« Anatomy of the Lower Urinary Tract and Male Genitalia Bony Pelvis The pelvic bones are the sacrum (the termination of the axial skeleton) and the two ...» Document abstract
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The pelvic bones are the sacrum (the termination of the axial skeleton) and the two innominate bones. The latter are formed by the fusion of the iliac, ischial, and pubic ossification centers at the acetabulum. The ischium and pubis also meet below, in the center of the inferior ramus, to form the obturator foramen. The weight of the upper body is transmitted from the axial skeleton to the innominate bones and lower extremities through the strong sacroiliac (SI) joints. As a whole, the pelvis is divided into a bowl-shaped false pelvis, formed by the iliac fossae and largely in contact with intraperitoneal contents, and the circular true pelvis wherein lie the urogenital organs. At the pelvic inlet, the true and false pelves are separated by the arcuate line, which extends from the sacral promontory to the pectineal line of the pubis. The lumbar lordosis that accompanies erect posture tilts the axis of the pelvic inlet so that it parallels the ground; the pelvic inlet faces anteriorly, and the inferior ischiopubic rami lie horizontal. When approaching the pelvis through a low midline incision, the surgeon gazes directly into the true pelvis.
- Bony Pelvis
- Anterior Abdominal Wall
- Skin and Subcutaneous Fasciae
- Abdominal Musculature
- Inguinal Canal
- Internal Surface of the Anterior Abdominal Wall
- Soft Tissues of the Pelvis
- Pelvic Musculature
- Pelvic Fasciae
- Fasciae of the Perineum and the Perineal Body
« the inferior pubic arch and the striated urinary sphincter to AL: Nitric oxide control of lower genitourinary tract Devine CJ Jr, Angermeier KW: Anatomy of the ...» Document abstract
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medical studies
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date published
26/11/2007
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At the bifurcation of the aorta, the middle sacral artery arises posteriorly and travels on the pelvic surface of the sacrum to supply branches to the sacral foramina and the rectum. The common iliac arteries arise at the level of the fourth lumbar vertebra, run anterior and lateral to their accompanying veins, and bifurcate into the external and internal iliac arteries at the SI joint. The external iliac artery follows the medial border of the iliopsoas muscle along the arcuate line and leaves the pelvis beneath the inguinal ligament as the femoral artery. Its inferior epigastric artery is given off proximal to the inguinal ligament and ascends medial to the internal inguinal ring to supply the rectus muscle and overlying skin. Because the rectus is richly collateralized from above and laterally, the inferior epigastric arteries may be ligated with impunity. A rectus myocutaneous flap based on this artery has been used to correct major pelvic and perineal tissue defects. Near its origin, the inferior epigastric artery sends a deep circumflex iliac branch laterally and a pubic branch medially. Both vessels travel on the iliopubic tract and may be injured during inguinal hernia repair. Its cremasteric branch joins the spermatic cord at the internal inguinal ring and forms a distal anastomosis with the testicular artery. In 25% of people, an accessory obturator artery arises from the inferior epigastric artery and runs medial to the femoral vein to reach the obturator canal. This vessel must be avoided during obturator lymph node dissection.
- Arterial Supply
- The anterior trunk gives off seven parietal and visceral branches:
- Venous Supply
- The internal iliac vein is joined by tributaries corresponding to the branches of the internal iliac artery and ascends medial and posterior to the artery
- Pelvic Lymphatics
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