★Pelvic diaphragm 。Superior fascia ● Muscles=Levator ani Coccygeus 。Inferior fascia The tendinous arch女 -----sup./inf fascia (splited -----the origin of levator ani IaG塔 Rectum Peritonoum Obturator tascia intenor and superior tascia of levator ani- Obturator internus -Lovator ani Inferior rectal Pudendal can vessels and nerve Ischionnal foss利 External anal of perineum sphincter
★ Pelvic diaphragm • Superior fascia • Muscles = Levator ani + Coccygeus • Inferior fascia The tendinous arch ★ -----sup./ inf fascia (splited ) ----- the origin of levator ani
Identify the extent of the peritoneum and its folds and reflections in the male and female pelvis and their relationship to the pelvic contents. Rectovesicle pouch Rectouterine pouch Douglas'g recess★ THORAX erosity PERINEUM Infraperitoneal space Vesicouterine pBuch Most pelvic organs are infraperitoneal,except the uterine sotia is intraperitoneal
Identify the extent of the peritoneum and its folds and reflections in the male and female pelvis and their relationship to the pelvic contents. Infraperitoneal space Rectovesicle pouch Vesicouterine pouch Rectouterine pouch Douglas’s recess ★ Most pelvic organs are infraperitoneal, except the uterine sotia is intraperitoneal
Membranous pelvic fascia:parietal and visceral Parietal pelvic fascia A continuation of the transversalis fascia and iliopsoas fascia Forming the tendinous arch,covering the muscles,puboprostatic lig./pobovesical lig. =the origin of levator ani splits as sup./inf.fascia of pelvic diaphragm Visceral pelvic fascia Between the peritoneum and the pelvic viscera Ensheathes retroperitoneal viscera forming adventitial layers Subperitoneal -Peritoneum Exteral urethral sphincter Pubovosical ligamont ondopeivic fascia 一um Obturator intemus Prostate Obturator fascia Tendinous arch of lovator ani (thickenngofobturatorasca) Obturator internus Levator ani. Plane of E Rooto sheath-- Viscaralfascia Pariotal polvic Tendinous arch ot levator ani -Coccygeus Levator an fascia- Superior and interio lasciaof petuic dfaohtaom Pinformis Ischioanal fossa Utorosacral (roctoutorino)ligament Deep perineal tascia Penneal membrane
Membranous pelvic fascia: parietal and visceral Parietal pelvic fascia • A continuation of the transversalis fascia and iliopsoas fascia • Forming the tendinous arch, covering the muscles, puboprostatic lig./ pobovesical lig. = the origin of levator ani splits as sup. / inf. fascia of pelvic diaphragm Visceral pelvic fascia • Between the peritoneum and the pelvic viscera • Ensheathes retroperitoneal viscera forming adventitial layers
Endopelvic fascia:loose and condensed extraperitoneal connective tissue or subperitoneal endopelvic fascia between the parietal and viscereal mambranous layers 。 The loose:fatty---space --Retropubic space --Pararectal Retrorecta space The condensations:fibrous fascial condenstions------ligament and septa --hypogastric sheath to convey NVB to provide support --Rectovesical septum,Rectovaginal septum -Lat.Bladder lig.,Cadinal lig.=transverse cervical lig.,lateral rectal lig. Bladder dder sphincter
Endopelvic fascia: loose and condensed extraperitoneal connective tissue or subperitoneal endopelvic fascia between the parietal and viscereal mambranous layers • The loose: fatty --- space -- Retropubic space -- Pararectal / Retrorecta space • The condensations ★ : fibrous fascial condenstions------ligament and septa -- hypogastric sheath to convey NVB to provide support -- Rectovesical septum, Rectovaginal septum -- Lat. Bladder lig. , Cadinal lig.= transverse cervical lig., lateral rectal lig
*Location of External urethral sphincter Rectum Pubovosical ligamont ischial spine Obturator internus Uterosacral Cardinal (transverse Tondinous arch of lova loament cervical)ligament Tondinous arch o!polvic fascia (thickening of obturato Levator ani Bed of biadder Cervix foutlined) Root of hypogas Tendinous arch Paracolpium Parlotal polvic (cut edges)'tnscia" of levator an Nock of bladder Coccygous Levator ani Obturator internus Pubic bones muscie -Piritormis Pubic Tendinous arch of ELeft anterolateral view symphyals pelvic fascia Pelvic fascia:endopelvic fascia and fascial ligaments. Pubic bone Bladde Retropubic (prevesical)space Visceral fascia of bladdor Pubovesical ligament(green) Paravesical space. Obturator membrane Obturator intemus Lateral ligament of bladder Obturator fascia- -Ureter Plane of A Paravesical space Cervix- Cardinal (transverse cervical)ligament Tendinous arch of pelvic Hypogastric sheath NVB fascia (green) Lateral rectal ligaments Sacrogenital ligament Visceral fascia of rectum Sacrum
NVB