Pelvis and Perineum
Topographic Anatomy | Pelvis and Perineum
Sternocleidomastoid muscle
Trapezius muscle
Deltoid muscle
Pectoralis major muscle
Serratus anterior muscle
Tendinous intersection
External oblique muscle
Linea alba
Umbilicus
Iliac crest
Inguinal ligament
Pubic tubercle
Body (shaft) of penis
Scrotum
Nipple
Semilunar line
Rectus abdominis muscle
Anterior superior iliac spine
Superficial circumflex iliac vein
Superficial epigastric veins
Pubic symphysis
Superficial dorsal vein of penis
Glans of penis
External urethral orifice (meatus)
Bones and Ligaments | Bones and Ligaments of Pelvis
Median (sagittal) section
Intermediate zone of Iliac crest
Inner lip of Iliac crest
Iliac fossa (wing of ilium)
Anterior superior iliac spine
Arcuate line
Anterior inferior iliac spine
Iliopubic eminence
Obturator canal
Superior pubic ramus
Pecten pubis (pectineal line)
Pubic tubercle
Symphyseal surface
Obturator membrane
Body of L5 vertebra
False pelvis
Lumbosacral (L5-S1) intervertebral disc
Sacral promontory
Greater sciatic foramen
True pelvis
Ischial spine
Sacrospinous ligament
Lesser sciatic foramen
Sacrotuberous ligament
Coccyx
Ischial tuberosity
Lateral view
Supraspinous ligament
Posterior, anterior, and inferior gluteal lines
Posterior superior iliac spine
Median sacral crest
Posterior inferior iliac spine
Posterior sacroiliac ligament
Greater sciatic foramen
Sacrospinous ligament
Posterior and lateral sacrococcygeal ligaments
Sacrotuberous ligament
Ischial spine
Lesser sciatic foramen
Ischial tuberosity
Obturator membrane
Body of L4 vertebra
Intermediate zone of Iliac crest
Outer lip of Iliac crest
Iliac tubercle of Iliac crest
Wing (ala) of ilium (gluteal surface)
Body of ilium
Anterior superior iliac spine
Anterior inferior iliac spine
Acetabulum
Acetabular labrum
Acetabular margin
Lunate (articular) surface
Acetabular notch
Transverse acetabular ligament
Superior pubic ramus
Pubic tubercle
Obturator crest
Obturator canal
Inferior pubic ramus
Bones and Ligaments | Bones and Ligaments of Pelvis (continued)
Posterior view
Iliolumbar ligament
Iliac crest
Supraspinous ligament
Posterior superior iliac spine
Posterior sacroiliac ligaments
Iliac tubercle
Posterior sacral foramina
Greater sciatic foramen
Anterior superior iliac spine
Sacrospinous ligament
Sacrotuberous ligament
Lesser sciatic foramen
Acetabular margin
Ischial tuberosity
Tendon of long head of biceps femoris muscle
Deep Posterior sacrococcygeal ligaments
Superficial Posterior sacrococcygeal ligaments
Posterior view
Anterior longitudinal ligament
Iliolumbar ligament
Iliac fossa
Outer lip of Iliac crest
Intermediate zone of Iliac crest
Iliac tubercle of Iliac crest
Inner lip of Iliac crest
Anterior sacroiliac ligament
Sacral promontory
Greater sciatic foramen
Anterior superior iliac spine
Ischial spine
Iliopectineal line
Arcuate line
Lesser sciatic foramen
Iliopubic eminence
Superior pubic ramus
Pecten pubis (pectineal line)
Obturator foramen
Inferior pubic ramus
Pubic tubercle
Anterior sacral foramina
Coccyx
Anterior sacrococcygeal ligaments
Pubic symphysis
Bones and Ligaments | Sex Different of Pelvis: Measurements
Female pelvis/female pelvic inlet: anterior view
Sacroiliac joint
Sacral promontory
Diagonal conjugate pelvic diameter
Transverse pelvic diameter
Oblique pelvic diameter
Ischial spine
Iliopubic eminence
Pubic symphysis
Ischial tuberosity
Pubic arch
Male pelvis/male pelvic inlet: anterior view
All measurements slightly shorter in relation to body size than in female
Pelvic inlet oriented more anteroposteriorly than in female, where it tends to be transversely, oval
Pubic symphysis deeper (taller)
Pubic arch (subpubic angle) narrower
Ischial tuberosities less far apart
Iliac wings less flared
Female pelvis/female pelvic outlet: inferior view
Transverse diameter
Pubic symphysis
Ischial tuberosity
Ischial spine
Tip of coccyx
Anteroposterior diameter of pelvic outlet
Female: sagittal section
Sacral promontory
Plane of pelvic inlet
Conjugate diameter of pelvic inlet
Pubic symphysis
Anteroposterior diameter of pelvic outlet
Bones and Ligaments | Female and Male Pelvis Radiographs
Female Pelvis
Sacrum
Ilium
Pubis
Ischium
Pubis symphysis
Obturator foramen
Head of femur
Greater trochanter
Lesser trochanter
Femur
Pelvic foramina
Air in colon
Sacroiliac joint
Acetabulum
Pelvic inlet
Male Pelvis
L5
Sacrum
Ala of Sacrum
Ilium
Pubis
Ischium
Pubic symphysis
Obturator foramen
Ischial tuberosity
Ischial spine
Head of femur
Greater trochanter
Lesser trochanter
Femur
Air in colon
Sacroiliac joint
Acetabulum
Subpubic angle
Pelvis Floor and Contents | Pelvic Diaphragm: Female
Superior view
Pubic symphysis
Inguinal ligament (Poupart’s)
Coccyx
Anterior sacro-coccygeal ligament
Sacral promontory
Inferior (arcuate) pubic ligament
Deep dorsal vein of clitoris
Transverse perineal ligament
Fascia of deep perineal muscles
Urethra
Vagina
Obturator canal
Obturator fascia (over obturator internus muscle)
Pubococcygeus muscle (part of levator ani muscle)
Tendinous arch of levator ani muscle
Rectum
Iliococcygeus muscle (part of levator ani muscle)
Ischial spine
Levator plate (median raphe) of levator ani muscle
Coccygeus (ischiococcygeus) muscle
Piriformis muscle
Medial view
Arcuate line of ilium
Obturator internus muscle and obturator fascia (cut)
Tendinous arch of levator ani muscle
Obturator canal
Iliococcygeus muscle (part of levator ani muscle)
Rectum
Urethra
Pubococcygeus muscle (part of levator ani muscle)
Vagina
Sphincter urethrae muscle
Left puborectalis muscle and perineal membrane
Compressor urethrae and urethrovaginal sphincter (portions of sphincter urethrae muscle)
Piriformis muscle
Ischial spine
Coccygeus (ischiococcygeus)
Left levator ani muscle (cut)
External anal sphincter muscle
Superficial and deep transverse perineal muscles
Pelvic Floor and Contents | Pelvic Diaphragm: Female (continued)
Inferior view
Pubic symphysis
Inferior (arcuate) pubic ligament
Deep dorsal vein of clitoris
Inferior pubic ramus
Urethra
Vagina
Rectum
Ischial spine
Coccygeus (ischiococcygeus) muscle
Piriformis muscle (cut)
Sacrospinous ligament (cut)
Sacrotuberous ligament (cut)
Sacrum
Musculofascial extensions to urethra
Musculofascial extensions to vagina
Interdigitating fibers of perineum
Puborectalis muscle (part of levator ani muscle)
Pubococcygeus muscle (part of levator ani muscle)
Tendinous arch of levator ani muscle
Obturator internus muscle
Iliococcygeus muscle (part of levator ani muscle)
Ischial tuberosity
Ischial spine
Obturator internus tendon
Sacrospinous ligament
Sacrotuberous ligament
Piriformis muscle
Median raphe of levator ani muscle
Anococcygeal body (ligament) (attachment of external anal sphincter muscle)
Tip of coccyx
Lateral view
Median sacral crest
Sacrotuberous ligament (cut)
4th posterior (dorsal) sacral foramen
Coccygeus (ischiococcygeus) muscle
Sacrospinous ligament (cut)
Coccyx
Piriformis muscle
Greater sciatic foramen
Ischial spine
Iliococcygeus muscle (part of levator ani muscle)
Tendinous arch of levator ani muscle
Pubococcygeus muscle (part of levator ani muscle)
Puborectalis muscle (part of levator ani muscle)
Pubic bone (cut surface)
Deep dorsal vein of clitoris
Urethra
Vagina
Rectum
Pelvic Floor and Contents | Pelvic Diaphragm: Male
Superior view (viscera removed)
Pubic symphysis
Pubic crest
Pubic tubercle
Pecten pubis (pubic part of iliopectineal line)
Superior ramus of pubis
Obturator canal
Obturator fascia
Iliopubic eminence
Acetabular margin
Anterior inferior iliac spine
Inferior (arcuate) pubic ligament
Hiatus for deep dorsal vein of penis
Transverse perineal ligament (anterior thickening of perineal membrane)
Hiatus for urethra
Muscle fibers from levator ani to conjoined longitudinal muscle of anal canal
Puborectalis of Levator ani muscle
Pubococcygeus of Levator ani muscle
Iliococcygeus of Levator ani muscle
Tendinous arch of levator ani muscle
Obturator internus muscle
Wing (ala) of ilium
Arcuate line (iliac part of iliopectineal line)
Ischial spine
Sacroiliac joint
Sacrum
Sacral canal
Anorectal hiatus
Anterior sacrococcygeal ligament
Anterior sacral (pelvic) foramina
Piriformis muscle
Coccygeus (ischiococcygeus) muscle
Ischial spine
Pelvic Floor and Contents | Pelvic Diaphragm: Male (continued)
Inferior view
Deep dorsal veins of penis
Fat in retropubic (prevesical) space
Sphincter urethrae muscle ascending anterior aspect of prostate
Urethra
Rectoprostatic (Denonvilliers’) fascia
Medial border (pillar) of levator ani muscle
Perineal membrane (cut away)
Ischiopubic ramus
Pubic symphysis
Inferior pubic (arcuate) ligament
Perineal body
Fibromuscular extensions of levator ani muscle to prostate
Pubic tubercle
Rectourethralis superior muscle
Prerectal muscle fibers (of Luschka) from levator ani muscle
Muscle fibers from Levator ani to conjoined longitudinal muscle of anal canal
Obturator internus tendon
Ischial tuberosity
Sacrotuberous ligament (cut)
Obturator internus muscle
Coccygeus (ischiococcygeus) muscle
Sacrospinous ligament (cut)
Sacrotuberous ligament (cut)
Tip of coccyx
Gluteus maximus muscle
Obturator internus muscle
Tendinous arch of levator ani muscle
Iliococcygeus of Levator ani muscle
Pubococcygeus of Levator ani muscle
Puborectalis of Levator ani muscle
Circular muscle layer of anorectal junction
Conjoined longitudinal muscle of anorectal junction
Pelvic Floor and Contents | Pelvic Viscera and Perineum: Female
Paramedian (sagittal) dissection
Ureter
Uterine (fallopian) tube
Ovary
Ligament of ovary
Round ligaments of uterus
Broad ligament (cut)
Superior pubic ramus (cut)
Inferior pubic ramus (cut)
Ischiocavernosus muscle
Body of clitoris
Labium minus
Labium majus
Rectourterine pouch (of Douglas)
Peritoneum (cut edge)
Vesicouterine pouch
Rectum
Ureter
Urinary bladder
Vagina
Pelvic diaphragm (levator ani muscle)
Deep transverse perineal muscle (cut)
External anal sphincter muscle
Median (sagittal) section
Sacral promontory
Ureter
Suspensory ligament of ovary
Uterine (fallopian) tube
Ovary
External iliac vessels
Ligament of ovary
Body of uterus
Round ligament of uterus (ligamentum teres)
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
Superficial transverse perineal muscle
Labium minus
Labium majus
Uterosacral ligament
Vesicouterine pouch
Rectouterine pouch (of Douglas)
Cervix of uterus
Posterior part of vaginal fornix
Rectum
Vagina
Perineal membrane
Levator ani muscle
Anal canal
External anal sphincter muscle
Anus
Vaginal orifice
Pelvic Floor and Contents | Pelvic Viscera and Perineum: Male
Paramedian (sagittal) dissection
External iliac vessels
Peritoneum
Rectus abdominis muscle
Anterior layer of rectus sheath
Transversalis fascia
Umbilical prevesical fascia
Fatty membranous (Camper’s) Subcutaneous tissue
(Scarpa’s) Subcutaneous tissue
Superior pubic 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
Corpus cavernosum
Deep (Buck’s) fascia of penis
Corpus spongiosum
Superficial (dartos) fascia of penis and scrotum
Septum of scrotum
Testis
Ductus (vas) deferens
Urinary bladder and fascia
Ureter (cut)
Seminal vesicle
Rectovesical pouch
Rectum
Rectoprostatic (Denonvilliers’) fascia
Prostate (covered by fascia)
Ischiopubic ramus (cut)
Pelvic diaphragm (levator ani muscle)
Deep transverse perineal muscle
Perineal body
Deep External anal sphincter muscle
Superficial External anal sphincter muscle
Subcutaneous External anal sphincter muscle
Deep perineal (investing or Gallaudet’s) fascia
Superficial perineal (Colles’) fascia (inferior fascia of superficial perineal space)
Superficial (dartos) fascia of scrotum
External spermatic fascia
Median (sagittal) section
Urachus
Apex of Urinary bladder
Fundus of Urinary bladder
Body of Urinary bladder
Trigone of Urinary bladder
Neck of Urinary bladder
Pubic symphysis
Fundiform ligament of penis
Suspensory ligament of penis
Inferior (arcuate) pubic ligament
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
Glans penis and external urethral meatus
Vesical fascia
Rectovesical pouch
Rectum
Seminal vesicle
Prostate
Rectoprostatic (Denonvilliers’) fascia
Sphincter urethrae muscle
Bulbourethral (Cowper’s) gland
Perineal body
Bulbospongiosus muscle
Deep perineal (investing or Gallaudet’s) fascia
Superficial perineal (Colles’) fascia
Buck’s fascia
Septum of scrotum
Navicular fossa
Pelvic Floor and Contents | Pelvic Contents: Female
Superior view
Uterus (fundus)
Ligament of ovary
Ovary
Uterine (fallopian) tube
Round ligament of uterus
Broad (lateral uterine) ligament
Femoral ring
Deep inguinal ring
Iliopubic tract (covered by peritoneum)
External iliac vessels
Iliac fossa (false pelvis)
Left paracolic gutter
Linea alba
Median umbilical fold and ligament (urachus)
Urinary bladder and transverse vesical fold
Rectus abdominis muscle
Medial umbilical fold and ligament (occluded part of umbilical artery)
Rectouterine pouch (of Douglas)
Rectum
Inferior epigastric vessels and lateral umbilical fold
Uterosacral fold
Ureteric fold
Suspensory ligament of ovary (contains ovarian vessels)
Cecum
Cecal folds
Right paracolic gutter
External oblique Abdominal muscles
Internal oblique Abdominal muscles
Transversus abdominis Abdominal muscles
Descending colon
Quadratus lumborum muscle
Sigmoid colon
Psoas major and minor muscles
Sympathetic trunk
Anterior longitudinal ligament
Body of L3 vertebra
Superior hypogastric plexus
Abdominal aorta
Sacral promontory
Inferior vena cava
Pararectal fossa
Ovarian vessels
Root of mesentery
Ureter
Terminal ileum
Ascending colon
Parietal peritoneum
Transversalis
Pelvic Floor and Contents | Pelvic Contents: Male
Superior view
Rectum
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
External iliac vessels
Testicular vessels (in peritoneal fold)
Iliac fossa (false pelvis)
Transversalis fascia
Parietal peritoneum
Left paracolic gutter
Linea alba
Median umbilical fold and ligament (urachus)
Urinary bladder and transverse vesical fold
Medial umbilical fold and ligament (occluded part of umbilical artery)
Rectus abdominis muscle
Rectovesical pouch
Inferior epigastric vessels and lateral umbilical fold
Vesicosacral (sacrogenital) fold
Pararectal fossa
Ureteric fold
Iliopubic tract (extraperitoneal)
Cecum
Cecal folds
External oblique Abdominal muscles
Internal oblique Abdominal muscles
Transversus abdominis Abdominal muscles
Descending colon
Quadratus lumborum muscle
Sigmoid colon
Psoas minor and major muscles
Sympathetic trunk
Anterior longitudinal ligament
Body of L3 vertebra
Superior hypogastric plexus
Abdominal aorta
Sacral promontory
Inferior vena cava
Testicular vessels
Root of mesentery
Ureter
Terminal ileum
Ascending colon
Right paracolic gutter
Pelvic Floor and Contents | Endopelvic Fascia and Potential Spaces
Female: superior view (peritoneum and loose areolar tissue removed)
Umbilical prevesical fascia
Medial umbilical ligament (occluded part of umbilical artery)
Urinary bladder and vesical fascia
Rectus abdominis muscle
Superior vesical artery in lateral ligament of bladder
Linea terminalis of pelvis
Femoral ring
Inferior epigastric artery and Pubic branch
Deep inguinal ring
Iliopubic tract
Transversalis fascia
External iliac vessels
Femoral nerve (under fascia)
Deep circumflex iliac vessels
Tendinous arch of pelvic fascia (reflected laterally)
Iliac fascia
Ovarian vessels in suspensory ligament of ovary
Iliacus muscle
Ureter
Psoas major muscle
Internal iliac vessels
Inferior vesical and vaginal arteries
Hypogastric (neurovascular) sheath
Middle rectal artery
Cervix of uterus and uterine fascia
Superior rectal artery (left branch)
Rectum and rectal fascia
Rectovaginal (potential) space
Presacral (potential) space (spread open)
Median sacral artery
Median umbilical ligament (urachus)
Pubic symphysis
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 artery
Obturator internus fascia
Tendinous arch of levator ani muscle
Tendinous arch of pelvic fascia
Uterosacral ligament
Cardinal (transverse cervical or Mackenrodt’s) ligament with uterine artery
Vaginorectal fascial fibers
Presacral fascia (pulled away)
Anterior sacrococcygeal ligament
Vesicocervical and vesicovaginal (potential) spaces
Urinary Bladder | Urinary Bladder: Orientation and Supports
Female: midsagittal section
Peritoneum
Transversalis fascia
Median umbilical ligament (urachus)
Umbilical prevesical fascia
Uterus (fundus)
Vesicouterine pouch
Fundus of Urinary bladder
Apex of Urinary bladder
Body of Urinary bladder
Ureteric orifice of Urinary bladder
Trigone of Urinary bladder
Neck of Urinary bladder
Pubic symphysis
Retropubic (prevesical) space and venous plexus
Inferior (arcuate) pubic ligament
Deep dorsal vein of clitoris
Transverse perineal ligament
Sphincter urethrae
Sphincter urethrovaginalis muscles
Perineal membrane
Urethra
Vagina
Labium minus
Labium majus
Perineal body
Ampulla of rectum
External anal sphincter muscle
Rectum
Superior view with peritoneum and vesical fascia removed
Pubic symphysis
Inferior (arcuate) pubic ligament
Deep dorsal vein of clitoris
Medial pubovesical ligament (medial puboprostatic ligament in male)
Transverse perineal ligament (anterior thickening of perineal membrane)
Tendinous arch of levator ani muscle
Obturator canal
Lateral 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)
Inferior vesical and vaginal arteries
Ureter
Urinary Bladder | Urinary Bladder: Female and Male
Female: frontal section
Peritoneum
Body of bladder
Fundus of bladder
Interureteric crest
Left ureteric orifice
Trigone of bladder
Neck of bladder
Paravesical endopelvic fascia and vesical venous plexus
Vesical fascia
Tendinous arch of levator ani muscle
Obturator internus muscle
Levator ani muscle
Tendinous arch of pelvic fascia
Urethra
Sphincter urethrae muscle
Perineal membrane
Inferior pubic ramus
Crus of clitoris and ischiocavernosus muscle
Bulb of vestibule and bulbospongiosus muscle
Deep perineal (investing or Gallaudet’s) fascia
Superficial perineal (Colles’) fascia
Male: frontal section
Peritoneum
Internal urethral sphincter
Tendinous arch of pelvic fascia
Anterior recess of ischioanal fossa
Inferior pubic ramus
Crus of penis and ischiocavernosus muscle
Superficial perineal (Colles’) fascia
Body of bladder
Fundus of bladder
Ductus (vas) deferens
Interureteric crest
Right ureteric orifice
Trigone of bladder
Neck of bladder
Paravesical endopelvic fascia and vesical venous plexus
Tendinous arch of levator ani muscle
Uvula of bladder
Obturator internus muscle
Levator ani muscle
Capsule of prostate
Prostate and prostatic urethra
Seminal colliculus
Bulbourethral (Cowper’s) gland
Perineal membrane and sphincter urethrae muscle
Bulbous portion of spongy urethra
Corpus spongiosum and bulbospongiosus muscle
Deep perineal (investing or Gallaudet’s) fascia
Urinary Bladder | Sphincters
Bladder
Trigonal ring of Internal sphincter (involuntary)
Posterior loop of Internal sphincter (involuntary)
Loop of Heiss of Internal sphincter (involuntary)
Vagina
Urethra
Levator ani muscle
Urogenital hiatus
Perineal body
Sphincter urethrae muscle of External sphincter (voluntary)
Urethrovaginal muscle of External sphincter (voluntary)
Compressor urethrae muscle of External sphincter (voluntary)
Pubic bone
Urinary Bladder | Male and Female Cystourethrograms
Bladder
Urethra
Female urethra, 8-year old child
Voiding cystourethrogram, 2-year-old male
Bladder
Prostatic urethra
Membranous urethra
Spongy urethra
Uterus, Vagina, and Supporting Structures | Pelvic Viscera: Female
Superior view with peritoneum intact
Paravesical fossa
Vesicouterine pouch
Median umbilical fold (urachus)
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
Rectouterine pouch (of Douglas)
Rectouterine fold
Uterine (fallopian) tube
External iliac vessels
Pararectal fossa
Suspensory ligament of ovary (contains ovarian vessels)
Ureteric fold
Abdominal aorta
Median sacral vessels
Sacral promontory
Sigmoid colon
Superior view with peritoneum and uterus removed
Obturator fascia
Vesical fascia (cut edge)
Urinary bladder
Obturator canal
Obturator artery
Superior fascia of pelvic diaphragm
Cervix of uterus and uterovaginal fascia
Uterine vessels
Cardinal (transverse cervical or Mackenrodt’s) ligament
Rectocervical and rectovaginal (potential) spaces
Rectal fascia (cut edge)
Rectouterine (sacrouterine) ligament
External iliac vessels
Ureter
Sacral promontory
Uterus, Vagina, and Supporting Structures | Uterus, Vagina, and Supporting Structures
Suspensory ligament of ovary
Cut edge of peritoneum forming floor of paravesical pouch
Broad ligament
Mesovarium
Ovary
Uterine (fallopian) tube
Round ligament of uterus
Ligament of ovary
Uterus (pulled up)
Linea terminalis (pelvic brim)
Internal iliac artery and vein
Cervix of uterus
Obturator membrane
Obturator fascia
Obturator internus muscle
Levator ani muscle (iliococcygeus and pubococcygeus muscles)
Ischiopubic ramus
Compressor urethralis muscle
Perineal membrane
Artery of bulb of vestibule
Sphincter urethrovaginalis muscle
Terminal part of round ligament of uterus
Labium majus
Labium minus
Vestibule
Vagina
Hymenal caruncle
Vaginal wall
Bulb of vestibule
Bulbospongiosus muscle and deep perineal (investing or Gallaudet’s) fascia
Superficial perineal (Colles’) fascia
Perineal artery
Superficial perineal space
Fascia lata of thigh
Ischiocavernosus muscle
Crus of clitoris
Anterior recess of ischioanal fossa
Uterovaginal fascia
Ureter
Vaginal artery
Tendinous arch of levator ani muscle
Cardinal (transverse cervical or Mackenrodt’s) ligament
Uterine vessels
Uterus, Vagina, and Supporting Structures | Uterus and Adnexa
Posterior view
Fundus of uterus
Ligament of ovary
Epӧphoron
Mesosalpinx (of broad ligament)
Suspensory ligament of ovary
Vesicular appendix (hydatid of Morgagni)
Corpus luteum
Ovary
Body of uterus
Mesometrium (of broad ligament)
Ureter
Uterosacral ligament
Rectouterine pouch (of Douglas)
Ligament of ovary
Mesovarium (of broad ligament)
Ovary
Suspensory of ligament of ovary
Isthmus of Uterine (fallopian) tube
Ampulla of Uterine (fallopian) tube
Infundibulum of Uterine (fallopian) tube
Fimbriae of Uterine (fallopian) tube
Abdominal ostium of Uterine (fallopian) tube
Frontal section
Uterine ostium
Fundus of uterus
Body of uterus
Isthmus of uterus
Internal os
Cervix of uterus
External os
Uterine part of Uterine (fallopian) tube
Isthmus of Uterine (fallopian) tube
Ampulla of Uterine (fallopian) tube
Infundibulum of Uterine (fallopian) tube
Folds of uterine tube of Uterine (fallopian) tube
Fimbriae of Uterine (fallopian) tube
Suspensory ligament of ovary (contains ovarian vessels)
Vesicular appendix (hydatid of Morgagni)
Epoӧphoron
Follicle (Graafian) of ovary
Corpus albicans of ovary
Corpus luteum of ovary
Ligament of ovary
Endometrium
Myometrium
Mesometrium (of broad ligament)
Uterine vessels
Cardinal (transverse cervical or Mackenrodt’s) ligament
Cervical canal with palmate folds
Vaginal fornix
Vagina
Uterus, Vagina, and Supporting Structures | Pelvic Ligaments
Anterior
Subdivisions and contents of the broad ligament
External iliac vessels
Ampulla of uterine tube
Round ligament
Laminae of the mesosalpinx
Obliterated umbilical artery
Ovarian branches of uterine vessels
Round ligament
Transverse vesical fold
Vesicouterine (uterovesical) pouch
Posterior
Suspensory ligament of the ovary (containing the ovarian vessels)
Infundibulum of uterine tube
Fimbriae of uterine tube
Right ovary
Right ureter
Laminae of the mesovarium
Posterior lamina of broad ligament
Anterior lamina of broad ligament
Uterine artery and venous plexus
Vaginal artery
Pelvic fascia
Horizontal portion of pubocervical fascia supports bladder and vagina
Vertical portion of vagina
Urethra
Uterosacral ligament
Cardinal ligament
Cervix
Horizontal portion of vagina
Arcus tendineous fasciae pelvis
Distal (vertical) portion of pubocervical fascia supports urethra and U-V junction and provides backdrop
Against which urethra is compressed during straining
Uterus, Vagina, and Supporting Structures | Uterus: Age Changes and Muscle Pattern
Adult (nulliparous)
Adult (parous)
Adult (postmenopausal)
C, Contrast medium in abdominal cavity
H, Hysterosalpingogram uterus
R, Right fallopian tube infection
Uterine musculature (schema)
Uterine (fallopian) tube
Ligament of ovary
Round ligament of uterus
Uterosacral ligament
Cardinal (transverse cervical or Mackenrodt’s) ligament
Vaginal wall
Spiral fibers pass deeply into wall and interlace (schema)
Uterus, Vagina, and Supporting Structures | Uterus: Position and Prolapse
Degrees of retroversion
Altered rectal contour in 3rd degree
3rd degree
2nd degree
1st degree
Normal
Variations in position
Normal
Retroflexion
Normal
Retrocession
Normal
Anteflexion (normal and severe)
Uterine prolapse
Urinary bladder
Uterus
Complete prolapse
Sagittal section
Rectum
Slight descent (1st degree)
Cervix at introitus (2nd degree)
Uterus, Vagina, and Supporting Structures | Ectopic Pregnancy
Sites of ectopic implantation
Interstitial
Tubal (isthmic)
Tubal (ampullar)
Abdominal
Cervical
Ovarian
Infundibular (ostial)
Unruptured tubal pregnancy
Section through tubal pregnancy
Lumen of tube
Hemorrhage in tubal wall
Villi invading tubular wall
Chorion
Amnion
Regional Transverse Section | Male Pelvis: Bladder-Prostate Junction
Superior portion of pubic symphysis
Spermatic cord
Beginning of urethra
Prostate gland with prostatic urethra
Psoas muscle and tendon
Iliacus muscle
Head of femur
Neck of femur
Gluteus medius muscle
Gluteus minimus tendon
Greater trochanter
Inferior gemellus muscle
Right sciatic nerve
Gluteus maximus muscle
Obturator internus muscle
Sacrotuberous ligament
Ejaculatory ducts
Perineal flexure (termination of rectum, beginning of anal canal)
Tip coccyx
Levator ani muscle (puborectalis)
Fat body of ischioanal fossa
Pudendal nerve
Internal pudendal artery and vein
Left sciatic nerve
Lunate (articular) surface of acetabulum
Acetabular fossa
Obturator artery, vein, and nerve
Gluteus medius muscle
Tensor fasciae latae muscle
Rectus femoris muscle
Iliopsoas muscle
Sartorius muscle
Femoral nerve
Femoral artery
Femoral vein
Pectineus muscle
Body of pubis
Adductor longus muscle
Interior of urinary bladder
Perineum and External Genitalia: Female | Female Perineum and External Genitalia (Pudenum or Vulva)
Mons pubis
Anterior commissure of labia majora
Prepuce of clitoris
Pudendal cleft (groove or space between the labia majora)
Glans of clitoris
Frenulum of clitoris
External urethral orifice
Labium minus
Labium majus
Openings of paraurethral (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)
Anus
Annular hymen
Septate hymen
Cribriform Hymen
Parous introitus
Perineum and External Genitalia: Female | Female Perineum (Superficial Dissection)
Superficial fatty (Camper’s) layer of Subcutaneous tissue
Deeper membranous (Scarpa’s) layer of Subcutaneous tissue
Rectus sheath (anterior layer)
Aponeurosis of external oblique muscle
Superficial inguinal ring
Anterior superior iliac spine
Round ligament of uterus and coverings (cut)
Inguinal ligament (Poupart’s)
Pubic tubercle
Pubic symphysis
Saphenous opening
Suspensory ligament of clitoris
Fascia lata of thigh
Ischiopubic ramus
Superficial perineal (Colles’) fascia (cut away) to open superficial perineal space
Ischiocavernosus muscle
Bulbospongiosus muscle (covers bulb of vestibule)
Perineal membrane
Deep perineal (investing or Gallaudet’s) fascia (partially cut away)
Superficial transverse perineal muscle
Ischial tuberosity
Superficial perineal (Colles’) fascia (cut edge turned down)
Fat body of ischioanal fossa
Superficial perineal (Colles’) fascia
Round ligament of uterus and coverings
Fatty of Subcutaneous tissue
Membranous of Subcutaneous tissue
Rectus sheath (anterior layer)
Pubic symphysis
Inferior (arcuate) pubic ligament
Transverse perineal ligament
Suspensory ligament of clitoris
Sphincter urethrae and sphincter urethrovaginalis muscles
Perineal membrane
Superficial perineal space
Superficial perineal (Colles’) fascia
Perineal body
Superior fascia of pelvic diaphragm
Inferior fascia of pelvic diaphragm
Levator ani muscle
External anal sphincter muscle
Anococcygeal body
Rectum
Vagina
Bladder
Uterus
Rectal fascia
Uterovaginal fascia
Vesical fascia
Rectus abdominis muscle
Transveralis fascia
Urachus
Peritoneum
Perineum and External Genitalia: Female | Female Perineum and Deep Perineum
Clitoris
Suspensory ligament of clitoris
Ischiocavernosus muscle
Bulb of vestibule
Perineal membrane
Greater vestibular (Bartholin’s) gland
Bulbospongiosus muscle (cut away)
Superficial transverse perineal muscle
Perineal body
Bulbospongiosus muscle with deep perineal (investing or Gallaudet’s) fascia partially removed
Superficial perineal space (pouch or compartment)
Ischiopubic ramus with cut edge of superficial perineal (Colles’) fascia
Perineal membrane
Ischial tuberosity
Sacrotuberous ligament
Gluteus maximus muscle
Ischioanal fossa
Coccyx
Anococcygeal (ligament) body
External anal sphincter muscle
Levator ani muscle
Inferior fascia of pelvic diaphragm (cut)
Tendinous arch of levator ani muscle
Obturator fascia
Urethra
Sphincter urethrae muscle
Perineal membrane (cut and reflected)
Compressor urethrae muscle
Sphincter urethrovaginalis muscle
Vagina
Deep transverse perineal muscle
Greater vestibular (Bartholin’s) gland
Perineal membrane
Bulb of vestibule
Ischiopubic ramus
Crus of clitoris
Perineum and External Genitalia: Male | Perineum and External Genitalia (Superficial Dissection)
Superficial fatty (Camper’s) and deeper membranous (Scarpa’s) layers of subcutaneous tissue
Skin of penis
Deep (Buck’s) fascia of penis
Superficial (dartos) fascia of penis and scrotum
Saphenous opening and femoral artery and vein
Great saphenous vein
Superficial perineal (Colles’) fascia
Broken line indicates line of attachment of Colles’ and Scarpa’s fasciae with deep fascia
Fat body in ischioanal fossa
Deep (investing) fascia over external oblique muscle
External spermatic fascia
Anterior superior iliac spine
Inguinal ligament (Poupart’s)
Fascia lata (deep fascia) of thigh
Ischiopubic ramus
Anus
Regions (triangles) of perineum: surface topography
Pubic symphysis
Urogenital triangle
Ischiopubic ramus
Ischial tuberosity
Anal triangle
Tip of coccyx
Perineum and External Genitalia: Male | Perineum and External Genitalia (Deeper Dissection)
Skin of penis
Superficial (dartos) fascia of penis
Aponeurosis of external oblique
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 fascia) of thigh
Bulbospongiosus muscle
Ischiocavernosus muscle covers crus of penis
Superficial perineal (Colles’) fascia (cut away to open superficial perineal space)
Perineal membrane
Deep perineal (investing or Gallaudet’s) fascia (partially cut away) covers muscles of superficial perineal space
Superficial transverse perineal muscle
Ischial tuberosity
Superficial perineal (Colles’) fascia (cut edge)
Levator ani muscle roofing ischioanal fossa
External anal sphincter muscle
Gluteus maximus muscle
Section through body of penis
Skin
Deep dorsal vein
Superficial (dartos) fascia of penis
Deep (Buck’s) fascia of penis
Intercavernous septum of deep fascia
Urethra
Superficial dorsal vein
Dorsal artery and nerve
Lateral superficial vein
Corpus cavernosum and its tunica albuginea
Deep artery
Corpus spongiosum and its tunica albuginea
Perineum and External Genitalia: Male | Penis
Frenulum
Skin
External urethral orifice (meatus)
Glans penis
Corona of glans
Neck of glans
Opening of preputial (Tyson’s) gland
Superficial (dartos) fascia of penis
Deep (Buck’s) fascia penis
External spermatic fascia investing spermatic cord (cut)
Superficial perineal (Colles’) fascia (cut away to open superficial perineal space)
Deep perineal (investing or Gallaudet’s) fascia (cut away) over muscles of superficial perineal space
Ischiocavernosus muscle (cut away)
Superficial transverse perineal muscle
Perineal membrane
Perineal body
Tip of coccyx
External anal sphincter muscle
Levator ani muscle and inferior fascia of pelvic diaphragm roofing ischioanal fossa
Gluteus maximus muscle
Ischial tuberosity.
Perineum and External Genitalia: Male | Perinal Spaces
Inferior views
Pubic symphysis
Superior pubic ramus
Inferior (arcuate) pubic ligament
Deep dorsal vein of penis
Ischiopubic ramus
Urethra
Perineal membrane
Perineal body
External anal sphincter muscle
Pubic bone
Transverse perineal ligament (anterior thickening of perineal membrane)
Dorsal artery and nerve of penis
Deep artery of penis
Urethral artery
Duct of bulbourethral (Cowper’s) gland
Artery of bulb of penis
Deep perineal (investing or Gallaudet’s) fascia over superficial transverse perineal muscles (cut away)
Superficial perineal (Colles’) fascia (cut away)
Superficial transverse perineal muscle (cut and reflected)
Ischial tuberosity
Sphincter urethrae muscle
Urethra
Deep transverse perineal muscle
Dorsal artery and nerve of penis
Deep artery of penis
Urethral artery
Bulbourethral (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
Frontal section, anterior view of perineum: schema
Levator ani muscle
Perineal membrane
Deep transverse perineal muscle
Deep perineal (investing or Gallaudet’s) fascia
Corpus cavernosum (crus of penis) and deep (Buck’s) fascia of penis
Ischiocavernosus muscle
Superficial perineal (Colles’) fascia (closes superficial perineal space)
Urinary bladder
Prostate
Obturator internus muscle
Ischiopubic ramus
Sphincter urethrae muscle
Bulbourethral (Cowper’s) gland
Ischiocavernosus muscle
Bulb of penis (corpus spongiosum) and deep (Buck’s) fascia of penis
Bulbospongiosus muscle
Perineum and External Genitalia: Male | Prostate and Seminal Vesicles
Frontal section, anterior view of bulbous portion of spongy urethra schematically extended
Uvula of bladder
Urethral crest
Openings of prostatic ducts in prostatic sinus
Ureteric orifice
Trigone of urinary bladder
Internal urethral sphincter
Prostate
Seminal colliculus
Prostatic utricle
Opening of ejaculatory duct
Sphincter urethrae muscle
Bulbourethral (Cowper’s) gland
Opening of bulbourethral duct
Sagittal section
Ureteric orifice
Trigone of urinary bladder
Internal urethral sphincter
Prostate
Seminal colliculus
Prostatic utricle
Opening of ejaculatory duct
Sphincter urethrae muscle
Bulbourethral (Cowper’s) gland
Opening of bulbourethral duct
Perineal body
Rectovesical or rectoprostatic (Deononvilliers’) fascia
Seminal vesicle
Rectum and rectal fascia
Posterior view
Urinary bladder
Ampulla of ductus deferens
Beginning of ejaculatory duct
Prostate
Ischiopubic ramus
Deep transverse perineal muscle and fascia
Bulbourethral (Cowper’s) glands
Ureter
Ductus deferens
Seminal vesicle
Cross section through prostate
Inferolateral lobe
Median lobe
Prostatic utricle
Isthmus and fibromuscular stroma (smooth muscle)
Anterior muscular band of skeletal muscle (continuation of sphincter urethrae)
Prostatic urethra
Seminal colliculus
Inferolateral lobe
Prostatic sinus
Ejaculatory ducts
Inferoposterior lobe
Capsule of prostate
Perineum and External Genitalia: Male | Urethra
Roof of Urethra
Internal urethral sphincter
Prostatic urethra
Intermediate part of (membranous) urethra
Spongy (cavernous) urethra
Bulbous portion
Pendulous (penile) portion
Prostate
Sphincter urethrae muscle
Corpus cavernosum
Tunica albuginea
Corpus spongiosum
Tunica albuginea
Deep artery of penis
Intercavernous septum of deep (Buck’s) fascia
Urethral lacunae (Morgagni) and urethral glands (Littré)
Lacuna magna (inconstant)
Navicular fossa
Glans penis
External urethral orifice (meatus)
Floor of Urethra
Internal urethral sphincter
Prostate
Prostatic sinuses
Prostatic utricle
Sphincter urethrae muscle
Bulb of penis
Crus of penis
Corpus cavernosum
Tunica albuginea
Corpus spongiosum
Tunica albuginea
Deep artery of penis
Intercavernous septum of deep (Buck’s) fascia
Urethral lacunae (Morgagni) and urethral glands (Littré)
Lacuna magna (inconstant)
Navicular fossa
Glans penis
External urethral orifice (meatus)
Trigone of urinary bladder
Uvula of bladder
Urethral crest
Openings of prostatic ducts
Openings of ejaculatory ducts
Bulbourethral (Cowper’s) gland
Openings of bulbourethral ducts
Perineum and External Genitalia: Male | Descent of Testis
8 weeks (22.5-mm crown-rump)
Suprarenal gland
Suspensory (diaphragmatic) ligament
Gonads
Mesonephric (wolffian) duct
Gubernaculum
Urinary bladder
11 weeks (43-mm crown-rump)
Suprarenal gland
Kidney
Suspensory (diaphragmatic) ligament (atrophic)
Testes
Epididymis
Gubernaculum
Deep inguinal ring
Urinary bladder
4 lunar months (107-mm crown-rump)
Testis
Epididymis
Deep inguinal ring
Gubernaculum
8 lunar months (26-cm crown-rump)
Superficial inguinal ring
Ductus deferens
Scrotum (cut open)
Epididymis
Testis
Processus vaginalis
Gubernaculum
Cavity of tunica vaginalis (cut open)
Perineum and External Genitalia: Male | Scrotum and Contents
Superficial inguinal ring
External spermatic fascia
Cremaster muscle and fascia
Septum of scrotum (formed by dartos fascia)
Superficial (dartos) fascia of scrotum
Skin of scrotum
Skin of penis
Superficial fascia of penis (Colles’ fascia)
Deep (Buck’s) fascia of penis
Testicular artery
Ductus deferens
Artery to ductus deferens
Genital branch of genitofemoral nerve
Pampiniform (venous) plexus
Epididymis
Appendix of epididymis
Appendix of testis
Testis (covered by visceral layer of tunica vaginalis)
Parietal layer of tunica vaginalis
Superficial (dartos) fascia of scrotum
External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia
Parietal layer of tunica vaginalis
Epididymis
Testis (covered by visceral layer of tunica vaginalis)
Skin of scrotum
Homologues of Genitalia | Homologues of External Genitalia
Undifferentiated
Glans area
Epithelial tag
Urogenital fold
Urogenital groove
Lateral part of tubercle
Anal tubercle
Anal pit
Genital tubercle
Male 45-50 mm (~10 weeks)
Glans
Epithelial tag
Coronal sulcus
Site of future origin of prepuce
Urethral fold
Urogenital groove
Lateral tubercle (shaft or corpus)
Labioscrotal swelling
Urethral folds partly fused (urethral raphe)
Anal tubercle
Anus
Female 45-50 mm (~10 weeks)
Glans
Epithelial tag
Coronal sulcus
Site of future origin of prepuce
Urethral fold
Urogenital groove
Lateral tubercle (shaft or corpus)
Labioscrotal swelling
Urethral folds partly fused (urethral raphe)
Anal tubercle
Anus
Male Fully developed
External urethral orifice
Glans penis
Prepuce
Body (shaft) of penis
Raphe of penis
Scrotum
Perineal raphe
Perianal tissues (including external anal sphincter muscle)
Female Fully developed
Body of clitoris
Prepuce
Glans of clitoris
External urethral orifice
Labium minus
Labium majus
Vaginal orifice
Posterior commissure
Perineal raphe
Perianal tissues (including external anal sphincter muscle)
Homologues of Genitalia | Homologues of Internal Genitalia
Paramesonephric (müllerian) duct
Mesonephric tubules
Mesonephric (wolffian) duct
Inguinal fold
Primordium of prostate (♂) or of paraurethral (Skene’s) (♀) glands
Diaphragmatic ligament (suspensory ligament of ovary)
Gonad
Genital cord
Urogenital sinus
Primordium of bulbourethral (Cowper’s)(♂) or of greater vestibular (Bartholin’s) (♀) glands
Undifferentiated Male
Seminal vesicle
Ductus deferens
Prostatic utricle
Prostate
Opening of ejaculatory duct
Bulbourethral (Cowper’s) gland
Appendix of epididymis
Epididymis
Efferent ductules
Appendix of testis
Testis
Paradidymis
Scrotal ligament (gubernaculum)
Undifferentiated Female
Uterine (fallopian) tube
Broad ligament
Cranial mesonephric (Gartner’s) duct
Epӧphoron (cranial mesonephric tubules)
Parӧphoron (caudal mesonephric tubules)
Vesicular appendix
Suspensory ligament of ovary
Ligament of ovary
Ovary
Uterus
Round ligament of uterus
Vagina (upper ⅘)
Residua of caudal mesonephric duct
Vagina (lower ⅕)
Urethra
Paraurethral (Skene’s) gland
Greater vestibular (Bartholin’s) gland
Vestibule
Testis, Epididymis, and Ductus Deferens | Testis, Epididymis, and Ductus Deferens
Frontal section
Ductus deferens
Head of Epididymis
Body of Epididymis
Tail of Epididymis
Efferent ductules
Aberrant ductule (vestigial mesonephric tubule)
Area of rete testis (in mediastinum testis)
Septa
Tunica albuginea
Lobules
Schema
Aberrant ductule
Epididymal duct
Ductus deferens
Efferent ductules
Epididymal duct
Rete testis (in mediastinum testis)
Aberrant ductule
Seminiferous tubules
Cross section through scrotum and testis
Lobules of testis
Scrotal septum
Septa
Rete testis (in mediastinum testis)
Ductus deferens
Skin of scrotum
Superficial (dartos) fascia
External spermatic fascia
Cremaster muscle and fascia
Internal spermatic fascia
Parietal layer of tunica vaginalis
Visceral layer of tunica vaginalis
Tunica albuginea of testis
Sinus of epididymis
Epididymis
Rectum | Rectum in Situ: Female and Male
Male
Sigmoid colon
Sigmoid mesocolon
Rectosigmoid junction
Peritoneal reflection
Rectovesical pouch
Rectum and rectal fascia
Levator ani muscle (pelvic diaphragm)
Coccyx
Puborectalis part of levator ani muscle
Deep External anal sphincter muscle
Superficial External anal sphincter muscle
Subcutaneous External anal sphincter muscle
Perineal body
Free taenia (taenia libera)
Ductus (vas) deferens (cut)
Ureter (cut)
Urinary bladder
Seminal vesicle
Rectoprostatic (Denonvilliers’) fascia
Prostate
Ischiocavernosus muscle and deep perineal (investing or Gallaudet’s) fascia (partially cut away)
Deep transverse perineal muscle
Superficial transverse perineal muscle and deep perineal (investing) fascia
Female
Sigmoid mesocolon
Rectosigmoid junction
Peritoneal reflection
Rectal fascia and rectum
Rectouterine pouch (of Douglas)
Coccyx
Levator ani muscle (pelvic diaphragm)
Puborectalis part of levator ani muscle
Deep External anal muscle
Superficial External anal muscle
Subcutaneous External anal muscle
Sigmoid colon
Free taenia (taenia libera)
Uterus
Vesicouterine pouch
Ureter (cut)
Vagina and vaginal fascia
Urinary bladder and vesical fascia
Ischiocavernosus muscle and deep perineal (investing or Gallaudet’s) fascia
Deep transverse perineal muscle and perineal membrane
Superficial perineal (Colles’) fascia
Superficial transverse perineal muscle and deep perineal (investing or Gallaudet’s) fascia
Perineal body
Rectum | Ischioanal Fossae
Ureter
Extraperitoneal (supralevator) space (fibrofatty tissue)
Deeper part of Fat body of ischioanal fossa
Superficial (perianal) part of Fat body of ischioanal fossa
Transverse fibrous septum of ischioanal fossa
Submucous space (internal venous plexus)
Perianal space (external venous plexus)
Intersphincteric groove (anocutaneous line)
Sigmoid colon
Iliacus muscle and fascia
External iliac vessels
Iliopectineal line
Obturator internus muscle and fascia
Pudendal canal (Alcock’s) contains internal pudendal vessels, pudendal nerve, and perineal nerve
Ischial tuberosity
Tendinous arch of levator ani muscle
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
External anal sphincter muscle
Conjoined longitudinal muscle
Internal anal sphincter muscle
Rectum | Rectum and Anal Canal
Sigmoid colon
Rectosigmoid junction
Superior Transverse folds of rectum (valves of Houston)
Middle Transverse folds of rectum (valves of Houston)
Inferior Transverse folds of rectum (valves of Houston)
Peritoneal reflection
Rectal fascia
Longitudinal muscle layer
Circular muscle layer
Muscularis mucosae
Levator ani muscle
Anorectal line
Anal columns (Morgagni’s)
Anal sinus
Pectinate (dentate) line
Internal rectal venous plexus in submucous space
Deep part of external sphincter muscle
Conjoined longitudinal muscle
Anal valve
Anal crypt
Superficial part of external sphincter muscle
Anal glands
Transverse fibrous septum
Muscularis mucosae of anal canal
Perianal space
Subcutaneous part of external sphincter muscle
Corrugator cutis and muscle
External rectal venous plexus in perianal space
Intersphincteric groove (anocutaneous line)
Rectum | Anorectal Musculature
Anterior view
Rectosigmoid junction
Sigmoid colon
Free taenia (taenia libera)
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
Levator ani muscle
Deep Parts of External anal sphincter muscle
Superficial Parts of External anal sphincter muscle
Subcutaneous Parts of External anal sphincter muscle
Fibrosum septum
Corrugator cutis ani muscle
Perianal skin
Frontal section
Superior 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 ischioanal fossa
Subcutaneous part of external anal sphincter muscle
Corrugator cutis ani muscle
External renal venous plexus
Intersphincteric groove (anocutaneous line)
Rectum | External Anal Sphincter Muscle: Perineal Views
Male
Superficial scrotal (dartos) fascia
Septum of scrotum
Deep (Buck’s) fascia of penis
Bulbospongiosus muscle with deep perineal (investing or Gallaudet’s) fascia removed
Ischiocavernosus muscle with deep perineal (investing or Gallaudet’s) fascia removed
Perineal membrane
Ischiopubic ramus
Perineal body
Superficial transverse perineal muscle with deep perineal (investing or Gallaudet’s) fascia removed
Subcutaneous Parts of external anal sphincter muscle
Superficial Parts of external anal sphincter muscle
Deep Parts of external anal sphincter muscle
Superficial perineal (Colles’) fascia (cut edges)
Transverse fibrous septum of ischioanal fossa (cut)
Ischial tuberosity
Sacrotuberous ligament
Pubococcygeus Levator ani muscle
Puborectalis Levator ani muscle
Iliococcygeus Levator ani muscle
Anococcygeal body (ligament) (posterior extensions of superficial external anal sphincter muscle)
Gluteus maximus muscle
Tip of coccyx
Female
Anus
Ischiopubic ramus
Vagina
External urethral orifice
Clitoris
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
Crossed fibers from superficial and deep external sphincters to superficial transverse perineal muscle
Deep Parts of external anal sphincter muscle
Superficial Parts of external anal sphincter muscle
Subcutaneous Parts of external anal sphincter muscle
Pubococcygeus Levator ani muscle
Puborectalis Levator ani muscle
Iliococcygeus Levator ani muscle
Gluteus maximus muscle
Anococcygeal body (ligament) (posterior extensions of superficial external anal sphincter muscle)
Rectum | Actual and Potential Perineopelvic Spaces
Sagittal section
Retropubic (prevesical) space (of Retzius)
Retrovesical of Rectovesical space
Prerectal of Rectovesical space
Retroprostatic of Rectovesical space
Sphincter urethrae
Deep and superficial transverse perineal muscles
Deep External anal sphincter muscle
Superficial External anal sphincter muscle
Subcutaneous External anal sphincter muscle
Deep (Buck’s) fascia of penis
Superficial perineal (Colles’) fascia
Rectal fascia
Presacral fascia
Presacral space
Rectovesical or rectoprostatic (Denonvilliers’) fascia (septum)
Levator ani muscle and fascia of pelvic diaphragm
Deep postanal space
Anococcygeal body (ligament)
Superficial postanal space (part of perianal space)
Submucous space
Perianal space
Bulbospongiosus muscle and deep perineal (Gallaudet’s) fascia
Superficial perineal compartment (space or pouch)
Spread of perineal abscess in perineal spaces
Perineal view
Perineal membrane
Deep transverse perineal muscle
Superficial transverse perineal muscle (cut away) to expose
Anterior recess of ischioanal fossa
Preanal communication (inconstant) between right and left ischioanal fossae
Pus in ischioanal fossa
Posterior communication between right and left ischioanal fossae via deep postanal space deep to anococcygeal body (ligament)
Gluteus maximus muscle
Sacrotuberous ligament (cut)
Posterior recess of ischioanal fossa
Regional Scans | Pelvic Scans: Sagittal MR Images
Median (A) and paramedian (B) sagittal MR images of female pelvis
A
Anal canal
External os of cervix
Dural (thecal) sac
Pubic symphysis
Rectum
B
Rectus abdominis muscle
Sacrum
Uterus
Urinary bladder
Vagina
Median (C) and paramedian (D) sagittal MR images of male pelvis
C
Corpus spongiosum
Corpus cavernosum
Glans penis
Pubic symphysis
Prostate
D
Rectum
Sacrum
Testis
Urinary bladder
Vasculature | Arteries of Rectum and Anal Canal (Male)
Posterior view
Left colic artery
Ascending branch
Descending branch
Sigmoid arteries
Marginal artery
Rectosigmoid arteries
Superior rectal artery (bifurcation)
Middle rectal artery
Ischial spine
Obturator internus muscle
Internal pudendal artery
Pudendal canal (Alcock’s)
Ischial tuberosity
Coccygeus (ischiococcygeus) muscle
Inferior rectal artery
Levator ani muscle
Puborectalis muscle (severed)
External anal sphincter muscle
Anus
Inferior rectal artery
Middle rectal artery
Superior vesical artery
Artery to ductus deferens
Inferior vesical artery
Umbilical artery
Internal pudendal artery
Obturator artery
Inferior gluteal artery
Inferior epigastric artery
Superior gluteal artery
Lateral sacral artery
Internal iliac artery
External iliac artery
Common iliac artery
Median sacral artery
Median sacral artery
Inferior vena cava
Abdominal aorta
Inferior mesenteric artery
Vasculature | Veins of Rectum and Anal Canal (Female)
Anterior view
Inferior vena cava
Common iliac veins
Median sacral vein
Inferior mesenteric vein (to portal vein via splenic vein)
Sigmoid veins
Superior rectal vein (bifurcation)
External iliac vein
Internal iliac vein
Obturator vein
Superior vesical and uterine veins (from uterine venous plexus)
Middle rectal vein
Internal pudendal vein
Communication between internal and perimuscular rectal plexuses
Vaginal vein (from vaginal venous plexus)
Inferior vesicular vein
Internal pudendal vein in pudendal canal (Alcock’s)
Inferior rectal vein
Communication between internal and external venous plexuses
Internal rectal plexus
External rectal plexus
Perimuscular rectal venous plexus
Vasculature | Arteries and Veins of Pelvic Organs: Female
Anterior View
Renal artery and vein
Kidney
Ovarian artery and vein
Ureter
Inferior vena cava
Psoas major muscle
Peritoneum (cut edge)
Suspensory ligament of ovary contains ovarian vessels
Rectum
Ovary
Uterine (fallopian) tube
Uterus
Round ligament of uterus
Vagina
Urinary bladder
Medial umbilical fold
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 rectal artery (cut)
Round ligament of uterus (cut)
Ovarian artery
Internal iliac artery
Anterior division
External iliac artery
Obturator artery and nerve
Umbilical artery (patent part)
Middle rectal artery
Uterine artery
Vaginal artery
Inferior vesical artery
Round ligament of uterus (cut)
Superior vesical arteries
Inferior epigastric artery and vein
Umbilical artery (occluded part)
Superior vesical arteries
Medial umbilical ligament
Median umbilical ligament (urachus)
Vasculature | Arteries and Veins of Testis
Anterior view
Renal vessels
Inferior vena cava
Abdominal aorta
Testicular vessels (part of spermatic cord)
Ureter
Inferior mesenteric artery
Common iliac vessels
Internal iliac vessels
External iliac vessels
Inferior vesical artery
Inferior epigastric vessels
Artery to ductus deferens
Cremasteric vessels
Testicular vessels in spermatic cord
Femoral vessels
Superficial external pudendal vessels (cut - pass superficial to spermatic rod)
Deep external pudendal vessels
Pampiniform venous plexus
Deep dorsal vein and dorsal arteries of penis under deep (Buck’s) fascia of penis
Vasculature | Arteries and Veins of Pelvis: Female
Sagittal section
Median sacral artery
Iliolumbar artery
Lateral sacral arteries
Superior gluteal artery
Piriformis muscle
Inferior gluteal artery
Internal pudendal artery
Coccygeus (ischiococcygeus) muscle
Sacrotuberous ligament
Obturator fascia (of obturator internus muscle)
Internal pudendal artery in pudendal canal (Alcock’s)
Levator ani muscle (cut edge)
Abdominal aorta
Right Common iliac arteries
Left Common iliac arteries
Internal iliac artery
Posterior division
Anterior division
External iliac artery
Umbilical artery (patent part)
Obturator artery
Middle rectal artery
Uterine artery
Vaginal artery
Inferior vesical artery
Superior vesical arteries
Medial umbilical ligament (occluded part of umbilical artery)
Pubic symphysis
Right paramedian section: lateral view
Abdominal aorta
Inferior vena cava
Right common iliac artery
Left common iliac artery
Ureteres
External iliac artery (cut)
Internal iliac artery
Posterior division
Anterior division
Obturator canal
Obturator internus muscle
Levator ani muscle
Superior gluteal artery
Umbilical artery (patent part)
Obturator artery
Piriformis muscle
Internal pudendal artery
Inferior gluteal artery
Coccygeus (ischiococcygeus) muscle
Middle rectal artery
Uterine artery
Vaginal artery
Inferior vesical artery
Internal pudendal artery
Inferior rectal artery
Superior vesical arteries
Medial umbilical ligament (occluded distal part of umbilical artery)
Vasculature | Arteries and Veins of Pelvis: Male
Left paramedian section: lateral view
Inferior vena cava
Right obturator vessels
Right umbilical artery (patent part)
Superior vesical artery
Umbilical artery (occluded)
Deep circumflex iliac vessels
Ductus deferens and its artery
Medial umbilical ligament
Median umbilical ligament (urachus)
Superior vesical artery
Superficial dorsal vein of penis
Deep dorsal vein and dorsal artery of penis
Deep (Buck’s) fascia of penis
Testicular artery
Pampiniform (venous) plexus
Artery to ductus deferens
Vesical (retropubic) venous plexus
Posterior scrotal arteries
Internal pudendal artery on superior aspect of perineal membrane
Perineal artery
Sphincter urethrae muscle
Prostatic venous plexus
Inferior rectal artery
Prostatic branches of inferior vesical artery
Ductus deferens and its artery
Internal pudendal artery
Middle rectal artery
Inferior vesical artery
Inferior gluteal artery
Ureter (cut)
Umbilical artery
Obturator artery
Superior gluteal artery
Lateral sacral artery
Iliolumbar artery
Internal iliac vessels
External iliac vessels (cut)
Median sacral vessels
Common iliac vessels
Abdominal aorta
Arterial supply of prostate
Inferior vesical artery
Branch to prostate
Urethral branches
Capsular branches
Hyperplastic middle lobe
Hyperplastic lateral lobe
Sphincter urethrae muscle
Arterial supply of prostate
(Frontal section, anterior view of specimen with benign hyperplasia)
Vasculature | Arteries and Veins of Perineum and Uterus
Posterior labial artery
Ischiocavernosus muscle
Bulbospongiosus muscle
Superficial perineal space
Perineal membrane
Perineal artery
Superficial transverse perineal muscle
Perineal artery
Internal pudendal artery in pudendal canal (Alcock’s)
Inferior rectal artery
External anal sphincter muscle
Dorsal artery of clitoris
Deep artery of clitoris
Bulb of vestibule
Compressor urethrae muscle
Artery to bulb of vestibule
Greater vestibular (Bartholin’s) gland
Deep transverse perineal muscle
Internal pudendal (clitoral) artery
Perineal membrane (cut away)
Perineal artery (cut)
Superficial perineal (Colles’) fascia (cut and reflected) to open superficial perineal space
Internal pudendal artery in pudendal canal (Alcock’s)
Inferior rectal artery
Note: Deep perineal (investing or Gallaudet’s) fascia removed from muscles of superficial perineal space
Round ligament of Branches of uterine artery
Tubal Branches of uterine artery
Ovary Branches of uterine artery
Ovarian vessels
Tubal branches of ovarian vessels
Uterine vessels
Ureter
Vaginal branches of uterine artery
Vaginal artery
Levator ani muscle
Perineal membrane
Internal pudendal artery
Perineal artery
Superficial perineal space
Superficial perineal (Colles’) fascia
Vasculature | Arteries and Veins of Perineum: Male
External spermatic fascia over testis and spermatic cord
Bulbospongiosus muscle
Ischiocavernosus muscle
Perineal membrane
Perineal body
Superficial transverse perineal muscle
Transverse perineal artery
Superficial perineal (Colles’) fascia (cut edge)
Pudendal canal (Alcock’s)
Superficial (dartos) fascia of scrotum
Septum of scrotum
Posterior scrotal arteries
Deep (Buck’s) fascia of penis
Superficial perineal (Colles’) fascia (cut edge)
Superficial perineal space (opened)
Perineal artery and vein
Internal pudendal artery passes superior to perineal membrane
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 rectal artery
Inferior fascia of pelvic diaphragm (roof of ischioanal fossa)
Deep artery of penis
Deep dorsal vein of penis
Dorsal artery and nerve of penis
Transverse perineal ligament (anterior thickening of perineal membrane)
Deep artery of penis
Dorsal artery of penis
Urethral artery
Perineal membrane
Artery of bulb of penis
Internal pudendal artery
Perineal artery (cut)
Internal pudendal vessels in pudendal canal (Alcock’s)
Superficial perineal (Colles’) fascia (cut edge)
Vasculature | Lymph Vessels and Nodes of Pelvis and Genitalia: Female
Lateral aortic (lumbar) nodes
Preaortic lymph nodes
Promontorial (middle sacral) nodes
Common iliac nodes
(Lateral) sacral node
Internal iliac node
Lateral (superior) external iliac node
Medial (inferior) external iliac nodes
Obturator node
Superficial inguinal nodes
Highest deep inguinal node (of Cloquet)
Deep inguinal nodes
Vasculature | Lymph Vessels and Nodes of Perineum: Female
Inguinal ligament (Poupart’s)
Highest deep inguinal node (of Cloquet)
Deep inguinal nodes
Fascia lata (cut away)
Femoral vessels and nerve
Superficial inguinal nodes
Inferior nodes (vertical group)
Superolateral nodes (horizontal group)
Superomedial nodes (horizontal group)
Vasculature | Lymph Vessels and Nodes of Pelvis and Genitalia: Male
Preaortic nodes
Pathways from testes along testicular vessels
Common iliac nodes
Promontorial (middle sacral) nodes
(Lateral) sacral node
Internal iliac nodes
External iliac nodes
Highest deep inguinal node (of Cloquet)
Deep inguinal nodes
Superficial inguinal nodes
Lymphatic drainage from prostate
Common iliac node
External iliac nodes
Pathway along inferior vesical vessels to internal iliac nodes (principal pathway)
Pathway over bladder to external iliac nodes
Prevesical plexus and pathway (broken line) to external iliac nodes
Preaortic node
Promontorial node
Internal iliac nodes
(Middle and lateral) sacral nodes
Pathway alongside rectum to (middle and lateral) sacral nodes
Pathway (broken line) from lower prostate and membranous urethra along internal pudendal vessels (beneath pelvic diaphragm) to internal iliac nodes
Innervation | Nerves of External Genitalia: Male
Greater splanchnic nerves
Lesser splanchnic nerves
Least splanchnic nerves
Subcostal nerves (T12)
Iliohypogastric nerve
Ilioinguinal nerve
Sympathetic trunk and ganglia
Genitofemoral nerve
Lateral femoral cutaneous nerve
Femoral branch and Genital branch of genitofemoral nerve
Lateral femoral cutaneous nerve
Femoral branches of genitofemoral nerve
Anterior cutaneous branches of femoral nerve
Anterior cutaneous branch of iliohypogastric nerve
Genital branch of genitofemoral nerve
Anterior scrotal nerve (from ilioinguinal nerve)
Dorsal nerves of penis
Testicular artery and plexus
Femoral nerve
Ductus deferens and plexus
Inferior hypogastric (pelvic) plexus
Hypogastric nerves
Superior hypogastric plexus
Testicular artery and plexus
Inferior mesenteric ganglion
Lumbar splanchnic nerves
Aorticorenal ganglia
Superior mesenteric ganglion
Celiac ganglia
Innervation | Nerves of Pelvic Viscera: Male
Anterior vagal trunk
Posterior vagal trunk
Celiac branch
Inferior phrenic arteries and plexuses
Left gastric artery and gastric plexus
Celiac ganglia, plexus, and trunk
Left aorticorenal ganglion
Superior mesenteric 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
Nerve from inferior hypogastric plexus to sigmoid and descending colon (parasympathetic)
Sacral splanchnic nerves (sympathetic)
Inferior hypogastric (pelvic) plexus
Obturator nerve and artery
Ductus deferens and plexus
Vesical plexus
Rectal plexus
Prostatic plexus
Cavernous nerves of penis
T10 spinal nerve (ventral ramus)
White and gray rami communicantes
Greater Splanchnic nerves
Lesser Splanchnic nerves
Least Splanchnic nerves
Diaphragm
Left renal artery and plexus
L1 spinal nerve (ventral ramus)
Gray Rami communicantes
White 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
S1 spinal nerve (ventral ramus)
Pelvic splanchnic nerves (parasympathetic)
Sacral plexus
Piriformis muscle
Gluteus maximus muscle and sacro-tuberous ligament
Coccygeus (ischiococcygeus) muscle and sacrospinous ligament
Pudendal nerve
Levator ani muscle
Inferior anal (rectal) nerve
Perineal nerve
Dorsal nerve of penis
Posterior scrotal nerves
Innervation | Nerves of Perineum: Male
Superficial Perineal nerves
Deep Perineal nerve
Posterior scrotal nerves
Dorsal nerve of penis
Perineal membrane (cut to show neurovascular structures on superior aspect of perineal membrane)
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)
Superficial and deep branches of perineal nerve
Dorsal nerve of penis (passes superior to perineal membrane)
Perineal nerve
Obturator fascia (of obturator internus muscle)
Posterior femoral cutaneous nerve
Pudendal canal (Alcock’s) (opened up)
Pudendal nerve
Inferior clunial nerves
Inferior anal (rectal) nerves
Perforating cutaneous nerve
Anococcygeal nerve
Sacrotuberous ligament (cut)
Gluteus maximus muscle (cut)
Piriformis muscle
Coccygeus (ischiococcygeus) muscle
Ischial spine
Pudendal nerve
Levator ani muscle
Obturator internus muscle
Inferior anal (rectal) nerve
Perineal nerve
Innervation | Nerves of Pelvic Viscera: Female
Sympathetic trunk and L2 ganglion
White and gray rami communicantes
Lumbar splanchnic nerves
Gray rami communicantes
L5 spinal nerve
Right hypogastric nerve (cut)
Piriformis muscle
Sacral splanchnic nerves (sympathetic)
Pudendal nerve
Pelvic splanchnic nerves (parassympathetic)
Coccygeus (ischiococcygeus) muscle
Rectal plexus
Rectum (retracted)
Abdominal aorta
Intermesenteric (aortic) plexus
Ovarian artery and plexus
Superior hypogastric plexus
Common iliac artery and plexus
External iliac artery and plexus
Left hypogastric nerve
Inferior hypogastric (pelvic) plexus
Uterine (fallopian) tube
Ovary
Symphyseal surface of pubis
Urinary bladder
Vesical plexus
Uterovaginal plexus
Uterus (retracted)
Peritoneum
Inferior vena cava
Extraperitoneal (subserous) fascia
Common iliac vessels and plexus
Ureter
Superior hypogastric plexus
Sacral promontory
Right sympathetic trunk
Uterus
Right and left hypogastric nerves
Sigmoid colon
Innervation | Nerves of Perineum and External Genitalia: Female
Anterior labial nerve (from ilioinguinal nerve)
Dorsal nerve of clitoris
Posterior labial nerves
Superficial Branches of perineal nerve
Deep Branches of perineal nerve
Perineal branch of posterior femoral cutaneous nerve
Dorsal nerve of clitoris passing superior to perineal membrane
Perineal nerve
Pudendal nerve
Pudendal nerve in pudendal canal (Alcock’s) (dissected)
Inferior clunial nerves
Gluteus maximus muscle (cut away)
Sacrotuberous ligament
Perforating cutaneous nerve
Inferior anal (rectal) nerves
Anococcygeal nerves
Block anesthesia of pudendal and other nerves of perineal area
Ischial tuberosity
Ischial spine
Innervation | Neuropathways in Parturition
Greater Splanchnic nerves
Lesser Splanchnic nerves
Least Splanchnic nerves
Celiac ganglion
Aorticorenal ganglion
Superior mesenteric ganglion
Intermesenteric (aortic) plexus
Lumbar splanchnic nerves
Iliohypogastric nerve (L1)
Ilioinguinal nerve (L1)
Vesical plexus
Dorsal nerve of clitoris
Posterior labial nerves
T7 spinal nerve (anterior ramus)
Sympathetic trunk and ganglia
T11 spinal nerve (anterior ramus)
Rami communicantes
Subcostal nerve (T12)
Inferior mesenteric ganglion
Intermesenteric (aortic) plexus
Superior hypogastric plexus
S1 spinal nerve (anterior ramus)
Hypogastric nerves
Pelvic splanchnic nerves
Inferior hypogastric (pelvic) plexus
Pudendal nerve (S2, 3, 4)
Inferior anal (rectal) nerve
Sensory fibers from uterine body and fundus accompany sympathetic fibers via hypogastric plexuses to T11, 12 (L1?)
Motor fibers to uterine body and fundus (sympathetic)
Sensory fibers from cervix and upper vagina accompany pelvic splanchnic nerves (parasympathetic) to S2, 3, 4
Motor fibers to lower uterine uterine segment, cervix, and upper vagina (parasympathetic)
Sensory fibers from lower vagina and perineum accompany somatic fibers via pudendal nerve to S2, 3, 4
Motor fibers to lower vagina and perineum via pudendal nerve (somatic)
Innervation | Innervation of Female Reproductive Organs: Schema
Sympathetic trunk and ganglion
Gray ramus communicans
White ramus communicans
Greater splanchnic nerve
Lesser splanchnic nerve
Least splanchnic nerve
Sympathetic trunk
Lumbar splanchnic nerves
L3 spinal nerve
Ovarian artery and plexus
Uterine (fallopian) tube
Celiac ganglia and plexus
Aorticorenal ganglia
Superior mesenteric ganglion
Intermesenteric (aortic) plexus
Inferior mesenteric ganglion
Superior hypogastric plexus
Hypogastric nerves
Inferior extent of peritoneum
Uterovaginal and inferior hypogastric (pelvic) plexuses
Pelvic splanchnic nerves
Sacral plexus
Pudendal nerve
Vagina
Cervix
Ovary
Uterus
T5
T6
T11
T12
L1
L4
S1
S2
S3
S4
S5
Preganglionic Sympathetic fibers
Postganglionic Sympathetic fibers
Preganglionic Parasympathetic fibers
Postganglionic Parasympathetic fibers
Afferent fibers
Note: Pain from intraperitoneal pelvic viscera (e.g., uterine contractions) goes via uterovaginal and pelvic plexuses, hypogastric nerves, superior 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.
Innervation | Innervation of Male Reproductive Organs: Schema
Sympathetic trunk and ganglia
Greater splanchnic nerve (T5-9)
Gray ramus communicans
White ramus communicans
Lesser splanchnic nerve
Least splanchnic nerve
Upper lumbar splanchnic nerves
Gray ramus communicans
Testicular artery and plexus
Ductus deferens and plexus
Ductus deferens and plexus
Inferior extent of peritoneum
Pelvic splanchnic nerves
Sacral plexus
Pudendal nerve
Inferior hypogastric (pelvic) plexus
Vesical plexus
Prostatic plexus
(Greater and lesser) cavernous nerves of penis
Celiac ganglia
Superior mesenteric ganglion
Left aorticorenal ganglion
Renal ganglion
Intermesenteric (aortic) plexus
Inferior mesenteric ganglion
Testicular artery and plexus
Superior hypogastric plexus
Hypogastric nerves
Ductus deferens and plexus
Pelvic splanchnic nerves
Sacral plexus
Pudendal nerve
Dorsal nerves of penis
Epididymis
Testis
T10
T11
T12
L1
L2
L3
L4
S1
S2
S3
S4
S5
Preganglionic Sympathetic fibers
Postganglionic Sympathetic fibers
Preganglionic Parasympathetic fibers
Postganglionic Parasympathetic fibers
Afferent fibers
Innervation | Innervation of Urinary Bladder and Lower Ureter: Schema
Spinal sensory (dorsal root) ganglion
L1
L2
Dorsal (posterior) root
Ventral (anterior) root
White Rami communicantes
Gray Rami communicantes
Celiac ganglia
Superior mesenteric ganglion
Aorticorenal ganglion
Renal artery and plexus
Intermesenteric (aortic) plexus
Inferior mesenteric ganglion
Superior hypogastric plexus
Hypogastric nerves
Inferior hypogastric (pelvic) plexus
Urinary bladder
Lumbar part of spinal cord L2 spinal nerve (ventral ramus)
1st and 2nd lumbar splanchnic nerves
Ureter
Sacral splanchnic nerves from sacral sympathetic trunk to inferior hypogastric (pelvic) plexus
Sacral part of spinal cord
Ascending fibers
Descending fibers
S2
S3
S4
Sympathetic trunk
Gray rami communicantes
Sacral plexus
Pelvic splanchnic nerves
Pudendal nerve
Vesical plexus
Prostatic plexus
Sphincter urethrae muscle superior to perineal membrane
Bulbospongiosus muscle
Sympathetic fibers
Preganglionic Sympathetic fibers
Postganglionic Sympathetic fibers
Preganglionic Parasympathetic fibers
Postganglionic Parasympathetic fibers
Somatic efferent fibers
Afferent fibers
No comments:
Post a Comment