《腹股沟韧带》PPT课件.ppt

Anatomy of Female reproductive system,Teng Yincheng M.D.,Ph.D.,Professor Department Of Obstetrics&Gynecology Renji Hospital Affiliated to SJTU School of Medicine,bony pelvis female genital organs blood supply of female genital organs,Bony pelvis,The bony pelvis is made up of 4 bones:,ilium,ischium,pubis,sacrum,1)2 os coxae or innominate bones the iliumcoxae the ischium the pubis,2)1 sacrum:Formed from 5 sacral vertebrae which fuse.3)1 coccyx:Formed from 4 fused vertebrae.,2.Joint and ligament,Sacro-iliac jointSacro-coccygeal joint腹股沟韧带骶棘韧带骶结节韧带,3.True pelvis and false pelvis,The pelvis is divided into the pelvis major(false pelvis)is bounded by the lumbar vertebrae posteriorly,an iliac fossa bilaterally,and the abdominal wall anteriorly the pelvis minor(true pelvis)is formed by sacrum and coccyx posteriorly and by the ischium and pubis laterally and anteriorly,4.Pelvic planes,The pelvic inlet(pelvic brim):the promontory,and alae of the sacrum,linea terminalis the superior border of the symphysis pubis The plane of greatest diameter is bounded by the junction of the second and third sacral vertebrae posteriorly,the upper part of the obturator foramina laterally,and the midpoint of the pubis anteriorly,The plane of least diameter:extends from the lower border of the pubis anteriorly to lower sacrum at the level of the ischial spinesThe plane of the outlet is irregular consisting of two intersecting triangles,5.The types of female pelvis,Gynecoid pelvis Occurs 40%-50%the inlet is rounded the side walls are straight the sacrum is well curved,and the sacrosciatic notch is adequate,Platypelloid pelvisoccurs in approximately 30%,10%to 15%of African-american women There is an oval inlet the sacrum is normal the side walls are straight the sacrosciatic notch is narrower,Android pelvis occurs in only 2%to 5%of women wedge-shaped inlet the side walls converge the sacrum is inclined forward the sacrosciatic notch is narrow,Anthropoid pelvisoccurs in approximately 20%;approximately 40%of black womenthe inlet is oval,long,and narrow the side walls are straight(do not converge)the sacrum is long and narrowthe sacrosciatic notch is wide.Both the interspinous and intertuberous diameter are somewhat smaller,6.Length of pelvic plane diameters,7.Pelvic floor,female genital organs,mons pubis:fatty tissuelabia majoralabia minora which lie inside the labia majoraclitoris:is located anterior to the labia minora,1.External genitalia,vestibuleLies between the labia minora Is bounded Anteriorly by clitoris Posteriorly by perineumUrethra and vaginal orifice open to the midline of the vestibuleBartholins glands also empty into the vestibule,2.Internal genitalia,1)VaginaMuscular tube from vestibule extends to uterusThe anterior vaginal wall is 2cm shorter than the posterior wallThe area around the cervix-the fornix the posterior fornix is important pouch which allows access to the peritoneal cavity from vaginaThe vaginal wall consists of a mucous membrane,Beneath this is a submucosal layer of connective tissue which contains a rich of veins and lymphatics The muscular wall has three layers of smooth muscle.,2)uterus,Cervix cylindrical shape,2-3cm long vaginal portion external os cervix tube stratified squamous epithelium simple columnar epithelium,2)Isthmus separate cervix and body3)Corpus cornu fundus long 7-8cm;wide 4-5cm;thick 2-3cmThe ratio of the body to the cervixBefore puberty 1:2;after puberty 2:1,The uterus is surported by the following ligamentsRound ligamentBroad ligamentCardinal ligamentUtero-sacral ligament,Histology of uterus,There are three layers of the bodyThe inner is endometrium which is consisted of the simple columnar epitheliumBeneath the mucosa is the muscular layer,covered by peritoneal serosa,3)Fallopian tubes,Length:8-14cmThe tube is divided four portionsInterstitialisthmusAmpulla:the centre portionInfundibulum:surround the ovary and help to collect the oocyte at the time of ovulationThe innner layer is covered by ciliate columnar epitheliun The cilia beat toward the uterus assisting in oocyte transport,4.ovaries,Be located on either side of the uterusVolume:4*3*1cmWeight:5-6gbe almond-shapedIs divided two portion:cortex(outer portion):contains amount of follicles medulla(central portion):blood vessels,nerve fibres,lymphatics,blood supply,Arterial systemOvarian artery:from abdominal aorta(left may be from kedney artery)Uterine arteryVaginal arteryInternal pudendal artery from internal iliac artery,Lymphatic drainage,外生殖器淋巴腹股沟浅上组下组腹股沟深盆腔淋巴髂淋巴组骶前淋巴组腰淋巴组,The organ in the neighborhood,UretheraUrinary bladderUreterRectumVermiform appendix,Teng Yincheng M.D.,Ph.D.,Professor Department of Obstetrics&Gynecology Renji Hospital Affiliated to SJTU School of Medicine,Thanks for Your Attention,