- Identify-
- Uterus
- Pubic symphysis- urinary bladder-uterus-rectum-sacrum
- If hysterectomy- vagina
- Pubic symphysis.
- Stony hard
- Secondary cartilage
- In between 2 pubic bones- hyaline cartilage with disc like fibrous cartilage
- Trigone of urinary bladder-
- Apex- remnant of embryonic uracus/allantois.
- Uracus/allantois later forms median umbilical fold/ligament
- Retropubic space of Retzius
- Between urinary bladder and pubic symphysis.
- Behind pubic symphysis
- Contains retropubic pad of fats to prevent friction between soft organs and bony prominence
- Also contains pubo vesicle ligament in females- from pelvic surface of pubic symphysis to urethra
- Also contains vesicle venous plexus- drains urinary bladder
- Urinary bladder-
- Superior surface above where fundus of uterus lies
- Base or posterior surface of bladder- related to body of uterus and cervix
- Apex
- Inferolateral surface-
- not covered by peritoneum-
- moves up above pubic symphysis when bladder is filled.
- Clinical-
- Suprapubic Cystectomy
- Catheter can be inserted to collect sterile urine
- Blood Supply-
- Superior and inferior vesicular artery
- Utero vesicle pouch-
- Pouch of douglas- recto uterine pouch
- Peritoneum path-
- Anterior abdominal wall
- Urinary bladder
- Dips down upto cervix- utero vesicle pouch
- Uterus
- Dips upto vagina- recto uterine pouch of douglas
- Rectum
- Urethra
- Uterus-
- Fundus-
- upto the opening of the fallopian tube
- Lies on the superior surface of urinary bladder
- Cervix
- Normal position-
- Anteversion- 90 degree angle between cervix and vagina
- Anteflexion- 120 degree angle between long axis of body of uterus and long axis of cervix
- Fallopian tube-
- Infundibulum with fimbriae
- Ampulla – most dilated part
- Isthmus- narrowest part
- Intramural part of fallopian tube
- Blood supply by ovarian and uterine artery
- Broad ligament-
- Posterior leaflet -mesovarium- contains the ovary
- Supports
- Blood supply
- Lymphatic-
- Upper fundus- para aortic nodes
- Cervix- internal iliac nodes
- Body – external iliac nodes
- Region of attachment of ligament of ovary and round ligament of uterus(angle of uterus to labia majora)- superficial inguinal nodes
- Fundus-
- Denon Villers fascia- covering of rectum
- Fascia of Waldeyer- Sacrum
- Rectum supply-
- 1 superior rectal
- 2 middle rectal
- 2 inferior rectal