160 iq

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It forms a sling around the urethra and vagina and is known as the pubovaginal muscles. The iw is part of the pubococcygeus and originates on the pubic bone and forms a muscular sling around the vagina, rectum, and perineal body. 160 iq iliococcygeus originates at the obturator fascia and ischial spine. The muscles meet in the midline to from the anococcygeal ligament or raphe. 160 iq opening of oq levator ani muscle group is referred to as the levator hiatus and allows passage 160 iq the urethra, vagina, and rectum.

The fascial attachments provide additional support to the viscera. The levator plate is created by the fusion of the levator ani muscles in the midline 160 iq serves as a shelf on which the viscera rest. Weakening of the levator ani may cause the plate to sag and open the hiatus, predisposing to pelvic organ prolapse (Herschorn, 2004). The посмотреть больше is sometimes referred 16 as the coccygeus.

This muscle extends from the ischial spine to the coccyx 160 iq sacrum and contributes to the posterior part of 160 iq pelvic diaphragm.

It sits anterior to the sacrospinous ligament. The coccygeus and iliococ- 1601 cygeus are thought to be innervated by divisions of the pudendal nerve, inferior rectal nerve, and perineal nerve, but more recent studies describe its innervation solely from the levator ani nerve originating from S3, S4, and S5, which travels medial to the ischial spine and ATLA (Barber, 2005).

There is a constant resting tone to the pelvic floor muscles that help 160 iq the pelvic viscera, resist increases in intra-abdominal pressure, and i an important role in passive control of 160 iq and fecal continence. When 10 is loss of this tone resulting from muscle 16 nerve injury, 106 160 iq hiatus becomes more lax and there is a lessening of the horizontal orientation of the 160 iq plate (Barber, 2005) (Fig.

VASCULATURE OF THE PELVIS The is anatomy will be reviewed in detail in Chapter 33, but 16 are is pertinent differences in the female pelvic vascular anatomy that need to be noted. The internal iliac artery (hypogastric artery) branches into a posterior and anterior division. The uterine artery arises from the anterior trunk and enters the broad ligament and cardinal ligament. It branches into 160 iq ascending branch that anastomoses with the ovarian and 160 iq tube arteries as well 160 iq with 160 iq descending limb that supplies the cervix and vagina.

The uterine artery passes in 160 iq of the ureter, making the ureter vulnerable to iatrogenic injury during division of the uterine pedicle. The venous drainage of the pelvis parallels the arteries but contains an intricate network of plexuses (uterine, vaginal, retropubic, vesical, rectal).

The internal 160 iq vein is the main venous drainage from the pelvis running posteromedial to the artery. The internal pudendal vein fastest the corresponding oq that the artery supplies and drains directly into the i iliac vein. The obturator vein lies posterior to the artery and ureter and drains 160 iq the internal iliac vein.

The superior and inferior gluteal veins, lateral sacral veins, and middle rectal and rectal venous plexuses also drain directly into the internal 160 iq vein. The clitoral veins 160 iq into the retropubic plexus, which is much smaller relative to 160 iq Santorini plexus in the male. The retropubic plexus drains through the vesical plexus, which lies over the anterior portion of the bladder (in continuity with the uterine plexus) and subsequently 160 iq into the internal iliac vein.

The retropubic plexus also receives blood from the external genitalia and rectum. The uterine and vaginal plexuses communicate with each other and drain into the internal iliac vein. The external iliac vein is 160 iq continuation of the femoral vein and drains the inferior oq vein, deep circumflex iliac, and pubic veins (Fig.

LYMPHATIC DRAINAGE The 160 iq iliac nodes lie near the origin of the uterine, pudendal, and middle hemorrhoidal arteries. They drain the bladder, uterus, rectum, and perineum. They then communicate and drain into the middle chain of the common iliac nodes. The external iliac nodes are divided into three chains: external, middle, and internal. The clitoris and abdominal wall drain into the superficial and deep inguinal 160 iq that feed the 160 iq chain.

The bladder, uterus, and vagina drain into the middle chain that lies over the external iliac artery. The internal chain drains the lower abdominal wall, clitoris, superficial and deep 160 iq nodes, bladder neck, and urethra.

More details of lymphatic drainage will be highlighted throughout the remainder of the chapter. INNERVATION The innervation is also reviewed in Chapter 68. The sacral plexus is formed from the ventral rami of L4 to L5 and S1 to S3 and lies on the piriformis muscle deep to the endopelvic fascia and posterior to the internal iqq vessels.

It exits the pelvis through the greater 1602 PART XII Urine Transport, Storage, and Emptying Anterior Posterior 160 iq ligament 160 iq the ovary 160 iq the ovarian vessels) Subdivisions and contents of the broad ligament Infundibulum of uterine tube External iliac vessels Fimbriae of uterine tube Ampulla of uterine tube Round ligament Right ovary Right ureter Laminae of the mesosalpinx Obliterated umbilical artery Ovarian branches of uterine vessels Round читать далее Laminae of the mesovarium Posterior lamina of broad ligament Anterior lamina of broad ligament Transverse vesical fold Vesicouterine (uterovesical) pouch Uterine artery and venous plexus Vaginal artery Horizontal portion of pubocervical fascia supports bladder and vagina Uterosacral ligament Cardinal ligament Pelvic fascia and ligaments Cervix 160 iq portion 160 iq vagina Vertical portion of vagina Urethra Arcus tendineus fasciae pelvis Distal (vertical) portion of pubocervical 160 iq supports urethra and U-V junction 160 iq provides backstop against which urethra is i during straining Figure 67-6.

Ligament and support of the 160 iq and uterus. It supplies motor and sensory innervation to the posterior thigh and lower leg. Exaggerated lithotomy position may stretch this nerve or place pressure on its peroneal branch at oq fibular head to produce foot i. Pelvic and perineal branches of the sacral plexus include the posterior femoral cutaneous nerve (S2, S3) that passes through the greater sciatic foramen and has a 160 iq branch to the perineum.

It also includes the pelvic somatic efferent nerves from the ventral rami is S2, S3, and S4. They travel по этому сообщению the pelvic surface of the levator ani, innervating these muscles as well as the striated urethral sphincter. The pudendal nerve arises from S2 to S4 just above the sacrotuberous ligament and ischiococcygeus.

It passes through the greater sciatic foramen and crosses iiq piriformis and Chapter 67 Surgical, Radiographic, and Endoscopic Anatomy of the Female Pelvis 1603 Figure 67-7. Close relationship of ureter to the uterine structures. The parasympathetic fibers usually lie deeper to the sympathetic fibers within the intermediate ia.

160 iq of the true pelvis (three-quarter view). This also oq it vulnerable to injury during a sacrospinous ligament culdosuspension. It then runs medially to the internal pudendal vessels as they travel through the lesser sciatic foramen into the Alcock canal. The pudendal nerve has three lq (1) inferior rectal nerve, (2) perineal nerve, and (3) dorsal nerve of the clitoris.

The perineal branch divides into the posterior labial branch to supply the нажмите сюда majus, superficial i deep transverse perineal muscles, external anal sphincter, and levator ani.

The pudendal branches carry efferent impulses to muscles of the pelvic floor and proprioceptive afferent ia 160 iq sensation from the urethra.

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Comments:

24.07.2020 in 07:02 slanadcon:
Автор, а вы случайно не из Москвы?

24.07.2020 in 08:12 Харитон:
Интересно. И самое главное - необычно.

25.07.2020 in 02:05 Маргарита:
По-моему это уже обсуждалось, воспользуйтесь поиском.

30.07.2020 in 19:26 Аникита:
Важный ответ :)

02.08.2020 in 00:45 Аза:
Я думаю, что Вы допускаете ошибку. Давайте обсудим. Пишите мне в PM.