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OBGYN Skills Lab
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Internal Pelvic Anatomy Video Basic pelvic structure is established by the pelvic bones. Three bones form the pelvis, two hip bones and the sacrum. The areas where the hip bones join the sacrum are called the sacro-iliac joints. When unstable, such as during pregnancy, movement of these joints can cause discomfort. Similarly uncomfortable is instability of the symphysis pubis. The muscles of the pelvic floor provide support for the bottom of the pelvis. The pelvic floor muscles have openings to allow passage of the urethra, the vagina, and the rectum. Click Here to watch the video. When performing abdominal surgery, the pelvis is viewed from above.
This model depicts the major pelvic structures, and includes the uterus, fallopian tubes, ovaries, bladder, ureters, uterosacral ligaments and rectum. The uterus is a firm, muscular organ located centrally in the pelvis. In this hysterectomy case, we begin by placing clamps at the corners of the uterus. This will make it easier for us to visualize the pelvic structures. The ovaries lie lateral to the uterus. They are suspended between the uterus and the pelvic sidewall. They are much more mobile than generally appreciated. The fallopian tube extends laterally from the uterus to the general area of the ovary. Like the ovary, the fallopian tube is quite mobile. The uterosacral ligaments are part of the main supporting structures of the uterus. They are also a common site for endometriosis implantation. The round ligaments start at the uterus, pass through the inguinal canal, and terminate in the upper portion of the labia majora. The bladder is positioned right next to the uterus. The open space between them is called the anterior culdesac. This model portrays the relationship between the bladder and the uterus as fixed. However, the bladder expands and contracts with urine, and the uterus is relatively mobile. Here, a catheter tip can be demonstrated within the bladder. The ureters pass along the pelvic sidewalls coming within about a centimeter of the cervix before passing into the bladder. The ureter crosses the external iliac vessels and passes just underneath or just next to the infundibulopelvic ligament. |
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This information is provided by The Brookside Associates, a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates. For educational simplicity, only one method is usually shown, but many alternative methods may give satisfactory or superior results. This information is provided solely for educational purposes. The practice of medicine and surgery is regulated by statute and restricted to licensed professionals and those in training under supervision. Performing these procedures outside of that setting is a bad idea, is not recommended, and may be illegal. The presence of any advertising on these pages does not constitute an endorsement of that product or service by the Brookside Associates. C. 2010 All Rights Reserved
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