Professional Documents
Culture Documents
Gwen Obedencio
Before I get into the pelvic area, let me start with the kidneys and related structures.
Kidney
Vascularization: left and right renal arteries and veins (branching of these vessels is
sometimes arbitraryas a result, the kidneys may get blood supply from two renal
arteries). The left renal vein passes anterior to the aorta.
Innervation: renal plexus supplied by fibers from the lesser and lowest splanchnic
nerves; consist of both sympathetic and parasympathetic fibers.
Lymphatics: lymph vessels follow the renal vein and drain into the lumbar lymph
nodes.
It is retroperitoneal.
Location: contacts ribs 11 and 12; lie at the level of T12 to L3 vertebrae
Covering: surrounded by a fibrous capsule and fat and fascia; from outside to
inside, the layers are: parietal peritoneum, pararenal fat, renal fascia, perirenal fat.
Renal Hilum: contains renal veins and arteries and the renal pelvis which narrows to
become the ureter.
Internal Parts: (see atlas) medulla, cortex, renal columns, renal pyramids, renal
papilla, minor calyx, major calyx, renal pelvis.
Ureters
Vascularization: arterial supply from three main sources: renal artery, superior
vesical artery, and common iliac artery or aorta; however, some other sources may
include the testicular or ovarian artery, internal iliac, inferior vesical and the uterine
artery. Venous drainage into the testicular or ovarian veins.
Innervation: same as the kidney.
Lymphatics: drains into the lumbar, common, external, and internal iliac lymph
nodes.
It is retroperitoneal and it adheres closely to the parietal peritoneum.
Function: carries urine from the kidney to the bladder.
Location: lie anterior to the psoas major muscle; right ureter lies closely to the
inferior vena cava, lumbar lymph nodes, and the sympathetic trunk.
PELVIC REGION
Bladder
Vascularization: arterial supply: the superior vesical arteries, branches of the
umbilical arteries supply the anterosuperior parts of the bladder; meanwhile, in the
male, the inferior vesical arteries supply the fundus of the bladder while the vaginal
arteries supply the posteroinferior parts of the bladder in the female. The obturator
and the inferior gluteal arteries also supply parts of the bladder. Venous drainage: in
the male, it includes the vesical venous plexus, the prostatic plexus, and the vertebral
venous plexuses. In the female, its just the vesical venous plexus.
uterus to the lateral walls and floor of the pelvis; the ovarian ligament lies
posterosuperiorly and the round ligament lies anteroinferiorly within the broad
ligament; has 3 parts:
Mesovarium: attaches the ovaries to the broad ligament anteriorly.
Mesosalphinx: part of the broad ligament between the ovarian ligament, the
ovary and the uterine tube.
Mesometrium: the rest of the broad ligament below the ovarian ligament.
PERINEUM REGION
Vascularization: branches of the external and internal pudendal vessels which
include the perineal vessels (terminate as labial arteries), artery of the bulb (supplies
the bulb of the vestibule and greater vestibular gland in the female), and the deep and
dorsal arteries of the penis/clitoris (deep travels within the corpora cavernosa and the
dorsal is more superficial).
Innervation: pudendal nerve branches perineal nerve (motor to the muscles and
sensory to the labia majora) and the dorsal nerve to the penis/clitoris; also branches of
the ilioinguinal nerve, the genital branch of the genitofemoral nerve, and branches of
the femoral cutaneous nerve of the thigh.
Lymphatics: superficial and deep inguinal lymph nodes
Structures:
-Deep Perineal Pouch
Muscles: deep transverse perineous and the sphinchter urethra
Female deep space: vagina and urethra
-Superficial Perineal Pouch
Clitoris: erectile organ of the female; it is made of the crura of the clitoris
which originate from the internal surface of the ramus of the ishium the two
crura meet midline to form the clitoris; the crura is surrounded by the
ishiocavernosus muscle at the origin; the clitoris has a root, a body, two
corpora cavernosa which are tissue continuous from the ishiocavernosus
muscle, and a glans. Suspended by a suspensory ligament.
Bulb of the Vestibule: two erectile tissues lateral to the vaginal orifice;
covered by the bulbospongiosus muscle; separated by the clitoris and the
vestibule of the vagina unlike the bulb of the penis, its counterpart in the male.
Greater Vestibular Glands: located on each side of the vestibule of the
vagina; secrete lubricating mucous during sexual arousal; lie posterior to the
bulb of the vestibule (aka Bartholins glands)
External Urethral Orifice: located posterior to the clitoris and immediately
anterior to the vaginal orifice.
Vaginal Orifice: larger opening anterior to the rectum and posterior to the
smaller external urethral orifice; surrounded by a thin mucous membrane
called the hymen.
Vestibule of the Vagina: space between the labia minora; the vagina,
urethra, and the ducts of the greater vestibular glands open to the vestibule.
Labia minora: thin, fat-free, hairless folds of skin between the labia majora;
they meet anterior to the clitoris to form the prepuce and posteriorly to form
the frenulum; enclose the vestibule of the vagina.
Labia majora: folds of skin filled with subcutaneous fat lateral to the labia
minora; serves to protect structures within the labia minora and the vestibule
of the vagina; the two folds meet anteriorly to form the anterior labial
commisure.
Mons Pubis: rounded fatty elevation anterior to the pubis symphysis.
Perineal Body: tendinous center of the perineum; wedge-shaped fibrous
tissue; landmark of the perineum because several muscles attach there
(transverse perineal, bulbospongiosus, levator ani, etc)
Muscles: superficial transverse perineus muscle two small horizontal
muscles that attach to the perineal body and the ishial tuberosity