2-pelvic muscles &sacral plexus
Post on 02-Jun-2018
230 Views
Preview:
TRANSCRIPT
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
1/22
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
2/22
Pelvic Muscles& Sacral
Plexus
For
Medical Students
Anat 212 Prof. EL Hassan
Heidar
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
3/22
mportant
Notice
These slides are only to
illustrate the lecture and are
not substitute for the
recommended textbooks.
!"#
$%&'(
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
4/22
Piriformis Muscle
1- Origin
!rises from the front of the middle " sacral pieces.
Its tendon lea#es the pel#is through the greater
sciatic foramen to the gluteal region.
$- nsertion into the top of the greater trochanter.
Ner#e supply
%y branches from the sacral plexus &'() *1) $+.
"- !ction
'ateral rotation and abduction of the thigh.
,- elations in the pel#is
!nteriorly rectum) sacral plexus) branches of the
internal iliac #essels.
Posteriorly sacrum.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
5/22
Piriformis Muscle
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
6/22
Obturator Internus Muscle
Origin from
Inner surface of the ilium ust belo/ the arcuate
line and obturator membrane.
nsertion
The tendon comes out from the pel#ic ca#itythrough the lesser sciatic foramen to be inserted
into the medial surface of the greater trochanter.
The tendon takes the insertion of the t/o gemelli.
Ner#e supplyarises from sacral plexus &'() *1)$+.
!ction
'ateral rotator to the thigh and assist in the
abduction of the thigh.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
7/22
Obturator Internus Muscle
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
8/22
1- 'e#ator ani Muscle
Origin from the back of body of pubis.1- 0rom the inner surface of ischial spine.$- 0rom the tendinous arch of the obturator fascia.
Insertion
Inserted /ith those of the opposite side into the
perineal body. The most posterior fibers
Inserted into the side of coccyx and ano-coccygeal
body.
The intermediate fibers
0use /ith those of the opposite side ust behind the
recto-anal unction to form pubo-rectalis muscle.
Morphologically the muscle is di#ided into t/o parts
according to the origin into
Pubococcygeus and iliococcygeus
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
9/22
'e#ator !ni Muscle
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
10/22
$- 'e#ator !ni Muscle
Ner#e supply
Pel#ic &upper+ surface from the ,thsacral ner#e.
Perineal &lo/er+ surface from the inferior rectal branch of the
pudendal ner#e.
!ction
%oth muscles act together to increase the intra-abdominal
pressure by raising the pel#ic floor.The pubo-rectalis part acts as a sphincter to constrict the
rectum and reinforces the anal sphincter.
elations
- Pel#ic &upper+ surface
In the male related to urinary bladder) prostate) seminal #esicleand rectum.
In the female related to urinary bladder) #agina) broad ligament
and rectum.
- Perineal &lo/er+ surface
0orms the medial /all of the ischio-rectal fossa.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
11/22
'e#ator !ni muscle
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
12/22
2occygeus Muscle
Origin from the tip of the
ischial spine.
nsertion into the side of
the last piece of sacrumand first piece of coccyx.
Ner#e supply from
the ,thand (thsacral ner#e.
It unite /ith its follo/ to
form /ith the le#ator ani
the pel#ic floor) /hich
sometimes called pel#ic diaphragm.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
13/22
Pel#ic 3iaphragm It forms a partition bet/een the pel#is and perineum. The pel#ic diaphragm is formed by le#ator ani and
coccygeus of both sides at the floor of the pel#is and
pierced by) urethra) rectum in the male and added #agina
in the female.
The pel#ic floor is co#ered by a layer of fascia called
parietal layer of the pel#ic fascia
The pel#ic fascia /hich co#er the pel#ic organs is called
#isceral layer or endopel#ic fascia) its loose on the
expansile organs and dense on the organ /hich does not
expand as prostate.
N.%. The fascia /hich co#ers the #iscera is loose toallo/ for distension) of the organs) /hile the fascia
/hich co#ers the muscles is tough.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
14/22
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
15/22
Ner#es of the Pel#is
The ner#es include the follo/ing
sacral plexus and coccygeal plexus. The obturator ner#e.
Pel#ic parts of the sympathetic trunks and)
parasympathetic ner#e supplies the pel#ic #iscera.
1- 2occygeal Plexus
It4s formed by the lo/er part of the ,thsacral /ith (thsacral and coccygeal ner#e.
It gi#es branches to the le#ator ani and coccygeus.
$- Pel#ic part of the sympathetic trunks
The sympathetic trunk in the pel#is is directed as
continuation of the sympathetic trunks of the abdomen. 5ach trunk enter the pel#is then descends medial to
anterior sacral foramina and carries , sympathetic
ganglia.
%oth trunks &right and left+ ends in one ganglion called
ganglion impar lies in front of the coccyx.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
16/22
Ner#es Of The Pel#is
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
17/22
*acral Plexus
It lies on the pel#ic surface of the sacro-iliac oint andpiriformis) it4s found bet/een the muscles and its fascia.
It is formed by the anterior primary rami of ',) ( and
*1)$)"),.
The lo/er part of the ,thand (thlumbar form the lumbo-
sacral trunk /hich descends on6 the medial side of thepsoas maor) on the ala of the sacrum and on the
sacro-iliac oint to share in the formation of the sacral
plexus.
elations of the *acral Plexus to the %lood 7essels
The superior gluteal #essels pass bet/een the lumbo-sacral trunk and first sacral ner#e.
The inferior gluteal #essels pass bet/een the 1stand $nd
sacral ner#es.
The internal pudendal #essels lies in front of the sacral
ner#es.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
18/22
*acral Plexus
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
19/22
elation Of %lood 7essels to The
*acral Plexus
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
20/22
%ranches Of *acral Plexus
%ranches
!- 0rom the roots to
Piriformis &'() * 1)$+.
'e#ator ani &pel#ic surface *,+.
2occygeus &*,)(+.
%- 0rom the plexus1-*uperior gluteal ner#e. &',)( )*1+
$- Ner#e to 8uadratus femoris.
"- Inferior gluteal ner#e &'() *1) $+
,- Ner#e to obturator internus.
(- Posterior cutaneous ner#e of the thigh &*1)$)"+. Perineal branch of the ,thsacral ner#e.
2- T/o terminal branches of the plexus
1- *ciatic ner#e &',)( and *1)$)"+ The largest one.
$- Pudendal ner#e &*$)"),+ The smallest one.
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
21/22
%ranches Of The *acral Plexus
-
8/10/2019 2-Pelvic Muscles &Sacral Plexus
22/22
hankou
top related