Anatomy of Pelvis N Perineum

Arteries of the Pelvis and Perineum
Artery aorta, abdominal Source the continuation of the descending thoracic aorta Branches inferior phrenic aa. (2), celiac trunk, middle suprarenal aa. (2), lumbar aa. (4 pairs), superior mesenteric a., renal aa. (2), testicular/ovarian aa. (2), inferior mesenteric a., median sacral a., common iliac aa. (2) no named branches Supply to abdominal wall; gastrointestinal tract; body below the level of the respiratory diaphragm Notes abdominal aorta passes posterior to the diaphragm (aortic hiatus) at the level of the !2 vertebral body
of bulb of penis
internal pudendal a.
bulb of the penis and associated tissues
artery of the bulb of the penis courses within the deep perineal space to enter the deep surface of the bulb
of bulb of vestibule
no named branches
bulb of the artery of the bulb vestibule and of the vestibule associated tissues courses within the deep perineal space to enter the deep surface of the bulb corpus cavernosum of the clitoris deep a. of the clitoris and dorsal a. of the clitoris are the terminal brs. of the internal pudendal a. dorsal a. of the clitoris and deep a. of the clitoris are the terminal brs. of the
clitoris, deep a. of
no named branches
clitoris, dorsal a. of
no named branches
superficial structures of the clitoris
internal pudendal a. cremasteric inferior epigastric a. no named branches cremaster m., coverings of the spermatic cord cremasteric a. is one of the contents of the spermatic cord; it anastomoses with the testicular artery distally deep e"ternal pudendal a. may arise from the medial circumfle" femoral a. deep a. of the clitoris and dorsal a. of the clitoris are the terminal brs. of the internal pudendal a. deep a. of the penis and dorsal a. of the penis are the terminal brs. of the internal pudendal a.
deep e"ternal pudendal
femoral a.
unnamed muscular branches
origins of pectineus m., adductor longus m.; scrotum/labium ma#us corpus cavernosum of the clitoris
deep, of clitoris
no named branches
deep, of penis
no named branches
corpus cavernosum of the penis
dorsal, of clitoris
no named branches
superficial tissues dorsal a. of the of the clitoris clitoris and deep a. of the clitoris are the terminal brs. of the internal pudendal a. superficial tissues dorsal a. of the of the penis penis and deep a. of the penis are the terminal brs. of the internal pudendal a.
dorsal, of penis
no named branches
ductus deferens, artery of
umbilical a.; no named branches may be a branch of the superior or inferior vesical a. e"ternal iliac a. cremasteric a.
ductus deferens, seminal vesical; possibly supplies the ureter
artery of the ductus deferens is also known as$ deferential a.
epigastric, inferior
lower rectus abdominis m., pyramidalis m., lower abdominal wall origins of pectineus m., adductor longus m.; scrotum/labium ma#us skin and superficial fascia of the upper medial thigh, skin of the pubic region
inferior epigastric m. anastomoses with the superior epigastric m. within the rectus abdominis m. deep e"ternal pudendal a. may arise from the medial circumfle" femoral a. superficial e"ternal pudendal a. is one of three superficial branches of the femoral a. near the inguinal ligament (see also$ superficial circumfle" iliac a., superficial epigastric a.) inferior gluteal a. participates in the formation of the cruciate anastomoses of the hip superior gluteal a. participates in the formation of the cruciate anastomoses of the hip
e"ternal pudendal, deep
femoral a.
e"ternal pudendal, superficial
femoral a.
no named branches
gluteal, inferior
internal iliac a., anterior division
gluteus ma"imus m., hip #oint
gluteal, superior
internal iliac, superficial br., deep posterior br. division
gluteus ma"imus m., gluteus medius m., gluteus minimus m., hip #oint
iliac, common
abdominal aorta
e"ternal iliac a., internal iliac a.
pelvis, lower limb abdominal aorta bifurcates at the level of the %4 vertebral body to form the right and left common iliac aa.; the common iliac artery bifurcates anterior to the sacroiliac articulation into its terminal brs. (e"ternal iliac a. and internal iliac a.) lower limb e"ternal iliac a. is continuous with the femoral a., the name change occurs at the inguinal ligament; the common iliac artery bifurcates anterior to the sacroiliac articulation common iliac artery bifurcates anterior to the sacroiliac articulation to form the internal iliac a. and the e"ternal iliac a.
iliac, e"ternal
common iliac inferior epigastric a., a. deep circumfle" iliac a., femoral a.
iliac, internal
common iliac anterior division gives pelvic viscera, a. rise to the $ umbilical gluteal region, a., obturator a., hip, medial thigh uterine a., vaginal a., inferior vesical a., middle rectal a., internal pudendal a., inferior gluteal a.; posterior division gives rise to the$ iliolumbar a., lateral sacral a., superior gluteal a. internal iliac a., posterior division iliac br., lumbar br. iliacus m., psoas ma#or m., &uadratus
iliolumbar
lumbar br. of the iliolumbar a. sends a small
lumborum m. inferior gluteal internal iliac a., anterior division unnamed muscular branches gluteus ma"imus m., hip #oint
spinal br. into the vertebral canal inferior gluteal a. participates in the formation of the cruciate anastomoses of the hip inferior rectal a. anastomoses with the middle rectal a. and the superior rectal a. inferior vesical a. anastomoses with the middle rectal a.
inferior rectal
no named branches
anus, ischioanal fossa
inferior vesical
internal iliac no named branches a., anterior division or it may arise from the middle rectal a.
lower part of the urinary bladder, prostate/vagina
internal iliac common iliac anterior division gives pelvic viscera, a. rise to the $ umbilical gluteal region, a., obturator a., hip, medial thigh uterine a., vaginal a., inferior vesical a., middle rectal a., internal pudendal a., inferior gluteal a.; posterior division gives rise to the$ iliolumbar a., lateral sacral a., superior gluteal a. internal pudendal internal iliac a., anterior division inferior rectal a., perineal a., artery of the bulb of the clitoris/penis, urethral a., deep clitoral/penile a., dorsal clitoral/penile a. anus, muscles of the superficial and deep perineal spaces, clitoris/penis, posterior aspect of the scrotum/labium ma#us
common iliac artery bifurcates anterior to the sacroiliac articulation to form the internal iliac a. and the e"ternal iliac a.
internal pudendal a. is the primary blood supply to the perineum
labial, posterior
perineal a.
no named branches
posterior aspect of the labium ma#us sacrum, sacral nerve rootlets, meninges, ad#acent muscles
posterior labial a. courses through the superficial perineal space there are usually 2 lateral sacral aa. on each side, a superior one and an inferior one
lateral sacral
internal iliac a., posterior division
spinal brs.
middle rectal
internal iliac, no named branches anterior division
middle portion of middle rectal a. the rectum anastomoses with the inferior rectal a and the superior rectal a. medial thigh and hip anterior and posterior brs. pass on the anterior and posterior sides of the adductor brevis m.; aberrant obturator a. arises from the inferior epigastric a. in '() of cases ovarian a. anastomoses with the uterine a. deep a. of the penis and dorsal a. of the penis are the terminal brs. of the internal pudendal a.
obturator
pubic br., acetabular br., anterior br., posterior br.
ovarian
abdominal aorta internal pudendal a.
tubal brs., uterine brs. ovary, uterine tube no named branches corpus cavernosum of the penis
penis, deep
penis, dorsal internal pudendal a.
no named branches
superficial tissues dorsal a. of the of the penis penis and deep a. of the penis are the terminal brs. of the internal pudendal a. bulb of the penis artery of the bulb
penis, of
internal
no named branches
bulb
pudendal a.
and associated tissues
of the penis courses within the deep perineal space to enter the deep surface of the bulb perineal a. courses superficial to the superficial transverse perineus m.; it courses with the perineal n. posterior labial a. courses through the superficial perineal space posterior scrotal a. passes superficial to the superficial transverse perineus m. deep e"ternal pudendal a. may arise from the medial circumfle" femoral a. internal pudendal a. is the primary blood supply to the perineum
perineal
posterior posterior aspect labial/scrotal; deep br. of the scrotum/labium ma#us; muscles of the superficial perineal space
posterior labial
perineal a.
no named branches
posterior aspect of the labium ma#us posterior aspect of the scrotum
posterior scrotal
perineal a.
no named branches
pudendal, deep e"ternal
femoral a.
origins of pectineus m., adductor longus m.; scrotum/labium ma#us anus, muscles of the superficial and deep perineal spaces, clitoris/penis, posterior aspect of the scrotum/labium ma#us skin and superficial fascia of the upper
pudendal, internal
inferior rectal a., perineal a., artery of the bulb of the clitoris/penis, urethral a., deep clitoral/penile a., dorsal clitoral/penile a.
pudendal, superficial e"ternal
femoral a.
no named branches
superficial e"ternal pudendal a. is one of three
medial thigh, skin superficial of the pubic branches of the region femoral a. near the inguinal ligament (see also$ superficial circumfle" iliac a., superficial epigastric a.) rectal, inferior internal pudendal a. no named branches anus, ischioanal fossa inferior rectal a. anastomoses with the middle rectal a. and the superior rectal a.
rectal, middle
internal iliac, no named branches anterior division
middle portion of middle rectal a. the rectum anastomoses with the inferior rectal a and the superior rectal a. superior part of the rectum superior rectal a. is the continuation of the inferior mesenteric a. after the sigmoid brs. are given off; it anastomoses with the middle rectal a. and the inferior rectal a. there are usually 2 lateral sacral aa. on each side, a superior one and an inferior one median sacral a. appears to be the continuation of the abdominal aorta in the median plane, although it is
rectal, superior
inferior two unnamed mesenteric a. branches
sacral, lateral
internal iliac a., posterior division
spinal brs.
sacrum, sacral nerve rootlets, meninges, ad#acent muscles sacrum
sacral, median
abdominal aorta
*th lumbar aa.
much smaller in si+e scrotal, posterior perineal a. no named branches posterior aspect of the scrotum posterior scrotal a. passes superficial to the superficial transverse perineus m. superficial e"ternal pudendal a. is one of three superficial branches of the femoral a. near the inguinal ligament (see also$ superficial circumfle" iliac a., superficial epigastric a.) testicular a. is one of the contents of the spermatic cord; the origin of the testicular a. from the aorta at the %2 vertebral level indicates the embryonic level of origin of the testis prior to its descent distal to the branches described at left, the lumen of the umbilical a. becomes obliterated after birth and the remnant of the vessel becomes the medial
superficial e"ternal pudendal
femoral a.
no named branches
skin and superficial fascia of the upper medial thigh, skin of the pubic region
testicular
abdominal aorta
ureteric brs.
testis, epididymis, lower part of the ductus deferens, ureter near its midpoint
umbilical
superior vesical aa., a. superior part of of the ductus deferens the bladder; ductus deferens
umbilical ligament urethral internal pudendal a. no named branches penile urethra urethral a. branches off of the internal pudendal a. within the deep perineal space uterine a. anastomoses with the ovarian a. and the vaginal a.; it passes superior to the ureter in the pelvis; remember the saying ,water under the bridge, anastomoses with the uterine a.; participates in the formation of the a+ygos arteries along the lateral surface of the vagina inferior vesical a. anastomoses with the middle rectal a.
uterine
tubal br., vaginal br.
uterus, uterine tube
vaginal
internal iliac numerous unnamed a., anterior branches division; occasionally it arises from uterine a.
vagina
vesical, inferior
internal iliac no named branches a., anterior division or it may arise from the middle rectal a. umbilical a. no named branches
lower part of the urinary bladder, prostate/vagina
vesical, superior
superior aspect of superior vesical the bladder aa.arise from the umbilical a. pro"imal to where its lumen becomes obliterated bulb of the artery of the bulb vestibule and of the vestibule associated tissues courses within
vestibule, bulb of
no named branches
the deep perineal space to enter the deep surface of the bulb
Bones of the Pelvis and Perineum

Bone Structure Description Notes paired; the os co"ae forms the lateral one of three bones that part of the pelvis; it is formed by three form the pelvis fused bones$ ischium, ilium - pubis; also known as the innominate bone a cup.shaped depression in the lateral surface of the os co"ae bone acetabulum means vinegar cup; it is the socket for the head of the femur; it is formed by the$ ilium (!/*), ischium (2/*) and pubis (2/*); the acetabular fossa lies in the floor of the acetabulum
os coxae
acetabulum
acetabular notch acetabular fossa
it is spanned by the transverse a notch in the inferior acetabular ligament; the acetabular br. margin of the of the obturator a. enters the hip #oint by acetabulum passing through the acetabular notch a roughened depression in the the ligament of the head of the femur occupies the acetabular fossa
center of the acetabulum lunate surface the smooth articular of the surface of the acetabulum acetabulum the lunate surface surrounds the acetabular fossa and the acetabular notch obturator means to occlude or stop up, a reference to the fact that the obturator membrane closes the obturator foramen almost completely; a site of attachment for the obturator e"ternus m. and the obturator internus m.
obturator foramen
a large foramen formed by the pubic and ischial rami
pubis
an angulated bone the one of three bones that form the os forms the anterior part co"ae$ ilium, ischium, pubis; its body of the pelvis forms !/* of the acetabulum; its symphyseal surface unites with the pubis of the opposite side to form the pubic symphysis; the superior and inferior pubic rami participate in the formation of the obturator foramen body pubic crest superolateral portion of the pubis the body of the pubis forms about !/* of the acetabulum
ridge on the superior attachment of rectus abdominis border of the superior pyramidalis mm. ramus attachment point of the medial end of the inguinal ligament articulates with the superior ramus of the opposite side at the pubic symphysis
pubic tubercle process at the lateral end of pubic crest superior ramus pecten superior ,limb, that passes medially from the body of the pubis
ridge on superior attachment point of the pectineal surface of the superior ligament pubic ramus articulates with the ischial ramus to form the ischiopubic ramus; attachment site for the root of the penis (clitoris)
inferior ramus inferior ,limb, that passes inferolaterally from the pubic symphysis obturator groove
groove on the inferior marks the area of passage of the surface of the superior obturator vessels and n. in the obturator pubic ramus canal
ischium
the ,/,. shaped bone one of the three bones that form the os that forms the co"ae$ ilium, ischium, pubis posteroinferior part of the pelvis ischial ramus the limb of the ischium that passes anteriorly and superomedially toward the pubis it articulates with the inferior ramus of the pubis
body
the part of the ischium it articulates with the ilium and the that participates in the pubis at the acetabulum; the body of the formation of the ischium forms 2/* of the acetabulum acetabulum the roughened pro#ection that protrudes posteroinferiorly from the body of the ischium it is the site of attachment of the sacrotuberous ligament; it is the site of origin of the inferior gemellus m., &uadratus femoris m. and the hamstring mm. (semitendinosus, semimembranosus, long head of biceps femoris, ischiocondylar portion of the adductor magnus) the lesser sciatic notch is converted to the lesser sciatic foramen by the sacrospinous ligament and the sacrotuberous ligament it is the site of attachment of the sacrospinous ligament and the site of origin of the superior gemellus m. one of three bones that form the os co"ae$ ilium, ischium, pubis
ischial tuberosity
lesser sciatic notch
the notch located between the ischial tuberosity and the ischial spine the spine that arises #ust superior to the lesser sciatic notch fan.shaped bone that forms the lateral prominence of the pelvis
ischial spine
ilium
body
the portion of the the body of the ilium forms 2/* of the ilium that participates acetabulum in the formation of the acetabulum arching superior edge attachment for abdominal wall muscles the ilium that forms the rim of the ,fan, roughened area along
iliac crest
iliac tubercle
the outer edge of the iliac crest anterior superior iliac spine posterior superior iliac spine arcuate line spine at the anterior end of the iliac crest spine at the posterior end of the iliac crest lateral attachment of the inguinal ligament position marked by a dimpling of the skin
ridge running from inferior boundary of the iliac fossa; anteroinferior to marks the plane of transition from posterosuperior on the abdominal cavity to pelvic cavity inner surface of the ilium a triangular bone that is the posterior skeletal element forming the pelvis it is formed by * fused vertebrae; the sacrum and two os co"ae bones form the pelvis
sacrum
base
the base of the sacrum includes the the superior part of the articular surface for the fifth lumbar sacrum vertebra and the superior portion of the two ala a pro#ection of the superior part of the sacrum in an anterior direction the lateral portion of the sacrum the body of the fifth lumbar vertebra sits on the sacral promontory and articulates with it through a symphysis paired; it pro#ects laterally from the body of the sacrum; it represents the fused costal and transverse processes of the first sacral vertebra
promontory
ala
anterior sacral an opening in the there are four pairs; each transmits the foramina anterior surface of the ventral primary ramus of the respective sacrum sacral spinal nerve; branches of the lateral sacral aa. 0nter the sacral canal through these openings posterior sacral foramina sacral canal an opening in the posterior surface of the sacrum the opening in the center of the sacrum there are four pairs; each transmits the dorsal primary ramus of the respective sacral spinal nerve it is the continuation of the vertebral canal at sacral vertebral levels
sacral hiatus
an opening in the posterior surface of the sacrum in the midline the roughened area located on the lateral surface of the sacrum the central portion of the sacrum
it is a normal feature that results from the failure of fusion of the laminae of the fifth sacral segment (and sometimes the fourth) during development this surface articulates with the ilium in the sacroiliac articulation the body is e&uivalent to the bodies of the other vertebra
articular surface body base
the superior surface of the base of the sacrum articulates with the sacrum the fifth lumbar vertebra through an intervertebral disk the most inferior portion of the vertebral column the coccy" results from the fusion of the four coccygeal vertebrae; it may be a single bone or the first coccygeal vertebra may be separated from the other three; it articulates with the fifth sacral segment; coccygeal vertebrae are reduced in comple"ity, having no pedicles, laminae or spines
coccyx
Fasciae of the Pelvis & Perineum - Arranged Alphabetically

Structure fascia, cremasteric fascia, deep penile/clitoral ocation!Description Notes intermediate covering layer of derived from the internal abdominal the spermatic cord obli&ue muscle an e"tension of the muscular fascia of the ischiocavernosus m. and bulbospongiosus m. onto the shaft of penis/clitoris deep fascia of the penis/clitoris forms a tubular sheath surrounding the erectile bodies, dorsal n. of the penis/clitoris, dorsal a. of the penis/clitoris, deep dorsal v. of the penis/clitoris; the superficial dorsal v. of penis/clitoris lies superficial to the deep fascia of the penis/clitoris; deep fascia of the penis is also known as$ 1uck2s fascia
fascia, endopelvic
fascia within the true pelvis endopelvic fascia is continuous with that supports the pelvic viscera the e"traperitoneal connective tissue and with the superior fascia of the pelvic diaphragm
fascia, e"ternal spermatic
outermost covering of the spermatic cord that is derived from a layer of the abdominal wall an e"tension of the obturator internus fascia covering the inferior surface of the pelvic diaphragm innermost covering of the spermatic cord fascia covering the obturator internus m.
derived from the aponeurosis of the e"ternal abdominal obli&ue muscle
fascia, inferior, of the pelvic diaphragm fascia, internal spermatic fascia, obturator
inferior fascia of the pelvic diaphragm is the superior boundary of the ischioanal fossa derived from the transversalis fascia obturator fascia attaches to the margin of the obturator foramen; it has a thickening (arcus tendineus m. levatoris ani) that is the origin of the iliococcygeus portion of the pelvic diaphragm superior fascia of the pelvic diaphragm is continuous with the iliacus fascia and covers the anterior surface of the piriformis m.
fascia, superior, of the pelvic diaphragm
an e"tension of the transversalis fascia covering the superior surface of the pelvic diaphragm
"oints and igaments of the Pelvis and Perineum isted Alphabetically

"oint or ligament iliolumbar ligament Description Notes
a ligament that the iliolumbar ligament stabili+es the lumbosacral connects the #oint transverse process of the %* vertebra to the iliac crest the articulation between the %* vertebral body and the body of the first sacral segment a symphysis; this articulation is characteri+ed by all of the features of a typical intervertebral articulation which include$ an intervertebral disk, anterior and posterior longitudinal ligaments, synovial #oints between articular processes, ligamenta flava, interspinal and supraspinal ligaments; a strong iliolumbar ligament strengthens this #oint a symphysis; a fibrocartilage interpubic disk
lumbosacral #oint
pubic
the midline #oint
symphysis
uniting the superior unites the bones; the subpubic angle in the female rami of the two pubic is greater than the subpubic angle in the male bones a synovial #oint; the fibrous articular capsule is thickened dorsally and ventrally to form the sacroiliac ligaments; because of the interlocking nature of the #oint surfaces and the strong sacroiliac ligaments, only limited movement is permitted at the sacroiliac #oint
sacroiliac #oint the articulation between the ala of the sacrum and the auricular surface of the ilium sacrospinous ligament
the ligament that together with the sacrotuberous ligament, it connects the ischial converts the greater and lesser sciatic notches into spine to the lateral greater and lesser sciatic foramina surface of the sacrum and coccy" the ligament that connects the ischial tuberosity to the lateral surface of the sacrum and coccy" together with sacrospinous ligament, it converts the greater and lesser sciatic notches into greater and lesser sciatic foramina
sacrotuberous ligament
ymphatics of the Pelvis and Perineum - isted Alphabetically

Structure cisterna chyli ocation between the abdominal aorta and the inferior vena cava anterior to the body of the %! or %2 vertebra Afferents from #fferents to $egions drained all of the body below the respiratory diaphragm; all of the abdominal and pelvic viscera lower limb; pelvic organs, perineum, lower part of the anterior Notes cisterna chyli is an enlargement of the lower end of the thoracic duct; it occurs in about 2*) of individuals
right and - thoracic duct left lumbar trunks; possibly the intestinal trunk
iliac nodes, along the common common iliac vessels; over the sacral promontory
e"ternal iliac nodes, internal iliac nodes
lumbar (lateral aortic) chain of nodes
common iliac nodes are appro"imately 3 in number
abdominal wall iliac nodes, along the superficial common iliac e"ternal e"ternal iliac inguinal nodes vessels nodes; deep inguinal nodes; inferior epigastric nodes iliac nodes, along the internal internal iliac vessels lymphatic vessels from the pelvic viscera superficial inguinal nodes, popliteal nodes lower limb; e"ternal iliac e"ternal nodes are 4 to !( genitalia; in number lower part of the anterior abdominal wall
common iliac pelvis, internal iliac nodes, perineum and nodes are 4 to 4 in e"ternal iliac gluteal region number nodes e"ternal iliac lower limb, nodes e"ternal genitalia, lower part of the anterior abdominal wall e"ternal iliac nodes; deep inguinal nodes lower abdominal wall; e"ternal genitalia; superficial parts of the lower limb the deep inguinal node in the femoral canal is called the node (or gland) of 5lo&uet
inguinal along the nodes, deep medial side of the femoral v. deep to the fascia lata and inguinal ligament inguinal nodes, superficial in the superficial fascia parallel to the inguinal ligament and along the terminal part of the greater saphenous v.
lymphatic vessels from the superficial lower limb, superficial abdominal wall, perineum
superficial inguinal nodes are !2.2( in number; they become inflamed during infections of the lower limb; they may become inflamed during infections of the e"ternal genitalia
internal along the iliac nodes internal iliac vessels
lymphatic vessels from the pelvic viscera
common iliac pelvis, internal iliac nodes, perineum and nodes are 4 to 4 in e"ternal iliac gluteal region number nodes also known as$ lumbar nodes; the intestinal trunk
lateral aortic nodes
along the inferior vena cava and
common efferents lower limb; iliac nodes; form one pelvic lymphatic lumbar trunk organs;
abdominal aorta from the aortic bifurcation to the aortic hiatus of the diaphragm
vessels from the posterior abdominal wall and viscera
on each side
perineum; anterior and posterior abdominal wall; kidney; suprarenal gland; respiratory diaphragm lower limb; pelvic organs; perineum; anterior and posterior abdominal wall; kidney; suprarenal gland; respiratory diaphragm
drains into to the left lumbar trunk; the lumbar trunks unite to form the thoracic duct/cisterna chyli
lumbar nodes
along the inferior vena cava and abdominal aorta from the aortic bifurcation to the aortic hiatus of the diaphragm
common iliac nodes; lymphatic vessels from the posterior abdominal wall and viscera
efferents form one lumbar trunk on each side
also known as$ lateral aortic nodes; the intestinal trunk drains into to the left lumbar trunk; the lumbar trunks unite to form the thoracic duct/cisterna chyli
lumbar trunk
between the lumbar vertebral bodies and inferior vena cava (right) or aorta (left) at the upper end of the lumbar chain of nodes
lumbar (lateral aortic) nodes; the intestinal trunk #oins the left lumbar trunk
thoracic left lumbar duct/cisterna trunk . left chyli side of the body below the respiratory diaphragm, gut; right lumbar trunk . right side of body below the diaphragm
lumbar trunks unite to form the lower end of the thoracic duct; an enlargement of the lower end of the thoracic duct (called the cisterna chyli) occurs in about 2*) of individuals, and when it is present, the lumbar trunks drain into it inferior mesenteric nodes may number as high as 6(; an important node group in cases of cancer of the colon and rectum
mesenteric around the nodes, root of the inferior inferior mesenteric a.
peripheral nodes located along the marginal a.
lumbar chain of nodes, superior mesenteric nodes
distal !/' of the transverse colon, descending colon, sigmoid colon, rectum
pararectal nodes
along the course of the superior rectal vessels along the course of the lateral sacral aa.
lymphatic inferior vessels mesenteric from the nodes rectum and anal canal lymphatic vessels from the pelvic viscera
rectum and anal canal
pararectal nodes are small lymph nodes that are not well locali+ed
sacral nodes
common iliac prostate sacral nodes are 2 nodes gland, uterus, or ' in number vagina, rectum, posterior pelvic wall
%uscles of the Pelvis and Perineum - isted Alphabetically

%uscle &rigin 'nsertion Action 'nnervation Artery Notes anal sphincter, perineal e"ternal body or central tendinous point of the perineum encircles constricts inferior rectal inferior skeletal the anal the anal nerves (from rectal a. (voluntary) canal; canal the pudendal muscle, as superficial nerve) contrasted fibers with sphincter attach to ani internus, the coccy" which is smooth (involuntary) muscle; the e"ternal anal sphincter is considered part of the pelvic diaphragm constricts parasympath middle smooth the anal etic fibers rectal a. muscle canal from 74 (involuntary),
anal sphincter, encircles encircles internal the anal the anal canal canal
as contrasted with sphincter ani e"ternus, which is skeletal muscle (voluntary) bulbospongios perineal us, in female body and fascia of the bulb of the vestibule perineal membrane and corpus cavernosu m of the clitoris compresse s the vestibular bulb and constricts the vaginal orifice compresse s the bulb of the penis, compresse s the spongy urethra deep branch of the perineal nerve (from pudendal nerve) perinea skeletal l a. muscle
bulbospongios central us, in male tendinous point and the midline raphe on the bulb of the penis coccygeus ischial spine
perineal membrane, dorsal surface of the corpus spongiosu m, deep penile fascia
deep branch of the perineal nerve (from pudendal nerve)
perinea e"pels the last l a. drops of urine from urethra; e"pels semen during e#aculation
side of the elevates coccy" and the pelvic lower floor sacrum
branches of inferior coccygeus and the ventral gluteal levator ani primary rami a. combined of spinal form the nerves 7'.74 pelvic diaphragm deep branch of perineal nerve from pudendal nerve internal superficial pudend and deep al a. transverse perineus muscles are separated by the perineal membrane superio r and inferior vesical muscles in the neck of bladder must contract and
deep transverse perineus
medial surface of the ischial ramus
contralater al muscle and perineal body/centr al tendinous point fascicles are arranged roughly in
fi"es and stabili+es the perineal body/centr al tendinous point compresse s the urinary bladder
detruser of bladder
smooth muscle in the wall of the
parasympath etic nerve fibers from the pelvic
urinary bladder
three layers
splanchnic nerves (72. 74 spinal cord levels)
aa.
cause the internal urethral orifice to open before the detruser muscle can void the bladder
iliococcygeus arcus tendineus levator ani and the ischial spine
anococcyg elevates eal raphe the pelvic and the floor coccy"
branches of inferior the the ventral gluteal combination primary rami a. of of spinal puborectalis, nerves 7'.74 pubococcygeu s and iliococcygeus is called the levator ani m. deep branch of the perineal nerve (from pudendal nerve) perinea ischiocaverno l a. sus m. is closely applied to the surface of the crus penis/clitoris
ischiocaverno medial sus surface of the ischial tuberosit y and the ischiopub ic ramus levator ani
corpus cavernosu m and crus of the penis/clitor is
compresse s the corpus cavernosu m
posterior anococcyg elevates surface eal raphe the pelvic of the and coccy" floor body of the pubis, fascia of the obturator internus m. (arcus tendineus levator ani), ischial spine posterior fascia of elevates aspect of the prostate the
branches of inferior the the ventral gluteal combination primary rami a. of of spinal puborectalis, nerves 7'.74 pubococcygeu siliococcygeus is the levator ani m.; coccygeus and levator ani combined form the pelvic diaphragm branches of the ventral inferior levator gluteal prostatae is
levator prostatae
the pubis
prostate
primary rami a. of spinal nerves 7'.74 nerve to the obturator internus m.
part of the puborectalis m.
obturator internus
the internal surface of the obturator membran e and margin of the obturator foramen
greater trochanter on its medial surface above the trochanteri c fossa
laterally rotates and abducts the thigh
obturat the obturator or a. internus m. leaves the pelvis by passing through the lesser sciatic foramen; the superior and inferior gemellus mm. insert on the obturator internus tendon piriformis leaves the pelvis by passing through the greater sciatic foramen
piriformis
anterior surface of sacrum
upper border of greater trochanter of femur
laterally rotates and abducts thigh
ventral rami of 7!.72
pubococcygeu posterior coccy" s aspect of the superior pubic ramis
elevates branches of inferior the the pelvic the ventral gluteal combination floor primary rami a. of of spinal puborectalis, nerves 7'.74 pubococcygeu s and iliococcygeus is called the levator ani m. draws the distal rectum forward and superiorly ; aids in voluntary retention branches of inferior the the ventral gluteal combination primary rami a. of of spinal puborectalis, nerves 7'.74 pubococcygeu s and iliococcygeus is called the levator ani m.
puborectalis
posterior aspect of the body of the pubis
unites with the puborectali s m. of other side posterior to the rectum
of feces pubovaginalis posterior aspect of the body of the pubis sphincter ani e"ternus perineal body or central tendinous point of the perineum fascia of the vagina and perineal body draws the vagina forward and superiorly branches of inferior pubovaginalis the ventral gluteal is part of the primary rami a. levator ani of spinal muscle nerves 7'.74
encircles constricts inferior rectal inferior skeletal the anal the anal nerves (from rectal a. (voluntary) canal; canal the pudendal muscle, as superficial nerve) contrasted fibers with sphincter attach to ani internus, the coccy" which is smooth (involuntary) muscle; the e"ternal anal sphincter is considered part of the pelvic diaphragm constricts parasympath middle smooth the anal etic fibers rectal a. muscle canal from 74 (involuntary), as contrasted with sphincter ani e"ternus, which is skeletal muscle (voluntary) compresse s urethra and vagina deep branch of perineal nerve from pudendal nerve internal skeletal pudend muscle al a.
sphincter ani internus
encircles encircles the anal the anal canal canal
sphincter urethrae, in female
encircles encircles the urethra and urethra vagina; e"tends superiorly along the urethra as far as the inferior surface of the bladder
sphincter urethrae, in male
encircles encircles the urethra, urethra reaches lateral surface of prostate and inferior bladder medial surface of the ischial ramus contralater al muscle and the perineal body/centr al tendinous point contralater al muscle and perineal body/centr al tendinous point contralater al muscle and the perineal body/centr al tendinous point
compresse deep branch s urethra of perineal nerve from pudendal nerve
internal skeletal pudend muscle al a.
superficial transverse perineus
fi"es and stabili+es perineal body/centr al tendinous point fi"es and stabili+es the perineal body/centr al tendinous point fi"es and stabili+es perineal body/centr al tendinous point
deep branch of perineal nerve from pudendal nerve
perinea superficial l a. and deep transverse perineus muscles are separated by the perineal membrane internal superficial pudend and deep al a. transverse perineus muscles are separated by the perineal membrane perinea superficial l a. and deep transverse perineus muscles are separated by the perineal membrane
transverse medial perineus, deep surface of the ischial ramus
transverse perineus, superficial
medial surface of the ischial ramus
Nerves of the Pelvis and Perineum - isted Alphabetically

Nerve Source Branches no named branches %otor none Sensory Notes anococcygea coccygeal l n. ple"us (74. 5!) anterior labial n. ilioinguinal n. skin anococcygeal overlying the n. pierces the coccy" sacrotuberous ligament skin of the anterior aspect of the labium ma#us skin of the anterior aspect of the scrotum communicates with the genital br. of the genitofemoral n. anterior scrotal n. is the continuation of the ilioinguinal n. at the superficial inguinal ring; it communicates with the genital br. of the genitofemoral n. only part of the 74 ventral primary ramus is contributed to the coccygeal ple"us nerve to
no named branches
none
anterior scrotal n.
anterior no named cutaneous br. branches of the ilioinguinal n.
none
coccygeal ple"us
ventral anococcygea none primary rami l n. of spinal nerves 74, 7*, 5!
skin of the region overlying the coccy"
coccygeus
sacral ple"us no named
coccygeus m.,
none
m., n. to
(brs. of the branches ventral primary rami of spinal nerves 7'. 74) pudendal n. no named branches
levator ani m.
coccygeus enters the muscle on its pelvic surface
dorsal n., of the clitoris
sympathetic motor innervation to skin sympathetic motor innervation to skin
skin of the shaft of the clitoris skin of the shaft of the penis skin of the lateral thigh
the terminal branch of the pudendal n. the terminal branch of the pudendal n. cutaneous nn. carry postganglionic sympathetic a"ons to skin
dorsal n., of the penis
pudendal n.
no named branches
femoral cutaneous, lateral
lumbar anterior sympathetic ple"us posterior brs. motor (ventral innervation to primary rami skin of spinal nerves %2. %') lumbar ple"us (ventral primary rami of spinal nerves %2. %4) anterior femoral cutaneous brs., nn. to$ sartorius m., rectus femoris m., vastus lateralis m., vastus intermedius m., vastus medialis m., pectineus m. contributes to the inferior mesenteric ple"us; contributes to the
femoral n.
sartorius, skin of rectus femoris, anterior vastus lateralis, thigh vastus intermedius, vastus medialis, pectineus
passes under inguinal ligament lateral to femoral a.
ganglion, inferior mesenteric
preganglionic sympathetic a"ons from the intermesenter ic ple"us and the 2nd
vascular smooth muscle of brs. of the inferior mesenteric a.
pain from descending colon and sigmoid colon; pain from upper rectum
a sympathetic ganglion; located on the abdominal aorta at the origin of the inferior
lumbar superior splanchnic n. hypogastric ple"us
mesenteric a.; may be a series of small, indistinguisha ble ganglia rather than a single large one cremaster m. skin of the anterior scrotum/labi a ma#ora upper medial thigh genitofemoral n. lies on the anterior surface of the psoas ma#or in the abdomen; the genital br. passes through the deep inguinal ring and inguinal canal; brushing the thigh elicits an elevation of the testis via the cremasteric refle" inferior gluteal n. passes through the greater sciatic foramen inferior to the piriformis m. superior gluteal n. passes through the greater sciatic foramen superior to the piriformis m.
genitofemora lumbar genital br., l n. ple"us femoral br. (ventral primary rami of spinal nerves %!. %2)
gluteal, inferior
sacral ple"us no named (ventral branches primary rami of spinal nerves %*, 7!.72)
gluteus ma"imus m.
none
gluteal, superior
sacral ple"us superior (ventral inferior brs. primary rami of spinal nerves %4. %*, 7!)
gluteus medius none m., gluteus minimus m., tensor fasciae latae m.
hypogastric n.
superior hypogastric ple"us
inferior hypogastric ple"us
supplies pain from vascular the pelvic smooth muscle viscera of the pelvic viscera
paired; hypogastric n. lies inferior to the common iliac vessels; it contains postganglionic sympathetic a"ons inferior hypogastric ple"us lies between the pelvic viscera and the pelvic wall
hypogastric ple"us, inferior
hypogastric nn. and sacral splanchnic nn. (postganglion ic sympathetic a"ons); pelvic splanchnic nn. (preganglioni c parasympathe tic a"ons from the ventral primary rami of spinal nerves 72. 74)
contributes branches to$ uterine/vagin al ple"us, vesical ple"us, prostatic ple"us
sympathetic$ supplies vascular smooth muscle of vessels supplying the pelvic viscera; parasympatheti c$ supplies smooth muscle of the pelvic viscera
pain from the pelvic viscera; general visceral afferent from the pelvic viscera
hypogastric ple"us, superior
intermesenter hypogastric ic ple"us and nn. (right lumbar and left) splanchnic nn. (postganglion ic sympathetic a"ons) lateral and anterior cutaneous brs.
vascular smooth muscle of the pelvic viscera (sympathetic)
pain from the pelvic viscera; general visceral afferent from the pelvic viscera
superior hypogastric ple"us is the continuation of the intermesenteri c ple"us; it crosses the pelvic brim iliohypogastri c n. receives a contribution from !2 in appro"imately
iliohypogastr lumbar ic n. ple"us (ventral primary ramus of
muscles of the skin of the lower lower abdominal wall abdominal wall, upper hip and
spinal nerve %!) ilioinguinal n. lumbar ple"us (ventral primary ramus of spinal nerve %!) hypogastric nn. and sacral splanchnic nn. (postganglion ic sympathetic a"ons); pelvic splanchnic nn. (preganglioni c parasympathe tic a"ons from the ventral primary rami of spinal nerves 72. 74) preganglionic sympathetic a"ons from the intermesenter ic ple"us and the 2nd lumbar splanchnic n. anterior muscles of the cutaneous br. lower (also known abdominal wall as$ anterior labial/scrotal n.) contributes branches to$ uterine/vagin al ple"us, vesical ple"us, prostatic ple"us sympathetic$ supplies vascular smooth muscle of vessels supplying the pelvic viscera; parasympatheti c$ supplies smooth muscle of the pelvic viscera
upper thigh skin of the lower abdominal wall and anterior scrotum/labi um ma#us pain from the pelvic viscera; general visceral afferent from the pelvic viscera
*() of cases ilioinguinal n. courses through the inguinal canal and superficial inguinal ring inferior hypogastric ple"us lies between the pelvic viscera and the pelvic wall
inferior mesenteric ganglion
contributes to the inferior mesenteric ple"us; contributes to the superior hypogastric ple"us
vascular smooth muscle of brs. of the inferior mesenteric a.
pain from descending colon and sigmoid colon; pain from upper rectum
a sympathetic ganglion; located on the abdominal aorta at the origin of the inferior mesenteric a.; may be a series of small, indistinguisha ble ganglia rather than a
single large one inferior mesenteric ple"us intermesenter multiple ic ple"us unnamed nn. course along the branches of the inferior mesenteric a. sympathetic$ smooth muscle of the vessels supplying the descending colon, sigmoid colon and rectum pain from the descending colon, sigmoid colon and rectum inferior mesenteric ple"us contains no vagal parasympathet ic fibers; pelvic splanchnic n. a"ons #oin the most distal nn. of the ple"us near gut wall inferior rectal nerve is one of the first branches of the pudendal n. intermesenteri c ple"us is continuous with the superior mesenteric ple"us; it continues inferiorly as the inferior mesenteric ple"us and superior hypogastric ple"us; intermesenteri c ple"us does not carry vagal parasympathet ic fibers; located anterior to the
inferior rectal n.
pudendal n.
no named branches
e"ternal anal sphincter
skin of the anus
intermesente lumbar ric ple"us splanchnic nn. ! and 2
renal, testicular (or ovarian) and ureteric brs.
sympathetic$ smooth muscle of vessels supplying the gut distal to the left colic fle"ure
pain from the descending colon, sigmoid colon and rectum
abdominal aorta between the superior and inferior mesenteric aa. labial, anterior ilioinguinal n. no named branches none skin of the anterior aspect of the labium ma#us skin of the posterior aspect of the labium ma#us skin of the lateral thigh communicates with the genital br. of the genitofemoral n. communicates with the perineal br. of the posterior femoral cutaneous n. cutaneous nn. carry postganglionic sympathetic a"ons to skin
labial, posterior
perineal n. (a no named branch of the branches pudendal n.)
none
lateral lumbar anterior sympathetic femoral ple"us posterior brs. motor cutaneous n. (ventral innervation to primary rami skin of spinal nerves %2. %') lumbar n. ventral primary rami of spinal nerves %!.%* contributes numerous$ see to the lumbar and formation of sacral ple"uses the lumbar and sacral ple"uses
numerous$ see lumbar and sacral ple"uses
lumbar nn. enter into the formation of the lumbar and sacral ple"uses and do not give branches directly to muscles or skin lumbar ple"us is noted for its variable branching pattern of nerves that supply the
lumbar ple"us
ventral primary rami of spinal nerves %!.%4
branches of the lumbar ple"us$ iliohypogastr ic n., ilioinguinal n.,
muscles of the lower abdominal wall; cremaster m., psoas ma#or and minor mm.,
skin of the lower abdominal wall, skin of the anterior scrotum/labi um ma#us,
genitofemora l n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral ple"us), brs. to the psoas ma#or and minor mm., branches to the &uadratus lumborum m. lumbar splanchnic nn. lumbar sympathetic ganglia %!. %4 no named branches
&uadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip
skin of the abdominal anterior and wall medial thigh and lateral hip
smooth muscle of vessels that supply the abdominal and pelvic viscera
pain from abdominal and pelvic viscera
sympathetic nerves; there are four of these on each side; lumbar splanchnic nn. contribute to preaortic abdominal ple"uses (celiac, superior mesenteric, intermesenteri c, superior hypogastric) also known as$ lumbar sacral ple"uses
lumbosacral ventral ple"us primary rami of spinal nerves %4.74
branches of the lumbosacral ple"us$ iliohypogastr ic n., ilioinguinal n., genitofemora
muscles of the lower abdominal wall; cremaster m., psoas ma#or and minor mm., &uadratus lumborum m.,
skin of the lower abdominal wall, skin of the anterior scrotum/labi um ma#us, skin of the anterior and
l n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral ple"us), brs. to the psoas ma#or and minor mm., branches to the &uadratus lumborum m., superior - inferior gluteal nn., n. to the obturator internus m., n. to the &uadratus femoris m., sciatic n., n. to the piriformis m., posterior femoral cutaneous n., pudendal n., n. to the pelvic diaphragm, pelvic splanchnic nn. lumbosacral part of the trunk ventral primary ramus of %4 united with the ventral
iliacus m.; muscles of the anterior and medial thigh and hip, muscles of the pelvic urogenital diaphragm, posterior hip, posterior thigh, leg and foot
medial thigh and lateral hip2 skin of the perineum, posterior thigh, leg and foot
no named muscles of the see sacral branches; it hip and ple"us contributes posterior thigh to the formation of the sacral
the lumbosacral trunk is not considered to be part of the lumbar ple"us
primary ramus of %* mesenteric ganglion, inferior preganglionic sympathetic a"ons from the intermesenter ic ple"us and the 2nd lumbar splanchnic n.
ple"us contributes to the inferior mesenteric ple"us; contributes to the superior hypogastric ple"us vascular smooth muscle of brs. of the inferior mesenteric a. pain from descending colon and sigmoid colon; pain from upper rectum a sympathetic ganglion; located on the abdominal aorta at the origin of the inferior mesenteric a.; may be a series of small, indistinguisha ble ganglia rather than a single large one inferior mesenteric ple"us contains no vagal parasympathet ic fibers; pelvic splanchnic n. a"ons #oin the most distal nn. of the ple"us near gut wall
mesenteric ple"us, inferior
intermesenter multiple ic ple"us unnamed nn. course along the branches of the inferior mesenteric a.
sympathetic$ smooth muscle of the vessels supplying the descending colon, sigmoid colon and rectum
obturator n.
lumbar anterior and muscles of the skin of the obturator n. ple"us posterior brs. medial thigh$ lower medial passes through (ventral adductor thigh the obturator primary rami longus m., canal of spinal adductor brevis nerves %2. m. and %4) adductor magnus m., gracilis m., obturator e"ternus m. sacral ple"us n. to the obturator none nerve to
obturator
internus m., n. to
(ventral superior internus m., primary rami gemellus m. superior of spinal gemellus m. nerves %*.72 )
obturator internus m. crosses the ischial spine and enters the ischioanal fossa by passing through the lesser sciatic foramen parasympathet ic nerves; these contain preganglionic parasympathet ic a"ons
pelvic ventral splanchnic n. primary rami of spinal nerves 72.74 (cell bodies are located in the lateral horn gray of the sacral spinal cord)
unnamed branches contribute to the pelvic ple"us (inferior hypogastric) ple"us
smooth muscle none and glands of the gut distal to the left colic fle"ure; smooth muscle and glands of all pelvic viscera
perforating sacral ple"us no named cutaneous n. (ventral branches primary rami of spinal nerves 72.') perineal n. pudendal posterior scrotal/labial n., deep (muscular) br.
none
skin of the perforating inferomedial cutaneous n. buttock pierces the sacrotuberous ligament skin of the posterior surface of the scrotum/labi um ma#us perineal n.branches from the pudendal n. at the posterior margin of the urogenital diaphragm
muscles of the perineum$ bulbospongios us m., ischiocavernos us m., superficial and deep transverse perineus mm., sphincter urethrae m., sphincter urethrovaginali s, compressor urethrae
ple"us, coccygeal
ventral anococcygea none primary rami l n.
skin of the region
only part of the 74 ventral
of spinal nerves 74, 7*, 5!
overlying the primary ramus coccy" is contributed to the coccygeal ple"us contributes branches to$ uterine/vagin al ple"us, vesical ple"us, prostatic ple"us sympathetic$ supplies vascular smooth muscle of vessels supplying the pelvic viscera; parasympatheti c$ supplies smooth muscle of the pelvic viscera pain from the pelvic viscera; general visceral afferent from the pelvic viscera inferior hypogastric ple"us lies between the pelvic viscera and the pelvic wall
ple"us, inferior hypogastric
hypogastric nn. and sacral splanchnic nn. (postganglion ic sympathetic a"ons); pelvic splanchnic nn. (preganglioni c parasympathe tic a"ons from the ventral primary rami of spinal nerves 72. 74)
ple"us, inferior mesenteric
intermesenter multiple ic ple"us unnamed nn. course along the branches of the inferior mesenteric a.
sympathetic$ smooth muscle of the vessels supplying the descending colon, sigmoid colon and rectum
inferior mesenteric ple"us contains no vagal parasympathet ic fibers; pelvic splanchnic n. a"ons #oin the most distal nn. of the ple"us near gut wall intermesenteri c ple"us is continuous with the superior
ple"us, lumbar intermesente splanchnic ric nn. ! and 2
renal, testicular (or ovarian) and ureteric brs.
sympathetic$ smooth muscle of vessels supplying the gut distal to the
pain from the descending colon, sigmoid
left colic fle"ure
colon and rectum
mesenteric ple"us; it continues inferiorly as the inferior mesenteric ple"us and superior hypogastric ple"us; intermesenteri c ple"us does not carry vagal parasympathet ic fibers; located anterior to the abdominal aorta between the superior and inferior mesenteric aa. lumbar ple"us is noted for its variable branching pattern of nerves that supply the abdominal wall
ple"us, lumbar
ventral primary rami of spinal nerves %!.%4
branches of the lumbar ple"us$ iliohypogastr ic n., ilioinguinal n., genitofemora l n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral ple"us), brs. to the psoas ma#or and minor mm.,
muscles of the lower abdominal wall; cremaster m., psoas ma#or and minor mm., &uadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip
skin of the lower abdominal wall, skin of the anterior scrotum/labi um ma#us, skin of the anterior and medial thigh and lateral hip
branches to the &uadratus lumborum m. ple"us, ventral lumbosacral primary rami of spinal nerves %4.74 branches of the lumbosacral ple"us$ iliohypogastr ic n., ilioinguinal n., genitofemora l n., lateral femoral cutaneous n., femoral n., obturator n., lumbosacral trunk (considered to be part of sacral ple"us), brs. to the psoas ma#or and minor mm., branches to the &uadratus lumborum m., superior - inferior gluteal nn., n. to the obturator internus m., n. to the &uadratus femoris m., sciatic n., n. to the piriformis m., posterior femoral cutaneous n., muscles of the lower abdominal wall; cremaster m., psoas ma#or and minor mm., &uadratus lumborum m., iliacus m.; muscles of the anterior and medial thigh and hip, muscles of the pelvic urogenital diaphragm, posterior hip, posterior thigh, leg and foot skin of the lower abdominal wall, skin of the anterior scrotum/labi um ma#us, skin of the anterior and medial thigh and lateral hip2 skin of the perineum, posterior thigh, leg and foot also known as$ lumbar sacral ple"uses
pudendal n., n. to the pelvic diaphragm, pelvic splanchnic nn. ple"us, prostatic inferior hypogastric (pelvic) ple"us is continuous with the rectal and vesical ple"uses sympathetic$ vascular smooth muscle of the pelvic viscera, especially the urethra, prostate gland and e#aculatory ducts; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the urethra, prostate gland, and e#aculatory ducts sympathetic$ vascular smooth muscle of the pelvic viscera, especially the rectum; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the rectum muscles of the pelvic diaphragm; pain from the pelvic viscera listed at left the autonomic nerve ple"uses of the pelvis (prostatic, rectal and vesical in the male; rectal and uterovaginal in the female) are in communicatio n with each other
ple"us, rectal inferior no named hypogastric branches (pelvic) ple"us, posterior part
pain and general sensation from the rectum
rectal ple"us is continuous with the vesical ple"us in the male, uterovaginal ple"us in the female
ple"us, sacral
lumbosacral superior trunk (ventral inferior primary rami gluteal nn.,
skin of the perineum, posterior
the sacral ple"us is often grouped with
of spinal nerves %4. %*), ventral primary rami of spinal nerves 7!.74
n. to obturator internus m., n. to &uadratus femoris m., sciatic n., n. to piriformis, posterior femoral cutaneous n., pudendal n., n. to pelvic diaphragm, pelvic splanchnic nn.
muscles of the urogenital diaphragm; muscles of the posterior hip, posterior thigh, leg and foot
thigh, leg and foot (e"cluding the medial side of the leg and foot)
the lumbar ple"us as the ,lumbosacral ple"us,
ple"us, superior hypogastric
intermesenter hypogastric ic ple"us and nn. (right lumbar and left) splanchnic nn. (postganglion ic sympathetic a"ons)
pain from the pelvic viscera; general visceral afferent from the pelvic viscera pain from the pelvic viscera listed at left
superior hypogastric ple"us is the continuation of the intermesenteri c ple"us; it crosses the pelvic brim the uterovaginal ple"us is a subsidiary ple"us of the inferior hypogastric ple"us
ple"us, inferior uterovaginal hypogastric ple"us
continuous sympathetic$ with the vascular rectal ple"us smooth muscle of the pelvic viscera, especially the uterus, uterine tubes and vagina; parasympatheti c$ smooth muscle and glands of pelvic viscera, especially uterus, uterine tubes and vagina
ple"us, vesical
continuous with the prostatic ple"us
sympathetic$ vascular smooth muscle of the pelvic viscera, especially the urinary bladder, seminal vesicle, ductus deferens and e#aculatory duct; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the urinary bladder, seminal vesicle, ductus deferens and e#aculatory duct sympathetic motor innervation to skin
pain and general sensation from the bladder, seminal vesicle and ductus deferens
vesical ple"us is continuous with the other autonomic nerve ple"uses in the pelvis and cannot be distinguished from them
posterior sacral ple"us inferior femoral (ventral cluneal nn.; cutaneous n. primary rami perineal br. of spinal nerves 7!. 7') posterior labial n. perineal n. (a no named branch of the branches pudendal n.)
skin of the lower buttock posterior thigh skin of the posterior aspect of the labium ma#us skin of the posterior aspect of the scrotum
cutaneous nn. carry postganglionic sympathetic a"ons to skin communicates with the perineal br. of the posterior femoral cutaneous n. posterior scrotal n. communicates with the perineal br. of the posterior
none
posterior scrotal n.
perineal n., from the pudendal n.
no named branches
none
femoral cutaneous n. prostatic ple"us inferior hypogastric (pelvic) ple"us is continuous with the rectal and vesical ple"uses sympathetic$ vascular smooth muscle of the pelvic viscera, especially the urethra, prostate gland and e#aculatory ducts; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the urethra, prostate gland, and e#aculatory ducts its branches supply$ e"ternal anal sphincter, bulbospongios us m., ischiocavernos us m., superficial deep transverse perineus mm., sphincter urethrae m., sphincter urethrovaginali s, compressor urethrae &uadratus femoris m., inferior gemellus m. pain from the pelvic viscera listed at left the autonomic nerve ple"uses of the pelvis (prostatic, rectal and vesical in the male; rectal and uterovaginal in the female) are in communicatio n with each other
pudendal n.
ventral primary rami of spinal nerves 72.74 (sacral ple"us)
inferior rectal n., perineal n., dorsal n. of the clitoris/penis
its branches supply$ skin of the anus, posterior scrotum/labi um ma#us, clitoris/penis
pudendal n. passes through the pudendal canal formed by fascia on the medial surface of the obturator internus m.
&uadratus femoris m., n. to
sacral ple"us n. to the (ventral inferior primary rami gemellus m. of spinal nerves %4.
none
nerve to the &uadratus femoris m. passes anterior to the
%*, 7!)
obturator internus tendon carries none postganglionic sympathetic a"ons to the spinal nerve; spinal nerve will carry those a"ons peripherally to the skin, blood vessels, etc. a"ons contained within white rami communicantes will synapse on postganglionic cell bodies that will ultimately innervate the skin, viscera, glands, blood vessels, etc. sympathetic$ vascular smooth muscle of the pelvic viscera, especially the rectum; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the rectum e"ternal anal sphincter pain from viscera is carried back to the spinal cord through the white ramus communican s gray rami communicante s connect the sympathetic chain to spinal nerves at all vertebral levels
ramus cell bodies none communican located in the s, gray sympathetic chain ganglia
ramus cell bodies none communican located in the s, white lateral horn gray matter of spinal cord levels !.%2;
white rami communicante s connect the sympathetic chain to spinal nerves at vertebral levels !.%2; carries preganglionic sympathetic a"ons rectal ple"us is continuous with the vesical ple"us in the male, uterovaginal ple"us in the female
rectal ple"us inferior no named hypogastric branches (pelvic) ple"us, posterior part
pain and general sensation from the rectum
rectal, inferior
pudendal n.
no named branches
skin of the anus
inferior rectal nerve is one of
the first branches of the pudendal n. sacral ple"us lumbosacral trunk (ventral primary rami of spinal nerves %4. %*), ventral primary rami of spinal nerves 7!.74 superior inferior gluteal nn., n. to obturator internus m., n. to &uadratus femoris m., sciatic n., n. to piriformis, posterior femoral cutaneous n., pudendal n., n. to pelvic diaphragm, pelvic splanchnic nn. unnamed branches contribute to the pelvic ple"us (inferior hypogastric) ple"us muscles of the pelvic diaphragm; muscles of the urogenital diaphragm; muscles of the posterior hip, posterior thigh, leg and foot skin of the perineum, posterior thigh, leg and foot (e"cluding the medial side of the leg and foot) the sacral ple"us is often grouped with the lumbar ple"us as the ,lumbosacral ple"us,
sacral sacral splanchnic n. sympathetic ganglia
vascular pain from smooth muscle the pelvic of the pelvic viscera viscera
sacral splanchnic nn. contain both preganglionic and postganglionic sympathetic nerve fibers with postganglionic fibers predominating in number sciatic n. is composed of tibial and common fibular divisions; branches to
sciatic n.
sacral ple"us (ventral primary rami of spinal nerves %4.%* and 7!.7')
tibial n., common fibular (peroneal) n.
semitendinosus m., semimembrano sus m., biceps femoris m., ischioconylar part of the
its branches supply the skin of the leg and foot (e"cluding the medial side of leg -
adductor foot) magnus m.; its branches supply all muscles of the leg and foot
muscles come from one of the two divisions, so that the sciatic n. is considered to have no direct muscular brs., only 2 terminal brs. anterior scrotal n. is the continuation of the ilioinguinal n. at the superficial inguinal ring; it communicates with the genital br. of the genitofemoral n. posterior scrotal n. communicates with the perineal br. of the posterior femoral cutaneous n. sympathetic nerves; there are four of these on each side; lumbar splanchnic nn. contribute to preaortic abdominal
scrotal, anterior
anterior no named cutaneous br. branches of the ilioinguinal n.
none
skin of the anterior aspect of the scrotum
scrotal, posterior
perineal n., from the pudendal n.
no named branches
none
skin of the posterior aspect of the scrotum
splanchnic, lumbar
lumbar sympathetic ganglia %!. %4
no named branches
smooth muscle of vessels that supply the abdominal and pelvic viscera
pain from abdominal and pelvic viscera
ple"uses (celiac, superior mesenteric, intermesenteri c, superior hypogastric) splanchnic, pelvic ventral primary rami of spinal nerves 72.74 (cell bodies are located in the lateral horn gray of the sacral spinal cord) sacral sympathetic ganglia unnamed branches contribute to the pelvic ple"us (inferior hypogastric) ple"us smooth muscle none and glands of the gut distal to the left colic fle"ure; smooth muscle and glands of all pelvic viscera parasympathet ic nerves; these contain preganglionic parasympathet ic a"ons
splanchnic, sacral
unnamed branches contribute to the pelvic ple"us (inferior hypogastric) ple"us
vascular pain from smooth muscle the pelvic of the pelvic viscera viscera
sacral splanchnic nn. contain both preganglionic and postganglionic sympathetic nerve fibers with postganglionic fibers predominating in number the subcostal n. is e&uivalent to a posterior intercostal n. found at higher thoracic levels superior hypogastric ple"us is the continuation of the
subcostal n.
ventral lateral muscles of the primary cutaneous abdominal wall ramus of !2 br., anterior cutaneous br.
skin of the anterolateral abdominal wall
superior hypogastric ple"us
intermesenter hypogastric ic ple"us and nn. (right lumbar and left) splanchnic nn.
pain from the pelvic viscera; general visceral
(postganglion ic sympathetic a"ons) sympathetic chain ganglia preganglionic sympathetic fibers arrive via white rami communicant es of ventral primary rami of spinal nerves !.%2 postganglion ic sympathetic fibers depart via gray rami communican tes to all spinal nn.; internal e"ternal carotid nn.; cervical cardiac brs.; thoracic direct visceral brs.; greater, lesser least thoracic splanchnic nn.; lumbar splanchnic nn.; sacral splanchnic nn.
afferent from intermesenteri the pelvic c ple"us; it viscera crosses the pelvic brim dilator pain from pupillae, viscera vascular smooth muscle, arrector pili muscles, sweat glands, suprarenal medulla, heart, lungs and gut located lateral to the vertebral bodies in the neck, thora" abdominopelv ic cavity; the ganglia plus their interconnectin g fibers are also known as the sympathetic trunk; preganglionic cell bodies are located in the intermediolate ral gray matter of spinal cord levels !.%2
to coccygeus sacral ple"us no named m. (brs. of the branches ventral primary rami of spinal nerves 7'. 74) uterovaginal inferior ple"us hypogastric ple"us
coccygeus m., levator ani m.
none
nerve to coccygeus enters the muscle on its pelvic surface
continuous sympathetic$ with the vascular rectal ple"us smooth muscle of the pelvic viscera, especially the uterus, uterine tubes and
pain from the pelvic viscera listed at left
the uterovaginal ple"us is a subsidiary ple"us of the inferior hypogastric ple"us
vagina; parasympatheti c$ smooth muscle and glands of pelvic viscera, especially uterus, uterine tubes and vagina vesical ple"us inferior hypogastric ple"us continuous with the prostatic ple"us sympathetic$ vascular smooth muscle of the pelvic viscera, especially the urinary bladder, seminal vesicle, ductus deferens and e#aculatory duct; parasympatheti c$ smooth muscle and glands of the pelvic viscera, especially the urinary bladder, seminal vesicle, ductus deferens and e#aculatory duct pain and general sensation from the bladder, seminal vesicle and ductus deferens vesical ple"us is continuous with the other autonomic nerve ple"uses in the pelvis and cannot be distinguished from them
(opographical Anatomy of the Pelvis & Perineum isted Alphabetically
Structure!Space anal triangle
Description!Boundaries posterior subdivision of the diamond.shaped perineum; its boundaries are$ anteriorly . posterior margin of the perineal membrane (corresponds to an imaginary line connecting the ischial tuberosities); posterolaterally . sacrotuberous ligament a fat.filled space located lateral to the anal canal and inferior to the pelvic diaphragm; its boundaries are$ superomedially . pelvic diaphragm (anterior recess e"tends superior to the urogenital diaphragm); medially . e"ternal anal sphincter muscle and anal canal; laterally . obturator internus fascia and ischial tuberosity; posterolaterally . sacrotuberous ligament and gluteus ma"imus m.; (posterior recess e"tends superior to the gluteus ma"imus m.) midline cleft between the buttocks
Significance anal triangle is the location of the terminal end of the gastrointestinal tract (anus) the fat and loose connective tissue in the ischioanal fossa compresses to allow passage of feces; also known as$ ischiorectal fossa
ischioanal fossa
natal cleft
natal cleft lies between the gluteus ma"imus muscles perineum is subdivided into the anal triangle and urogenital triangle by an imaginary line connecting the ischial tuberosities urogenital triangle is the location of the terminal portion of the urinary tract and genital tract
perineum
a diamond.shaped space forming the outlet of the pelvis; its boundaries are$ anterolaterally . inferior pubic ramus, ischial ramus and ischial tuberosity; posterolaterally . sacrotuberous ligament anterior subdivision of the diamond.shaped perineum; its boundaries are$ anterolaterally . inferior pubic ramus, ischial ramus; posteriorly . posterior margin of perineal membrane (corresponds to an imaginary line connecting the ischial tuberosities)
urogenital triangle
NOTE: Many veins follow the branching and distribution pattern of the artery of the same name. This table contains veins that do not travel with an artery of the same name, or that run an independent course from the artery of the same name. See also: rteries Tables.
Selected )eins of the Pelvis and Perineum - isted Alphabetically

)ein (ributaries Drains 'nto vesical venous ple"us $egions Drained erectile tissue of the clitoris Notes deep dorsal v. of the clitoris passes anterosuperior to the urogenital diaphragm (between the arcuate pubic ligament and the transverse ligament of the perineum) to enter the pelvic cavity; an unpaired vein deep dorsal v. of the penis passes anterosuperior to the urogenital diaphragm (between the arcuate pubic ligament and the transverse ligament of the perineum) to enter the pelvic cavity; an unpaired vein deep e"ternal pudendal v. shares its region of drainage with the
deep dorsal v. many unnamed of the clitoris tributaries
deep dorsal v. many unnamed of the penis tributaries
prostatic venous ple"us
erectile tissue of the penis
deep e"ternal part of the drainage of femoral pudendal v. the superficial dorsal v. of the penis/clitoris
skin and superficial fascia of the penis/clitoris;
pubic region internal pudendal v. deep dorsal v. of the internal iliac penis/clitoris, v. of the bulb, posterior labial/scrotal v., inferior rectal v. many unnamed tributaries vesical venous ple"us crus and bulb of the clitoris/penis; urogenital region, anal region erectile tissue of the clitoris
superficial e"ternal pudendal v. internal pudendal v. passes through the pudendal canal
of clitoris, deep dorsal
deep dorsal v. of the clitoris passes anterosuperior to the urogenital diaphragm (between the arcuate pubic ligament and the transverse ligament of the perineum) to enter the pelvic cavity; an unpaired vein superficial dorsal v. of the clitoris is located superficial to the deep fascia of the clitoris deep dorsal v. of the penis passes anterosuperior to the urogenital diaphragm (between the arcuate pubic ligament and the transverse ligament of the perineum) to enter the pelvic cavity; an unpaired vein superficial dorsal v. of the penis is located superficial
of clitoris, superficial dorsal
no named tributaries
superficial skin and e"ternal superficial pudendal v. fascia of the clitoris prostatic venous ple"us erectile tissue of the penis
of penis, deep many unnamed dorsal tributaries
of penis, superficial dorsal
superficial skin and e"ternal superficial pudendal v. fascia of the
penis ovarian v. no named tributaries right$ inferior vena cava; left$ left renal v. ovary and the distal part of the uterine tube; ureter
to the deep fascia of the penis connects with the uterine v.; a pampiniform ple"us occurs, but is not as well developed as that seen in the male pampiniform venous ple"us surrounds the testicular a. to cool arterial blood before it reaches the testis pampiniform venous ple"us surrounds the testicular a. to cool arterial blood before it reaches the testis
pampiniform no named tributaries venous ple"us
becomes the testicular vein at the deep inguinal ring becomes the testicular vein at the deep inguinal ring
testis, epididymis, ductus deferens
ple"us, no named tributaries pampiniform venous
testis, epididymis, ductus deferens
ple"us, prostatic venous
deep dorsal v. of the penis
internal iliac penis and the prostatic venous v. prostate gland ple"us is connected with the vesical venous ple"us superior, middle inferior rectal vv. rectum and anal canal; anus rectal venous ple"us is a site of portal.caval anastomosis connects with the ovarian v. and the vaginal venous ple"us connects with the uterine venous ple"us, the vesical venous ple"us and the rectal venous
ple"us, rectal no named tributaries venous
ple"us, uterine venous ple"us, vaginal venous
multiple tributaries from the uterus; deep dorsal v. of the clitoris multiple tributaries from the vagina
uterine vv. uterus to the uterine tubes internal iliac v. vaginal v. to vagina the internal iliac v. or uterine v.
ple"us ple"us, vertebral venous, e"ternal intervertebral vv. ad#acent segmental vv.; vertebral v. in the cervical region ad#acent segmental vv. vertebral column and associated muscles two ple"uses are described$ anterior and posterior; connects with the internal vertebral venous ple"us connects with the e"ternal vertebral venous ple"uses; valveless; a route for potential spread of metastases from the pelvis to the brain in the male . connects with the prostatic venous ple"us and the rectal venous ple"us; in the female . connects with the rectal venous ple"us, uterine venous ple"us and vaginal venous ple"us portal v. connects with the vena caval drainage at !) esophagus, 2) rectum, ') umbilicus, 4) retroperitoneal gut structures; portal v. courses between two capillary beds (gut and liver)
ple"us, vertebral venous, internal
anterior and posterior longitudinal vertebral sinuses
spinal cord, meninges, vertebral column
ple"us, vesical venous
multiple tributaries superior and urinary from the bladder in both inferior bladder se"es vesical vv. to the internal iliac v.
portal v.
formed by the union of the superior mesenteric v. and the splenic v.; tributaries$ posterior superior pancreaticoduodenal v., right gastric v., left gastric v.
divides into all of the gut right and and its glands left branches before entering the liver; into the liver sinusoids
prostatic deep dorsal v. of the venous ple"us penis
internal iliac penis and the prostatic venous v. prostate gland ple"us is connected with the
vesical venous ple"us pudendal, part of the drainage of femoral deep e"ternal the superficial dorsal v. of the penis/clitoris skin and superficial fascia of the penis/clitoris; pubic region crus and bulb of the clitoris/penis; urogenital region, anal region skin and superficial fascia of the penis/clitoris; pubic region rectum and anal canal; anus deep e"ternal pudendal v. shares its region of drainage with the superficial e"ternal pudendal v. internal pudendal v. passes through the pudendal canal
pudendal, internal
deep dorsal v. of the internal iliac penis/clitoris, v. of the bulb, posterior labial/scrotal v., inferior rectal v. part of the drainage of great the superficial dorsal v. saphenous of the penis/clitoris
pudendal, superficial e"ternal
superficial e"ternal pudendal v. shares its region of drainage with the deep e"ternal pudendal v. rectal venous ple"us is a site of portal.caval anastomosis superficial dorsal v. of the clitoris is located superficial to the deep fascia of the clitoris superficial dorsal v. of the penis is located superficial to the deep fascia of the penis superficial e"ternal pudendal v. shares its region of drainage with the deep e"ternal pudendal v.
rectal venous no named tributaries ple"us
superior, middle inferior rectal vv.
superficial dorsal v. of the clitoris
superficial skin and e"ternal superficial pudendal v. fascia of the clitoris superficial skin and e"ternal superficial pudendal v. fascia of the penis skin and superficial fascia of the penis/clitoris; pubic region
superficial dorsal v. of the penis
superficial e"ternal pudendal v.
part of the drainage of great the superficial dorsal v. saphenous of the penis/clitoris
testicular v.
pampiniform ple"us
left$ left renal v.; right$ inferior vena cava
testis, ureter
left testicular v. is longer than the right testicular v.
uterine multiple tributaries venous ple"us from the uterus; deep dorsal v. of the clitoris vaginal multiple tributaries venous ple"us from the vagina
uterine vv. uterus to the uterine tubes internal iliac v. vaginal v. to vagina the internal iliac v. or uterine v.
connects with the ovarian v. and the vaginal venous ple"us connects with the uterine venous ple"us, the vesical venous ple"us and the rectal venous ple"us the inferior vena cava is longer than the abdominal aorta
vena cava, inferior
formed by the union of right atrium the paired common iliac vv; tributaries$ lumbar vv. !.4, right ovarian/testicular v., renal vv., right suprarenal v., right inferior phrenic v., hepatic vv. intervertebral vv. ad#acent segmental vv.; vertebral v. in the cervical region ad#acent segmental vv.
all of the body below the level of the respiratory diaphragm
vertebral venous ple"us, e"ternal
vertebral column and associated muscles
two ple"uses are described$ anterior and posterior; connects with the internal vertebral venous ple"us connects with the e"ternal vertebral venous ple"uses; valveless; a route for potential spread of metastases from the pelvis to the brain in the male . connects with the prostatic venous
vertebral venous ple"us, internal
anterior and posterior longitudinal vertebral sinuses
spinal cord, meninges, vertebral column
vesical multiple tributaries superior and urinary venous ple"us from the bladder in both inferior bladder se"es vesical vv.
to the internal iliac v.
ple"us and the rectal venous ple"us; in the female . connects with the rectal venous ple"us, uterine venous ple"us and vaginal venous ple"us
)isceral Structures of the Pelvis and Perineum Arranged Alphabetically
&rgan!Part of &rgan
ocation!Description
Notes ampulla of the ductus deferens #oins with the duct of the seminal vesical to form the e#aculatory duct ampulla of the uterine tube arches over the ovary and ends laterally in the infundibulum anal canal is continuous with the rectum above and opens at the anus below; it is regulated by e"ternal and internal anal sphincters
ampulla of the dilated part of the ductus ductus deferens deferens located posterior to the bladder ampulla of the uterine tube anal canal widest and longest part of the uterine tube terminal end of the digestive tract
anal columns
longitudinal folds of mucosa on anal columns are connected inferiorly the inner wall of the anal canal by anal valves; rectal vessels lie beneath the submucosa of the anal columns folds of mucosa #oining ad#acent anal columns at their inferior ends anal valves can be difficult to locate in the older individual
anal valves
appendi" of the small appendage on the head of appendi" of the epididymis is a epididymis the epididymis remnant of the most cranial part of the mesonephric duct appendi" of the small appendage on the upper testis testis bladder, urinary hollow muscular organ posterior to the pubic symphysis and body of the pubis that acts as a reservoir for urine body of the uterus broad ligament part of the uterus between the fundus and the isthmus appendi" of the testis is a remnant of the paramesonephric duct urinary bladder is held in place by the pubovesical/puboprostatic ligaments; ureters enter the posterolateral surface of the bladder at the posterior two angles of the vesical trigone the uterine cavity is thin anteroposteriorly and wide in the transverse plane
peritoneal fold e"tending from broad ligament has three named parts$ the pelvic walls to the uterus mesovarium, mesosalpin", and uterine tubes mesometrium e"panded part of the corpus bulb of the penis is covered on its spongiosum that attaches to the superficial surface by the perineal membrane bulbospongiosus muscle; it contains a
bulb of the penis
portion of the spongy/penile urethra; it is the homologue of the bulb of the vestibule bulb of the vestibule erectile tissue located on either side of the vestibule of the vagina, attached to the perineal membrane an e"ocrine gland located posterolateral to the membranous urethra within the sphincter urethrae muscle (in the urogenital diaphragm) condensations of endopelvic (e"traperitoneal) connective tissue surrounding the uterine vessels within the base of the broad ligament narrowed inferior end of the uterus bulb of the vestibule is continuous with the glans clitoris; it is covered on its superficial surface by the bulbospongiosus muscle; it is the homologue of the bulb of the penis male only; its duct passes through the perineal membrane and drains into the spongy/penile urethra in the bulb of penis cardinal ligament helps in support of the uterus by attaching the uterine isthmus to the lateral pelvic wall
bulbourethral gland
cardinal ligament
cervi"
cervi" is inferior to the isthmus of the uterus and pro#ects into the vagina; it is surrounded by the vaginal fornices (anterior, posterior and lateral) clitoris is covered by smooth skin
clitoris
combination of ' erectile bodies$ glans clitoris and 2 corpora cavernosa clitoris
corpus cavernosum
primary erectile bodies (paired) corpora cavernosa attach via the crura of the penis and clitoris to the ischiopubic rami and the perineal membrane; each crus is covered by an ischiocavernosus muscle; supplied by the deep a. of the penis/clitoris midline erectile body, attached to the perineal membrane at its pro"imal end (bulb of the penis) lateral part of the corpus cavernosum which is attached to the ischiopubic ramus and the perineal membrane lateral part of the corpus cavernosum which is attached corpus spongiosum e"pands distally as the glans penis which caps the distal ends of the corpora cavernosa; it contains the spongy/penile urethra crus clitoris is covered on its superficial surface by the ischiocavernosus muscle
corpus spongiosum
crus clitoris
crus of penis
crus penis is covered on its superficial surface by the ischiocavernosus muscle
to the ischiopubic ramus and the perineal membrane ductus deferens duct of the testis ductus deferens is continuous with the tail of the epididymis; it passes through the superficial inguinal ring, inguinal canal and deep inguinal ring to reach the posteroinferior surface of the bladder where it #oins with the duct of the seminal vesicle to form the e#aculatory duct e#aculatory duct passes through the prostate gland to empty onto the seminal colliculus along the urethral crest in the prostatic urethra
e#aculatory duct duct formed by the union of the duct of the seminal vesicle and the ampulla of the ductus deferens epididymis
beginning of the duct system of the head of the epididymis is located on the testis the superior surface of the testis and receives sperm from the efferent ductules; the body of the epididymis lies posterolateral to the testis and is separated from the testis by the sinus of the epididymis; the tail of the epididymis is located inferiorly and is continuous with the ductus deferens; the ductus deferens ascends to pass through the abdominal wall via the inguinal canal an e"tension of the muscular fascia of the ischiocavernosus m. and bulbospongiosus m. onto the shaft of penis/clitoris deep fascia of the penis/clitoris forms a tubular sheath surrounding the erectile bodies, dorsal n. of the penis/clitoris, dorsal a. of the penis/clitoris, deep dorsal v. of the penis/clitoris; the superficial dorsal v. of penis/clitoris lies superficial to the deep fascia of the penis/clitoris; deep fascia of the penis is also known as$ 1uck2s fascia derived from the aponeurosis of the e"ternal abdominal obli&ue muscle
fascia, deep penile/clitoral
fascia, e"ternal spermatic
outermost covering of the spermatic cord that is derived from a layer of the abdominal wall intermediate covering layer of the spermatic cord
fascia, cremasteric
derived from the internal abdominal obli&ue muscle
fascia, internal spermatic fossa navicularis fimbria of the uterine tube
innermost covering of the spermatic cord dilation of the spongy/penile urethra in the glans penis finger.like pro#ections surrounding the opening into the uterine tube speciali+ation of the membranous layer of superficial (7carpa2s) fascia passing from the lower abdominal wall onto the base of the penis/clitoris
derived from the transversalis fascia the largest diameter of the penile urethra occurs here fimbria spread over the medial surface of the ovary; the ovarian fimbria is an e"tra long fimbria that attaches to the ovary suspensory ligament of the penis/clitoris is a deep fascia speciali+ation that lies deep to the fundiform ligament
fundiform ligament
fundus of the uterus
the rounded anterosuperior part fundus of the uterus is defined as that of the uterus portion of the uterus located superior to an imaginary line #oining the points of entry of the uterine tubes; the uterus is normally anteverted and antefle"ed, so the fundus normally points anterosuperiorly e"panded distal end of the the fossa navicularis is an e"panded corpus spongiosum which caps portion of the penile urethra that occurs the ends of the corpora in the glans cavernosa greater vestibular gland is covered by the bulbospongiosus muscle; it produces a mucous secretion that drains into the vestibule of the vagina for lubrication of the vulva the hymen is the remnant of the urogenital septum of the embryo, and the hymeneal caruncles are remnants of the hymen
glans penis/clitoridis
greater an e"ocrine gland located in vestibular gland the superficial perineal space posterior to the bulb of the vestibule hymen thin, usually incomplete septum at the inferior vaginal orifice
infundibulum of funnel.shaped distal end of the fimbria are attached to the margin of the uterine tube uterine tube the infundibulum interureteric ridge mucosal fold on the inner posterior wall of the bladder connecting the paired ureteric orifices interureteric ridge is the superior boundary of the vesical trigone
isthmus of the uterine tube isthmus of the uterus labia ma#ora
constricted part of the uterine tube that is ad#acent to the uterus constricted part of the uterus between the body and the cervi" fat.filled elevations of hair. covered skin lying on either side of the vestibule of the vagina paired folds of hairless skin located medial to the labia ma#ora and e"tending posteroinferiorly from the clitoris a connective tissue band that attaches to the inner aspect of the labium ma#us and the uterus
isthmus of the uterine tube is the narrowest part isthmus of the uterus is about ! cm in length and its cavity enters into the internal cervical os labia ma#ora are #oined across the midline by the anterior and posterior labial commissures; they blend into each other anteriorly to form the mons pubis the anterior end of each labium minus divides$ the anterior division of each labium forms the prepuce of the clitoris and the posterior division of each labium forms the frenulum of the clitoris ligamentum teres uteri traverses the superficial inguinal ring, inguinal canal and deep inguinal ring to reach the lateral surface of the uterus below the uterine tube; it is a remnant of the gubernaculum; it is continuous with the ovarian ligament; it holds the fundus of the uterus forward; also known as$ round ligament of the uterus mesometrium attaches the body of the uterus to the pelvic wall
labia minora
ligamentum teres uteri
mesometrium
part of the broad ligament below the #unction of the mesosalpin" and the mesovarium part of broad ligament that supports the uterine tube part of broad ligament that forms a shelf.like fold supporting the ovary
mesosalpin"
mesosalpin" e"tends inferiorly to meet the root of the mesovarium; it attaches the uterine tube to the mesometrium mesovarium is located perpendicular to the plane of the mesosalpin" and mesometrium; it attaches the ovary to the mesometrium and mesosalpin"
mesovarium
ovarian ligament
a band of connective tissue that a remnant of the gubernaculum; it is connects the ovary to the continuous with the round ligament of lateral surface of the uterus the uterus at the lateral surface of the
uterus; ovarian ligament lies within the mesovarium; also known as$ proper ovarian ligament ovary female gonad that lies in the ovarian fossa within the true pelvis in contact with the fimbria of the uterine tube an irregular line #oining the undersides of the anal valves ovary is both an endocrine and an e"ocrine gland; it is held in place by the ovarian ligament, mesovarium, and suspensory ligament of the ovary pectinate line is where the mucosal lining of the digestive tract becomes continuous with the skin of the anal aperture
pectinate line
perineal membrane
membrane stretching across the perineal membrane is pierced by the urogenital triangle attaching to urethra, vagina and branches of the both ischiopubic rami pudendal neurovascular bundle an incision made superiorly through posterior forni" will enter the rectouterine pouch of the peritoneal cavity the anterior divisions of the labia minora combine to form the prepuce of the clitoris multiple small ducts drain into the prostatic urethra as it passes through the prostate; sub#ect to benign and malignant enlargement, which may compromise micturition due to pro#ection of the uvula into the bladder prostatic utricle is a remnant of the fused lower ends of the paramesonephric ducts . the fused paramesonephric ducts form the uterine canal in the female rectouterine fold contains the rectouterine ligament which is a condensation of endopelvic fascia that is important for support of the uterus rectouterine ligament is important for support of the uterus
posterior forni" space within the vaginal canal of the vagina posterior to the cervi"
prepuce
fold of smooth skin e"tending over the glans penis/clitoris e"ocrine gland located inferior to the urinary bladder and superior to the urogenital diaphragm
prostate
prostatic utricle a small blind diverticulum in the posterior wall of the prostatic urethra on the summit of the seminal colliculus rectouterine fold a peritoneal fold e"tending across the floor of the pelvic cavity from the sacrum (beside the rectum) to the uterus rectouterine ligament a condensation of e"traperitoneal connective tissue - smooth muscle (rectouterine muscle)
connecting the isthmus of the uterus to the sacrum rectum distal end of the colon rectum begins at about the 7' vertebral level; it is continuous distally with the anal canal round ligament of the uterus traverses the superficial inguinal ring, inguinal canal and deep inguinal ring to reach the lateral surface of the uterus below the uterine tube; it is a remnant of the gubernaculum; it is continuous with the ovarian ligament; it holds the fundus of the uterus forward; also known as$ ligamentum teres uteri scrotal ligament is the remnant of the gubernaculum testis
round ligament of the uterus
a connective tissue band that attaches to the inner aspect of the labium ma#us and the uterus
scrotal ligament band of connective tissue that attaches the inferior end of the testis to the inner aspect of the scrotal sac scrotum sac of hair.covered skin containing the testis
in the scrotum the fatty and membranous layers of the superficial fascia (as seen in the lower abdominal wall) are fused to form the tunica dartos scroti the seminal colliculus is a mound in the posterior wall of the prostatic urethra; on its summit is found the opening of the prostatic utricle seminal vesicle produces seminal fluid; its duct #oins with the ampulla of the ductus deferens to form the e#aculatory duct
seminal colliculus
elevation on the posterior wall of the prostatic urethra
seminal vesicle
blind sac located on the posterior surface of the bladder lateral to the ampulla of the ductus deferens
sinus of the epididymis
a thin space within the tunica sinus of the epididymis is lined by a vaginalis testis between the serous membrane (visceral layer of the body of the epididymis and the tunica vaginalis testis) testis bundle of vessels, nerves and lymphatics ensheathed in tissue layers derived from the abdominal wall; it begins at the deep inguinal ring, passes spermatic cord contains the$ ductus deferens, testicular a., pampiniform ple"us, deferential a. - v. and genital br. of the genitofemoral n.; coverings of the cord are the$ internal spermatic
spermatic cord
through the inguinal canal and fascia (from the transversalis fascia), the superficial ring to reach the cremasteric muscle and fascia (from the testis in the scrotum internal abdominal obli&ue), e"ternal spermatic fascia (from the e"ternal abdominal obli&ue aponeurosis) suspensory ligament of the penis/clitoris testis a speciali+ation of deep fascia connecting the pro"imal end of the penis/clitoris to the pubis and pubic symphysis an endocrine and e"ocrine gland contained within the scrotum the fundiform ligament is a speciali+ation of superficial fascia that lies superficial to the suspensory ligament testis is the male gonad; its e"ocrine product is sperm which drain to the head of the epididymis via efferent ductules; its endocrine product is testosterone; the testis migrates into the scrotum shortly before birth; it is tethered to the scrotum inferiorly by the scrotal ligament (a remnant of the gubernaculum)
tunica albuginea, corpus cavernosum
outer white fibrous covering of tunica albuginea is a dense connective the corpus cavernosum of the tissue layer that is not distensible, penis/clitoris causing erection when the corpus cavernosum becomes engorged with blood
tunica outer white fibrous covering of tunica albuginea is a dense connective albuginea, testis the testis tissue capsule that is covered on its e"ternal surface by the visceral layer of the tunica vaginalis testis tunica dartos scroti a subcutaneous layer of smooth fatty and membranous layers of the muscle located in the scrotum superficial fascia (as seen in the lower abdominal wall) are fused in the scrotum to form the tunica dartos scroti tunica vaginalis testis has two layers$ visceral and parietal; the visceral layer lies on the anterolateral surface of the testis and epididymis; the parietal layer lines the inner surface of the scrotal sac; the word ,vaginalis, is derived from the %atin word for sheath urethra has three parts in the male$ prostatic, membranous penile/spongy; female urethra is much
tunica vaginalis a peritoneal sac located testis anterolateral to the testis
urethra
duct that drains the urinary bladder
shorter than the male urethra, consisting of the membranous part only urethra, membranous part of the urethra that passes through the urogenital diaphragm (sphincter urethrae muscle and perineal membrane) part of the urethra contained within the bulb and the corpus spongiosum of the penis female$ membranous urethra connects the urinary bladder to the e"ternal urethral orifice at the vestibule of the vagina; male$ membranous urethra connects the prostatic urethra with the spongy/penile urethra longest part of male urethra; penile urethra has a dilation in the region of the glans called the navicular fossa; also known as$ spongy urethra
urethra, penile
urethra, prostatic
part of the male urethra passing prostatic urethra begins at the internal through the prostate gland urethral orifice at the anteroinferior angle of the vesical trigone; posterior wall of the urethra has an elevated ridge called the urethral crest with a prominence called the seminal colliculus (veru montanum); seminal colliculus has a blind diverticulum called the prostatic utricle with orifices of e#aculatory ducts located below it longest part of male urethra; spongy urethra has a dilation in the region of the glans called the navicular fossa; also known as$ penile urethra
urethra, spongy part of the urethra contained within the bulb and the corpus spongiosum of the penis ureter
muscular tube that serves as the ureter is continuous pro"imally with duct of the kidney to carry the renal pelvis; it passes over the urine to the bladder pelvic brim medial to the testicular/ovarian vessels; it passes obli&uely through the posterior wall of the urinary bladder and drains at the posterolateral angle of the vesical trigone the duct of the ovary; it e"tends uterine tube has four named parts$ from the ovary to the uterus infundibulum is the funnel shaped opening . fimbria encircle this opening; ampulla is a dilated region that connects the infundibulum with the isthmus; isthmus is the constricted part nearest the uterus; intramural part is within the uterine wall
uterine tube
uterus
hollow muscular organ within which the fertili+ed ovum develops; normally lies anteverted posterosuperior to the bladder
uterus is antefle"ed (curved anteroinferiorly) at the uterine isthmus; the fundus is the part superior to the entrance of the uterine tubes and it normally lies anterosuperiorly; the body meets the cervi" at a constricted area called the isthmus; the cervi" pro#ects into the vagina uvula is caused by the middle lobe of the prostate gland; if the prostate becomes enlarged (either benin hypertrophy or malignancy) the uvula can constrict the internal urethral orifice and cause difficulty in voiding the bladder; only found in males
uvula of the bladder
elevation of the inner bladder wall posterosuperior to the internal urethral orifice
vagina
part of the female genital canal vaginal fornices surround the cervi"; located between the vestibule the word ,vagina, is derived from the and the cervi" %atin word for sheath smooth triangular region located on the inner surface of the posterior wall of the urinary bladder vesical trigone is bounded by the openings of the ureters (2) superolaterally, the interureteric ridge between the openings of the ureters and the internal urethral orifice inferiorly
vesical trigone
vestibule of the vagina
region inferior to the vestibule of the vagina contains the hymen/hymeneal caruncles and e"ternal urethral orifice, the opening of between the labia minora the vagina and the openings of the greater vestibular glands

Anatomy of Pelvis N Perineum

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Anatomy of Pelvis N Perineum

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Arteries of the Pelvis and Perineum

bulb of the penis and associated tissues

superficial structures of the clitoris

deep e"ternal pudendal

unnamed muscular branches

corpus cavernosum of the penis

ductus deferens, artery of

ductus deferens, seminal vesical; possibly supplies the ureter

artery of the ductus deferens is also known as$ deferential a.

e"ternal pudendal, deep

unnamed muscular branches

e"ternal pudendal, superficial

internal iliac a., anterior division

unnamed muscular branches

gluteus ma"imus m., hip #oint

internal iliac, superficial br., deep posterior br. division

e"ternal iliac a., internal iliac a.

lumbar br. of the iliolumbar a. sends a small

anus, ischioanal fossa

lower part of the urinary bladder, prostate/vagina

internal pudendal a. is the primary blood supply to the perineum

internal iliac a., posterior division

internal iliac, no named branches anterior division

internal iliac a., anterior division

pubic br., acetabular br., anterior br., posterior br.

abdominal aorta internal pudendal a.

penis, dorsal internal pudendal a.

and associated tissues

posterior aspect of the labium ma#us posterior aspect of the scrotum

pudendal, deep e"ternal

unnamed muscular branches

internal iliac a., anterior division

pudendal, superficial e"ternal

superficial e"ternal pudendal a. is one of three

internal iliac, no named branches anterior division

inferior two unnamed mesenteric a. branches

internal iliac a., posterior division

sacrum, sacral nerve rootlets, meninges, ad#acent muscles sacrum

*th lumbar aa.

superficial e"ternal pudendal

internal iliac a., anterior division

internal iliac a., anterior division

tubal br., vaginal br.

uterus, uterine tube

lower part of the urinary bladder, prostate/vagina

Bones of the Pelvis and Perineum

acetabular notch acetabular fossa

a large foramen formed by the pubic and ischial rami

lesser sciatic notch

articular surface body base

Fasciae of the Pelvis & Perineum - Arranged Alphabetically

fascia, e"ternal spermatic

derived from the aponeurosis of the e"ternal abdominal obli&ue muscle

fascia, superior, of the pelvic diaphragm

"oints and igaments of the Pelvis and Perineum isted Alphabetically

the midline #oint

ymphatics of the Pelvis and Perineum - isted Alphabetically

e"ternal iliac nodes, internal iliac nodes

lumbar (lateral aortic) chain of nodes

common iliac nodes are appro"imately 3 in number

internal along the iliac nodes internal iliac vessels

lymphatic vessels from the pelvic viscera