6. Pelvis
Ligaments
1. Sacrospinous ligament 骶棘韧带
Extend from the lateral border of the
sacrum and coccyx to the spine of the
ischium
2. Sacrotuberous ligament 骶结节韧带
Extend from the posterior aspect of
the lower 3 sacral vertebrae to the
ischial tuberosity
7.
8. Pelvis
Pelvic divisions (iliopectineal line
髂耻线 )
1. False pelvis (pelvis major)
2. Ture pelvis (pelvis minor)
Bony birth canal
the Pelvic inlet, the pelvic out let and the
pelvic cavity
9.
10. Pelvis
Types of pelvis
1. The gynecoid type ( 女型骨盆 )
round, slightly ovoid or elliptical inlet.
adequate sacrosciatic notch. wide
interspinous diameters(≥10cm). 52%-
58.9%
2. The platypelloid type ( 扁平型骨盆 )
distinct oval inlet. very wide subpubic
arch. 23.2%-29%
11.
12. Pelvis
3. The anthropoid type ( 类人猿型骨盆 )
long, narrow, oval inlet. extended
and narrow anterior and posterior
segment. wide sacrosciatic notch. long ,
narrow sacrum. Straight side walls.
4. The android type ( 男型骨盆 )
13. Pelvic floor
The tissues closing down the pelvic
outlet (muscles and fasciae)
suspend and support the pelvic organs,
such as uterus and bladder and rectum
Posterior part (urogenital triangle)
urethra and vagina pass through
Anterior part (anal triangle)
rectum pass through
16. Pelvic floor
3. Inner layer (pelvic diaphragm 盆膈 )
1) the main support of the pelvic floor
2) formed by the levator ani and
coccygenus muscles and covering
fasciae.
3) Levator ani: pubococcygenus ( 耻尾肌 ),
iliococcygenus ( 髂尾肌 ), puborectalis
( 坐尾肌 )
17. Pelvic floor
Perineum
general conception: the tissues closing
down the pelvic outlet
Clinical conception: the tissues between
vagina and anus.
18. External genitalia
mons pubis
阴阜
Labium majus
大阴唇
Clitotis
阴蒂
Labium minus
小阴唇
Urethral orifice
尿道口 Vaginal orifice
阴道口
Vaginal vestibule
阴道前庭 Fossa navicularis
舟状窝Perineal body
会阴体 Anus
肛门
19. External genitalia
Labia majora
The venous drainage is extensive and
forms a plexus with numerous
anastomoses. Vulva hematoma
Vaginal vestibule
Bordered by the labia minora laterally,
by the frenulum labiorum pudendal ( 阴
唇系带 ) posteriorly, by the urethra and
clitoris anteriorly, by the hymenal ring
inferiorly.
22. Internal genitalia
Vagina
1. strong canal of muscle (7.5cm)
extend from the uterus to the vestibule of the external
genitalia. its long axis is almost parallel with that of
the lower part of the sacrum. the anterior wall of the
vagina is 1.5-2cm shorter than the posterior wall.
2. vaginal fornix
the circular cul-de-sac formed around the cervix
4 regions: the anterior fornix, the posterior fornix
and 2 lateral fornices.
23. Internal genitalia
3. Wall structure
1) mucosal layer (stratified squamous
epithelium)
2) muscular layer (3 layer)
3) submucous area ( with a dense plexus of
veins and lymphatics)
25. Internal genitalia
Uterus
1. Pear-shaped,thick-walled, muscular
organ
2. Body and cervix:
Babyhood 1:2, manhood 2:1
3. Isthmus uteri
connect the body to cervix, 1cm (non-
pregnancy)
26. Internal genitalia
4. Layers of uterine wall
1) The serous layer (perimetrium)
Thin and firmly adherent over the fundous
and most of the body
Uterovesical pouch of the peritoneum
Rectouterine pouch of the peritoneum
(pouch of Douglas)
2) The muscular layer
Outer layer (longitudinal fibers)
Inner layer (interlaced and various
directions)
27. Internal genitalia
3) The mucous layer (endometrium)
compact layer: response to hormone
periodically, a single layer of ciliated
columnar epithelium
spongy layer: response to hormone
periodically. contains many tubular
glands
funous: non-response to hormone
periodically
28. Internal genitalia
Cervix
1. lower 1/3 of uterus. connects uterus
to vagina via endocervical canal
2. External os: opening of
endocervical canal to ectocervix
3. Internal os: indistinct upper limit of
endocervical canal
34. Internal genitalia
Ovary
1. Anatomy
1) Paired organ, elliptic
2) The suspensory ligament of the
ovary
3) The ovarian ligament
35.
36. Internal genitalia
2. Structure of ovary
1) Covered by cuboid or low columnar
epithelium
2) Consist of a cortex and a medulla
3) Cortex: oocytes in various stages of
maturity.
4) Medulla: fibers, smooth muscle cells,
blood vessel, nerves.
37. Vessel and nerve and lymph
Blood vessel
1. The ovarian artery
1) Orginated as branches of the
abdominal aorta, (left: left renal
artery).
2) Turn over the common iliac
artery and ureter,descend into
the pelvis. Enter into ovary
through the mesovarium
38.
39. Vessel and nerve and lymph
2. The uterine artery
1) a terminal branch of the hypogastric
artery
2) Cross the ureter near the cervix (2cm)
3) Ascend along the lateral border of the
uterus
4) uterine body branch and cervix-vagina
branch
40. Vessel and nerve and lymph
3. Vaginal artery
4. Internal Pudendal artery
41. Vessel and nerve and lymph
Lymph
1. External genitalia
1) superfical inguinal gland ( 腹股沟浅淋
巴结 )
2) deep inguinal gland ( 腹股沟深淋巴结 )
42. Vessel and nerve and lymph
2. Pelvic lymph
1) iliac lymph
common iliac, internal iliac and
external iliac
2) Anterior Sacral lymph
3) Lumbar lymph: abdominal aorta
Ture pelvis is located below the iliopectineal line, bounded anteriorly by the pubic bones, posteriorly by the sacrum and coccyx, laterally by the ischium and a small segment of the ilium.
