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ABDOMEN
& PELVIS
PRESENTED BY:- BIKASH
BHANDARI
B.SC.MIT 2017
MODERATOR:- MR. RANJIT
KUMAR JHA
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.
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
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
• 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.
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.
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
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.
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).
CONTENTS OF PELVIS
• Sigmoid colon
• Rectum
• Anal canal
• Urinary bladder
• Urethra
• Male reproductive organs
• Female reproductive organ
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
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
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)
ARTERIAL SUPPLY
Superior Rectal
Art.
Middle Rectal
Art.
Inferior Rectal
Art.
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.
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.
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
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
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
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
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)
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.
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
• 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
ARTERIAL SUPPLY
• Urethral artery
• Dorsal penile artery
VENOUS DRAINAGE
• Deb dorsal vein of
penis
• Prostatic and
vesical venous
plexus
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
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)
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
PENIS
• Male organ of copulation
• Has :-
1. Root
2. Body
ARTERIAL SUPPLY
• Internal pudendal artery
• Femoral artery
• Venous drainage
• External pudendal veins
Penis
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
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
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
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
Coverings of Testis
• Tunica vaginalis
• Tunica albuginea and
• Tunica vasculosa
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.
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.
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
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
• 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
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.
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
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
• 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
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.
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
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
• 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
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
PARTS OF UTERUS
• A fundus
• Body with two
surfaces (anterior
or vesical and
posterior or
intestinal)
• Two lateral borders
• Cervix
LIGAMENTS OF UTERUS
PERITONEAL LIGAMENTS
• Anterior ligament
• Posterior ligament
• Right and left broad
ligament
FIBROMUSCULAR LIGAMENT
• Round ligament
• Transverse cervical
ligament
• Uterosacral ligament
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
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)
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
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
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.
BLOOD SUPPLY OF PELVIS
ARTERIAL SUPPLY OF PELVIS
• Internal iliac artery
VENOUS DRAINAGE OF PELVIS
• Internal iliac vein
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
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
Abdomen & Pelvis II

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Abdomen & Pelvis II

  • 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)
  • 14.
  • 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
  • 21.
  • 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)
  • 30.
  • 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
  • 46.
  • 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
  • 48.
  • 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