What is the general structure of the pelvic floor?
-Funnel Shaped Structure. Attached to the wall of lesser pelvis to separate the perineum inferiorly from the pelvic cavity. Contains:
- Urogenital hiatus and Rectal Hiatus.
- Perineal Body lies between Urogenital Hiatus and Rectal Hiatus. Attaches the Pelvic Floor to Perineum
What are the Pelvic Floor Muscles?
- Levator Ani
- Coccygeus Muscle
- Fascia Covering Muscles
- Superficial Muscles
What are the components of Levator Ani?
- Puborectalis
- Pubococcygeus
- Illiococcygeus
What are the functions of Puborectalis?
Extending from the Bodies of Pubic Bones past Urogenital Hiatus
- Mainly to maintain Faecal Incontinence
- Maintain Urinary Incontinence
What are the Superficial Muscles?
- Bulbospongiosus
- Ischiocavernosus
- Superficial Transverse Perineal Muscle
- External Anal Sphincter
What supplies the Pelvic Floor?
- Pudendal Nerve
- Internal Pudendal Artery
What is the innervation of vulva?
Sensory
- Anterior Portion: Ilioinguinal Nerve and Genitofemoral Nerve
- Posterior Portion: Pudendal Nerve and Posterior Nerve of Thigh
Parasympathetic Nervous Supply – clitoris and vestibule
-Cavernous Nerve
What is the vascular supply of the Vulva?
Vascular Supply
- Arteries: Pudendal Arteries
- Veins: Pudendal Veins
- Lymph: Superficial inguinal Lymph Nodes
What is the histological Structure of Vagina?
- Stratified squamous epithelium
- Elastic lamina propria
- Fibromuscular layer
- Adventitia
What are Fornix of the Vagina?
- Anterior fornix, which is near the vesicouterine pouch
- Posterior fornix is near the rectouterine pouch
What is the Vasculature of the Vagina?
Artery – Uterine and Vaginal Arteries
Vein – Uterine Vein
Lymphatic – Iliac and Superficial Inguinal Lymph Nodes
What is the Innervation of the Vagina?
Uterovaginal Nerve Plexus for Superior Part – SNS and PNS
Inferior Part of Vagina – Pudendal Nerve
What composes the Cervix?
Lower Portion of the Uterus. Composed of Ectocervix and Endocervix
- Ectocervix opens to External Os
- Endocervix opens to Internal Os
What is the Vasculature of the Cervix?
Artery – Uterine Artery
Vein – Uterine Veins
Lymphatics – Iliac, Sacral, Aortic, Inguinal
What are Positions of the Uterus?
- Anteverted: Rotated forwards toward anterior surface of body
- Anteflexed: Flexed towards the anterior surface of the body
What is the Structure of the Uterus?
- Peritoneum
- Myometrium
- Endometrium
What is the structure of the Endometrium?
- Deep stratum basalis: Changes little throughout the menstrual cycle and is not shed at menstruation.
- Superficial stratum functionalis: Proliferates in response to oestrogens, and becomes secretory in response to progesterone. It is shed during menstruation and regenerates from cells in the stratum basalis layer.
What are the ligament of the Uterus?
- Broad Ligament
- Round Ligament – Remnant of Gubernaculum
- Ovarian Ligament – Joins Ovaries to Uterus
- Cardinal Ligament – Extends from Cervix to Lateral Pelvic Walls
- Uterosacral Ligament – Cervix to Sacrum. Provides support to Uterus
- Suspensory Ligament of Ovary – Ovary to lateral abdominal wall
- Ligament of Ovary
What are the part of the Broad Ligament?
Mesometrium – surrounds the uterus and largest subsection of broad ligament
Mesovarium – associated with ovaries
Mesosalpinx – Encloses the Fallopian Tubes
What is the Vasculature of the Uterus?
Artery - Uterine Artery (Ureter cross under)
Veins – Uterine Veins
Lymphatics – Iliac, Sacral, Aortic and Inguinal Lymph Nodes
What is the innervation of the Uterus?
- Uterovaginal Plexus
- Parasympathetic Fibres: Pelvic Splanchnic Nerves
What is the structure of the Fallopian tubes?
- Fimbriae
- Infundibulum
- Ampulla
- Isthmus
What is the Vasculature of the Fallopian tubes?
Arteries - Uterine and Ovarian arteries.
Venous - Uterine and Ovarian veins.
Lymphatics - Iliac, Sacral and Aortic lymph nodes.
What is the Vasculature of the Ovary?
Artery – Ovarian Arteries
Veins – Ovarian Veins
- Left drains to Left Renal Vein
- Right Drains to Inferior Vena Cava
Lymphatics – Para-Aortic Nodes
What is the Innervation of the Fallopian tubes?
-Sympathetic and Parasympathetic Nerve fibres
What is the innervation of of the Fallopian tubes?
Ovarian and Uterine Plexuses