All about anatomy of anatomy and pelvis

1. ABDOMEN
& PELVIS
PRESENTED BY:- BIKASH
BHANDARI
B.SC.MIT 2017
MODERATOR:- MR. RANJIT
KUMAR JHA

2. PELVIS
• Pelvis is a basin like
structure which is
formed by
articulation of each
of the two hip bones
in front and sacrum
and coccyx behind
and is situated
between the
abdomen and thigh.

3. CLASSIFICATION OF PELVIS
• Gynaecoid
type(41.4%);normal
female pelvis; inlet round
or ovoid
• Android
type(32.5%);resemble
male pelvis; inlet
triangular
• Anthropoid
type(23.5%);resemble
pelvis of anthropoid apes.
• Platypelloid
type(2.6%);opposite to
anthropoid pelvis.
Only gynaecoid pelvis

4. SN FEATURE FEMALE
PELVIS
MALE
PELVIS
1. Shape of cavity circular Heart
shaped
2. Subpubic angle Larger
(80°-85°)
Shorter
(50°-60°)
3. Ischial spines Out
turned
inturned
4. Acetabular
cavity
shallow large
5. Pelvic cavity shorter longer
6. Obturator
foramen
Small and
triangular
Large
and oval

5. • Divided into 2 parts
by the plane of
pelvic inlet or pelvic
brim
1. Greater or false
pelvis
2. Lesser or true
pelvis
• Greater or false
pelvis includes the
two iliac fossae, and
forms a part of the
posterior abdominal
wall.

6. LESSER
PELVIS
Pelvic wall
Pelvic wall are made up of
bones, ligaments and muscles.
Bony wall; these are formed
by,
Anteriorly: pubic symphysis
and bodies of the pubic
bones.
Posteriorly: sacrum and
coccyx.
On each side: two rami of
the pubis, the ischium with
its ramus, and the lower
part of the ilium
Ligament and membrane;
Obturatoe membrane,
Sacrotuberous and
sacrospinous ligaments.

7. Pelvic inlet(superior aperture of
pelvis)
It is an oblique plane, making
an angle of 50-60 degrees with
the horizontal.
Bounded posteriorly by the
sacral promontory, anteriorly by
the upper margin of pubic
symphysis, and on each side by
the linea terminalis.
Heart-shaped in the male, and
is widest in its posterior part.
In the female, it is oval widest

8. Pelvic outlet(inferior aperture of pelvis)
It is bounded anteriorly by the arcuate or inferior
pubic ligament; posteriorly by the coccyx; and on
each side by the ischiopubic rami/side of the pubic
arch, the ischial tuberositis and the sacrotuberous
ligament.
The plane of the pelvic outlet makes an angle of
15 degrees with the horizontal.

9. Pelvic floor
Pelvic floor is formed by the pelvic
diaphragm(separate the pelvis from the
perineum) which consists of levator ani and
coccygeus muscles.
Pelvic cavity
Continuous above with the abdominal cavity at
the pelvic brim, and is limited below by the
pelvic diaphragm.
The cavity is curved in such way that it is first
directed downwards and backwards, and then
downwards and forwards(J-shaped).

10. CONTENTS OF PELVIS
• Sigmoid colon
• Rectum
• Anal canal
• Urinary bladder
• Urethra
• Male reproductive organs
• Female reproductive organ

11. SIGMOID COLON
• 37.5 cm long
and extends
from the pelvic
brim to the
third piece of
the sacrum,
where it
becomes the
rectum
• Suspended by
sigmoid
mesocolon

12. RECTUM
• Lower dilated part of
large gut
• Devoid of taenia coli,
sacculation, appendices
epiploicae and
mesentery.
• Begins as continuation of
sigmod colon at the 3rd
sacral vertebra and
continuous with anal
canal at anorectal

13. Curvatures/flexures
a. Anteroposterior Curvature:
- Sacral curve
- Perineal curve
b. Lateral Curvature:
- Upper (Right)
-Middle (Left) Most prominent
-Lower (Right)
Mesurement
• Length= 15cm(5inches)
• Breadth= Upper part 4cm
lower part form
dilatation (ampulla)

15. ARTERIAL SUPPLY
Superior Rectal
Art.
Middle Rectal
Art.
Inferior Rectal
Art.

16. VENOUS DRAINAGE
Upper part
• Superior rectal vein –
inferior mesenteric vein
Middle part
Middle rectal vein-
internal iliac vein
Lower part
• Inferior rectal vein –
internal pudendal vein.

17. LYMPHATIC DRAINAGE
Upper part
• Left common iliac lymph
node
Middle part
• Internal iliac nodes
Lower part
• Internal iliac nodes
From the anal canal
• Superficial inguinal
lymph nodes.

18. NERVE SUPPLY
Sympathetic fibres
• Superior hypogastric
plexus(L1,L2)
• Stimulate the internal
sphincter an inhibit
rest of musculature
of rectum.
Parasympathetic
• Pelvic splanchnic
nerves(S2,S3,S4)
• Stimulate peristalsis
and relax the

19. ANAL CANAL
Terminal part of large
intestine situated below
the level of pelvic
diaphragm.
Extends from anorectal
junction and open at anal
orifice.
Length(adult)=3.8cm

20. ANAL CANAL
RELATION
In front
Perineal body (in both)
Lower urethra & bulb of penis (in male)
Lower end of vagina (in female)
Behind
-Anococcygeal Ligament
-Tip of coccyx
Lateraly
-Ischiorectal fossa

22. ARTERIAL SUPPLY
• Superior rectal artery
above the pectinate
line
• Inferior rectal artery
line below the
pectinate line
VENOUS DRAINAGE
• Internal rectal venous
plexus
• External venous plexus
• Anal veins

23. LYMPHATIC DRAINAGE
• Internal iliac nodes
• Medial group of the superficial inguinal nodes
NERVE SUPPLY
1. Above the pectinate line by both sympathetic
(L1-L2) and parasympathetic (pelvic
splachnic-S2, S3, S4)
2. Below the pectinate line by somatic nerves
(inferior rectal S!, S2, S3)

24. URINARY BLADDER
• Entirely in the pelvic cavity
when empty
• Expands superiorly into the
abdomen when full.
• An empty bladder is somewhat
tetrahedral and oval when full.
• Has a base(fundus), neck, apex,
a superior and two infero-
lateral surfaces.
• Mean capacity is 220ml.
• 150 to 250 ml collection lead to
desire to micturition
• Volume > 500 ml cause pain
due to its distension.

25. ARTERIAL SUPPLY
Main supply- Superior and
inferior vesical artery
Additional supply- Obturator
and inferior gluteal artery
VENOUS DRAINAGE
Vesical venous plexus –
internal iliac veins
LYMPHATIC DRAINAGE
Most of lymphatics- external
iliac nodes
Few vessels- internal iliac
nodes or lateral aortic nodes
NERVE SUPPLY
vesical plexus of nerve
derived from inferior
hypogastric plexus

26. • 18 to 20 cm long that extends from internal urethral orifice in
urinary bladder to external opening at the end of penis
Considered in two parts
• Relatively short posterior urethra
- It is 4 cm long and consists of
a. Preprostatic segment
b. Prostatic segment
c. Membranous segment
• Relatively long anterior urethra
-It is 16cm long, it consists of
a. Bulbar urethral component
b. Penile component
MALE URETHRA

27. ARTERIAL SUPPLY
• Urethral artery
• Dorsal penile artery
VENOUS DRAINAGE
• Deb dorsal vein of
penis
• Prostatic and
vesical venous
plexus

28. FEMALE URETHRA
• 4cm long and
6mm in diameter
• begins at the
internal orifice of
bladder and runs
anteroinferiorly
behind the
symphysis pubis
embedded in the
anterior wall of
vagina

29. ARTERIAL SUPPLY
• Superior vesicle and
vaginal arteries
VENOUS DRAINAGE
• Vesical venous
plexus
LYMPHATIC
DRAINAGE
• Internal and iliac
nodes
NERVE SUPPLY
• Parasypathetic
(S2nd-S4th)
• Somaticfibres from
(S2nd-S4th)

31. REPRODUCTIVE SYSTEM
• Male genital organs include the external and
internal genitalia.
1. Penis
2. Scrotum
3. Testes
4. Epididymis
5. Ductus deferens
6. Seminal vesicle
7. Ejaculatory duct
8. Prostate

32. PENIS
• Male organ of copulation
• Has :-
1. Root
2. Body
ARTERIAL SUPPLY
• Internal pudendal artery
• Femoral artery
• Venous drainage
• External pudendal veins
Penis

33. SCROTUM
• Contains right and left testes, the epididymis and
lower part of the spermatic cord
• Layers of scrotum
1. Skin
2. Dartos muscle
3. External spermatic fascia
4. Cremasteric muscle
5. Internal spermatic fascia
6. Parietal layer of the tunica vaginalis

34. ARTERIAL SUPPLY
1. Superficial external pudendal
2. Deep external pudendal
3. Scrotal branches of internal oudendal
4. Cremasteric branch of inferior epigastric
NERVE SUPPLY
• Segment L1 of the spinal cord for anterior one
third
• Segment S3 of the spinal cord for the posterior
two third

35. TESTIS
• male gonad
homologous with
ovary of the female.
• suspended in the
scrotum by the
spermatic cord.
• Left testis is slightly
lower than the right.
• Has 2-poles, 2-
borders, and 2-
surfaces(medial and

36. Shape and size
• The testis is oval
in shape
• It is 3.75cm long,
2.5cm broad,
1.8cm thick and
weighs about 10-
15 gram

37. Coverings of Testis
• Tunica vaginalis
• Tunica albuginea and
• Tunica vasculosa

38. ARTERIAL SUPPLY
• The testicular artery-
branch of abdominal aorta.
VENOUS DRAINAGE
• The veins emerging from
testis form the
pampiniform plexus .The
plexus condenses into four
veins at superficial inguinal
ring ,and into two veins at
deep inguinal ring.
• Ultimately 1 vein is formed
which drains to IVC on Rt.
Side and Lt. renal vein on
left side.

39. LYMPHATIC DRAINAGE
• The lymphatics from the testis ascend along
the testicular vessels and drain into preaortic
and para-aortic groups of lymph node.
NERVE SUPPLY
• The testis is supplied by sympathetic nerves
arising from T10 segment of spinal cord.

40. EPIDIDYMIS
• Highly coiled tube that act
as reservoir of spermatozoa
• At its lowest end it become
continuous with the ductus
deferens.
ARTERIAL SUPPLY
• Testicular artery
NERVE SUPPLY
• Sympathetic nerves
through testicular plexus
which are derived from the
segment T11 to L1 of the
spinal cord

41. SPERMATIC CORD
• Cord like structure.
• Contains following
1. Ductus deferens
2. Testicular and
cremasteric artery and
artery of the ductus
deferens
3. Pampiniform plexus of
veins
4. Lymph vessels from the
testis
5. Genital branch of
genitofemoral nerve,
and the plexus of
sympathetic nerves and

42. • Also called vas deferens or the
deferent duct
• Thick-walled, muscular tube which
transmits spermatozoa from the
epididymis to the ejaculatory duct.
• Length:- 45 cm when straightened
• Location:- within the scrotum along
the posterior border of the testis.
• ARTERIAL SUPPLY:- one of the
terminal branches of the superior
vesical artery.
• VENOUS DRAINAGE:- vesical venous
DUCTUS DEFERENS

43. SEMINAL VESICLES
• These are two
lobulated sacs,
situated between the
bladder and rectum.
• 5cm long
• Joins the ductus
deferens to form
ejaculatory duct
• Secret seminal fluid
called vesiculase.

44. PROSTATE
• Accessory gland of male reproductive
system.
• Situation:- lesser pelvis, in front of the
ampulla of the rectum.
• Shape:- resembles an inverted cone
• Size:-measuring about 4cm transversely
width, 3cm vertically length and 2cm
anteroposteriorly thickness.
• Weight:- 8g
• Zones:- peripheral zone
-Central zone
-Periurethral zone
• Lobes:- two lateral lobes
-One median lobe

45. BLOOD SUPPLY
• Branches from the inferior vesical, middle rectal and
internal pudendal arteries
VENOUS DRAINAGE
• Drains into the vesical and
• internal iliac veins.
LYMPHATIC DRAINAGE
• Internal iliac and sacral nodes
NERVE SUPPLY
• Lower part of the inferior hypogastric plexus

47. • Ovaries are female
gonads.
Situation
Each ovary lies in the
ovarian fossa on the lateral
pelvic wall.
Position
The position of ovary is
variable. In nulliparous
women its long axis is
nearly vertical, however in
multiparous women the
OVARIES

49. ARTERIAL SUPPLY
1. Ovarian artery-branch
of abdominal aorta
2. Uterine artery
VENOUS DRAINAGE
Pampiniform plexus
condenses into a single
ovarian vein and drains
to IVC on Rt side, left
renal vein on left side.

50. LYMPHATIC DRAINAGE
Ovarian vessels drain into- lateral aortic and
preaortic lymph nodes.
NERVE SUPPLY
Ovarian plexus of nerves
Sympathetic-T1o,T11 are afferent for pain as
well as efferent or vasomotor.
Parasympathetic-S2,S3,S4 are vasodilator

51. UTERINE TUBES
• Also called fallopian
tubes/salpinx
• Convey oocyte from the ovary
to the uterus
• Situation:- free upper margin
of the broad ligament of
uterus
• Dimensions:-10cm long
• Sub-division; -infundibulum
-ampulla
-Isthmus

52. • ARTERIAl SUPPLY:- uterine artery supplies the
medial two thirds, and the ovarian artery
supplies the lateral one-third of the tube.
• LYMPHATIC DRAINAGE:- lateral aortic and
preaortic nodes
• NERVE SUPPLY:- sympathetic nerve from T10
to L2 segments derived from the hypogastric
plexuses
-Parasympathetic nerves
derived from the vagus for the lateral half of
the tube and from the pelvic splanchnic
nerves from the S2-S4 segments of spinal
cord for the medial half

53. UTERUS
• Also called womb or
hystera
• Child- bearing organ in
females, situated in the
pelvis between bladder
and rectum
• Size and shape:-
pyriform in shape
-7.5cm
long, 5cm broad, and
2.5cm thick.
• Weight:- 30 to 40 g

54. PARTS OF UTERUS
• A fundus
• Body with two
surfaces (anterior
or vesical and
posterior or
intestinal)
• Two lateral borders
• Cervix

55. LIGAMENTS OF UTERUS
PERITONEAL LIGAMENTS
• Anterior ligament
• Posterior ligament
• Right and left broad
ligament
FIBROMUSCULAR LIGAMENT
• Round ligament
• Transverse cervical
ligament
• Uterosacral ligament

56. ARTERIAL SUPPLY
• Chiefly by the two
uterine arteries
• Partly by the ovarian
arteries
VENOUS DRAINAGE
• Plexus drain through
the uterine, ovarian
and vaginal veins
into the internal iliac
veins

57. LYMPHATIC DRAINAGE
• Upper lymphatics drain mainly into the aortic
nodes
• Lower lymphatics drain in to the external iliac,
internal iliac and sacral nodes, the middle
lymphatics drain into the external iliac nodes.
NERVE SUPPLY
• Sympathetic nerves from T12, L1 segments of
spinal cord and parasympathetic nerves (S2-
S4)

58. VAGINA
• Fibromuscular canal,
forming the female
copulatory organ
Situation
• Extends from the vulva to
the uterus, and is situated
behind the bladder and the
urethra, and in front of the
rectum and anal canal
Size and shape
• Anterior wall 8cm long and
posterior wall 10cm long

59. ARTERIAL SUPPLY
• Vaginal artery with
additional supplied
by cervicovaginal
branch of the
uterine artery
VENOUS DRAINAGE
• Drains into the
internal iliac veins
through the vaginal
veins

60. LYMPHATIC DRAINAGE
• Upper one-third drain into the external iliac
nodes, from the middle one-third drain into
the internal iliac nodes, and from the lower
one-tjird into the medial group of superficial
inguinal nodes.
NERVE SUPPLY
• Lower one-third supplied by the pudendal
nerve through the inferior rectal and posterior
labial branches of the perineal nerve
• The upper teo-thirds are supplied by
sympathetic L1, L2 and parasympathetic
segments S2- S4.

61. BLOOD SUPPLY OF PELVIS
ARTERIAL SUPPLY OF PELVIS
• Internal iliac artery
VENOUS DRAINAGE OF PELVIS
• Internal iliac vein

62. LYMPHATIC DRAINAGE OF PELVIS
1. Common iliac nodes
2. External iliac nodes
3. Internal iliac nodes
NERVE SUPPLY
1. Lumbosacral plexus
2. Coccygeal plexus
3. Pelvic autonomic nerves

63. PELVIC MUSCLES
1. Piriformis and
obturator
internus
2. Levator ani and
coccygeus
JOINTS OF PELVIS
1. Lumbosacral
joints
2. Sacrococcygeal
and
intercoccygeal
joints
3. Sacroiliac joints
4. Pubic
symphysis