Internal Organs of the Pelvis

8 April 2008

Pelvic Visceral Organs

· Three systems

– Urinary

– Reproductive

– Digestive

· Blood supply from internal iliac a.

· Visceral motor innervation

– Sympathetic from inferior hypogastric plexus

– Parasympathetic from pelvic splanchnic nn.

Organ systems

· Urinary

– Ureters

– Bladder

– Urethra

· Digestive

– Sigmoid colon

– Rectum

– Anal canal

· Reproductive - female

– Uterus

– Uterine tubes

– Ovaries

– Vagina

· Reproductive - male

– Prostate

– Ducti deferens

– Seminal vesicles

· Urinary bladder

· Detrusor m.

· Apex

· Neck

· Fundus

· Urethral orifice

· Vesicle trigone

Netter, 2003, pls. 347, 367; Netter, 2006 pl. 360, 384

Rosse & Gaddum-Rosse, 1997, Fig. 27-23

Associated structures in Males

· Prostate gland

· Seminal vesicles

· Ducti deferens

· Ejaculatory ducts

· Prostatic utricle

Ureteric sphincters

· Neck of bladder

· Pubococcygeus m.

· Urogenital diaphragm

Netter, 2003 pl. 366; Netter 2006 pl. 383

Prostate

· Anterior lobe

· Middle lobe

· Posterior lobe

· Ejaculatory duct

Clemente, 1997; Fig. 444

Netter, 2003 pl. 367; Netter, 2006 pl. 384

Female Urogenital Diaphragm

· Vagina

· Deep transverse perineus m.

· Superficial transverse perineus m.

Netter, 2003 pl. 361; Netter, 2006 pl. 379

Internal pelvic organs - female

· Bladder

· Urethra

· Vagina note longer posterior wall

· Cervix

· Uterus

– Posterior fornix

– Anterior fornix

· Rectum

Netter, 2003 pl. 347; Netter, 2006 pl. 360

Ligaments of Uterus

· Broad ligament

– Mesovarium

– Mesometrium

– Mesosalpinx

· Round ligament

– Attaches anterolaterally

· Uterosacral ligament

– Attaches posterolaterally

Netter, 2003 pl. 356; Netter, 2006 pl. 371

Rosse & Gaddum-Rosse, 1997; Fig. 27-33

Spaces:

· Vesicouterine pouch

· Rectouterine pouch

Netter, 2003 pl. 347; Netter, 2006 pl. 360

Blood supply of the uterus

· Ovarian a.

– tubal branches

· Uterine a.

– ovarian br.

– tubal br.

· Vaginal a.

· Internal pudendal a.

Netter, 2003, pl. 384; Netter, 2006 pl. 404

Ischiorectal Fossa

· Levator ani m.

· Obturator Internus m.

· External & internal anal sphincters

· Pudendal canal

Netter, 2003 pl. 373; Netter 2006 pl. 392

Interior of rectum

· Transverse folds of rectum

· Pectinate line

– anal columns

– anal sinuses

Marks junction between endodermal & ectodermal zones. Watershed for

nervous innervation, blood supply & lymphatic drainage

Netter, 2003 pls. 374, 375; Netter, 2006 pls. 393, 394

see Moore & Dalley 2006, Fig. 3.45

Anal sphincters

· Internal anal sphincter

· Internal rectal venous plexus

· External anal sphincter

· External anal venous plexus

Netter, 2003 pls. 375, 396; Netter, 2006 pl. 394, 395

Pelvic vasculature

• Branches to viscera

– Umbilical, Inferior vesicle, Middle rectal, Uterine, Vaginal

• Branches to pelvic wall

– Iliolumbar, Lateral sacral

• Branches to lower limb

– Obturator, Sup. gluteal, Inf. gluteal

• Branch to perineum

– Internal pudendal

Rectal aa.

· Superior rectal

– Inferior mesenteric a.

· Middle rectal

– Internal iliac a.

· Inferior rectal

– Internal pundendal a.

Netter, 2003 pl. 378; Netter, 2006 pl. 396

Umbilical a.

· Superior vesicle a.

Obturator a.

Uterine/Vaginal aa. (female)

Middle Rectal

· Inf. Vesicle a.

· prostatic a. (male)

Superior gluteal a.

Inferior gluteal a.

Internal pudendal a.

Netter, 2003 pl. 382; Netter, 2006 pl. 402