Download lateral cellular space

Anatomical and Physiological
Substantiations of Operative
Interventions on Pelvic Organs
Osseous Basis of Pelvis
(anterior view)
Osseous Basis of Pelvis (posterior view)
Suprapiriform foramen:
a. glutea superior
v. glutea superior
n. gluteus superior
Infrapiriform foramen:
n. gluteus inferior
a. glutea inferior
v. glutea inferior
n. pudendus
n.ischiadicus
a. pudenda interna
n. cutaneus femoris posterior
Pelvic Compartments:

Peritoneal compartment

Subperitoneal compartment

Subcutaneous compartment (ischiorectal fossa)
Pelvic Compartments
Culdocentesis
Colpotomy for pelvic abscess
Fasciae and Cellular Spaces of the Pelvis
Spread of Pelvic Abscesses

From lateral cellular space to:
1) visceral cellular space
2) gluteal region
3) medial surface of thigh

From prevesical space to:
1) thigh
2) ventral abdominal wall

From paravesical space to:
1) retroperitoneal space

From retrorectal space to:
1) retroperitoneal space

From parametric space to:
1) internal inguinal ring, than – ventral abdominal wall
2) iliac fossa, and than – retroperitoneal space
Branches of the Internal Iliac
Artery
Anterior trunk:
 a. umbilicalis
 a. uterina (a. ductus deferentis)
 a. vesicalis inferior
 a. rectalis media
 a. obturatoria
 a. pudenda interna
Posterior trunk:
 aa. sacrales laterales
 a. iliolumbalis
 a. glutea superior
 a. glutea inferior
Sacral Plexus
Ischio-rectal Fossa
Female Perineum
Trigone of Urinary Bladder
Ligamentous Apparatus of Uterus



Fixative apparatus:
- Cardinal ligament
- Sacrouterine ligament
- Pubovesical ligament
- Vesicouterine ligament
Suspending apparatus:
- Round ligament of uterus
- Wide ligament of uterus
Supporting apparatus:
Muscles and fasciae of pelvic bottom
Pouches and Ligaments/Topography of
Female Pelvis
Types of Acute Paraproctitis
1.
2.
3.
4.
Subcutaneous
Ischiorectal
Pelviorectal
Submucous
Types of Pararectal Fistulae
а) subcutaneous; б) lower anal; в) higher anal;
г) submucous; д) ischiorectal; е) pelviorectal
Paracentesis of Urinary Bladder
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