Anatomy of the abdomen

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Pelvis and perineum: organisation

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The pelvic floor

The pelvic floor is formed by the pelvic diaphragm and, in the anterior midline, the perineal membrane and the muscles in the deep perineal pouch

The pelvic diaphragm is formed by the levator ani and

muscles from both sides

The pelvic floor separates the pelvic cavity, above from the

which is below

Pelvic diaphragm- this is the

part of the pelvic floor. It is shaped like a bowl and attached superiorly to pelvic walls, it consists of the levator ani and coccygeus muscles

Most of the pelvic bone facing the pelvic cavity is covered by the

muscle and its fascia The lumbosacral plexus supplies the lower limbs

Pelvic diaphragm;

The muscle groups are collectively known as levator ani which is very important in determining

The three muscle groups that make up levator ani are:

Iliococcygeus, pubococcygeus and puborectalis

Nerve supply is pudendal and from

Thick fascial sheet called

membrane- occupies anterior part

The structure is weaker in women because of the

The keystone that has to be preserved during surgery is the

Ureters are muscular tubes that transport urine from kidneys to the bladder, they are continuous superiorly with

This is formed from a condensation of 2 or 3 major calices which are formed by condensation of minor calices

The renal pelvis

as it passes inferiorly through the hilum of the kidney and becomes continuous with the ureter at the uteropelvic junction

Inferior to this junction, the ureters descend retroperitoneally on the medial aspect of the

muscle

At the pelvic brim, the ureters cross either the end of the common iliac or the beginning of the external iliac arteries, enter the pelvic cavity and continue their journey to the bladder

Constriction of the ureters can occur at: 1.

junction

2. Where the ureters cross the common iliac vessels at the pelvic brim

3. Where the ureters enter the

As a result kidney stones can become lodged at these areas

In the pelvis, the ureter is crossed by: the

in men and the

in women

In females internal urethral sphincter

well organised, external urethral sphincter is skeletal muscle surrounding the urethra in the deep perineal pouch

There are two extra groups of muscles in females: sphincter uretherovaginalis and compressor urethrae

The bladder:

The apex of the bladder is directed towards the top of the

a structure known as the median umbilical ligament continues from it superiorly up the anterior abdominal wall to the umbilicus

The tetrahedral bladder has a structure at each corner

The bladder is the most

of the pelvic viscera. Despite being part of the pelvic cavity when empty, it expands superiorly when full into abdominal cavity. It is a tetrahedral when empty

Ureters enter at supero-posterior angles and leaves through inferior angle. Superior surface covered in peritoneum. Expands between transversals fascia and lining peritoneum

Look at notes



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