影像解剖-The Pelvis Wall课件

ThePelvicWall

(P145-154)1.Thebonypelvis1)Formation

hipbones(ilium,pubis,ischium),sacrum,coccyxandjoints2)Superiorpelvicaperture:superiormarginofpubicsymphysis,pectenofpubis,arcuateline,promontoryofsacrumGreaterpelvisLesserpelvis3)InferiorpelvicapertureInferiormarginofpubicsymphysisPubicarchesIschialtuberositiesSacrotuberous

lig.TipofcoccyxThedifferencesofthemaleandfemalepelvis

femalepelvis

malepelvis

*anguluspubis90degree70-75degree*

highdegreeofthelesserpelvis

shorterhigher*superiorpelvicaperturelargersmallerthanfemale*ischialtuberosity

turninglaterallynotturninglaterally*ischialspinesmallerlarger*transversediameterbetweenlongershorter

the2ischialtuberosity

*bonysurfacesmootherlessersmooth

2.MusclesofthepelvicwallObturater

internusPiriformisLevatoraniCoccygeus3.Bloodvesselsandnerves1)Commoniliaca.2)Internaliliaca.(1)parietalbr.Illiolumbara.Lateralsacrala.Superiorgluteala.Inferiorgluteala.Obturatora.**Mediansacrala.(2)visceralbr.Internalpudendaa.Umbilicala.Inferiorvesiclea.Inferiorrectala.Uterinea.—about2cmfromthecervixoftheuterus,itcrossesaboveandinfrontofureter.3)Pelvicveins(1)theveinssurroundtheorganstoformthevenousplexus(2)theveinsoftheorgansinthepelvisbeginwiththethevenousplexusandaccompanythesamea.(3)thereareanastomosesbetweentheplexus.4)Sacralplexus(1)Tolieontheanteriortothepiriformis(2)Tobeformedbythelumbosacraltrunk,ventralramiofsacralandcoccygealnerves(3)Br.Superiorglutealn.Inferiorglutealn.Pudendaln.Sciaticn.5)Theothers

Superiorrectala.Obturatorn.PelvicsympathetictrunkPelvicsplanchnicn.Pelvicviscera

(P154-167,173-177)1.Pelvicpartoftheureter

2.Urinarybladder1)position:2)relation:Posteriorly:seminalvesicles,rectum,ampullaofductusdeferens---inmaleuterus,vaginainfemaleInferiorly:

Inmale,prostateInfemale,urogenitaldiaphragm3)Thefeatureandshapeofurinarybladder(1)division:apex,fundus,neckandbodyVolumeisabout300-500milliliters(2)Trigoneofthebladder:

Attheinnersurfaceofthefundus

Formedbyleftandrightorificesofuretersinternalurethralorifice3.Urethra1).Femaleurethra:broader,shorter,straighterOpeninginthevestibuleofvagina2)Maleurethra3parts:

ProstaticpartMembranouspartSpongypart3narrowparts(strictures)1statinternalorifice2ndatmembranouspart3rdatexternalopening2curvesSubpubiscurve(fixed)Prepubiscurve(variable)3enlargementsfunctions4rectum(1)curvessacralflexureperinealflexure(2)anteriorrelationshipInmale–fundusofurinarybladder,ampullaofductusdeferens,seminalvesicle,prostate,rectovesiclepouchInfemale–uterinecervix,vagina,rectouterinepouch5.AnalcanalAnalcolumnsAnalvalesAnalsinusPectinatelineAnalpectenHiltonlineAnalsphincters(internalanalsphincter,externalanalsphincter)Thedifferenceaboveandbelowthepectinateline

abovethepectinatelinebelowthepectinatelineepitheliummucosaskina.supplysup.andinf.rectalaa.anala.veinopeninginto

ernalpudendalv.lymphdrainingintointernaliliacL.nodesInguinalL.nodesinf.mesentericL.nodesinnervationvisceralnervesomaticnerve

Malegenitalorgans1.Testis2.Epididymis3.DuctusdeferensTesticularpart

FunicunalpartInguinalpartPstateBetweenthebladderandurogenitaldiaphragmDivision:base,apexandbodyLobes:anterior,posterior,middleand2laterallobesStructurespiercingtheprostate6.Seminalvesicles7.bulbourethralglands(Intheurogenitaldiaphragm)TosummarizetheplaceofthespermsproducedandcourseofspermstransportedTestis→epididymis→ductus

deferense→ejaculatory→maleurethra→externalorificeofthemaleurethra→externalbodyThespermaticcord*Tobecomposedof

*3membranes

Ductusdeferens,Testiculara.

InternalspermaticfasciaPampinformvenousplexus

Cremastericm.Nerves,L.vessels

ExternalspermaticfasciaRemnantofprocessus

vaginalis

Thefemalegenitalorgans1.Ovaries1)feature:almond-shapedglandsMesovariumSuspensorylig.Lig.ofovary2)function:toproducefemalehormoneandovum3)position:tobelocatedclosetolateralpelvicwall;atthebifurcationofthecommoneiliaca.4)arterialsupply:

overiana.,overian

br.fromuterinea.2.uterinetubesMuscular,tortuous,trumpet-liketubesDivisionInfundibulum

(fimbria,abdominal

ostium)AmpullaIsthmuspart:ligationisperformedatthispart.Uterinepart3.uterusPosition*inthemiddleofthethepelvicminor*betweenthebladderandrectum*fundusbelowthelevelofsuperioraperture*inferiorendabovelevelofischealspine*anteversion(前倾)andanteflexion(前屈)2).division(1)divisionFundusBodyNeck—supravaginalpartvaginalpart

Isthmus(2)Internalcavity–uterinecavitycervicalcanal3).LigamentsoftheuterusBroadlig.2layer-foldsof

peritoneum

Mesosalpinx

Mesometrium

MesovariumContents:Function:Roundlig.:Function: