Pelvis anatomy

• The true (lesser) pelvis is from the pelvic inlet downwards
• The false (greater) pelvis is classed as part of the abdominal cavity

  There is no true diaphragm between the abdomen and pelvis
• A physical diaphragm exists between the true (lesser) pelvis and the perineum = pelvic floor
• Hip bones = innominate bones

  There are 3 bones per hip - ilium, ischium and pubis
• ilium:

  • Widest and largest of the three parts of the hip bones
  • Expands to form the wing - iliac crest
  • Extends to form the anterior superior iliac spine (ASIS)
• Ischium:

  • Ischium spine - palpable PV and used as a landmark for pudendal nerve block
  • Ischial tuberosity - what we sit on
• Pubis:

  • Most anterior portion of the hip bones
  • Body, superior and inferior ramus
• The sacrotuberous ligament and sacrospinous ligaments form 2 foramen (holes) in the pelvis - greater sciatic foramen and lesser sciatic foramen
• The greater sciatic foramen contains sciatic nerve

  The lesser sciatic foramen contains the pudendal nerve
• The ovaries are intraperitoneal
• Ovarian ligaments – ovarian ligament and suspensory ligament – suspensory ligament carries vessels and nerves to the ovaries
• Blood supply to the female reproductive system:

  • Vagina - vaginal arteries from the internal iliac artery
  • Uterus - uterine artery from the internal iliac artery
  • Ovaries - ovarian artery from the abdominal aorta
• Lymph drainage of the female reproductive system:

  • vagina and uterus - deep pelvic lymph nodes
  • Ovaries - retroperitoneal lymph nodes
• Normal position of the uterus is anteverted and anteflexed
• The ovaries produce oestrogen and progesterone in response to pituitary hormones LH and FSH
• Venous drainage of the ovaries:

  • Left ovarian vein drains into the left renal vein
  • Right ovarian vein drains directly into the inferior vena cava
• Rupture of an ectopic pregnancy can cause diaphragmatic irritation and therefore shoulder tip pain
• The majority of ovarian cancers are derived from epithelium = adenocarcinomas
• External genitalia in males and females drain into local groin lymph nodes
• The pelvic floor is under voluntary control via the pudendal nerve - from S2, 3 and 4
• Most cervical cancers are adenocarcinomas
• Menarche is when females start their period = 11-15 years old