyx!

Flow of urine to outside!

Kidney filters-renal papilla-minor calyx-major

calyx-renal pelvis-ureter-bladder-urethrae!


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A!

B!

C!

D!

Adrenal gland!

Adrenal Glands! Cortex!Mineral corticoids!Glucocorticoids!Androgens!

Medulla!Catocholamines!

Blood:!Superior suprarenal-infer. phrenic!Middle suprarenal-aorta!Inferior suprarenal-renal!

Pre ganglionic!sympathetic fibers!


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Nerves of kidneys !and adrenal gland!

Male sexual response!Erection!!Flacid-BV constricted and little blood to erictile tissues!!Sexual stimulus- Parasym. Reflex (S2-4)!!to dilate BV (Internal Pudendal a.) !!

blood flows to into erectile tissues. Erect penis!! compresses veins inhibiting venous return.!

Ejaculation!!Stimulus of smooth muscle in ducts via Sympathetic Reflex!!(L1 and L2)!!1. Activate glands (3)!!2. Bladder sphincter constricts!!3. Bulbospongiosus contracts propelling semen!! !!

ANUSINTERNAL ANAL SPHINCTER (smoothmuscle)EXTERNAL ANAL SPHINCTER (skeletalmuscle)ANAL (Rectal) COLUMNS!


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Blood and nerve supply to rectum and anas!


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Pelvic floor!Vs!

Urogenital !diaphragm!Obturator m.!

Levator ani m.!

11. Abdominal _ 3 Pelvis Viscera 630 S 09 %28Macintosh-6%27s conflicted copy 2010-06-29%29

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