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Anatomy male and female pelvis and external genitalia (Bony pelvis (Male…
Anatomy male and female pelvis and external genitalia
Bony pelvis
Iliac crest
ASIS
Pectineal line
Pubic tubercle
Pubic sympyhsis (centre)
Pubic crest
Pelvic inlet: linea terminalis: (superior ramus + pectineal line + sacrum)
abdominal cavity
Medial surface
ASIS
Illiac fossa
Iliacus
Greater sciatic notch
Ischial spine
Lesser sciatic notch
Obturator foramen
Ischial tuberosity
Pubic arch
Pubic tubercle
Male vs Female
Pubic arch angle wider in female (50-60 vs 80-85)
Promontory of sacrum
Linea terminalis
Arcuate line of ilium
Pectinea line
Pubic crest
Male: heart, woman: oval
Coronoal view
Pelvic floor muscles
Perineum: muscles and fascia: support
Pelvic cavity
Abdominal cavity
Plane of the linea terminalis
Pelvic fascia
Obturator foramen: nerves out
Scrotum and testis: descent of gonad
Superficial components of male genital organs consist of scrotum and penis
Scrotum is male homologue of labia majora in women
In fetus, labioscrotal scrotal swellings fuse across midline, resulting in single scrotum
Gonad
Gubernaculum
Processus vaginalis (obliterates and becomes tunica vaginalis)
Before descent, a cord of tissue (
gubernaculum
) passes through anterior abdominal wall
Connects inferior pole of gonad with labioscrotal swellings
Tubular extension of peritoneal cavity (
Processus vaginalis
) and accompanying muscle layers project along gubernaculum on each side into labio scrotal swellings
Scrotal Ligament (reminant of gubernaculum) testes to internal surface of scrotum
Ductus Deferens: through inguinal canal: passes through bladder, brings spermatazoa from scrotum
Scrotum and testis: scrotum
Testis
Ellipsoid shaped, enclosed in musculofascial pouch, continous with anterior abdominal wall
Spermatic cord: tube shaped connection between puch and ant.abdo.wall
Anterior and lateral aspect of testis covered by closed sac of peritoneum (
tunica vaginalis
) which orginally connected to abdominal cavity
Each testis composed: seminiferous tubules and interstitial fluid: surrounded by connective tissue capsule (
tunica albuginea
)
Testicular vein, Ductus deferens, testicular artery, epididymis, testis and tunica vaginalis
Spermatazoa produced in highly coiled
seminiferous tubules
: modified at each end to become straight tubules: connects to
rete testis
(collecting chamber)
12-20 efferent ductules connect rete testis with epididymis
Stored in epididymis until ejaculation
Pass via
ductus deferens
into ejact duct
Superficial features: male perineum
Pubic symphysis
Penis
Raphe
Coccyx
Ischial tuberostiy
Scrotum
Remnant of line of fusion between labioscrotal swelling in fetus:
raphe
Extends from anus, over scrotal sac and onto inferior aspect of body of penis
Penis
Body of penis covered by skin; tip of body is covered by glans penis (expanded cap of corpus spongiosum)
External urethral orifice
: sagittal slit at tip of glans
Fold of skin neck of glans continuous anteriorly with thick skin tightly adhering to glans and posteriorly with thicker skin loosely adhered to body:
Prepuce
Prepuce, Glans penis, External urethral orifice, frenulum of glans, neck of glans, and corona of glans
Superficial perineal space
Perineal membrane: superior border/ roof of superficial perineal space: all external genitalia attached to under surface of this membrane
Penis composed mainly of two corpora cavernosa (DORSAL) and single corpus spongiosum (VENTRAL)
Root and body
:
Root
: two crura, proximal parts of corpora cavernosa attached to pubic arch
Bulb
: proximal part of corpus spongiosum: anchored to perineal membrane
Body
: Formed by tethering of two proximal free parts of corpora cavernosa and related free part of corpus spongiosum
Erections
Various stimuli:sight, smell, sound and touch
Vascular event, generated by parasympatheitc fibres carried in pelvic sphlancnic nerves (ventral rami S2-S4)
Stimulation of these nerves cause arteries in erectile tissue to relax (vasodialtion)
Corpora cavernosa
and spongiosum become engorged with blood and expand
Veins
become compressed against surrounding fascia, prevents outflow of blood
Increase
in internal pressure results in increase in penile length and diameter
Ejaculation: penis flaccid state vasoconstriction of arteries
Male and Female pelvic floor
Supports pelvic viscera
Separates pelvic cavity and perineum below
Formed by pelvic diaphragm (Levator ani, coccygeus adn their fascial coverings)
Incomplete anteriorly: allows passage of urethra and vagina
Levator ani
Pubococcygeus
Intermediate fibres
:
Puborectalis
Posterior fibres
:
Pubococcygeus proper
Anterior fibres
Pubovaginalis/levator prostatae
Iliococcygues
(attached to ischium)
Used to control urination
Females: muscle may damage by childbirth: weakness of sphincter mechanism and stress incontinence
Puborectalis part: control defecation
Form sling around junction bteween recrum and anus (
perineal flexure
): relaxation will increase angle in conjunction with int and ext anal sphincters
First degree tear: superficial perineal skin or vaginal mucosa
Second degree tear: Perineal skin, mucosa, muscles, fascia NOT ANAL SPHINCTER
Third degree: Perineal skin, mucosa, fascia and anal sphincter
Fourth degree: all above and rectal mucosa
Female external genitalia
Pair of erectile structure:
Bulbs of vestibule
: situated either side of vaginal opening + root of clitoris
Small bands of erectile tissues connect anterior ends of bulbs to pea-sized erectile mass:
glans clitoris
Root
: two crura
Body
: formed by unattached parts of two corpora cavernosa
Clitoris and vestibular apparatus + numerous skin and tissue folds form
vulva
Either side of midline: two thin skin folds:
labia minora
Region between, into which urethra and vagina open is
vestibule
Anteriorly, labia minora each bifurcate and medial portions unite to form
frenulum of clitoris
: joins glans clitoris
Lateral folds form prepuce of clitoris