Pelvis adalah daerah batang tubuh yang letaknya dibawah cavum abdomen dan merupakan daerah peralihan dari batang tubuh ke ekstremitas inferior. Pelvis dibatasi oleh dinding yang dibentuk ole…Full description
anatomyFull description
Full description
abses pelvis atau abses regio pelvis
mri pelvisFull description
Full description
Full description
fraktur pelvisDeskripsi lengkap
Deskripsi lengkap
terjadi akibat cerdera terbuka atau tertutupFull description
Full description
Deskripsi lengkap
Descripción: La ley de Snell (también llamada ley de Snell- Descartes) es una fórmula utilizada para calcular el ángulo de refracción de la luz al atravesar la superficie de separación entre dos medios de pr...
ley snellDescripción completa
Full description
Text for Lower Limb
Descripción: neuroanatomia
THE PELVIS: PART II --- THE PELVIC CAVITY
o
-
Cavity of the true pelvis The area between the pelvic inlet & the pelvic outlet -
-
-
-
lon# .e#ins as a continuation of the %escen%in# colon in front of the pevic bri$ .elow/ it beco$es continuous with the in front of the s $obile Han#s %own into the pelvic cavity in the for$ of a loop s attache% to the posterior pelvic wall by the fan0shape%
-
-
3ale2 Fe$ale2
o
The is %evoi% of peritoneu$ ts $uscular coat2 s arran#e% in the usual outer lon#itu%inal an% inner o circular layers of s$ooth $$ ts co$e to#ether so that the lon#itu%inal fibers for$ a broa% ban% on the anterior an% posterior surfaces of the rectu$ 3ucous $e$brane @ circular layer of s$ooth $$ o For$s * or + se$icircular per$anent fol%s calle% the )Vary in positionServe to support the wei#ht of the feces To prevent e4cessive %istention of the rectal a$pulla 1elations2 o Posterior2 n contact with the sacru$ & coccy4 Pirifor$is Coccy#eus Levatores ani $$ Sacral ple4us Sy$pathetic trun>s o !nterior )in the $ale$aleApper *B+ is relate% to the si#$oi% colon coils of ileu$ that occupy the retrovesical pouch covere% by peritoneu$ lower B+ is relate% to the posterior surface of the bla%%er to the ter$ination of the vas %eferens se$inal vesicles on each si%e prostate %evoi% of peritoneu$ !nterior )in the fe$alefe$aleo Apper *B+ is relate% to Si#$oi% colon Coils of ileu$ that occupy the rectouterine pouch )pouch of
1elations2 o !nterior2
ts peritoneu$ o Covers the o
-
Pulls this part of the bowel forwar%/ pro%ucin# the
-
Posterior2
-
-
.loo% supply2 !rteries2 o o Veins2 Ly$ph %raina#e2 Ly$ph %rains into no%es alon# the course of the o si#$oi% aa Fro$ these no%es/ the ly$ph travels to the o
-
NS2 Shows #reat variation in len#th $ay $easure as $uch as +5 in )6c$in chil%/ $ay lie $ainly in the ab%o$en lies only a short %istance fro$ the anus )
-
-
-
-
-
.e#ins as a continuation of the si#$oi% colon t passes %ownwar%/ followin# the curve of the sacru$ an% coccy4 En%s in front of the tip if the coccy4 by piercin# the pelvic %iaphra#$ & beco$in# continuous with the anal canal ts lower part is %ilate% ; ly returns to the $e%ian plane Lateral view2 Follows the anterior concavity of the sacru$ before o ben%in# %ownwar% an% bac>war% at its ?unction with the anal canal The o For$s a slin# at the ?unction of the rectu$ with the anal canal
-
.loo% supply )!rterieso
a %irect continuation of the inferior $esenteric aa
enters the pelvis by %escen%in# in the root of the si#$oi% $esocolon 1
THE PELVIS: PART II --- THE PELVIC CAVITY
in front of S+ vertebra/ it %ivi%es into branches/ which pierce the $uscular coat an% supply the $ucous $e$brane
-
they anasto$ose with one another & with $i%%le an% inferior rectal aa
-
o
! s$all branch of the internal iliac aa s %istribute% $ainly to the $uscular coat
o
-
! branch of the internal pu%en%al aa in the perineu$ !nasto$oses with the $i%%le rectal aa at the anorectal ?unction
Venous %raina#e2 )their union for$s an i$portant
-
-
o
! tributary of the portal circulation
o
o
-
.loo% supply2 o Apper en%2 3i%%le2 o o n pelvis2 NS2 & Pierce the bla%%er wall obli=uely ; this provi%es a valveli>e action/ which prevents a reverse flow of urine towar% the >i%neys as the bla%%er fills
Situate% i$$e%iately behin% the pubic bones within the pelvis Stores urine !%ult2 $a4 capacity of about (''$L Has a stron# $uscular wall s shape an% relations vary accor%in# to the a$ount of urine it contains E$pty bla%%er in the youn# chil% Pro?ects above the pelvic inlet o o Later/ when the pelvic cavity enlar#es/ the bla%%er sin>s into the pelvis to ta>e up the a%ult position E$pty bla%%er in a%ults2 Lies entirely within the pelvis o o s pyra$i%al havin#
-
Ly$ph %raina#e2
nferior $esenteric no%es Ly$ph vessels of the lower part of the rectu$
-
NS2 sy$pathetic & parasy$pathetic nerves fro$
-
s sensitive
-
-
Points anteriorly Lies the upper $ar#in of sy$physis pubis s connecte% to the u$bilicus by the )1e$ains of urachus-
Each is a $uscular tube that e4ten%s fro$ the >i%ney to the posterior surface of the bla%%er t enters the pelvis by
Faces posteriorly Trian#ular are ?oine% by the ureters #ives rise to the urethra * vasa %eferentia lie si%e by si%e on the posterior surface of the bla%%er & separate the se$inal vesicles fro$ each other Apper part of its posterior surface is covere% by peritoneu$/ which for$s the
Then runs %own the lateral wall of the pelvis in front of the internal iliac artery to the re#ion of the ischial spine
Tunrs forwar% to enter the lateral an#le of the bla%%er -
-
Near its ter$ination/ it is crosse% by the vas %eferens Passes obli=uely throu#h the wall of the bla%%er for about Has + Constrictions2 Dhere the renal pelvis ?oins the ureter in the o ab%o$en o Dhere it is >in>e% as it crosses the pelvic bri$ to enter the pelvis o Dhere it pierces the bla%%er wall
The lower part of the posterior surface is separate% fro$ the rectu$ by o Vasa %eferentia Se$inal vesicles o o 1ectovesical fascia
Covere% with peritoneu$ s relate% to coils of ileu$ or si#$oi% colon !lon# the lateral $ar#ins of this surface/ the peritoneu$ passes to the lateral pelvic walls 2
THE PELVIS: PART II --- THE PELVIC CAVITY
!s the bla%%er fills/ it beco$es ovoi%/ an% superior surface bul#es upwar% into the ab%o$inal cavity The peritoneal coverin# is peele% off the lower part of the anterior ab%o$inal wall so that the bla%%er co$es into %irect contact with the anterior ab%o$inal wall
orifice/ which is pro%uce% by the un%erlyin# $e%ian lobe of the prostate o
o
!re relate% in front to the
o
-
-
Lies inferiorly 1ests on the upper surface of the prostate Here/ the s$ooth $$ fibes of the bal%%era re continuous with those of the prostate s hel% in position by the in $ale ) in fe$aleo !re thic>enin#s of the pelvic fascia
Fille% bla%%er in a%ults2 o ts superior wall rises up into the hypo#astric re#ion The posterior surface an% nec> re$ain $ore or less o unchan#e% in position
o o
E$pty bla%%er2 is thrown into fol%s Fille% bla%%er2 fol%s %isappear
o
Venous %raina#e2 %rain into internal iliac vein Ly$ph %raina#e2 o nternal iliac no%es E4ternal iliac no%es o NS2 o Sy$pathetic post#an#lionic fibers Ori#inate in st & *n% lu$bar #an#lia
-
.ranches of the internal iliac aa
o
-
$ore posteriorly/ they lie in contact with the obturator internus o above o levator ani $$ below
.loo% supply )!rterieso
o
Co$pose% of s$ooth $$ s arran#e% as + layers of interlacin# bun%les ; !t the nec> of the bla%%er/ the circular co$ponent of the $uscle coat is thic>ene% to for$ the
The area of the $ucous $e$brane coverin# the internal surface of the base of the bla%%er Here/ the $ucous $e$brane is always s$ooth/ even when the viscus is e$pty/ bcause the $ucous $e$brane is fir$ly a%herent to the un%erlyin# $uscular coat ts superior an#les ; correspon% to the openin#s of the ureter nferior an#le ; correspon% to the internal urethral orifice s li$ite% above by a $uscular ri%#e ;
-
1uns fro$ the openin# of one ureter to that of the other
! s$all elevation situate% i$$e%iately behin% the urethral
-
a refle4 action is controlle% by hi#her centers in the brain refle4 is initiate% when the volu$e of urine reaches about +''$L .la%%er stretches Stretch receptors in the bla%%er wall are sti$ulate% Trans$it i$pulses to the CNS The in%ivi%ual has a conscious %esire to $icturate is assiste% by contraction of the ab%o$inal $$ to 3
THE PELVIS: PART II --- THE PELVIC CAVITY
raise the intera0ab%o$inal an% pelvic pressures o e4ert e4ternal pressure on the bla%%er in youn# chil%ren2 o it is a si$ple refle4 act Ta>es place whenever the bla%%er beco$es o %isten%e% n a%ults2 o !lso a si$ple refle4 act s inhibite% by the activity of the cerebral corte4 until o the ti$e an% place for $icturition are favorable o
-
-
-
-
-
-
nhibitory fibers Pass %ownwar% with corticospinal tracts n% r% th Then to the * / + / an% sacral se#$ents of the cor% -
Voluntary control2 o is acco$plishe% by contractin# the / which closes the urethra o s assiste% by the which co$presses the bla%%er nec> s nor$ally %evelope% %urin# the secon% or + r% year o of life
-
-
a fir$ structure lyin# posterior to the testis/with the vas %eferens lyin# on its $e%ial si%e has hea% 00 e4pan%e% o o bo%y tail G pointe% o laterally/ a %istinct #roove lies between the testis an% the epi%i%y$is/ which is line% with the inner visceral layer of the tunica va#inalis ; is a $uch coile% tube ) the tube e$er#es fro$ the tail of the epi%i%y$is as )enters the sper$atic cor%functions2 o provi%es stora#e space for the sper$atoIoa allows the$ to $ature o o $ain f4n2 absorption of flui% a%%ition of substances to the se$inal flui% to o nourish the $aturin# sper$
.loo% supply for testes & epi%i%y$is -
venous %raina#e for testes & epi%i%y$is o
-
$ost afferent i$pulses pass up the Enter the *n%/ +r%/ an% th sacral se#$ents of the spinal cor%
e$er#e fro$ the testis an% epi%i%yis as a venous networ>/ the beco$es re%uce% to sin#le vein as it ascen%s throu#h the in#uinal canal
o
-
so$e afferent i$pulses travel with the sy$pathetic verves via the Enter the st & *n% lu$bar se#$ents of the spinal cor%
-
leave the cor% fro$ the * n%/ +r%/ th sacral se#$ents Pelvic splanchnic nerves & inferior hypo#astric ple4uses Pass via the parasy$pathetic pre#an#lionic nerve fibers To the bla%%er wall where they synapse with post#an#lionic neurons The s$ooth $$ of the bla%%er wall )
-
also pass to the urethral sphincter via the
-
a fir$ $obile or#an lyin# within the scrotu$ left testis usually lies at a lower level than the ri#ht each is surroun%e% by a tou#h fibrous tissue ;
-
%rains into inferior vena cava
o
-
-
-
?oins the left renal vein
a thic>0walle% tube len#th2 conveys $ature sper$ fro$ the epi%i%y$is to the e?aculatory %uct an% the urethra arises fro$ the lower en% or tail of the epi%i%y$is Passes throu#h the in#uinal canal E$er#es fro$ the %eep in#uinal rin# Passes aroun% the lateral $ar#in of the inferior epi#astric artery Passes %ownwar% an% bac>war% on the lateral wall of the pelvis Crosses the ureter in the re#ion of the ischial spine 1uns $e%ially an% %ownwar% on the posterior surface of the bla%%er its ter$inal part is %ilate% to for$ o
its inferior en% narrows %own an% ?oins the %uct of the se$inal vesicle to for$ the 4
THE PELVIS: PART II --- THE PELVIC CAVITY
-
-
-
-
are * lobulate% or#ans len#th2 on the $e%ial si%e of each vesicle2 lies the ter$inal part of the vas %eferens relations2 2 rectu$ o o each narrows & ?oins the vas %eferens of the si%e to for$ e?aculatory %uct each consists of a $uch0coile% tube e$be%%e% in connective tissue bloo% supply )!rteries-
anterior fibers of the levator ani as they run posteriorly fro$ the pubis is inco$pletely %ivi%e% into (lobes2
-
-
anterior surface of the rectal a$pulla )is separate% fro$ it by the
o
o
-
the prostate is connecte% to the posterior aspect of the pubic bones by the fascial
o
o
-
sy$physis pubis )separate% fro$ it by the in the
o
venous %raina#e2 ly$ph %raina#e2 f4n2 pro%uce a secretion that is a%%e% to the se$inal o flui% ; nourishes the sper$atoIoa %urin# e?aculation/ they contract an% e4pel their o contents into the e?aculatory %ucts ; wash the sper$atoIoa out of the urethra
lies in front of the urethra is %evoi% of #lan%ular tissue
o
the we%#e of #lan% situate% between the urethra an% e?aculatory %ucts its upper surface is relate% to the tri#one of the bla%%er is rich in #lan%s
o
-
-
-
len#th of each2 are for$e% by the union of the vas %eferens an% the %uct of the se$inal vesicle Peirce the posterior surface of the prostate Open into the prostatic part of the urethra/ close to the $ar#ins of the prostatic utricle F4n2 to %rain the se$inal flui% into the prostatic urethra
o o
-
-
-
-
-
! fibro$uscular #lan%ular or#an that surroun%s the prostatic urethra Len#th2 Lies between the nec> of the bal%%er above an% uro#enital %iaphra#$ below s surroun%e% by a fibrous capsule Has a o G lies a#ainst the bla%%er nec> above o lies a#ainst the uro#enital %iaphra#$ below 2 where the * e?aculatory %ucts pierce to open into the prostatic urethra at the lateral $ar#ins of the prostatic utricle
the is continuous with the nec> of the bla%%er )the s$ooth $$ passin# wBo interruption- fro$ one or#an to the other enters the base of the prostate
F4n2
-
Pro%uces a thin/ $il>y flui% containin# citric aci% an% aci% phosphatase that is a%%e% to the se$inal flui% at the ti$e of e?aculation ts s$ooth $$/ which surroun%s the #lan%s/ o s=ueeIes the secretion into the prosatatic urethra Secretion2 al>aline 0000 helps neutraliIe the aci%ity of o the va#ina .loo% supply )!rterieso
o
-
-
-
o
the lies on the upper surface of the uro#enital %iaphra#$ urethra leaves the prostate ?ust above the ape4 on the anterior surface
!re separate% fro$ one another by a shallow vertical #roove on the posterior surface of the prostate Contain $any #lan%s
-
relations2 o
behin% the urethra below the e?aculatory %ucts contains #lan%ular tissue
-
Venous %raina#e2 o Lies outsi%e the capsule of the prosate 1eceives the %eep %orsal vein of the penis & o nu$erous vesical veins
7*( in )+c$- lon# .e#ins at the nec> of the bla%%er t passes throu#h the prostate fro$ the base of the ape4/ where it beco$es continuous with the $e$branous part of the urethra
-
o
5
THE PELVIS: PART II --- THE PELVIC CAVITY
-
On its posterior wall2 a lon#itu%inal ri%#e calle% the
-
On each si%e/ the ri%e is a #roove calle% the o Dhere prostatic #lan%s open On the su$$it of the urethral crest is a %epression/ the
-
o
on the e%#e of its $outh are the openin#s of the * e?aculatory %ucts
-
-
-
-
crosses over the pelvic inlet in front of the bifurcation of the co$$on iliac aa it runs o %ownwar% an% bac>war% in front of the internal iliac aa o behin% the ovary until it reaches the re#ion of the ishcial spine forwar% an% $e%ially beneath the base of the broa% o li#a$ent/ where it crosse% by the uterine aa o then runs forwar%/ lateral to the lateral forni4 of the va#ina/ to enter the bla%%er
connects the lateral $ar#in of the uterus to the ovary usually lies a#ainst the lateral wall of the pelvis in a %epression calle% the o boun%e% by the e4ternal iliac vessels above o internal iliac vessels behin% its position is e4tre$ely variable is often boun% han#in# %own in the rectouterine pouch )pouch of es up a variable position in the pelvis surroun%e% by a thin fibrous capsule 000 o is covere% e4ternally by a $o%ifie% area of peritoneu$ calle% f4n2 o pro%uction of fe$ale #er$ cells/ fe$ale se4 hor$ones o o
-
-
-
-
arteries2 arises fro$ the ab%o$inal aorta at the level of L veins2 inferior vena cava on the ri#ht si%e & into left renal vein on the left si%e NS2 acco$panies the ovarian arteryo
-
-
situate% i$$e%iately behin% the pubic bones lies at a lower level than in the $ale pelvis because of the absence of prostate the nec> rests %irectly on the upper surface of the uro#enital %iaphra#$
o
lies behin% the sy$physis pubis
o
separate% by the va#ina fro$ the rectu$
o
relate% to
-
-
JThey cross the e4ternal iliac vessels J1each the ovary by passin# throu#h the lateral en% of the broa% li#a$ent/ the part >nown as the suspensory li#a$ent of ovary Jfinally enter the hilu$ of the ovary via the $esovariu$
-
the uterovesical pouch of peritoneu$ the bo%y of the uterus
-
o o
in front2 $ore posteriorly2 they lie in contact with the obturator internus $$ above levator ani $$ below
Paire%
-
-
Lie in the upper bor%er of the broa% li#a$ents Each connects the peritoneal cavity in the re#ion of the ovary with the cavity of the uterus parts2 o
-
o
rests on the upper surface of the uro#enital %iaphra#$
Funnel0shape% lateral en% Pro?ects beyon% the broa% li#a$ent an% overlies the ovary ts free e%#e has several fin#erli>e processes 000
o
-
oval0shape% $easure$ent2 7( in 4 '79( in )c$ 4 *c$attache% to the bac> of the broa% li#a$ent by the
wi%est
o
Narrowest Lies lateral to the uterus
Pierces the uterine wall
o
o
the part of the broa% li#a$ent e4ten%in# between the attach$ent of the $esovariu$ an% the lateral wall of the pelvis
-
-
F4n2 o o
o
represents the re$ains of the upper part of the #ubernaculu$s
o
receives the ovu$ fro$ the ovary Provi%es a site where fertiliIation of the ovu$ can ta>e place Provi%es a nourish$ent for the fertiliIe% ovu$ Transports it to the cavity of the uterus 6
THE PELVIS: PART II --- THE PELVIC CAVITY
o
-
!rteries2 o o
-
-
-
-
-
-
-
Serves as a con%uit alon# which the sper$atoIoa travel to reach the ovu$ )Fro$ internal iliac artery)Fro$ ab%o$inal aorta-
si#$oi% colon is a co$$on site for cancer of the lar#e bowel because the ly$phatic vessels of this se#$ent of the colon %rain ulti$ately into the inferior $esenteric no%es/ it follows that an e4tensive resection of the #ut an% its associate% ly$phatic file% is necessary to e4tirpate the #rown & its local ly$phatic $etastases is re$ove% fro$ the left colic fle4ure to the %istal en% of the si#$oi% colon an% the transverse colon is anasto$ose% to the rectu$
because of its e4tre$e $obility/ the si#$oi% colon so$eti$es rotates aroun% its $esentery $ay correct itself spontaneously rotation is co$$only in countercloc>wise %irection
%iverticula of the $ucous $e$brane alon# the course of the arteries supplyin# the si#$oi% colon is a co$$on clinical con%ition it $ay beco$e a%herent to the bla%%er o o rectu$ ileu$ or o o ureter an% pro%uce an internal fistula
