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HUMAN ANATOMY VOLUME VI RETROPERITONEAL SPACE AND TRUE PELVIS First edition HABIB TRIAA Professor of Anatomy Monastir Faculty of Medecine Tunisia EDITIONS ADAM 1 BOOKS OF HUMAN ANATOMY BY PROFESSOR HABIB TRIAA VOLUME I : UPPER LIMB : 2014 VOLUME II : LOWER LIMB : 2014 VOLUME III : BODY WALLS : 2014 VOLUME IV : CONTENTS OF THORAX : 2014 VOLUME V : ABDOMINOPELVIC DIGESTIVE SYSTEM : 2014 VOLUME VI : RETROPERITONEAL SPACE AND TRUE PELVIS : 2014 VOLUME VII : HEAD AND NECK : 2014 VOLUME VIII : CENTRAL NERVOUS SYSTEM : 2014 Our deep thanks go to: Maurice LAUDE: Emiritus Professor of Anatomy, and Honorary Dean of the Faculty of Medicine Of Amiens, FRANCE. Spiritual Father of French Contemporary Anatomy. Daniel LE GARS: Professor of Anatomy, Head of Department of Neurosurgery and Dean of the Faculty of Medicine of Amiens, FRANCE. Legal deposit: October 2014 – ISBN : 978-9938-893-09-0 All rights reserved worldwide. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including photocopiers or scanners or other electronic devices, nor used by any information storage and retrieval system without written permission from the copyright owner, except for private use. 2 PREFACE Professor Habib TRIAA was trained by us during two successive years (1989 - 1990). He showed an outstanding willingness to learn but also to transmit knowledge about anatomy in the best and proper way. After two decades, he published six volumes of excellent quality on the descriptive and topographic Anatomy of the: Upper Limb; Lower Limb; Body Walls; Contents of Thorax; Abdominopelvic Digestive System; Retroperitoneal Space and True Pelvis. The osteoarticular and muscular components, as well as the viscera of the trunk and their trophic peduncles, are described with precision and simplicity. The drawings are clear and colorful for easy reading. The latin names are used wisely. They must be accepted and used nowadays by all physicians. 5000 additional questions in separate volumes (Short Answer Questions; MCQ; Synthetic Questions) help students to practice for the exam. The textbooks are compiled for a didactic purpose. There are no – and for a good reason - photos of dissections and, therefore, no introduction to surgical techniques. For students of medical and paramedical disciplines, they are excellent foundations to approach a subject as difficult and complex as Anatomy. Professor Maurice LAUDE Emeritus Professor of Anatomy Honorary Dean of the Faculty of Medicine of Amiens – FRANCE 3 PREFACE The diversity of the modern books of Anatomy, inspires doctors that this science has reached the highest degree of perfection and that there is nothing more to add on this discipline and that it would be difficult to find « something new » in Anatomy; but Science is a field whose boundaries recede gradually as we advance. «Science is an ever unfinished monument». Anatomy remains a difficult discipline to be remembered because it is easily forgotten. It requires periodic reviews, a prodigious memory and a high intelligence in interpretation. The theoretical approach of the chapters draws the attention by its descriptive and topographic quality and refinement, disposing Anatomy from all ambiguities. It is enriched with anatomical drawings of outstanding quality, coming with very explicit captions, confirming the talent, expertise and the thoroughness of the author. The exam practise questions (MCQ; Short Answer Questions and Synthetic Questions) presented in other volumes, make it easier for students to prepare for exams and make the study of Anatomy more understandable, more pleasant and very useful. The anatomical language used in these books is exclusively based on the formal latin nomenclature, adapted to the English Language. To learn Anatomy, we suggest that students reproduce the schemas many times without giving too much importance to the three-dimensional effects but with full respect of color chart. We hope that these books enrich the knowledge of Anatomy and contribute to educating and stimulating student’s enthusiasm for a subject that constitutes the basic science of medical and paramedical studies and the foundations of operating techniques. We wish these books the success they deserve, and we present our congratulations and encouragement to the author Professor Habib TRIAA. Professor Daniel LE GARS Professor of Anatomy Dean of the Faculty of Medicine of Amiens - FRANCE 4 RETROPERITONEAL SPACE AND TRUE PELVIC ABDOMINAL AORTA Relations of the abdominal aorta Collateral branches Common iliac artery INFERIOR VENA CAVA Relations of the inferior vena cava Afferent branches Common iliac vein Portocaves anastomoses Cavocaves anastomoses ABDOMINOPELVIC LYMPHATICS Lymphatics of pelvis Lymphatics of abdomen ABDOMINAL VEGETATIVE SYSTEM Lumbar sympathetic trunk Collateral branches Superior hypogastric plexus Vegetatif ganglia Afferent branches Efferent branches VEGETATIVE PELVIC SYSTEM Sympathetic sacral trunk Superior hypogastric plexus Inferior hypogastric plexus RENAL LODGE Renal fascia capsule adipose of kidney KIDNEY Renal medulla Renal cortex Relations of kidney Minor calices Major calices Renal pelvis Renal artery Renal vein Plexus renal SUPRARENAL GLAND Suprarenal arteries Suprarenal vein Suprarenal plexus URETER Lumbar ureter Iliac ureter Pelvic ureter in male Pelvic ureter in female BONY PELVIS ARTICULATIONS OF PELVIS Sacroiliac articulation Pubic Symphysis TOPOGRAPHIC OF TRUE PELVIS Piriformis muscle Obturator internus muscle Levator ani muscle Coccygeal muscle Peritoneal pelvic space Subperitoneal pelvic space INTERNAL ILIAC ARTERY Umbilical artery Inferior vesical artery Middle rectal artery Uterine artery Vaginal artery Iliolumbar artery Superior sacral lateral artery Inferior sacral lateral artery Obturatror artery Gluteal superior artery Gluteal inferior artery Pudendal internal artery INTERNAL ILIAC VEIN Perivicseral venous plexus Vesical veins Middle rectal veins Uterine veins Vaginal veins Superior gluteal vein Inferor gluteal vein Obturator vein Internal pudendal vein EXTERNAL ILIAC ARTERY Inferior epigastric artery Deep iliac circumflex artery EXTERNAL ILIAC VEIN Deep iliac cicumflex vein Inferior epigastric artery PUDENDAL PLEXUS Pudendal nerve COCCYGEAL PLEXUS BLADDER Umbilical vesical fascia Bladder of new-born Vascularization Innervation URETER TESTIS Testicular lobules Seminiferous right tubes Testis rete EPIDIDYMIS Efferent canaliculi Epididymal duct Testicular artery Cremasteric artery 5 Testicular vein Cremasteric veins Testicular plexus Vaginalis testis Internal spermatic fascia Cremaster muscle External spermatic fascia Scrotum Proper ligament of ovary Uterosacral ligament Paravesical fossa Preovarian fossa Tuboovarian recess Parauterine fossa Pararectal fossa Ovarian fossa Infraovarian fossa SPERMATIC DUCT Ductus deferens Ejaculatory duct VAGIN Vaginal fornix Hymen Vaginal ostium MASCULINE GENITAL GLANDS Prostate Seminal vesical Bulbourethral gland VESSELS AND NERVES OF INTERNAL GENITAL ORGANS Uterine artery Ovarian artery Vaginal artery Uterine veins Ovarian vein Vaginal veins Ovarian plexus Vaginal nerves PENIS Body of penis Gland of penis Root of penis Corpus cavernosum Corpus spongiosum of penis Prepuce Vascularization Innervation VULVA Vulvar vestibule Labia majora Labia minora Mons pubis Clitoris Vestibular bulbs Major vestibular gland Paraurethral gland Vestibular groove Vaginal ostium External ostium of urethra Vascularization Innervation PERINEUM OF MAN Urogenital perineum Deep space of perineum Deep transverse muscle of perineum Sphincter muscle of urethra Bulbourethra gland Urogenital fascia of diaphragm Superficial space of perineum Corpus cavernosum of penis Bulb of penis Superficial transverse muscle Ischiocavernosum muscle Bulbospongiosum muscle Supeficial fascia of perineum PERINEUM OF WOMEN Urogenital perineum Deep space of perineum Deep transverse muscle of perineum Sphincter muscle of urehtra Fasciae of urogenital diaphragm Superficial perineal space Corpus cavernosum of clitoris Vestibular bulb Major vestibular gland Transverse superficial gland Ischiocavernosum muscle Bulbospongiosum muscle Superficial fascia of perineum Perineal anal External anal sphincter muscle Ischiorectal fossa Internal pudendal artery Internal pudendal vein Pudendal nerve PERINEAL ANAL External anal sphincter muscle Iliorectal fossa Internal pudendal artery Internal pudendal vein Pudendal nerve OVARY UTERINE TRUNK UTERUS Nulliparous Multipare Primiparous Body of uterus Isthmus of uterus Neck of uterus Broad ligament Round ligament 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24