盆部与会阴局部解剖学--课件

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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版文本样式,第二级,单击此处编辑母版标题样式,Pelvic,Bony pelvis,Composition,:formed by paired hip bones,sacrum,coccyx,and their articulations,Two portions,Greater pelvis,Lesser pelvis,Terminal line,(pelvic inlet):formed by promontory of sacrum,arcuate,line,pectin of pubis,pubic tubercle,upper border of pubic,symphysis,Pelvic outlet,:formed by tip of coccyx,sacrotuberous,ligament,ischial,tuberosity,ramus,of,ischium,inferior,ramus,of pubic,symphysis,Muscles of pelvic wall,Piriform,m.,Obturator,internus,m.,Muscles of floor of pelvis and,pelivic,diaphragm,Muscles of floor of pelvis,Levator,ani,肛提肌,Levateo,prostate,前列腺提肌,(,pubovaginalis,耻骨阴道肌,),Puborectalis,耻骨直肠肌,Pubococcygeus,耻尾肌,and,iliococcygeus,髂尾肌,Coccygeus,尾骨肌,Pelivic,diaphragm,盆膈,Superior fascia of pelvic diaphragm,盆膈上筋膜,Levator,ani,肛提肌,Coccygeus,尾骨肌,Inferior fascia of pelvic diaphragm,盆膈下筋膜,Pelvic fascia,Parietal pelvic fascia,A continuation of the transverse fascia into the pelvis.It coves the,piriformis,and,obturator,internus,Attaches to the,arcuate,line of the pubis and,ilium,thickens over the,obturator,internus,to form the,arcus,tendineus,the origin of portions of the,levator,ani,muscle,At the,tendinous,arch of,levator,ani,it splits to cove both superior and inferior surfaces of the,levator,ani,as superior and inferior fascia of pelvic diaphragm,Visceral pelvic fascia,Lies between the peritoneum and the pelvic viscera,It is a continuation of the,extraperitoneal,connective tissue,Ensheathes,retroperitoneal viscera and forms septa between retroperitoneal organs,Rectovesical,septum,直肠膀胱隔,Rectovaginal,septum,直肠阴道隔,Retropubic,space,耻骨后隙,Lies between pubic,symphysis,and urinary bladder,Pararectal,space,直肠周间隙,Lies around the,rectus,Retrorectal,space,直肠后隙,Common iliac artery,髂总动脉,Common iliac artery,Continuation of abdominal aorta at level of L4 vertebra,Terminates in front of sacroiliac joint by dividing into internal and external iliac arteries,Internal iliac artery,髂内动脉,Parietal iliac artery,Obturator,a.,闭孔动脉,Iliolumber,a.,髂腰动脉,Lateral sacral a.,骶外侧动脉,Superior,gluteal,a.,臀上动脉,Inferior,gluteal,a.,臀下动脉,Visceral branches,Umbilical a.,脐动脉,superior,vesical,a.,膀胱上动脉,Inferior,vesical,a.,膀胱下动脉,Uterine a.,子宫动脉,Inferior rectal a.,直肠下动脉,Internal,pudendal,a.,阴部内动脉,Uterine a.,子宫动脉,about 2cm from neck of uterus it crosses above and in front of,ureter,Internal,pudendal,artery,阴部内动脉,Perineal,artery,Anal artery,Dorsal artery of penis(clitoris),External iliac artery,Inferior,epigastric,artery,Deep iliac circumflex artery,Veins of pelvis,Internal iliac vein,髂内静脉,Parietal tributaries:accompany with arteries,Visceral tributaries,superior rectal,veininferior,mesenteric v.,Rectal venous plexus inferior rectal,veininternal,iliac v.,直肠静脉丛,anal,veininternal,pudendal,v.,Vesical,venous plexus,膀胱静脉丛,vesical,v.,Uterine venous plexus,子宫静脉丛,uterine v.,External iliac vein,髂外静脉,accompany the artery,Common iliac vein,髂总静脉,formed by union of internal and external iliac veins in front of sacroiliac joint,end upon L4L5 by uniting each other to form inferior vena cava,The lymphatic drainage of pelvis,Internal iliac lymph node,Surround internal iliac vessels,Receive afferents from pelvic viscera,perineum,buttock and back of thigh,External iliac lymph nodes,Lie along external iliac artery,Receive afferents from lower limb and some parts of pelvic viscera,Sacral lymph node,Common iliac lymph node,Lie along common iliac artery,Receive afferents from all the above nodes,Efferents,pass to lumbar lymph node,Sacral plexus,骶丛,Formation,:formed by anterior,rami,of L4 and L5 spinal nerves(the,lumbrosacral,trunk)and anterior,rami,of sacral and,coccygeal,nerves,Position,:lies in pelvic cavity,anterior to sacrum and,piriformis,Branches,Superior,gluteal,Inferior,gluteal,Pudendal,Posterior femoral,cutaneou,Sciatic Common,Pudendal,nerve block,Autonomic plexuses of,plevic,Hypogastric,plexus,Superior,hypogastric,plexus,上腹下丛,:lies in front of L5 between common iliac,ateries,Inferior,hypogastric,plexus,下腹下丛,(pelvic plexus):lie on each side of rectum,Sacral sympathetic trunk,Is,continuos,above with the abdominal part,Has 4or 5 ganglion,Relationships of,rectus,Anteriorly,In male,Fundus,of bladder,Seminal vesicle,Prostate,Ampulla,ductus,deferentis,In female,neck of uterus,Vagina,Posteriorly,Sacrum and coccyx,Piriformis,Median sacral vessels,Anterior branches of sacral and,coccygeal,nerves,Sacral sympathetic trunk,Laterally,Pelvic plexus,Superior and inferior rectal vessels,Levator,ani,Vessels and,lymphatics,of rectum,Arteries,Superior rectal a.,Inferior rectal a.,Median sacral a.,Lymphatic,drainge,Lymphatics,follow arterial blood supply to following nodes:,Superior rectal,ln,.,Inferior mesenteric,ln,.,Pararectal,ln,.,Internal iliac,ln,.,Sacral,ln,.,Perineum,山东大学医学院 解剖教研室,李振华,General features,Region of below pelvic diaphragm,A diamond-shape space whose boundaries are those of the pelvic outlet,Lower border of,symphysis,pubis,Rami,of pubis and,ischium,Ischial,tuberosities,Sacrotuberous,li
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