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PELVIS AND PERINEUM
5 PELVIS AND
PERINEUM
Topographic Anatomy
Plate 329
329
Pelvis and Perineum: Surface Anatomy
Bones and Ligaments

Plates 330-334
330
Bony Framework of Pelvis
331
Radiographs of Male and Female Pelvis
332
Sex Differences of Pelvis: Measurements
333
Bones and Ligaments of Pelvis
334
Bones and Ligaments of Pelvis (continued)
Pelvic Floor and Contents

Plates 335-345
335
Pelvic Diaphragm: Female
336
Pelvic Diaphragm: Female (continued)
337
Pelvic Diaphragm: Female (continued)
338
Pelvic Diaphragm: Male
339
Pelvic Diaphragm: Male (continued)
340
Pelvic Viscera and Perineum: Female
Atlas of Human Anatomy
341
Pelvic Contents: Female
342
Pelvic Viscera: Female
343
Endopelvic Fascia and Potential Spaces
344
Pelvic Viscera and Perineum: Male
PELVIS AND PERINEUM
PELVIS AND PERINEUM

Pelvic Contents: MaleUrinary
Genitalia: Male
Bladder
Plates 358-365
Plates 346-348
345 Urinary Bladder: Orientation and Supports
346 Female Sphincters
357 Male Perineum and External Genitalia (Superficial

Dissection)
358 Male Perineum and External Genitalia (Deeper
Dissection)
347 Urinary Bladder: Female and Male

359 Penis
Uterus,
Vagina,
Structures
and
Supporting
360 Male Perineal Spaces
Plates 349-353
348 Uterine Growth
361 Prostate and Seminal Vesicles
349 Uterus, Vagina, and Supporting Structures
362 Urethra
350 Uterus: Fascial Ligaments
363 Descent of Testis
351 Uterus and Adnexa
364 Scrotum and Contents
Homologues of Genitalia
352 Pelvic Ligaments
Plates 366-367
365 Homologues of External Genitalia
Perineum and External Genitalia: Female
366 Homologues of Internal Genitalia
Plates 354357
353 Female Perineum and External Genitalia (Pudendum

Testis,
or Vulva)
Plate 368
Epididymis, and Ductus Deferens

367 Testis, Epididymis, and Ductus Deferens
354 Female Perineum (Superficial Dissection)
Rectum
Plates 369-374
355 Female Perineum and Deep Perineum

368 Rectum in Situ: Female and Male
356 Female Perineal Spaces
369 Ischio-anal Fossae
Perineum
and
External
370 Rectum and Anal Canal
Female
371 Anorectal Musculature
385 Lymph Vessels and Nodes of Pelvis and Genitalia:

Male
372 External Anal Sphincter Muscle: Perineal Views
Innervation
373 Actual and Potential Perineopelvic Spaces
Plates 387-395
Regional Scans
386 Nerves of External Genitalia: Male
Plate 375
374 Pelvic Scans: Sagittal CT Images
Vasculature
Plates 376-386
375 Arteries of Rectum and Anal Canal: Male
376 Veins of Rectum and Anal Canal: Female
377 Arteries and Veins of Pelvic Organs: Female
378 Arteries and Veins of Testis
387 Nerves of Pelvic Viscera: Male
388 Nerves of Perineum: Male
389 Nerves of Pelvic Viscera: Female
390 Nerves of Perineum and External Genitalia: Female

391 Neuropathways in Parturition
392 Innervation
Schema
of
Female
Reproductive
Organs:
393 Innervation of Male Reproductive Organs: Schema

379 Arteries of Pelvis: Female
380 Arteries and Veins of Pelvis: Male
381 Arteries and Veins of Perineum and Uterus
382 Arteries and Veins of Perineum: Male
383 Lymph Vessels and Nodes of Pelvis and Genitalia:

Female
384 Lymph Vessels and Nodes of Perineum:
394 Innervation of Urinary Bladder and Lower Ureter:

Schema
Cross-Sectional Anatomy
Plates 396-397
395 Male Pelvis: Cross Section of Bladder-Prostate

Junction
396 Female Pelvis: Cross Section of Vagina-Urethra
Muscle Table
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Chu hng v y chu
Pelvis and Perineum: Surface Anatomy
Nipple
nguyt
c rng trc
muscle
Tendinous tr gn
intersection ngang
oblique c cho bng
muscle "3oi
c thng
bng
Lineaalba ng trng
gai chu
s abdominis
muscle
trc trn
Umbilicus nn Iliac crest mo
or
superior
chu
nngiliac
tnhspine
chu
mach
thngiliac vein
ficial
circumflex
v nng
ficial epigastric veins
khp mu
nng ca
ficial
vein of penis
dv dorsal
qui u
Inguinal dy
ligament
oi
chng
bn
Pubic tubercle c mu
Body (shaft) of thn dv penis

External
urethral
orifice (meatus)
Scrotum
Transverse processes of lumbar vertebrae

Inner lip
Iliac tuberosity
Iliac < crest
Pubic tubercle Topographic
Inferior
Iliopubicpubic
acspine
spine
ramus
eminence
Anatomy
Inferior pubic ligament
Greater
Iliac crest sciatic
notch
Pecten pubis
(pectineal line)
Lesser Arcuate
line
sciatic notch
Pubic symphysis
Ischial spine
Greater
trochanter
Lesser
trochanter
Ischial
tuberosityof
of femur
femur
Plate 6
Topographic Anatomy
Plate 7
Radiographs of Male and Female
Pelvis
Plates 243 475
See a
Female
Pelvis
acrum
Sacro-iliac joint
acral foramina
Ilium
Pelvic inlet (dashed line)

Ischia] spine
ad of femur Greater
trochanter
Pubic symphysis
Superior pubic ramus

Obturator foramen
Ischium
er trochanter Femur
Male Pelvis
um
Sacro-iliac joint
acrum
Acetabulum
Pubis
Pubic symphysis
Ischium
Femur
Obturator
foramen
Subpubic angle
See also Plate 243
Female pelvis/female pelvic

inlet: anterior view
-ir
V- Sacral promontory
'
___A ------ Diagonal conjugate (~12 cm)

_Transverse (~13 cm)
.^-"Oblique (~12.5 cm)

Pubic symphysis
Ischial tuberosity
Sex Differences of Pelvis: Measurements
Diagonal / All measurements slightly shorter in conjugate I relation to body size than in female is only \ Pelvic
inlet oriented more antero- diameter of I posteriorly than in female, where pelvic / it tends to be transversely
oval inlet that J Pubic symphysis deeper (taller) can be / Pubic arch (subpubic angle) narrower measured I
Diameters
the pelvis
of
Ischial tuberosities less far apart clinically \ Iliac wings less flared
rse diameter of pelvic outlet (~11 cm)
True conjugate is ~1.5 cm shorter than

diagonal
onjugate
True conjugate diameter
tuberosity
osterior diameter of pelvic outlet

(varies 9.5-11.5 cm
because of mobility
of coccyx)
Female pelvis/female pelvic outlet:

inferior view
Ischial spine
Anteroposterior diameter of pelvic outlet
(9.5-11.5 cm)
Transverse diameter is the widest distance of pelvic inlet
Female: sagittal section
Bones and Ligaments of Pelvis

KHBHS Plate 473
Iliac crest
:
Iliolumbar ligament
Supraspinous ligament
superior iliac spine Posterior

sacro-iliac
Posterior
sacral
foramina
Greater
sciatic
inous
ligament
berous
ligament
sciatic
foramen
lar margin
uberosity
of long head
of biceps
femoris
muscle
Anterior
longitudinal
ligament
Iliolumbar
ligament
uperficial j ligaments
Iliac
fossa
c ligament Sacral promontory

gament
Posterior
Greater
sciatic view
foramen
Anterior superior iliac spine -v.
Sacrotuberous
ligament
Sacrospinous ligament
Anterior inferior iliac spine Ischial
spine Lesser sciatic foramen
Ischiopubic ramus
Pubic tubercle
Pubic
symphysis
Iliac
tubercle
foramen
spine
superior iliac
ligaments
Iliopubic eminence Superior pubic ramus-
Anterior view
Plate 158
Median (sagittal) section
Body of L5 vertebra
Iliac ) Intermediate zone crest | Inner lip
False pelvis
Lumbosacral (L5-S1) intervertebral disc
Anterior superior iliac spine
Sacral promontory
Greater
Anterior inferior iliac spine
sciatic
foramen
True
pelvis Iscbial spine Sacrospinous

ligament Lesser sciatic foramen
Sacrotuberous ligament Coccyx
Ischial tuberosity
Pecten pubis (pectineal line)
Supraspinous ligament
Posterior, anterior, and
inferior gluteal lines
Intermediate zone
Outer lip Iliac
tubercle
Wing (ala) of
(gluteal surface)
Posterior superior iliac spine
ilium
Body of ilium
Median sacral crest
Anterior superior 'Mac

spine
Posterior inferior iliac spine
Anterior inferior
liac spine
Posterior sacro-iliac ligament
Acetabulum
Greater sciatic foramen
Acetabular labrum
Acetabular margin
Posterior
and
lateral
sacrococcygeal ligaments
Lunate (articular) surface

Acetabular notch
Transverse
acetabular
ligament
Sacrotuberous ligament
Ischial spine
Lesser sciatic foramen

Ischial
Pubic
tuberosity
Obturator membrane
tubercle
Obturator
crest
Obturator canal Ischiopubic ramus
Pelvic Diaphragm:
Medial view
Female
Plates 348, 350, 370
Arcuate line
Obturator internus muscle and obturator fascia (cut)
Tendinous arch of levator ani muscle Obturator canal
lliococcygeus muscle (part of levator ani muscle)
Rectum
Urethra
Pubococcygeus muscle (part of levator ani muscle)
Vagina
Left puborectalis muscle and perineal membrane
Compressor urethrae and urethrovaginal sphincter
(portions of sphincter urethrae muscle)
(ischiococcygeus)
muscle
Left levator ani
muscle (cut)
External anal
sphincter muscle
Superficial and deep

transverse perineal muscles
Ischial
spine
Sphincter urethrae muscle
Sacrospinous ligament (cut)
Pubic bone
{cut surface)
Coccyx
Deep dorsal vein of clitoris

Urethra
Vagin
if
f
Pelvic Diaphragm: 1
Lateral view
For urogenital diaphragm see
Sacrotuberous ligament (cut)
Medial viel
Median sacral crest
Piriformis muscle Greater sciatic foramen Ischial
Plate 356
spine
lliococcygeus muscle (part
of levator ani muscle)
Tendinous arch of levator ani muscle
Pubococcygeus
muscle
(part of levator ani muscle)
Puborectalis muscle (part
Pubic bone (cut surface)
Obturator internus muscle and

obturator fascia {cut)
ygeus (ischiococcygeus) muscle

Obturator canal
Urethra
Arcuate line of ilium

Tendinous arch
levator ani muscle
of
Ischial
spine
Rectum
lliococcygeus muscle
Piriformis
muscle
C/ihdad-
Coccygeus
Inferior (arcuate) pubic ligament

Transverse perineal ligament
Fascia of deep perineal muscles
Urethra
Vagina
Superior view
Inguinal ligament (Poupart's)
Coccyx
coccygeal ligament
Obturator canal
Obturator
fascia
(over
obturator
internus muscle)
Pubococcygeus muscle
(part of levator ani
muscle)
Tendinous arch of levator
ani muscle
-Rectum
lliococcygeus muscle (part
Ischial spine
tor plate (n vator ani n
eus (ischiococcygeus)
muscleof levator ani muscle
Levator plate (median raphe)
ament)
Musculofascial extensions to
Pubic symphysis
urethra
Inferior (arcuate)
pubic ligament
Musculofascial extensions
to vagina
Deep dorsal
vein of clitoris
Interdigitating fibers of
perineum
Puborectalis
Urethra
Vagina
(ischiococcygeus)
Piriformis muscle {cut)
Sacrospinous
ligament
(cut)
Sacrotuberous ligament {cut)

Sacrum
muscle (part of levator ani muscle)


Obturator internus muscle
lliococcygeus muscle (part of levator ani muscle)
Ischial tuberosity
Ischial spine
Obturator internus tendon
Piriformis muscle
Median raphe of levator ani muscle
Anococcygeal body (ligament)
(attachment of externaL anal sphincter muscle)
Tip of coccy
ee also
ubic
Plates 258 261

Superior view
(viscera removed)
Superior ramus of pubis

crest Pubic tubercle Pecten pubis
Obturator canal
Obturator fascia
Iliopubic eminence
Acetabular margin
Anterior inferior iliac spine^^
muscle of anal canal
Inferior (arcuate) pubic ligament Hiatus for deep dorsal

vein of penis
Transverse perineal ligament
thickening of Perineal membrane)
Puborectalis )
Pubococcygeus>
Iliococcygeus ) mu5cle
(anterior
Hiatus for urethra

Muscle fibers from levator ani to conjoined longitudinal

Obturator internus muscl
Wing (ala) / of ilium /
Arcuate lin
e
Coccvgeus
muscl
(ischiococcygeus)
Piriformis muscle Anterior

sacral
(pelvic)
foramina
ligament Anorectal hiatus
Anterior
sacrococcygeal
For urogenital diaphragm see
Plate 361
Inferior vie
Pubic symphysis
wDeep dorsal veins of penis
Fat in retropubic (prevesical) space
Sphincter urethrae muscle ascending anterior aspect of

prostate
Urethra
villiers') fascia
utaway)
Medial border (pillar) of levator ani

muscle
Inferior pubic (arcuate) ligament Perineal body

Fibromuscular extensions of levator ani muscle to
prostate
Pubic tubercle
Recto-urethral is superior muscle
Prerecta I muscle fibers (of Luschka) from levator
ani muscle
Muscle fibers from levator ani to conjoined longitudinal muscle of anal cana
Obturator internus tendon
otuberous ligament {cut)

Sacrospinous ligament (cut)
cygeus) muscle
Sacrospinous ligament {cut)
Gluteus maximus muscle
Obturator internus muscle Tendinous arch of levator ani muscle
lliococcygeus
Pubococcygeus
>
Puborectalis
ICircular muscle layer
Conjoined
Levator ani
)
!
f anorectal
longitudinal muscle J
junction
muscle
4fe
Paramedian (sagittal) dissection
Ureter Uterine (fallopian) tube Ovary

Ligament of ovary
Round ligament of
uterus Broad
ligament (cut)
Ischiocavernosus
muscle
Body of clitoris
Labia minus
(cut)
Inferior
pubic
ramus (cut)
Labium
majus
Sacral promontory
Recto-uterine pouch (of Douglas)
Urinary bladder Vagina

Pelvic diaphragm (levator ani muscle)
Deep transverse perineal muscle (cut)
External anal sphincter muscle
Ureter
Suspensory ligament of ovary Uterine (fallopian) tube Ovary
External iliac vessels Ligament of ovary Body of uterus Round ligament of uterus (ligamentum teres
uteri) Fundus of uterus Urinary bladder Pubic symphysis Urethra Sphincter urethrae Deep transverse perineal
muscle
Deep dorsal vein of clitoris Crus of clitoris External urethral orifice Labium minus Labium maju
bladder and
Linea
albatransverse vesical fold
Uterus (fundus) Urinary
Median
Ligament
of
ovary
Rectus abdominis muscle
umbilical
Ovary
fold and
Medial umbilical fold and ligament
Uterine (fallopian) tube
ligament
(occluded part of umbilical artery)
(urachus)
Round ligament of uterus Broad
ligament
Superior view
Femoral ring
Deep inguinal ring
Iliopubic tract (covered
by peritoneum) External
iliac vessels
Iliac fossa
(false
pelvis)
/Inferior epigastric vessels and lateral umbilical fold

/Uterosacral fold /Ureteric fold
/Suspensory ligament of
ovary (contains ovarian
vessels)
Cecum
Cecal
folds
Right
paracolic
gutter
Uterosacral ligament Vesico-uterine pouch

Recto-uterine pouch
(of Douglas)
Cervix of uterus
Posterior vaginal
fornix
Anterior vaginal
fornix
Rectu
m
Vagina
Perineal
membrane
Levator
ani
muscle
Extern
al anal
sphincter
muscle
Sigmoid colon
Quadratus
lumborum
muscle
Psoas
major
minor muscles
Descendingand
colon
Transversus )
Sympathetic trunk
abdominis
( Abdominal
Anterior
/
Internal oblique f muscles
longitudinal ligament
Body of L3 vertebra Superior hypogastric plexus
Ovarian
vessels
\
Parietal peritoneum
Ascending colon Terminal ileum
Ureter Root of mesentery
Superior view with peritoneum intact
Vesico-uterine
pouch
Ureteric fold
ligament External iliac vessels

Ureter Sacral
promontory
Superior view with peritoneum and uterus

removed
Sigmoid
Paravesical fossa
promontory
colon
Median
Sacral
sacral
vessels Abdominal aorta

Obturator canal Obturator
artery
Cervix of uterus and uterovaginal fascia Uterine
vessels
Cardinal (transverse cervical or Mackenrodt's)
ligament Rectocervical and rectovaginal (potential) spaces ~ Rectal
fascia (cut edge)
0
Recto-uterine (sacro-uterine)
Urinary bladder Fundus of uterus Deep inguinal ring Round ligament of uterus Body of
uterus Broad ligament Ligament of ovary Mesosalpinx (of broad
ligament) Cervix of uterus Ovary
Recto-uterine pouch (of Douglas)
Recto-uterine fold
External iliac vessels
Pararectal fossa
Suspensory ligament of ovary (contains
ovarian vessels)
Urinary bladder
Vesical fascia (cut edge) Obturator fasci
Endopelvic Fascia and Potential Spaces
Female: superior view (peritoneum and loose areolar tissue removed)

Umbilical prevesical fascia Median umbilical ligament (urachus)
Medial umbilical ligament (occluded part of umbilical artery)
y bladder and vesical
fascia
r vesical artery in lateral ligament of bladder
ersalis fascia
Linea terminalis of pelvis

Femoral ring
Inferior epigastric artery
and
Pubic branch
Deep inguinal ring
Iliopubic tract
Inferior (arcuate) pubic ligament Deep dorsal vein of clitoris

Retropubic (prevesical) space
Transverse perineal ligament (anterior
thickening of perineal membrane)
Medial pubovesical ligament Lateral
pubovesical ligament Vesicocervical
fascial fibers Superior fascia of pelvic
diaphragm (superior levator ani fascia)
Obturator canal and obturator arter
rcumflex iliac vessels
us arch of pelvic fascia (reflected

laterally)
fasci
a
vessels in suspensory
ligament
of ovary
Obturator
internus
fascia
Tendinous arch of
levator ani muscle
Tendinous arch of pelvic
fascia
Uterosacral ligament
Cardinal (transverse cervical or MackenrodTs)
ligament with uterine artery
-rS-,'*-..
Iliacus muscle ^
Ureter
Psoas major muscle
Internal iliac vessels
Inferior vesical and
arteries'
Hypogastric (neurovascular) sheath
Middle
rectal
vaginal
Vaginorectal
artery
Cervix of uterus and uterine

fascia'
Superior rectal artery (left branch)
Rectum
and
fascial
fibers
Presacral fascia (pulled away)

Anterior sacrococcygeal ligament Vesicocervical and
vesicovaginal (potential) space
rectal
fascia
Rectovaginal (potential) space Presacral

(potential) space (spread open)
Median sacral artery
Pelvic
Viscera and Perineum: Male
s
Paramedian (sagittal)
dissection
External
vessels
Urinary bladder and fascia
iliac
Ureter (cut)
Parietal
Seminal vesicle
peritoneum
Rectus
abdominis
muscle
Anterior layer of rectus sheath
Transversalis fascia
Umbilical prevesical
fascia
(fatty (Camper's)
membranous tissue ((Scarpa's)
bic ramus (cut)
Fundiform ligament
of penis
Suspensory
ligament of penis
Areolar tissue and vesical
venous plexus in retropubic (prevesical) space
Deep dorsal vein of penis
Rectovesical pouch
Rectum
Rectoprostatic
(Denonvilliers') fascia
^-Prostate (covered by fascia)
Ischiopubic ramus (cut)
Pelvic diaphragm (levator ani
muscle)
Deep
transverse
perineal muscle
Corpus cavernosum
Deep (Buck's)
fascia of penis
Corpus spongiosum
Superficial (dartos) fascia
of penis and scrotum
Deep perineal (investing or

Gallaudet's) fascia
Superficial perineal (Colies') fascia
(inferior fascia of superficial perineal
space)
Superficial (dartos) fascia of scrotum
External spermatic fascia
Vesical fascia
Rectovesical pouch
Rectum
Seminal
vesicle
Prostate

Apex Fundus- Body Trigone
Neck
Suspensory
Pubic
symphysis
ligament
of
penis
External urethral sphincter muscle
Inferior (arcuate) pubic ligament

Prostatic venous plexus
Transverse perineal ligament (anterior
thickening of perineal membrane)-------Perineal
membrane
Superficial perineal space Corpus cavernosum
Corpus spongiosum Superficial (dartos) fascia of
penis and scrotum Deep (Buck's) fascia of penis
Prepuce
Clans penis and external urethral meatus
Bui bo-urethra I
(Cowperis) gland
Perineal
Bulbospongiosus muscle
Deep perineal (investing or Gal laudet's) fascia
Superficial perineal (Colles') fascia
Deep (Buck's) fascia of penis Septum of
scrotum Navicular fossa
body
Pelvic Contents: Male

Superior view
Rectum
Median
umbilical
fold
and
ligament
(urachus
)
Seminal
vesicle
(subperitoneal)
Ductus deferens (in peritoneal fold)

Linea
terminalis
of
pelvis Femoral
ring
Pubic
branch
of
inferior
epigastric
artery
(obturator
anastomotic)
Deep inguinal ring
Testicular
vessels
(in
peritoneal fold)
Urinary bladder and transverse vesical fold

Medial umbilical fold and ligament
(occluded part of umbilical artery)
Rectovesical pouch
Inferior epigastric vessels and lateral umbilical fold
Vesicosacral (sacrogenital) fold Pararectal
fossa /Ureteric fold
Iliopubic
tract
(extraperitoneal)
Cecum
Cecal fold
Transversalis fascia
tal peritoneum
olic gutter
\
s
Quadratus
Sigmoid
colon
lumborum
Psoas minor
musc e
^
and major
Descending colon
muscles
,_
\
Sympathetic trunk
I Transversus j
.
abdominis ( Abdominal Anterior Internal oblique ( muscles
longitudinal ligament External oblique
)
Body of L3
vertebra
\ Ascending colon
Sacral
Abdominal
promontory
aorta
hypogastric plexus
Superior
\ Terminal ileum Ureter
al
verse
Urinary Bladder: Orientation and Supports
Female: midsagittal section
Parietal peritoneum Transversalis fascia Median umbilical ligament (urachus)

pubovesical
ligament
(medial
puboprostatic ligament in male)
Umbilical prevesical
perineal
fascia
Uterus
(fundus)
Vesico-uterine pouch
Fundus Apex Body
Ureteric orifice Trigone Neck
Pubic symphysis
Retropubic
(prevesical) space
and venous plexus
(space of Retzius)
Inferior
(arcuate)
pubic ligament Deep
dorsal vein of clitoris
Transverse perineal
ligament
and
Sphincter
urethrovaginal
is
muscles
Perineal membrane Urethra Vagina Labium
minus Labium maju
Sphincter
Perineal body
External anal Ampulla of rectum
sphincter muscle
Rectum
urethrae
ligament
Pubic symphysis
Inferior (arcuate) pubic ligament Deep
Superior view with

peritoneum and
vesical fascia
removed
dorsal vein of clitoris
(anterior thickening of perineal

membrane)
nous arch of levator ani muscle
Obturator canal
al pubovesical ligament (lateral puboprostatic ligament
in male)
Tendinous arch of pelvic fascia
Superior fascia
of pelvic
diaphragm (covering levator ani
muscle) Obturator fascia over
obturator
internus
muscle
Urinary bladder pulled up and
back (vesical fascia removed)
Median umbilical ligament (urachus) (cut)
ferior vesical and
vaginal arteries
Ureter
Urinary Bladder
Plate 35
Female Sphincters
BBS Plate 356
Trigonal ring
Posterior loop
Loop of Heiss
Bladder
Vagina
Urethra
Levator
ani
muscle
Urogenital hiatus
Sphincter urethrae muscle
Compressor urethrae muscle
External
urethral
^
sphincter
(voluntary)
bng quang : n v nam
Urinary Bladder: Female and Male

See also Plates 340, 344, 381
Female: frontal section n th it ng ngang

Parietal peritoneum phc mc Fundus of bladder thn
bng quang Interureteric crest y bng quang Left ureteric
orifice np gian niu qun Trigone of bladder tam gac
bng quang Neck of bladder c bng quang Paravesical
endopelvic fascia khoang cnh bng quang and vesical
venous plexus v m ri tn h mch Vesical fascia mc
bng quang Tendinous arch of levator ani muscle cung gn
c ca Obturator internus muscle c bt c nng hu mn
Levator apLmuscle
trong
c nng n mon
Tendinous arch of pelvic fascia
cung gn ca mc chu
Urethra niu o
Sphincter urethrae muscleCO' tht niu o Perineal membrane honh
niu dc Inferior pubic ramus ngnh di xng mu Crus of clitoris and
ischiocavernosus muscle tr m vt v c ngi hang Bulb of vestibule and
bulbospongiosus muscle vt xp v c hnh xp Deep perineal (investing or
Gallaudefs) fascia y chu su Superficial perineal (Colles') fascia mc y
ligament of uterus
chu nng
Male: frontal section nam: thit ng ngang
Parietal
peritoneum
phc mc
thn bng quang

Fundus of bladder
ng quang ngDuctus
dn tinh
(vas) deferens Interureteric crest Right
ian niu qun tam gic bng
ureteric orifice Trigone
quang
of bladder Neck of
bladder
c bng quang khoang cnh bng quang

Paravesical endopelvic fascia v m ri tnh mch and
vesical venous plexus
s arch of levator ani muscle c nng hu mn li bq

Uvula of bladder
Obturator internus muscle
c nng hu mn mc tin lit
Levator ani muscle Capsule of

prostate
Internal c tht niu

urethral o trong
sphincter
arch of
cungpelvic
gn ca mc chu
fascia
Anterior ngch trc recess

Cl a
of A I sch ich
l
h
?, hû
mn
anal
Qtrc
fossa trng
tuyn tin lit v niu o tienf

Prostate and prostatic urethra
Seminal colliculus
li tinh
tuyn honh niu o
Bulbo-urethral (Cowperis) gland
Perineal membrane and sphincter urethrae muscle
u dc
ngnh di pubic cua xng

mu ramus
Bulhi^feWi
of
tr ca dv
v c ngi
nosus muscle
Superficial
perineal
mc yfascia
chu nng
(Codes')
Uterine Growth
Newborn
4 years
Puberty
Adult
(nulliparous)
Adult
(postmenopausal)
Adult
(parous)
Plate 38
Uterus, Vagina, and Supporting Structures
erus,
m o , cu trc nng
Vagina,
Plates 382, 384, 390
and Supporting Structures

mc treo dy chng
bung trng Mesovarium
mt phng thit
Plane of section
gc nhn, Angle
of view
dy chng rng
Uterine
(fallopian) tube Cut edge of peritoneum mp ct ca forming floor of
Round ligament l of uterus------------------1
External
iliac
artery and vein
tiVminalis
'
phucmac
(pelvic brim)
c t cung
Cervix of uterus
mng bt
Uterine vessels cc mch mu

t cung
Obturator
membrane
mac bit
cervical
or
dy
chng
t cung
ngang Mackenrodt's)c
ligament
Tendinous arch cung gn ca c of
levator ani
nng hu mn
muscle
Vaginal artery ng mach m o
Ureterniu qun
Uterovaginal fascia mc t cung
.
___ m o
Anterior recess
of ischio-anal fossa ngch trc ca
h ngi
C US
L 9 dilss... trc trng
Obturator
fascia
Obturator internus muscle ngnh

di xng mu
Levator ani muscle (iliococcygeus
and pubococcygeus muscles)
c niu o
Ischiopubic ramus
c niu o
Compressor
urethrae muscle honh niu dc
Perineal
membrane
m cho hnh tin nh
Artery of bulb of vestibule
c tht niu m o
Sphincter urethrovaginalis muscle
tr c m vt Ischiocavernosus
"c'if^fjoi hang Fascia lata of
thigh m?c i
Superficial perineal space khoang

y chu nng
Perineal artery ng mch y ch
u
Terminal part of round ligament of uterus--------mc y chu nng
n cng ca dy chpg trn t cung

C/faack*__^D.
Bulbospongiosus muscle and deep c hnh xp v perineal (investing or

Gallaudet's) fasfflc y chu su
Labium minus
mi b
Vestibule
tin nh
Bulb of vestibule hnh tin nh

Vaginal wall thnh m o
Vagina
Hymenal caruncle mng trinh
m
o
Uterus: Fascial Ligaments

BQ Plate 343
Fascial ligaments
of uterus
Ligament of ovary
Round ligament of uterus
Uterosacral ligament
Cardinal (transverse cervical or Macken rodfs) ligament
Pelvic fascia and ligament

s
agina (anterior fornix)
e pelvis
(vertical) portion of pubocervical fascia supports urethra and ureterovesical junction and provides backstop against which urethra is compressed during strainin
erosacral ligament
ervix
Cardinal (transverse cervical

or Mackenrodes)
orizontal
portion of ligament
pubocervical fascia
supports bladder
and vagina
Urethra
t cung v cc phn ph
Uterus and Adnexa
dy chng treo Suspensory ligament of ovary
nhn sau
Posterior view
Mesosalpinx (of broad ligament)
mc treo vi trng
Ligament of ovary
/
uterus
J/
Fundus of
km*L
baûg k
ytkcung
l ngof(bng) ostium
th vng Corpus luteum 'Hr bung

trng Ovary
thn t cung Body
Suspensory ligamenfa chng treo

of ovary
bung trng
of uterus
dy chng
rng
Infundibulum |\ilu
Ampulla
dv
Ovary bung trng

Mesovarium (of bung trng gia dy
broad ligament) chng rng Ligament of ovary
dy chng ring bung trng Uterine (fallopian)
tube vi t cung
Mesometrium (of
broad ligament) "
niu qun Ureter

uterosacral ligament
t cung-cng
Recto-uterine pouch
"9 (of Douglas trc trng- t
cung
y t cung
l trong ca vi t cung
Body
thn t cung of uterus
uterine ni thnh ostium
nhng np
vi
sk ^
Isthmus
Of
os c t cung
uterus
.____ \v
Internal
c t cung Cervix of
uterus
'
ill.
Fimbriae^/tua vi
Suspensory ligament d chng treo

of ovary (contains bung trng
ovarian vessels)
Vesicular appendix mu thy bo
(hydatid of Morgagni) bung trng
vt trn bung trng
ringbi
mc t cung '"Mypmeim
ct_ng_
dy chng rng Epo< Uterine vessels ^^^ T mu

Cardinal (transverse
(graafian) cervical
or dy chand Corpus albica

chand Corpus albicans (
van
oro
tip cung
with palmate foldsing c6 tip cung va cac nip la co

External
os c t cung
$jx0
Frontal section
thit ng ngang
: r
< Vagina
nang trng
of ovary bung trng
Pelvic Ligaments
Anterior
Posterior
Suspensory ligament of ovary (containing ovarian

vessels)
Subdivisions and
contents of broad
ligament
Infundibulum of uterine tube

Fimbriae of uterine tube
Ampulla of uterine tube
Round ligament
Right ovary Right ureter
Laminae of mesosalpinx
Laminae of mesovarium
Obliterated umbilical artery

Ovarian branches
of uterine vessels
Posterior lamina of broad ligament

Anterior lamina of broad ligament
Round ligament
Transverse vesical fold
Vesico-uterine
(uterovesical) pouch
Uterine artery and venous plexus

ff.f.
Vaginal artery
am of uterus
Right
fallopian
tube infection
Contrast medium in abdominal cavity
ons pubis
udendal
cleft (groove or
space between labia
majora)
nterior commissure of
labia majora
epuce of clitoris
Gians of clitoris Frenulum of clitoris External urethral orifice

Labium minus
Labium majus
Openings of para-urethral (Skene's) ducts
Vestibule of vagina (cleft or space surrounded by labia minora)
Vaginal orifice
Opening of greater vestibular (Bartholin's) gland
Hymenal caruncle Vestibular fossa
Frenulum of labia minora
Posterior commissure of labia majora
Perineal raphe (over perineal body)
Anu
Female Perineum (Superficial Dissection)
Superficial fatty (Camper's) layer )
(
f
)
,
Subcutaneous
tissue
Deeper membranous
(Scarpa's) layer
Rectus sheath (anterior layer)
Aponeurosis of external oblique muscle
Superficial inguinal ring

Round ligament of uterus and coverings (cut)
Inguinal ligament (Poupart's)
Pubic tubercle
Saphenous opening
Suspensory ligament of clitoris
Fascia lata of thigh
Ischiopubic ramus
Superficial perineal (Colles') fascia (cutaway) to open superficial perineal space
Ischiocavemosus muscle
Bulbospongiosus muscle (covers bulb of vestibule)
Perineal membrane
Deep perineal (investing or Gallaudet's) fascia (partially cut a way)
Superficial transverse perineal muscle Ischial tuberosity
Superficial perineal (Colles') fascia (cut edge turned down)
Fat body of ischio-anal fossa
-Transversalis fascia - Rectus

/
fascia
Rectal fascia
cial perineal (Colles') fascia
Rectus sheath (anterior layer)

Pubic
symphysis
und ligament of uterusInferior
and coverings
(arcuate) pubic ligament Transverse perineal
ligament Suspensory ligament of clitoris Sphincter urethrae
and sphincter urethrovaginalis muscles
Perineal
membrane
Superficial perineal space Superficial
perineal (Codes') fascia Perineal
body
Superior fascia of pelvic diaphragm
Inferior fascia of pelvic diaphragm
Levator
ani
anal
Female Perineum and Deep Perineum
Bulbospongiosus muscle with deep perineal (investing

or Gallaudet's) fascia partially
removed
Suspensory ligament of clitoris

Ischiocavernosus muscle
Bulb of vestibule
ficial perineal space (pouch or compartment)
pubic
Perineal membrane
ramus
Greater vestibular
(Bartholin's) gland
with cut edge of

superficial perineal
(Colles') fascia
Bulbospongiosus
muscle
(cut
away)
Superficial
transverse
perineal
muscle
us maximus muscle
Coccyx
Obturator
fascia
Tendinous arch of
levator ani muscle
Inferior fascia of pelvic
diaphragm (cut)
Levator ani muscle
Perineal membrane (cut and reflected)

Anococcygeal (ligament) body
Sphincter urethrovaginalis muscle
Greater vestibular (Bartholin's) gland

muscle
Female Perineal Spaces

Plates 382 391
Superficial perineal space

Pubic symphysis
Crus of clitoris
Cut edge of superficial perineal (Colles') fascia
Suspensory ligament of clitoris Clitoris

avernosus muscle
Bulb of vestibule
Internal pudendal (clitoral) artery
Deep and superficial branches of perineal
nerve
Perineal
artery
pongiosus muscle
membrane
Perineal nerve Pudendal nerve
Branch of inferior analÎnternal pudendal

(recta|) nerves
artery
icial transverse perineal muscle
Deep perineal space

Dorsal artery of clitoris
Dorsal nerve of clitoris

Compressor
urethrae muscle
Artery to bulb of
vestibule
Internal
pudendal
(clitoral) artery
al membrane (cut and deflected)

Cut edge of superficial
perineal (Colies') fascia
Vaginal orifice
d line- indicates line of

attachment
of
cial fatty (Camper's)^
and deeper
CoIIes'
and
membranous
nous opening Scarpa's
and femoral
(Scarpa's)
layersfasciae
with
artery
of
subcutaneous
Regions (triangles)
deep
fascia
tissueof
cial (dartos) fascia
penis and
(CoIIes')
of
perineum:
Buck's) fascia of penis
scrotum-.___
fascia
dy in ischio-anal fossa
surface
topography
-----------
(Bartholin's) gland
ducts
muscle
Deep and superficial

branches of perineal
transverse nerve (cut)
Deep
perineal muscle
Male Perineum and External Genitalia (Deeper Dissection)

Pistes 378, 380, 383
Skin of penis
Superficial (dartos)
fascia of penis
Aponeurosis of external oblique muscle

Deep membranous (Scarpa's) layer of subcutaneous
tissue (cut away)
Inguinal
ligament
(Poupart's)
Deep
(Buck's)
fascia of penis
Superficial
inguinal ring
External spermatic fascia investing spermatic cord
Fascia lata (deep Bulbospongiosus

fascia) of thigh muscle
covers crus of penis
Superficial perineal (Colies') fascia (cut
away to open superficial perineal space)
Deep perineal (investing or Gallaudet's) fascia (partially cutaway)

covers muscles of superficial perineal
Superficial
space transverse perineal muscle
Ischial tuberosity
(Colles') fascia (cut edge) Levator ani muscle

roofing
ischio-anal
fossa
External
anal
sphincter muscle Gluteus maximus muscle
Deep
dorsal
Superficial dorsal vein

Dorsal artery and nerve
vein Superficial (dartos) fascia of
Lateral superficial vein

-Corpus cavernosum
albuginea
penis Deep (Buck's) fascia of penis

Intercavernous septum of deep
Deep artery
fascia
Corpus spongiosum
and its tunica
albugine
Urethra
a
Transverse section through body of penis
and
its
tunica
Penis
External urethral orifice (meatus)

Gians penis
Corona of glans
Neck of glans
Opening of preputial (Tyson's) gland
Superficial (dartos) fascia of penis
Deep (Buck's) fascia of penis
External spermatic fascia investing spermatic cord (cut)
Superficial perineal (Colles') fascia (cutaway to open
superficial perineal space)
Deep perineal (investing or Gallaudet's) fascia (cut
away) over muscles of superficial perineal space
Ischiocavernosus muscle (cutaway)
Superficial transverse perineal muscle
Corpora cavernosa of penis

Intercavernous septum of deep (Buck's)
fascia
us maximus muscle
Levator ani muscle and
inferior fascia of pelvic
diaphragm
roofing
ischio-anal fossa
Perineal
body
Bulb of penis Crus of penis
External anal Anococcygeal sphincter muscle ligament
Male Perineal Spaces
Transverse perineal ligament (anterior thickening of perineal

membrane)
Dorsal artery and nerve of penis
c ligament
enis
amus
Duct of bulbo-urethral (Cowper's) gland Artery of bulb of penis
Deep perinea] (investing or GallaudeTs) fascia over ischiocavernosus,
bulbospongiosus, and superficial transverse perineal
muscles (cutaway)
Superficial transverse perineal muscle (cut and reflected)
Superficial perineal (Colies') fascia (cut

away)
Inferior views
Dorsal artery and nerve of penis Deep artery of penis Urethral artery Bulbo-urethral
(Cowper's) gland Artery of bulb of penis Perineal membrane (cut edge)
Internal pudendal artery and dorsal nerve of penis
Internal pudendal artery and perineal branch
Levator ani muscl

e
Perineal membrane
Deep transverse perineal muscle

Deep perineal (investing or Gallaudefs) fascia
s of penis) and deep (Buck's) fascia of penis

es') fascia (doses superficial perineal space)

e
Urinary bladder Prostate

Obturator internus muscle Ischiopubic ramus External urethral sphincter muscle Bulbourethral (Cowper's) gland Ischiocavernosus muscle
Bulb of penis (corpus spongiosum) and deep (Buck's) fascia of penis
Bulbospongiosus muscl
Frontal section, anterior view of perineum: schema
tuyn tin lit v cc ti tinh
Prostate and Seminal Vesicles

BR tm gic ba
Trigone
of
urinary
bladder-
Internal
urethral
sphincter -J
* c tht niu o trong Prostate
Uvula
of bladdi
Base of
prostate
pfr'ni
oprosa
lit trong
sinus
,
Seminal
olliculus
----------------------------------------
bu dc tuyn tin lit
Prostatic utricle--------------------l ca ng phng tinh
Opening of
prostatic
x
External ^Jy!
urethral
\ tuyn hnh niu oVH x Bulbo-urethral
' (Cowper's)
______________________
gland l ca tuyn nnh niu
o Ôpening of bulbo-urethral duct
Frontal section, anterior view of

bulbous portion of spongy
urethra schematically
extended
trung
tan?gan
day
Jhu
Rectovesical or recto prostatic /
(DenonvilliersO fascia------------I
Rectum trc trng

and v mc trc
rectal trng fascia
Sagittal section
C/fctdac&-
/./ip.
Ductus
/ deferens
Prostate superior view
Fibromuscular stroma
bng ca ng dn tii
Ampulla
of
ductus
deferens
Peripheral zone Ampulla of ductus deferens
g of ejaculatory
Prostate transverse section
V- Fibromuscular stroma
nsverse perineal muscle and

fascia
u su
(Cowper's) glands
Posterior view
Posterior view
Urethra
c vng niu o trn

Internal
xoang tuyn lit Prostatic sinuses bu dc tuyn tin lit

Prostatic utricle
c tht niu o
hnh dv Bulb of penis
Crus of penis tr ca dv
u o
tin lit
Prostatic
urethra
hc ln
Lacuna magna (inconstant)
h thuyn Navicular fossa
qui u Gians penis
termediate
part of
membranous)
urethra ---------
External urethral orifice (meatus)
ulbous
<
portion
u
o
hnh
Corpus cavernosum
Tunica albuginea
Corpus
spongiosum
Tunica albuginea ng mch
su ca dv Deep artery of
penis
vch gian su ca mc su
Intercavernous septum of
deep (Buck's) fascia
endulous ^
(penile)
Urethral lacunae (of Morgagni)
portion
and urethral glands (of Littr)
u o
cc hc v cc
tuyn niu o
urethral
sphincter-^ V
, . 1!a ' tuyn tin lit
Prostate
Openings of ejaculatory ducts
tam gic bng quang Trigone of urinary bladder
tuyn hnh niu o
li bng quang Uvula of bladder
Bulbo-urethral (Cowper's) gland
mo niu ao Urethral crest

l ca tuyn tin lit Openings of prostatic ducts
Openings of bulbo-urethral ducts

cc l ca ng tuyn hnh niu
cc l ca ng phng tinh
ol ngoi niu ao
Roof of
urethra
trn ca niu
Floor of
urethra
s i xung ca tinh hon

o
Descent of Testis
tuyn thng thn Suprarenal gland

dy chng treo (hon
sinh dc
ng trung tm
Suspensory
(diaphragmatic)
ligament
Gonads
(retroperitoneal)
Suprarenal gland
Suspensory
Mesonephric
(wolffian) duct
(diaphragmatic) ligament
(atrophic)
Testes
dy chng bu Gubernaculum
mo tinh Epididymis
bng quang Urnarv bladder
Gubernaculum
l bn sap , .
Deep
ring
inguinal
Urinary bladder
8 weeks
(22.5-mm crown-rump)
11 weeks
(43-mm crown-rump)
Epididymis
4 lunar months
(107-mm crown-rump)
l bn nng
Superficial inguinal ring
ng dn tinh
Ductus deferens
ti bu
Scrotum (cut open)
tinh
hoc ca v tinh hon
Processus vaginalis Gubernaculum
dy chng bu
open)
(26-cm crown-rump)
of
Scrotum and Contents

KBPTB Plates 321 344
Superficial fascia (dartos) of penis

Superficial
inguinal ring
mc dv su
mac tinh ngoi
Testicular
External
spermatic fascia
artery
mtinh
hon Ductus
deferens ng dn tinh
Artery to ductus deferens m ng dn
Cremaster muscle
and fascia
tinh
Genital branch of nhnh sinh dc ca tk sd

genitofemoral nervQi
Pampiniform (venous) plexus
Septum of scrotum
(formed by dartos
fascia)
mac
Epididymis (head) mo tinh hnh dy ,eo
m ri tm
Appendix of epididymis mu ph mo tinh
biu
mu ph tinh hon
Superficial
(dartos) fascia
of scrotum
Testis (covered by visceral tinh hon c bc bi l layer of tunica vaginalis)
tng ca lp bao tinh hon
Parietal layer of tunica vaginalis
da bu Skin of
scrotum
l thnh ca lp bao tinh hon
Superficial (dartos) fascia of scrotum
mc tê^|,ermatjc fascia
c bu v mac Cremaster muscle
and fascia
mac tinK trona , internal

spermatic fascia
l thnh ca lp bao tinh hoi

Parietal layer of tunica vaginalis
tinh hon c bao bi l tng ca lp bao tinh

Testis (covered by visceral layer of tunica
Skin of scrotum
Homologues of External Genitalia

Plate 354
45-50
mm
(~10
weeks)
Male
Lateral
tubercle
Undifferentiated
(shaft or corpus)
Female
Genital tubercle
------Epithelial tag
Coronal sulcus Site of
future origin of prepuce
Urethral fold Urogenital groove
45-50
mm (~10
weeks)
Labioscrotal swelling
Urethral folds partly
fused (urethral raphe)
Anal tubercle
Anus
urethral orifice
Prepuce
Fully developed
Fully
developed
Body (shaft) of
penis
Raphe of
penis
Perineal raphe
Peri-anal tissues- (including external anal
sphincter muscle)
cc cu trc tng ng ca c quan sinh dc trong
Homologues of Internal Genitalia
dy chng honh
Diaphragmatic ligament (suspensory ligament of ovary)
ng cnh trung thn

Paramesonephric (mUllerian) duct
Gonad sinh dc
cc tiu qun trung thn

Mesonephric tubules
ng trung thn Mesonephric

(wolffian) duct
np
bn
Inguinal fold
() or of para-urethral (Skene's)
(9) glands
tin thn tuyn tin lit (nam) hay tuyn cnh
niu o (n)
Male
thng sinh dc Urogenital sinus xoang niu dc

bulbo-urethral (Covvpe^s) ( ) or of greater vestibular
(Bartholin's) (9) glands
tin thn tuyn hnh niu o (namU hay tuyn tin nh ln

(n)
iW
Undifferentiated
cha bit ha
Female
Uterine (fallopian) tube vi t cu ng Broad ligament dy chng rng Cranial

mesonephric ng trung thn trn (Gartner's) duct Wt trn
bung trng (cc Epophoron (cranial |iu qun trung
thn trn) mesonephric tubules* vt cnh ung trng
Paroophoron (cau<*{ cc tiu qun trung
mesonephric tubules) 1^
mu ph nang
tui tinh
Seminal vesicle
n tinh ti bu dc tuyn tin lit
Ductus deferens
tuyn tin lit l ng

phng tinh
Prostatic utricle
Prostate
Opening
of
ejaculatory duct
Bulbo-urethral
(Cowper's) gland
tuyn hnh niu o

mu ph mo tinh
mo tinh of
ngepididymis
xut
Appendix
Epididymis Efferent
mu ph tinh hon
ductules
tinh hon
Appendix of testis Testis
th cnh tinh!hon
dy chng bu
Paradidymis
Scrotal ligament
(gubemaculum)
tro bung trng

y chng (ring) buong
tnWiji19 Uterus t cung
dy chng trn ca
Round ligament of uterus t cung Vagina (upper 4A) m o trn Residua
of caudal di tch phn di ng cn mesonephric
ducttrung thn
o di -Urethra niu ao
Para-urethral (Skene's) gland tuyn cnh niu
Greater vestibular tuyn tin

(Bartholin's) gland nh ln
Vestibule tin nh
o tinh, v cc ng dn tinh
Testis, Epididymis, and Ductus Deferens
ng xut
ule
(vestigial mesonephric tubule)
ng dn tinh
Ductus deferens
mo tinh
Epididymis
thn
Body
ui
ng lc
stinum testis) li tinh vch
rng
u thy tinh hon

/Epididymal duct ng mo tinh
Aberrant
ductule ng lc
Frontal section
thit ng ngang
cc ng xut Efferent ductules "
li tinh
M&Pakt'
Rete testis (in mediastinum testis)'
ng lc
Aberrant ductule
ng sinh tinh
Seminiferous tubules'
Ductus deferens/
ng dn tinh
Schema s
Skin
of scrotum Superficial (dartos) fascia

External spermatic fascia Cremaster fascia
Internal spermatic fascia Parietal layer of
tunica vaginalis Visceral layer of tunica
vaginalis Tunica albuginea of testis Sinus
epididymis Epididymis
stis Scrotal septum (dartos) Septa

Rete
testis
(in
of
mediastinum testis)-
Rectum in Situ: Female and Male
Ductus deferens-
Sigmoid colon
Sigmoid mesocolon
Rectosigmoid Cross
junctionsection through scrotum and testis
Ductus (vas) deferens (cut)
Peritoneal reflection
Rectovesical pouch
Rectum and
rectal fascia
Levator ani muscle
(pelvic diaphragm)
rectalis part of levator ani muscle

. , sphincter muscle* ) Superficial r
Subcutane
Ischiocavernosus muscle and deep perineal

(investing
or
Gallaudefs) fascia
(partially cut away)
Female
Superficial transverse
perineal muscle and
deep
perineal
(investing) fascia
Sigmoid
mesocolon
ctum
of Douglas)
Coccyx
Vesico-uterine pouch Ureter (cut)
elvic diaphragm)
Vagina and vaginal fascia
vator ani muscle
Urinary bladder and vesical fascia

Ischiocavernosus muscle and deep perineal (investing or
Gallaudet's) fascia
ncter muscle* Deep

Superficial
Subcutaneous
ten indistinct

and perineal membrane
Superficial perineal (Colles')fascia
Superficial transverse perineal muscle and deep perineal (investing or
Gallaudet's) fascia
Ischio-anal Fossae
Plates 296 388
Sigmoid
colon
muscle
and
fascia
External
iliac
vessels
Obturator
internus
muscle and
fascia
canal
(Alcock's) contains
internal pudendal
vessels, pudendal
nerve, and perineal
nerve
Ischial
tuberosity
Extraperitoneal
(supralevator)
space
(fibrofatty
tissue)
Fat body of ( Deeper part
ischio-anal < Superficial fossa
Transverse
fibrouspart
septum
( (peri-anal)
of ischio-anal fossa
Sacrogenital fold (uterosacral in

female)
Levator ani muscle and superior and
inferior fascia of pelvic diaphragm
Peritoneum (cut edge) forming floor of pararectal fossa
Rectal fascia
Submucous space (internal venous
fO hairs
weat glands and
in
perianal
skin
-13
cm
5-17
9
6
5
cm
5-3 cm -if------------------
Peri-anal space (external venous plexus)

Conjoined longitudinal muscle Internal
Intersphincteric groove (anocutaneous line)
anal sphincter muscle
Transverse folds Middle V of rectum (valves of Houston)
Rectal fascia
r Circular muscle layer Muscularis mucosae Levator ani muscle
Âno
gni's)
'410/ /Anal sinus T f/^/ÔPectinate (dentate) line

'Jj&s' s' Internal rectal venous plexus in submucous space
phincter muscle Conjoined longitudinal muscle Internal sphincter muscle Anal valve Anal crypt
Superficial part* of external sphincter muscle Anal glands
um Muscularis mucosae of anal canal -Peri-anal space
Anal
verge
Pectefi
Anoderm
1 Parts variable and often indistinct
Anorectal Musculature
Anterior view
"Fibers of taenia spread out to form longitudinal muscle layer of rectum -Fibers from longitudinal
muscle join circular muscle layer
-Window cut in longitudinal muscle layer to expose underlying -Circular muscle layer
Frontal section
Subcutaneous part* of external sphincter muscle Corrugator
cutis ani muscle External rectal
venous plexus in peri-anal space
Intersphincteric
groove
(anocutaneous line)'Deep
JI
Parts* of
'Superficial > external anal 'Subcutaneous \ sphincter muscle
- Corrugator cutis ani muscle
uperior fascia of pelvic diaphragm Inferior fascia of pelvic diaphragm Levator

ani muscle Rectal fascia Longitudinal muscle of rectum
Circular muscle of rectum Muscularis mucosae of
rectum Deep part* of external anal sphincter muscle
Internal rectal venous plexus Conjoined longitudinal
muscle Superficial part* of external anal sphincter
muscle Internal anal sphincter muscle Muscularis
mucosae of anal canal Transverse fibrous septum of
ischio-anal fossa Subcutaneous part* of external anal
s variable and often indistinct
sphincter muscle
Corrugator cutis ani muscle
Hi
External Anal Sphincter Muscle: Perineal Views

EEJPIates 356 359
Superficial scrotal (dartos) fascia Septum of scrotum

Bulbospongiosus muscle with deep perineal (investing or Gallaudet's) fascia
removed
Ischiocavernosus muscle with deep perineal (investing or Gallaudet's) fascia
removed
Superficial transverse perineal muscle with deep perineal (investing or

Gallaudet's) fascia removed
Subcutaneous Superficial Deep
(Colles') fascia (cut edges) Transverse fibrous septum of
ischio-anal fossa (cut) Ischial tuberosity Sacrotuberous
Parts* of external anal sphincter muscle
ligament Pubococcygeus )
Puborectalis > Levator ani muscle lliococcygeus )
Anococcygeal body (ligament) (posterior extensions of superficial external anal
sphincter muscle)
Gluteus maximus muscle Tip of coccyx
Female
External urethral
Superficial perineal (Colles') fascia (cut edge)

Ischiocavernosus muscle with deep perineal
(investing or Gallaudet's) fascia removed
Bulbospongiosus muscle with deep perineal
(investing or Gallaudet's) fascia removed Fibers
from superficial external anal sphincter muscle to
ischiopubic ramus Perineal membrane
Superficial transverse perineal muscle with deep
perineal (investing or Gallaudet's) fascia
removed------------------------------------------------Superficial perineal (Colles') fascia (cut edge)
Perineal body
d fibers from superficial and deep external sphincters to superficial
transverse perineal muscle
Parts* of external anal ( ? . sphincter
muscle 1 Superficial
Pubococcygeus
Puborectalis ( lliococcygeus Anococcygeal body
(ligament) (posterior extensions of superficial external
anal sphincter muscle)
ariable and often indistinct
-Îschiopubic
ramus
Anus
Superficial"""' sphincter j _
Actual and Potential Perineopelvic Spaces

Sagittal
section
Visceral
- peritoneum Vesical fascia

Rectal
fascia -
ubic (prevesical) space (of

Retzius)
( Retrovesical vesical \ P re rectal
Rectovesical
or
Subcutaneous
Buck's) fascia of
penis Superficial perineal (Colies')
-----------------------------------fascia
rse perineal muscles
rectoprostatic
(Denonvilliers')
fascia (septum)
Levator ani muscle

and fascia of pelvic
diaphragm
Deep postanal space
Anococcygeal body (ligament)
Superficial postanal space (part
of peri-anal space)
Submucous space
variable and often indistinct
Peri-anal space
Bulbospongiosus muscle and deep perineal (Gallaudet's) fascia
Superficial perineal compartment (space or pouch)
Deep transverse perineal muscle, and Superficial transverse perineal

muscle (cutaway) to expose Anterior recess of
ischio-anal fossa
Pre-anal communication (inconstant) between right and left ischio-anal
fossae
Pus in ischio-anal fossa
Posterior communication between right and left ischio-anal fossae via deep
postanal space deep to anococcygeal body
(ligament)
Gluteus maximus muscle and Sacrotuberous ligament (cut)
Posterior recess of ischio-anal fossa
if
Perineal view
Spread of perineal abscess in perineal
spaces
^CtfcvladL
Umbilicus
L5 vertebra
Rectus abdominis
muscle
Sacrum
Fundus of uterus
Urinary bladder
Peni
Rectus abdominis
s bone
Pubic
Male
muscle
Pubic
Liver
bone
Scrotum
Urinary
bladder
Rectum
RectumVagina
Inferior mesenteric artery
Left colic artery

Ascending
Descending
branch
branch
Sigmoid
Abdominal aorta
Inferior vena cava
arteries
Median sacral artery

Common iliac artery
Marginal artery Rectosigmoid arteries
External iliac artery

Internal iliac artery
Inferior ' epigastric artery
Obturator artery
Internal
artery
uscle
Umbilical artery Inferior

vesical artery 'Artery to ductus deferens
artery
cock's)
Perimuscular rectal
Anterior
venous
view
plexus
Common
Inferior
iliac
vena cava
Median
sacral
veinveins
pudendal
Superior vesical artery Middle rectal artery

Inferior rectal artery
External
rectal plexus
Internal
rectal plexus
Superior vesical and

Vaginal
vein
vaginal
Inferior mesenteric Communication
Internal
vein
(to portal
pudendal
vein
via
vein
in
Communication
uterine
veins(from
(from
between
internal
and
Sigmoidvein)
veins Inferior
Internal
pudendal
vein
Middle
rectal
venous
plexus)
External
Obturator
rectal
external
uterine
perimuscular
rectal
vesical
iliac
vein
iliac
venous
vein
venous
vein
(bifurcation)
vein
vein
vein
rectal
plexus)
plexuses
plexuses
splenic
pudendal
canal
(Alcock's)
Anterior view
Renal
artery
and
vein
Ovarian artery and vein

Abdominal aorta Ureter
Inferior
mesenteric
artery
Psoas major muscle Common

iliac
artery
Median
sacral
vessels Superior rectal artery

{cut) Round ligament of uterus
(cut) Ovarian artery Internal
iliac artery
External iliac artery
{cut edge)
Obturator artery and nerve
of ovary
contains
Umbilical artery (patent part)

Middle rectal artery
Uterine artery
Vaginal artery
Inferior vesical artery
Round ligament of uterus
(cut)
-------------
Superior vesical arteries

Inferior epigastric
and vein
s--------------------
Umbilical artery
(occluded part)
Medial umbilical ligament
Median umbilical ligament (urachus)
artery
Anterior view
Renal vessels Inferior vena cava Abdominal aorta Testicular vessels Ureter
Inferior
mesenteric artery
Common iliac vessels
Inferior epigastric vessels
Artery to ductus deferens
Cremasteric vessels
Testicular vessels in spermatic cord
Femoral vessels
Superficial external pudendal vessels (cutpass superficial to spermatic cord)
Deep external pudendal vessels
Pampiniform venous plexus
Deep dorsal vein and dorsal arteries of penis under deep (Buck's) fascia of penis
Internal iliac artery

Posterior division
Anterior division
External iliac artery Umbilical artery (patent part) Obturator
artery
Middle rectal artery Uterine artery Vaginal artery Inferior
al pudendal artery
vesical artery Accessory obturator

artery Superior vesical arteries
Medial umbilical ligament (occluded part of umbilical artery)
geus (ischiococcygeus) muscle
tuberous ligament
Obturator fascia (of obturator
internus muscle)
Internal pudendal artery in
pudendal canal (Alcock's)
Levator ani muscle (cut edge)
Pubic symphysis
Sagittal section
Right paramedian section:
lateral view
Abdominal aorta Inferior vena cava Right common iliac
artery Left common iliac artery
Ureters
External iliac artery (cut)
Internal iliac arteiy
Posterior division
Anterior division
Superior gluteal artery
Umbilical artery (patent part)
Obturator artery
Piriformis muscle
Internal pudendal artery
Inferior gluteal artery
Coccygeus (ischiococcygeus) muscle
Uterine artery
Vaginal arteryinferior vesical artery
Medial umbilical ligament (occluded
distal part of umbilical artery)
Obturator
canal
Obturator
internus
muscle
Levator
ani
muscle
Left paramedian section:

lateral view
Abdominal aorta
Inferior vena cava
Common iliac vessels
Right obturator vessels
cal artery {patent part)
Median sacral vessels

External iliac vessels (cut)
Superior vesical artery
uded part)
Iliolumbar artery
vessels
Lateral sacral artery

Superior gluteal artery
Obturator artery
ssels
Umbilical artery
Ureter (cut)
Inferior gluteal artery
ment

Internal
pudendal
artery
ment (urachus)
Ductus deferens and its

artery
Prostatic
branches
inferior vesical artery
n of penis
of

Prostatic venous plexus
d dorsal artery of penis

on superior aspect of perineal membrane
of penis
s) plexus
rens'
Inferior
vesical
enous plexus
Branch to
far
!+P.
Urethral
Capsular
Hyperplastic
Hyperplastic
lateral
middle
lobe
lobe
External
urethral sphincter
Arterial supply of prostate

(Frontal section, anterior view of specimen with benign
hyperplasia)
or labial artery
avernosus
muscle
pongiosus muscle
cial perineal space
al membrane
al artery
cial transverse perineal muscle
al artery
l pudendal artery in pudendal canal (Alcock's)

rectal artery
al anal sphincter muscle

Note: Deep perineal (investing or Gallaudet's) fascia removed from muscles of superficial
perineal space
Ovarian vessels
Tubal branches of ovarian vessels
Uterine vessels Ureter
cial
Vaginal branches of uterine artery Vaginal artery Levator ani muscle Perineal
membrane Internal pudendal artery Perineal artery Superficial perineal space
Compressor urethrae muscle
Artery to bulb of vestibule
(dartos)
Greater vestibular (Bartholin's) gland

Internal pudendal (clitoral) artery
cutaway)
Superficial perineal (Colies') fascia (cut and reflected) to open
superficial perineal space
Internal pudendal artery in pudendal canal (Alcock's)
Round ligament ) Branches

>
)
of
ut rme
.
/ artery
a over testis and

fascia of scrotum
Septum of scrotum
Posterior scrotal arteries

(Buck's) fascia of penis
Superficial perineal (Colles') fascia (cut edge)
Superficial perineal space (opened)
erineal muscle
Perineal artery and vein

Internal pudendal artery passes superior to perineal membrane
ry
olles') fascia (cut

edge)
s)
Superficial transverse perineal muscle and transverse perineal artery (cut and reflected)
Internal pudendal vessels and pudendal nerve (cut) in pudendal canal (Alcock's) (opened up)
Inferior fascia of pelvic diaphragm (roof of ischio-anal fossa
)
Note: Deep perineal (investing or Gallaudet's) fascia removed from muscles of superficial
perineal space
artery of penis
dorsal vein of penis
Dorsal artery and nerve of penis
Transverse perineal ligament (anterior thickening of perineal membrane)
artery of penis
Dorsal artery of penis
Urethral artery
Perineal membrane (cut edge)
Artery of bulb of penis
Perineal artery (cut)
Internal pudendal vessels in pudendal canal (Alcock's)
Superficial perineal (Colies') fascia (cut edge
)
Lateral aortic (lumbar) nodes
Pre-aortic lymph nodes Promontorial (middle sacral) nodes Common iliac nodes
Sacral (lateral) node

Internal iliac node
Lateral (superior) external iliac node
Medial (inferior) external iliac nodes
Obturator node
Superficial
inguinal
nodes
Proximal
(highest)
deep
inguinal
node
Deep
inguinal
Inguinal
ligament
(Poupart's)
Proximal
(highest) deep
inguinal node
(of Cloquet)
Fascia lata (cut a
Superficial inguinal nodes
Inferior
nodes
(vertical group)
way) Femoral vessels and nerve Deep
Superolateral
nodes
(horizontal group)
inguinal nodes
horizontal group)
along testicular vessels

Common iliac node
External iliac nodes
montorial (middle sacral) nodes Sacral (lateral) node
inguinal node (of Cloquet)
perficial inguinal nodes
Pre-aortic node
Promontorial node
Pathway alongside rectum to (middle and lateral) sacral nodes

athway (dashed line) to external iliac nodes- - -
ymphatic drainage
from prostate
(Middle and
lateral) 4V sacral
nodes
vesical vessels to internal iliac nodes
(principal pathway)
external iliac nodes
Pathway (dashed line)
from lower prostate and membranous urethra along internal pudendal vessels
(beneath pelvic diaphragm) to internal iliac node
Superior mesenteric ganglion
Lumbar splanchnic nerves
ganglia
Testicular artery and plexus
ous nerve------------------)
ofemoral
ous nerve
enitofemoral
Ductus deferens and plexus
anches of femoral
nerve
us branch of iliohypogastric nerve
genitofemoral nerve
ve (from ilio-inguinal nerve)
Anterior
vagal nerve
trunk- (ventral ramus)
T10 spinal
White and gray rami
Inferior phrenic arteries and plexuses

Left gastric artery and gastric plexus
Celiac ganglia, plexus, and trunk
Left aorticorenal ganglion
Superior mesenteric artery and plexus
Intermesenteric (aortic) plexus
Inferior mesenteric ganglion,
artery, and plexus
Ureter and ureteric plexus
Superior hypogastric plexus
Superior rectal artery and plexus
Hypogastric nerves
acral splanchnic
(sympathetic)
nerves
S1 spinal nerve
(ventral ramus)
communicantes
Greater / _ .
..
Splanchnic
nerves
Diaphragm
Posterior vagal trunk

and
Celiac branch
Left renal artery and plexus

L1 spinal nerve (ventral ramus)
Rami
communicantes 1st, 2nd, 3rd lumbar splanchnic nerves Gray rami communicantes Sympathetic
trunk and ganglia 5th lumbar splanchnic nerve L5 spinal nerve (ventral ramus) Lumbosacral trunk
Gray rami communicantes
Posterior scrotal nerves
Dorsal nerve of penis
Perineal membrane (cut to show
neurovascular structures on superior
aspect of perineal membrane)
Perineal
\
Superficial
nerves ) Deeo
Dorsal nerve of penis

(continuation of pudendal
nerve supplying muscles on
superior aspect of perineal
membrane)
Superficial perineal
(Colles') fascia (cut
to open superficial
perineal space)
Nerve
from
inferior
hypogastric
plexus
to
sigmoid and descending
colon (parasympathetic)
Superficial and deep branches of perineal nerve
ic) plexus
Dorsal nerve of penis (passes superior to
perineal membrane)
Obturator nerve
and artery
Ductus deferens
and plexus
Obturator fascia (of obturator internus muscle)

Posterior
femoral
cutaneous nerve
Pelvic splanchnic nerves
Pudendal canal
(Alcock's) (opened up)
Pudendal nerve
Gluteus
maximus
muscle and sacrotuberous ligament
Coccygeus (ischiococcygeus) muscle and sacrospinous

ligament
Pudendal nerve
4
P
Levator ani muscle Inferior anal (rectal) nerve

Inferior Perineal
clunial nerves
gluteusnerve
maximus
nerveonDorsal
of penis Posterior
muscle
scrotal nerves
Inferior anal (rectal) nerves
Perforating
Anococcygeal
cutaneous
nervenerve

Piriformis
muscle
ririrormis
muscie----------------4.
Obturator internus
muscle-------------------^
muscle
Levator
ani muscle
Ischial
spine
Pudendal
nerve
Nerves of Pelvic Viscera: Female

See also Plate 297
etic trunk and L2 ganglion
'Abdominal Inferior vena cava -
(subserous) fascia
communicantes
Common iliac vessels and
planchnic nerves
Ovarian artery and plexus
communicantes
Common iliac artery and plexus
nd left sacral sympathetic

trunks
and
ganglia
Internal
iliac artery
and plexus
External iliac artery and plexus
Right
and
left
hypogastric nerves
Uterus
Right sympathetic trunk
Left hypogastric nerve
Inferior hypogastric (pelvic) plexus
Uterine (fallopian) tube Ovary
Symphyseal
surface
of
pubis Urinary bladder Vesical plexus

Uterovaginal plexus Uterus (retracted)
anchnic nerves
us (ischiococcygeus) muscle
retracted)
Nerves of Perineum and External Genitalia: Female
Anterior labial nerve (from ilio-inguinal nerve)

Posterior labial nerves
Superficial
Branches
Deep
Perineal branch of posterior femoral cutaneous nerve
Dorsal nerve of clitoris passing superior to perineal

membrane
Perineal nerve
Pudendal nerve
(dissected)
in
pudendal
Inferior clunial nerves

Gluteus maximus muscle (cut away)
Perforating cutaneous nerve
Inferior anal (rectal) nerves
canal
(Alcock's)
Anococcygeal nerves
Neuropathways in Parturition
Splanchnic
nerves
spinal
nerve (ventral
ramus)
Celiac ganglion
trunk
Aorticorenal ganglion
Superior
mesenteric
ganglion
1
spinal
nerve (ventral
ramus)
Intermesenteric
(aortic) plexus
Rami
communicantes
nerve (T12)
ar splanchnic nerves
Intermesenteric
(aortic) plexus
1 spinal nerve
(ventral ramus)
Hypogastric nerves
pogastric nerve (L1)

Pelvic
splanchnic
nerves
llio-inguinal nerve {LI )
Inferior
hypogastric
(pelvic) plexus
Vesical plexus
Uterovaginal
Posterior labial nerves
plexus
Pudendal nerve (S2, 3, 4)
Inferior anal (rectal) nerve
Sensory fibers from uterine

Sensory fibers from cervix and upper
Sensory fibers from lower vagina
fundus accompany sympathetic fibers via vagina
hypogastric
accompany
plexuses
pelvic splanchnic nerves (parasympathetic)
and perineum
to S2,
accompany
3, 4
somatic fibers via pudendal nerve to S2,
Motor fibers to lower uterine segment,
to T11,12 (L1 ?)
3, 4
cervix, and upper vagina (parasympathetic)
Motor fibers to uterine body
fibers to lower vagina and
s (sympathetic)
perineum via pudendal nerve (somatic

)
mpathetic trunk and ganglion

Celiac ganglia and plexus
us communicans White ramus communicans
Greater
splanchnic nerve
Lesser
splanchnic nerve
T11
T11
T1
2
splanchnic nerves
L3 spinal nerve (ventral ramus)
artery and plexus
Note: Pain from intraperitoneal

pelvic
viscera
(e.g.,
uterine
contractions) goes via uterovaginal
and pelvic plexuses, hypogastric
nerves, superior
Ovary
hypogastric plexus, lower aortic
plexus, lower lumbar splanchnic
nerves, sympathetic trunk from L4
to L5 to spinal nerves T11, 12. Pain
from subperitoneal pelvic ' viscera
(e.g., cervical dilation and upper
vagina) goes via pelvic splanchnic
nerves to S2,
3, 4. Afferent fibers from lower
vagina and perineum go via
pudendal nerves to S2, 3, 4.
Sympathetic ( Preganglionic -------------- Parasympathetic

fibers
| Postganglionic
fibers
Inferior mesenteric ganglion
Inferior extent
of peritoneum
Uterovaginal and inferior hypogastric (pelvic) plexuses
( Preganglionic
| Postganglionic
-------------- Afferent fibers
d ganglia Greater splanchnic nerve

(T5-9)
nicans White ramus communicans
T11'
Lesser splanchnic nerve Least
Left aorticorenal ganglion
splanchnic nerve
nic nerves
Lt
Intermesenteric
(aortic) plexus
Inferior mesenteric ganglion
cans
y and plexus
d plexus Inferior extent of peritoneum
Ductus deferens and plexus
Pudendal nerve
Inferior hypogastric (pelvic) plexus
Vesical
plexus
Prostatic
plexus
(Greater and lesser) cavernous nerves of penis

Sympathetic
(
Preganglionic
fibers
j Postganglionic
Spinal sensory
(dorsal root)
ganglion
Afferent fibers
Parasympathetic
(
Preganglionic
fibers
j Postganglionic
Dorsal (posterior) root
Celiac ganglia
Aorticorenal ganglion
i . ')
Renal artery and plexus
Inferior
hypogastric
Intermesenteric
Inferior
Superior
mesenteric
hypogastric
ganglion
plexus
Hypogastric
nerves
(pelvic)
plexus
(aortic)
plexus
Urinary
bladder
Bulbospongiosus muscle
Sympathetic ( Preganglionic ------------------ Parasympathetic ( Preganglionic

fibers
) Postganglionic
fibers
) Postganglionic
Afferent fiber
Somatic efferent fibers
Male Pelvis: Cross Section of Bladder-Prostate Junction
Superior portion of pubic symphysis nterior of urinary bladder

Adductor longus muscle
*P.
Beginning
of
Body of pubis
urethra
Pectineus muscle
Spermatic cord
Prostate
Femora] vein
Femoral artery
gland
Femoral nerve
Psoas muscle and tendon lliacus muscle
Sartorius muscle
Head of femur Neck
" Iliopsoas muscle

Rectus femoris
muscle
of femur
Gluteus
mdius
muscle
Tensor
fasciae latae
muscle
inimus tendon
Obturator
artery, vein,
and nerve
ochanter
Acetabular
fossa
Lunate
(articular)
surface
of
acetabulum
Right
sciatic nerve
aximus muscle Obturator internus muscle

Left sciatic nerve
Openings of ejaculatory ducts (in
prostatic urethra)
Perineal flexure (termination of rectum,
beginning of anal canal)
Internal pudendal artery and vein Pudendal nerve Fat body of

ischio-anal fossa Levator ani muscle (puborectalis)
Tip of coccy
Pubic bone
Pectineus muscle Obturator extern us muscle
Iliopsoas muscle
Sartorius muscle
Vaginal venous plexus

Lymph node
Greater saphenous and femoral veins
Femoral artery
Fat tissue
cle
Gluteus maximus muscle
muscle
Internal pudendal vessels and pudendal nerve
Levator ani muscle (puborectalis)
Muscle Tables
MUSCLE
PROXIMAL
ATTACHMENT
(ORIGIN)
DISTAL
ATTACHMENT
(INSERTION)
INNERVATION
MAIN ACTIONS
BLOOD SUPPLY
Male: compresses bulb

Male:
perineal
membrane,
corpus
cavernosum,
bulb of penis
Deep
median raphe,
bulb of penis,
Female: dorsum
of
perineal body
clitoris,
inferior
Female: perineal body
fascia
of
urogenital
diaphragm, bulb
of
vestibule,
pubic arch
Male:
pongiosus
of penis, forces
blood into body
of penis during
erection,
removes
urine
from urethra and
semen
duringInternal
ejaculation
artery
branch
of
perineal
nerve
from
pudendalFemale:
constricts
nerve
vaginal
orifice,
assists
in
expressing
secretions
of
greater
vestibular gland,
forces blood into
body of clitoris
pudendal
and Its
branch (perineal
artery)
Ischial
spine,
pelvic
Ventral rami of lowerSupports
Coccygeus
Inferior sacrum, coccyx
sacrospinous
viscera,
drawsInferior gluteal artery
(ischiococcygeus)
sacral nerves
ligament
coccyx forward
Compressor
urethrae
Ischiopubic ramus
(female only)
Anterior aspect
urethra
ofPerineal branches of
Sphincter of urethra
pudendal nerve
Lower edge of
Genital
branch
of
internal obliquePubic tubercle, crest of
Retracts testicle
genitofemoral
pubis
and middle of
nerve
inguinal ligament
Cremaster
Perineal branch of
internal
pudendal artery
Cremasteric branch of
inferior epigastric
artery
Male: medial
Inner surface of inferior

ischial rami
verse perineal
tendinous raphe
Stabilizes
perinealPerineal branch of
and
perinealPerineal branches of
body,
supports
internal
pudendal nerve
body
prostate/vagina
pudendal artery
sides
vagina
Female:
External anal sphincter
lliacus
avernosus
Tip
or internus
Deeper fibers surround

anal canal, attachPerineal and inferior
rectal branches
posteriorly
to
Closes anal orifice
of
pudendal
coccyx
and
nerve
anteriorly
to
central point of
perineum
Superior 2/3 of iliacLesser trochanter of

fossa,
ala
of
femur and shaft
sacrum, anterior
Inferior to it, toFemoral nerve
sacro-iliac
psoas
major
ligaments
tendon
Inferior Internal surface
of
ischiopubicCrus of penis or clitoris
ramus,
ischial
tuberosity
Body
Levator ani
of
coccyx,
anococcygeal
ligament
of
Deep
Inferior
rectal
and
transverse
perineal artery
Flexes thigh at hipsIliac

branches
of
and stabilizes hip
iliolumbar artery
joint, acts with
psoas major
branch
ofForces blood into bodyInternal
pudendal
perineal
nerve
of penis and
artery and its
from
pudendal
clitoris
during
branch (perineal
nerve
erection
artery)
Inferior gluteal artery,

of
pubis,Perineal body, coccyx,
Ventral rami of lowerSupports
pelvic
anococcygeal
internal pudendal
tendinous arch of
sacral
nerves,
viscera,
raises
raphe, walls of
artery and its
obturator fascia,
perineal
nerve
pelvic
floor
prostate
or
branches (inferior
Ischial spine
vagina, rectum,
rectal
and
anal canal
perineal arteries)
Pelvic
surface
ofMedial
surface
obturator
greater
membrane and
trochanter
surrounding bone
femur
of
Nerve to obturator
of
internus
Laterally
rotates
extended thigh,Internal pudendal and
abducts
flexed
obturator arteries
thigh at hip
Variations in spinal nerve contributions to the innervation of muscles, their arterial supply, their attachments, and their actions are common themes in human
anatomy. Therefore, expect differences between texts and realize that anatomical variation is normal.
Muscle Tables
MUSCLE
PROXIMAL
ATTACHMENT
(ORIGIN)
DISTAL
ATTACHMENT
(INSERTION)
Piriformis
Anterior surface ofSuperior border

sacral segments
greater
2-4,
trochanter
sacrotuberous
femur
ligament
INNERVATION
of
Ventral rami of L5, S1,

of
S2
MAIN ACTIONS
BLOOD SUPPLY
Laterally
rotates
Superior and inferior gluteal
extended thigh,
arteries, internal
abducts
flexed
pudendal artery
thigh at hip
Puborectalis
Sphincter urethrae
Lower part of pubic

symphysis,
Loops around
fascia of
rectum; nosuperior
distal attachment
urogenital
diaphragm
Nerve to levator ani

muscle
External fibers from

junction of inferior
pubic and ischialMale: median raphe in
Compresses urethra at
front and behind
rami
and
end
of
Perineal branch of
urethra
adjacent fascia;
Perineal branches of
micturition;
in
internal
internal
fibersFemale:
pudendal
nerve
female
also
encloses
pudendal artery
pass medially to
compresses
the
urethra, attaches
surround
distal vagina
to sides of vagina
membranous
urethra
Sphincter
only)
Perineal body
Superficial transverseIschial
rami
perineal
tuberosities
Passes forward and anterior Perineal branches ofSphincter of urethraPerineal branch of

around urethra
pudendal nerve
and vagina
pudendal artery
andCentral
tendonPerineal branches ofStabilizes
(perineal body)
pudendal nerve
tendon
central
Perineal branch of
internal
pudendal artery
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PELVIS AND PERINEUM

Pelvis and Perineum: Surface Anatomy

Bones and Ligaments

Bony Framework of Pelvis

Radiographs of Male and Female Pelvis

Sex Differences of Pelvis: Measurements

Bones and Ligaments of Pelvis

Bones and Ligaments of Pelvis (continued)

Pelvic Floor and Contents

Pelvic Diaphragm: Female

Pelvic Diaphragm: Female (continued)

Pelvic Diaphragm: Female (continued)

Pelvic Diaphragm: Male

Pelvic Diaphragm: Male (continued)

Pelvic Viscera and Perineum: Female

Atlas of Human Anatomy

Pelvic Contents: Female

Pelvic Viscera: Female

Endopelvic Fascia and Potential Spaces

Pelvic Viscera and Perineum: Male

PELVIS AND PERINEUM

Atlas of Human Anatomy

PELVIS AND PERINEUM

345 Urinary Bladder: Orientation and Supports

346 Female Sphincters

357 Male Perineum and External Genitalia (Superficial

347 Urinary Bladder: Female and Male

360 Male Perineal Spaces

348 Uterine Growth

361 Prostate and Seminal Vesicles

349 Uterus, Vagina, and Supporting Structures

350 Uterus: Fascial Ligaments

363 Descent of Testis

351 Uterus and Adnexa

364 Scrotum and Contents

352 Pelvic Ligaments

365 Homologues of External Genitalia

Perineum and External Genitalia: Female

366 Homologues of Internal Genitalia

353 Female Perineum and External Genitalia (Pudendum

Epididymis, and Ductus Deferens

354 Female Perineum (Superficial Dissection)

355 Female Perineum and Deep Perineum

Atlas of Human Anatomy

370 Rectum and Anal Canal

371 Anorectal Musculature

385 Lymph Vessels and Nodes of Pelvis and Genitalia:

372 External Anal Sphincter Muscle: Perineal Views

386 Nerves of External Genitalia: Male

374 Pelvic Scans: Sagittal CT Images

375 Arteries of Rectum and Anal Canal: Male

376 Veins of Rectum and Anal Canal: Female

377 Arteries and Veins of Pelvic Organs: Female

378 Arteries and Veins of Testis

387 Nerves of Pelvic Viscera: Male

388 Nerves of Perineum: Male

389 Nerves of Pelvic Viscera: Female

390 Nerves of Perineum and External Genitalia: Female

393 Innervation of Male Reproductive Organs: Schema

380 Arteries and Veins of Pelvis: Male

381 Arteries and Veins of Perineum and Uterus

382 Arteries and Veins of Perineum: Male

383 Lymph Vessels and Nodes of Pelvis and Genitalia:

394 Innervation of Urinary Bladder and Lower Ureter: