《骶髂关节》PPT课件.ppt

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1、Anatomy of the Female Reproductive System Liu WeiDepartment of Ob&GyRen Ji hospital IntroductionPelvisPelvic floorExternal genitaliaInternal genitaliaVessel and nerve and lymphAdjacent organsPelvisPelvisBony pelvisos ilium髂骨髂骨os coccyx尾骨尾骨os sacrum骶骨骶骨os pubis耻骨耻骨os ischium坐骨坐骨PelvisJointsSacro-ilia

2、c joint骶髂关节骶髂关节Sacro-coccygeal joint骶尾关节骶尾关节Symphysis pubica耻骨联合耻骨联合PelvisLigaments1.Sacrospinous ligament 骶棘韧带骶棘韧带2.Extend from the lateral border of the sacrum and coccyx to the spine of the ischium2.Sacrotuberous ligament 骶结节韧带骶结节韧带3.Extend from the posterior aspect of the lower 3 sacral vertebra

3、e to the ischial tuberosityPelvisPelvic divisions(iliopectineal line 髂髂耻线耻线)1.False pelvis(pelvis major)2.Ture pelvis(pelvis minor)3.Bony birth canal 4.the Pelvic inlet,the pelvic out let and the pelvic cavityPelvisTypes of pelvis1.The gynecoid type(女型骨盆女型骨盆)2.round,slightly ovoid or elliptical inle

4、t.adequate sacrosciatic notch.wide interspinous diameters(10cm).52%-58.9%2.The platypelloid type(扁平型骨盆扁平型骨盆)3.distinct oval inlet.very wide subpubic arch.23.2%-29%Pelvis3.The anthropoid type(类人猿型骨盆类人猿型骨盆)long,narrow,oval inlet.extended and narrow anterior and posterior segment.wide sacrosciatic notc

5、h.long,narrow sacrum.Straight side walls.4.The android type(男型骨盆男型骨盆)Pelvic floorThe tissues closing down the pelvic outlet(muscles and fasciae)suspend and support the pelvic organs,such as uterus and bladder and rectumPosterior part(urogenital triangle)urethra and vagina pass through Anterior part(

6、anal triangle)rectum pass throughPelvic floorTissues1.Outer layer2.Bulbocavernosus muscle(球海绵体肌球海绵体肌)3.Ischiocavernosus muscle(坐骨海绵体肌坐骨海绵体肌)4.Superficial transverse perineal muscle(会阴浅横会阴浅横肌肌)5.External anal sphincter(肛门外括约肌肛门外括约肌)2.mid layer 3.urogenital diaphragm 泌尿生殖膈泌尿生殖膈Pelvic floor3.Inner laye

7、r(pelvic diaphragm 盆膈盆膈)1)the main support of the pelvic floor2)formed by the levator ani and coccygenus muscles and covering fasciae.3)Levator ani:pubococcygenus(耻尾肌耻尾肌),iliococcygenus(髂尾肌髂尾肌),puborectalis(坐尾肌坐尾肌)Pelvic floorPerineumgeneral conception:the tissues closing down the pelvic outletClini

8、cal conception:the tissues between vagina and anus.External genitaliamons pubis阴阜阴阜Labium majus大阴唇大阴唇Clitotis阴蒂阴蒂Labium minus小阴唇小阴唇Urethral orifice尿道口尿道口Vaginal orifice阴道口阴道口Vaginal vestibule阴道前庭阴道前庭Fossa navicularis舟状窝舟状窝Perineal body会阴体会阴体Anus肛门肛门External genitaliaLabia majora The venous drainage

9、is extensive and forms a plexus with numerous anastomoses.Vulva hematomaVaginal vestibule Bordered by the labia minora laterally,by the frenulum labiorum pudendal(阴唇系带阴唇系带)posteriorly,by the urethra and clitoris anteriorly,by the hymenal ring inferiorly.Internal genitaliaInternal genitaliaInternal g

10、enitaliaVagina1.strong canal of muscle(7.5cm)2.extend from the uterus to the vestibule of the external genitalia.its long axis is almost parallel with that of the lower part of the sacrum.the anterior wall of the vagina is 1.5-2cm shorter than the posterior wall.2.vaginal fornix the circular cul-de-

11、sac formed around the cervix 4 regions:the anterior fornix,the posterior fornix and 2 lateral fornices.Internal genitalia3.Wall structure1)mucosal layer(stratified squamous epithelium)2)muscular layer(3 layer)3)submucous area(with a dense plexus of veins and lymphatics)Internal genitaliaInternal gen

12、italiaUterus1.Pear-shaped,thick-walled,muscular organ2.Body and cervix:3.Babyhood 1:2,manhood 2:13.Isthmus uteri4.connect the body to cervix,1cm(non-pregnancy)Internal genitalia4.Layers of uterine wall1)The serous layer(perimetrium)2)Thin and firmly adherent over the fundous and most of the body3)Ut

13、erovesical pouch of the peritoneum4)Rectouterine pouch of the peritoneum(pouch of Douglas)2)The muscular layer3)Outer layer(longitudinal fibers)4)Inner layer(interlaced and various directions)Internal genitalia3)The mucous layer(endometrium)4)compact layer:response to hormone periodically,a single l

14、ayer of ciliated columnar epithelium5)spongy layer:response to hormone periodically.contains many tubular glands 6)funous:non-response to hormone periodicallyInternal genitaliaCervix1.lower 1/3 of uterus.connects uterus to vagina via endocervical canal2.External os:opening of endocervical canal to e

15、ctocervix3.Internal os:indistinct upper limit of endocervical canalInternal genitaliaLigaments1.Broad ligament2.Round ligament3.Cardinal ligament4.Utero-sacral ligamentInternal genitaliaOviduct1.Anatomy1)Interstitial portion:2)Isthmic portion:narrow3)Ampulla:wide and tortuous4)Fimbria:funnel-shaped

16、mouthInternal genitalia2.Layers of wall1)Serous2)Muscular:outer longitudinal and inner circular 3)Mucous:ciliated columnar epithelium,coarse longitudinal foldsInternal genitaliaOvary1.Anatomy1)Paired organ,elliptic2)The suspensory ligament of the ovary3)The ovarian ligamentInternal genitalia2.Struct

17、ure of ovary1)Covered by cuboid or low columnar epithelium2)Consist of a cortex and a medulla3)Cortex:oocytes in various stages of maturity.4)Medulla:fibers,smooth muscle cells,blood vessel,nerves.Vessel and nerve and lymphBlood vessel1.The ovarian artery1)Orginated as branches of the abdominal aort

18、a,(left:left renal artery).2)Turn over the common iliac artery and ureter,descend into the pelvis.Enter into ovary through the mesovariumVessel and nerve and lymph2.The uterine artery1)a terminal branch of the hypogastric artery2)Cross the ureter near the cervix(2cm)3)Ascend along the lateral border

19、 of the uterus4)uterine body branch and cervix-vagina branchVessel and nerve and lymph3.Vaginal artery4.Internal Pudendal arteryVessel and nerve and lymphLymph1.External genitalia1)superfical inguinal gland(腹股沟浅淋巴结腹股沟浅淋巴结)2)deep inguinal gland(腹股沟深淋巴结腹股沟深淋巴结)Vessel and nerve and lymph2.Pelvic lymph1

20、)iliac lymph2)common iliac,internal iliac and external iliac 2)Anterior Sacral lymph3)Lumbar lymph:abdominal aorta Adjacent organsUrethraUrinary bladderUreterRectumVermiform appendixAdjacent organsAnswer the questionsHow many types of pelvis are there?What are they?What is perineum?What is vaginal vestibule?How many ligaments of uterus are there?What are they?How many ligaments of ovary are there?What are they?What is uterine isthmus?END