骨盆和会阴的解剖生理学精品文档.pdf

骨盆和会阴的解剖生理学精品文档.pdf

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Pelvis+Perineum骨盆+会阴1PelvicCavity盆腔Enclosedbybony,ligamentousandmuscularwall由骨、韧带和肌壁围绕Containstheurinarybladder,ureters,pelvicgenitalorgans,rectum,bloodvessels,lymphaticsandnerves包括膀胱、输尿管、盆腔生殖器官、直肠、血管、淋巴管和神经Pelvicinlet（superiorpelvicaperture）骨盆入口（骨盆上口）Pelvicoutlet（inferiorpelvicaperture）骨盆出口（骨盆下口）2SuperiorApeture上面观3InferiorPelvicBorder骨盆下缘4LesserPelvis（pelvisminor）小骨盆Locationofpelvicvisceratheurinarybladderandreproductiveorganssuchastheuterusandovaries盆腔脏器的位置-膀胱和生殖器官，如子宫和卵巢。

Boundedbythepelvicsurfacesofthehipbones,sacrum,andcoccyx骨界面由髋骨、骶骨和尾骨组成Limitedinferiorlybythemusculofascialpelvicdiaphragm由盆底筋膜控制向下AKATruePelvis又名真骨盆5PelvicWallsandFloors骨盆壁和骨盆底Anteriorpelvicwallisformedprimarilybythebodiesandramiofthepubicbonesandthepubicsymphysis骨盆前壁-主要由耻骨体和耻骨分支以及耻骨联合组成Lateralpelvicwallsformedbythehipbonesandtheobturatorinternusmuscles（O:

proximalsurfaceoftheiliumandischium;obturatormembraneI:

greatertrochanterofthefemur）骨盆侧壁-由髋骨和闭孔内肌组成（O：

髂骨和坐骨的近端表面；闭孔膜I：

股骨大转子）6AnteriorPelvicWall骨盆前壁7PelvicWallsandFloor骨盆壁和骨盆底PosteriorPelvicWallformedbythesacrumandcoccyx,adjacentpartsoftheilia,andtheS-Ijoints;piriformismusclecoversthearea（O:

pelvicsurfaceof2ndand4thsacralsegments,superiormarginofthegreatersciaticnotchandsacrotuberousligament,I:

greatortrochanteroffemur）骨盆后壁由骶骨和尾骨、髂骨的相邻部分以及骶髂关节组成；梨状肌附着于此（O:

骶2和骶4的盆面，坐骨大切迹与骶结节韧带，I：

股骨大转子8PosteriorPelvicWall骨盆后壁9PosteriorPelvicWall骨盆后壁10PelvicFloor骨盆底Formedbythefunnelshapedpelvicdiaphragmconsistsofthelevatoraniandcoccygeusmusclesandtheirfascia由漏斗型骨盆隔膜-由肛提肌、尾骨肌及它们的筋膜组成Stretchesbetweenthepubisanteriorlyandthecoccyxposteriorlyandfromonelateralpelvicwalltotheother从前方耻骨延伸至后方尾骨延伸，一侧骨盆壁到对侧骨盆壁11PelvicDiaphragm骨盆隔膜12PelvicFloor-Male骨盆底-男性13PelvicFloor-Female骨盆底-女性14LevatorAni肛提肌Consistsofthreepartsthepubococcygeus,thepuborectalisandtheiliococcygeus.由三个部分组成耻骨尾骨肌、耻骨直肠肌和髂尾肌。

Collectivelytheyrunfromthebodyofthepubis,thetendinousarchoftheobturatorfasciaandtheischialspineTOtheperinealbody,thecoccyx,theanococcygealligament,thewallsoftheprostateorvagina,therectumandtheanalcanal起点为耻骨体的闭孔筋膜腱弓、坐骨棘到会阴体，尾骨，肛尾韧带，前列腺或阴道壁、直肠和肛管InnervatedbythenervetolevatoranifromS4andtheinferioranal（rectal）nerve（fromS2-S4）andthecoccygealplexus由来自S4的肛提肌神经、肛门下（直肠）神经（S2-S4）和尾骨神经丛支配。

Helptosupportthepelvicviscera;actingtogethertheyraisethepelvicfloorandassisttheabdominalmusclesinforcedexpirationactivities帮助支撑盆腔脏器；共同支撑盆底，辅助腹肌进行用力呼吸15PerinealBody会阴16CoccygeusMuscle尾骨肌O:

ischialspine,I:

inferiorendofthesacrum,I:

branchesofS4andS5O：

坐骨棘，I：

骶骨的下端，I：

S4和S5分支Formsasmallpartofthepelvicdiaphragmthatsupportsthepelvicviscera,flexesthecoccyx构成了盆隔膜的一小部分，支撑盆腔脏器以及使尾骨屈曲17Viscera内脏Urinaryorgansinthepelvis骨盆内的泌尿器官Uretersmuscular（smooth）tubesrunningfromkidneystobladder25to30cmlong输尿管-肾脏到膀胱25至30厘米长的肌肉（平滑肌）管Bladderahollowcontainersurroundedbyastrongsmoothmuscularwall膀胱一个中空的容器，内壁为强大的平滑肌Temporaryreservoirforurine尿液临时贮器Apex,Body,Fundus,Neck,Uvula由膀胱尖、膀胱体、膀胱底、膀胱颈和膀胱垂组成18PelvicViscera-Female盆腔脏器-女性19Uterus子宫20Perineum会阴Liesinferiortothepelvicoutletandisseparatedfromthepelviccavitybythepelvicdiaphragm（Levatoraniandcoccygeusmuscles）位于骨盆出口下部，被盆隔膜（肛提肌和尾骨肌）将其与盆腔分隔BoundedbyPubicsymphysisanteriorly;inferiorpubicramiandischialramianterolaterally;ischialtuberositylaterally;sacrotuberousligamentposterolaterally;inferiorlybysacrumandcoccyx前侧为耻骨联合;前外侧为耻骨支和坐骨支;外侧为坐骨结节;后外侧为骶结节韧带;下侧为骶骨和尾骨21Perineum会阴TwoTriangles两个三角形Analtriangle（posterior）containstheanus肛门三角（后侧）包含肛门Urogenitaltriangle（anterior）containstherootofthescrotumandpenisinmalesortheexternalgenitaliainfemales泌尿生殖三角（前侧）包含男性的阴囊根部和阴茎或者女性的外生殖器Theperinealmembranestretchesbetweenthetwosidesofthepubicarchandcoverstheanteriorpartoftheoutlet会阴膜在耻骨弓两侧延伸，覆盖出口的前部Theperinealbodyisanirregularfibromuscularmasslocatedbetweentheanalcanalandtheperinealmembrane会阴体是一个不规则的纤维块位于肛门和会阴膜之间22Triangles三角形23PerinealBody会阴24PerinealMembrane会阴膜25Perineum-Female女性会阴26Perineum-Male男性会阴27Perineum会阴Muscles肌肉BulbospongiosusFO:

centraltendonofperineum,MO:

centraltendonofperineumandbulbofpenis;FI:

dorsumofclitoris,urogenitaldiaphragm,MI:

rootofpenis;A:

compressvaginaorificeorcompressurethra,N:

perinealnerve,pudenalnerve海绵体FO：

会阴中心腱，MO：

会阴中心腱和阴茎球FI：

阴蒂背，尿生殖膈，MI：

阴茎根；A压缩阴道口或压缩尿道，N：

会阴神经，阴股沟神经IschiocavernosusO:

ramusofischium,I:

nearpubicsymphysis,maintainserectionofpenisorclitoris坐骨海绵体肌O:

坐骨支，I：

靠近耻骨联合，保持阴茎或阴蒂勃起28Muscles-Female女性肌肉29Muscles-Female女性肌肉30MusclesMale男性肌肉31Muscles-Male男性肌肉32Perineum会阴Muscles肌肉Externalanalsphincter（skeletalmuscle）O:

skinanfasciasurroundinganusandcoccyx,I:

perinealbody,A:

closesanalcanal,N:

InferiorAnalNerve（SomaticnervefromS2-S4）inhibitsvoiding肛门外括约肌（骨骼肌）O