Lecture Monday September 10: anatomy pelvis and perineum

Most of this material will be covered in the laboratory exercise. In terms of high yield information from this lecture I would recommend paying attention to the following:

A. Pelvic Diaphragm
-Coccygeus muscle and
-Levator Ani muscle (iliococcygeus, pubococcygeus, puborectalis)
*Innervation by ventral rami of S2-S4

Puborectalis- an important role in fecal continence.

B. Urogenital Diaphragm
Fascia (perineal membrane) and thin muscles including superficial and deep transverse perineal and external urethral sphincter.
*Innervation by pudendal nerve

C. Perineum
Divided into urogenital triangle and anal triangle
External genitalia attached to the external surface of urogenital diaphragm in the urogenital triangle.

Skeletal muscles cover the erectile tissues of both sexes: bulbospongiosus and ischiocavernosus.
*Innervation by pudendal nerve








D. Pouches/spaces within the Pelvis formed by peritoneal folds.
Females: vesico-uterine pouch and recto-uterine pouch (of Douglas)
Males: recto-vesical pouch

Clinical importance of the recto-uterine pouch is a site where infection and fluids typically accumulate.




E. Facial Supports of the Uterus and Vagina
Levator Ani muscles and three main condensations of fascia that form "ligaments":
- Pubocervical
- Transverse cervical/cardinal ligaments (*most important support structure)
- Uterosacral



Failure of these support structures results in uterine or vaginal prolapse.


F. *Learn the Arteries in the Lab*

Relationship of uterine artery to the ureter is important



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