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FEMALE PELVIS

Peritoneal Covering Covers/Relations Others

Recto-uterine pouch
(cul-de-sac of Douglas)
Vesiculo-uterine
pouch
Broad ligament
Parametrium
Mesosalphinx
Mesovarium
True ovarian ligament
False suspensory lig.
Infundibulo-pelvic lig.
Cardinal
(Mckenrodt’s) lig.
Utero-Sacral ligament
Round ligament
Pubo-vesical ligament
Fundus, uterus (posterior surface of body), upper 1/3 rectum Covering also used as
serosa of these organs
Fold inserted between upper 1/3 uterus & superior surface of
bladder
Below FT, sides of uterus and cervix Double layered fold
Fixed by infundibulo-pelvic ligament to sacro-iliac joint Encloses parametrium
Supports uterine vessels and nerves and distal ends of ureters Abundant endopelvic fascia
Covers fallopian tubes
Enfolds ovaries; includes true ovarian ligament
Supero-lateral angle of uterus below utero-tubal jxn  tubal pole
Tubal pole  lateral pelvic wall at sacro-iliac joint; ovarian vsls. Blends with infundibulo-
pelvic ligament
Thickening at sacro-iliac joint; encloses ovarian vessels
Thickennings at sides of cervix, extended to lateral pelvic walls Maintains cervix and uterus
Uterine arteries along its superior border in place
Back of cervix  recto-uterine fold and last segments of sacrum Prevents forward
displacement of cervis
Superior angles of uterus anterior to utero-tubal jxn  inguinal Remnants of Wolffian ducts
canal  fibrous tissue beneath labia majora
From pelvic surface of symphysis pubis to neck of bladder Normal position of uterus

Organ Definition
Ovaries Size of almond seed Fossa ovarica of Waldeyer – where it lodges; below
 age,  scarring (corpora lutea and albicans) bifurcation of ext and int iliac vessels
Mesovarium – covering of ovaries Superior or tubal pole – directed postero-laterally
Inferior or uterine pole – antero-medially
Fallopian Muscular tubes in lateral pelvic wall Below bifurcation of common iliac vessels
Tubes Vicinity of sacro-iliac joint 10-12 cms long, enveloped by mesosalphinx
Intramural Shortest, narrowest, most fixed part Embedded in uterus at superior lateral angle of
segment Opening: 1 mm in diameter uterus
Isthmus 2.5 cms From uterine wall and extended laterally
Ampulla Gradual widening; longest part Dilated ends curved downwards near tubal pole
Infundibulum Expanded end with finger-like extensions (fimbriae)
Abdominal opening (ostium abdominale) – potential but direct communication with ext env’t via utero-tubal
and vaginal passages
Ovarian fimbria – longer fimbria; facilitates entry of ovum through ostium into ampulla
Uterus Hollow muscular organ
Diameter: 7-8 cm (0-1 pregnancy), 9-10 (multi), 3-4 (menopause)
Fundus Slightly arching superior border anove utero-tubal junctions
Directed forwards towards symphysis pubis
Body Main part; Broadened below fundus
(corpus) Narrows inferiorly (isthmus)
Cervix Invaginated into upper end of vaginal Intravaginal portion – enclosed by vaginal fornices
canal Ant. fornix – nicest area to palpate for tumor; shallowest
Internal os – in isthmus of cervix Lateral fornices – BV
External os – rounded or narrow slit Post. fornix – largest and deepest; receptaculum seminis
Supravaginal portion – upper segment - rises above pelvic diaphragm into pelvic cavity  contact
with cul-de-sac of Douglas
Cavity Triangular; lined by endometrium Intrauterine openings – at superior angles of cavity
Plica palmatae – characteristic palm-leaf-like folds After deliver: involution; 8-12 weeks to recover
Vagina Upper end – distended for lower half of cervix Lower 1/3 of vaginal canal – surrounded by:
Fornices – pouches produced by walls at upper end Pubo-coccygeus (of levator ani)
Anterior vaginal wall – shorter, rough (due to rugae) Sphincter urethra and deep TP muscles
- related to neck of bladder and urethra Bulbo-cvernoss and superficial TP muscles
Posterior wall – longer , smoother; from rectal wall by Musculo-membranous tube; 7-8 cms long
thin fascial septum Opens into vestibule of perineum

NVS Origin Course End

Uterine a. Internal iliac Down, forwards, medially to lateral border of isthmus Anastomose with tubal
Enveloped by cardinal ligament branch of ovarian artery
Side of isthmus: Gives off vaginal branch
Ascends on lateral border of uterus  utero-tubal jxn
Ovarian a. Abdominal Oblique course down  crossing over the ureter Anastomose with uterine
aorta Pelvic brim: enters fold of infundibulo-pelvic ligament artery
Below origins Mesovarian border  hilus of ovary
of renal a. Gives tubal branch  mesosalphinx  utero-tubal jxn
Vaginal a. Int. iliac Gives branches to lowest part of bladder and rectum Anastomose to form median
Vaginal wall: gives off anterior and posterior branches longitudinal azygos artery
Veins Vaginal plexuses along sides of vagina  uterine plexuses  other pelvic plexuses
Lymphatic Sides of uterus and vagina + urethral, ovarian, and tubal channels  nodules along vein  int & ext iliac vsls
Efferent vsls  lumbar, aortic, and other nodes; some into femoral nodes
Sym Sacral Joins perivascular plexus (hemorrhoidal arteries, branches Innervate smooth muscles
nerves ganglia from inf hypogastric plexus) and glands (uterus &
PS nerves S2, 3, 4 Conveyed by pelvic splancnic nerve + above plexuses oviducts)

2006