Embryo, placenta and fetal membranes
										 Placenta at four and one-half months of gestation
										The umbilical arteries have been injected with red latex and the umbilical vein has been filled with blue latex.

														 1
						.
					 Placenta  2
						.
					 Amnion  3
						.
					 Chorion (left side)  4
						.
					 Cotyledon  5
						.
					 Umbilical vein (within umbilical cord)  6
						.
					 Umbilical arteries


Embryo, placenta and fetal membranes
										 Three-month-old fetus in situ within fetal membranes
										The uterus of this surgical specimen has been opened by means of a longitudinal incision. The chorion has been cut and reflected from the amnion.

														 1
						.
					 Chorion (cut and reflected from amnion)  2
						.
					 Placenta (lower portions of the placenta are visible through the amniotic sac)  3
						.
					 Umbilical cord  4
						.
					 Amniotic sac  5
						.
					 Myometrium  6
						.
					 Cervix of uterus (supravaginal part)  7
						.
					 Cervix of uterus (vaginal part)


Embryo, placenta and fetal membranes
										 Two-month-old embryo within amniotic sac
										The chorion of this fresh surgical specimen has been opened to expose the amniotic sac (1) and yolk sac (3), both of which have been displaced to reveal the fetal surface of the placenta (9). The yolk sac remains attached to the umbilical cord by a slender stalk containing blood vessels which are visible in the photograph.

														 1
						.
					 Amniotic sac (enclosing fetus within amniotic fluid)  2
						.
					 Umbilical arteries (distinguished by thicker, white walls and smaller lumen than those of umbilical vein)  3
						.
					 Yolk sac  4
						.
					 Yolk stalk (note vitelline artery within stalk)  5
						.
					 Cut edge of chorion  6
						.
					 Umbilical cord (note spiraling course of umbilical arteries within cord)  7
						.
					 Umbilical vein  8
						.
					 Chorionic VIII  9
						.
					 Placenta


Uterus and adnexae
										 Cavity of uterus; ovary sectioned transversely
										The uterine cavity has been opened by means of a T-shaped incision through the anterior wall of the uterus. The right ovary has been sectioned transversely. The sectioned surface of the ovary exhibits a vesicular follicle, a fresh corpus luteum, a regressing corpus luteum and a corpus albicans. The specimen is viewed from in front.

														 1
						.
					 Fundus of uterus  2
						.
					 Cavity of uterus  3
						.
					 Corpus albicans (sectioned)  4
						.
					 Vesicular follicle (unopened)  5
						.
					 Corpus luteum (recent)  6
						.
					 Corpus luteum (regressing)  7
						.
					 Upper pointer: Perimetrium (tunica serosa) Lower pointer: Myometrium (muscular tunic)  8
						.
					 Endometrium (mucosal tunic)  9
						.
					 Isthmus of uterus  10
						.
					 Cervix of uterus (supravaginal part)  11
						.
					 Anterior wall of vagina (cut and retracted)  12
						.
					 Cervix of uterus (vaginal part)  13
						.
					 Opening of uterus (note junction of cervical and vaginal mucosa)  14
						.
					 Posterior labium uterine opening  15
						.
					 Opening of uterine tube  16
						.
					 Left ovary (elevated)  17
						.
					 Uterine tube  18
						.
					 Ligamentum teres (of uterus)  19
						.
					 Broad ligament of uterus


Uterus and adnexae
										 Uterus, uterine tubes and ovaries, posterior aspect
										The specimen shown previously has been turned to expose its posterior aspect. The right ovary has been elevated.

														 1
						.
					 Fundus of uterus  2
						.
					 Body of uterus (covered by peritoneum)  3
						.
					 Proper ovarian ligament  4
						.
					 Isthmus of uterine tube  5
						.
					 Ligamentum teres (of uterus) (cut off)  6
						.
					 Mesovarium  7
						.
					 Mesosalpinx  8
						.
					 Ampulla of uterine tube  9
						.
					 Abdominal opening of uterine tube  10
						.
					 Free margin of ovary  11
						.
					 Posterior wall of vagina  12
						.
					 Cervix of uterus  13
						.
					 Corpus luteum  14
						.
					 Ovary  15
						.
					 Suspensory ligament of ovary  16
						.
					 Ovarian fimbria (see previous view label no. 6)  17
						.
					 Broad ligament of uterus  18
						.
					 Right margin of uterus


Uterus and adnexae
										 Uterus, uterine tubes and ovaries, anterior aspect
										The specimen, from an 18-year old girl, is viewed from in front. The ovaries have been elevated. The peritonealized parts of the specimen can be distinguished from the non-peritonealized lower portions by tracing the cut margin of peritoneum indicated in the drawing at 11.

														 1
						.
					 Fundus of uterus  2
						.
					 Uterine extremity of ovary  3
						.
					 Ovary  4
						.
					 Ovarian follicle  5
						.
					 Infundibulum of uterine tube (pointers also indicate tubal fimbriae)  6
						.
					 Ovarian fimbria  7
						.
					 Tubal extremity of ovary  8
						.
					 Mesosalpinx  9
						.
					 Ligamentum teres (of uterus) (cut off)  10
						.
					 Body of uterus  11
						.
					 Cut margin of peritoneum  12
						.
					 Anterior wall of vagina (note vaginal rugae)  13
						.
					 Posterior wall of vagina  14
						.
					 Cervix of uterus  15
						.
					 Isthmus of uterine tube  16
						.
					 Abdominal opening of uterine tube  17
						.
					 Ampulla of uterine tube (indicated by two pointers, it tapers abruptly medially into the isthmus (15)  18
						.
					 Mesovarium  19
						.
					 Broad ligament of uterus (parametrium)


Pelvic peritoneal cavity of female
										 Left ovarian fossa, close-up view
										The left wall of the pelvic cavity is viewed here with the specimen turned slightly to demonstrate the position of the ovary in the ovarian fossa and to show its relations to neighboring structures. The same specimen is also shown in view 161-4 and in subsequent views of that series.

														 1
						.
					 Appendix epiploica  2
						.
					 Sigmoid colon  3
						.
					 Fimbria of uterine tube  4
						.
					 Rectouterine fold  5
						.
					 Position of ureter (faintly visible through peritoneum)  6
						.
					 Ovarian fossa  7
						.
					 Fundus of uterus  8
						.
					 Urinary bladder  9
						.
					 Peritoneum overlying iliac vessels  10
						.
					 External iliac vein (visible as bluish discoloration beneath peritoneum)  11
						.
					 Peritoneum of anterior abdominal wall (reflected)  12
						.
					 Mesosalpinx  13
						.
					 Ovary  14
						.
					 Proper ovarian ligament  15
						.
					 Uterine tube  16
						.
					 Ligamentum teres (of uterus)  17
						.
					 Uterovesical pouch


Pelvic peritoneal cavity of female
										 Pelvic peritoneal relations with bladder deflated, close-up anterior view
										The bladder has been deflated to reveal the depth of the vesicouterine pouch and to demonstrate the transverse peritoneal fold of the bladder. The view is directed horizontally from in front.

														 1
						.
					 Fimbriae of uterine tube  2
						.
					 Pararectal fossa  3
						.
					 Rectouterine fold  4
						.
					 Transverse fold of bladder  5
						.
					 Fundus of uterus (note oval depression from which a small fibroma was removed)  6
						.
					 Uterovesical pouch  7
						.
					 Urinary bladder (empty)  8
						.
					 Promontory  9
						.
					 Sigmoid colon  10
						.
					 Sacral flexure of rectum  11
						.
					 Left pointer: Rectum Right pointer: Rectouterine space  12
						.
					 Upper pointer: Ampulla of uterine tube Lower pointer: Ovary  13
						.
					 Mesosalpinx  14
						.
					 Uterine tube  15
						.
					 Ligamentum teres (of uterus)  16
						.
					 Broad ligament of uterus


Pelvic peritoneal cavity of female
										 Lower abdominal and pelvic peritoneum, anterior view
										The small intestine has been detached from its mesentery and removed from the specimen. The descending colon has been divided at its confluence with the sigmoid colon and has also been detached along the lines of its peritoneal reflections onto the abdominal wall to permit its removal. A small fibroma has been taken away from the uterus leaving an oval depression on the surface of the fundus.

														 1
						.
					 Parietal peritoneum (overlying iliac vessels)  2
						.
					 Promontory  3
						.
					 Mesentery (cut along attachment to small intestine)  4
						.
					 Right pointer: Rectum (sacral flexure lies just above level of pointer) Left pointer: Pararectal fossa  5
						.
					 Ligamentum teres (of uterus)  6
						.
					 Uterovesical pouch  7
						.
					 Uterus  8
						.
					 Urinary bladder (inflated)  9
						.
					 Pubic symphysis  10
						.
					 Parietal peritoneum (of anterior abdominal wall)  11
						.
					 Cut edges of peritoneum at lines of reflection onto descending colon  12
						.
					 Sigmoid colon (transected at junction with descending colon)  13
						.
					 Upper pointer: Ampulla of uterine tube Lower pointer: Ovary  14
						.
					 Rectouterine fold (bordering rectouterine space)


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity; sacral plexus; pelvic diaphragm
										The pelvic blood vessels have been resected to reveal the component parts of the sacral plexus. The origin of the pelvic diaphragm in this specimen extends nearly to the pelvic brim with the result that there is no tendinous arch such as the one shown in 174-7. The larger divisions of the levator ani muscle that are usually described as distinct muscles (m. puborectalis, m. pubococcygeus and m. iliococcygeus) are not clearly separable here.

														 1
						.
					 Promontory  2
						.
					 Lumbosacral trunk (pointer on branch from lumbar nerve V)  3
						.
					 Lateral sacral artery  4
						.
					 Ramus communicans  5
						.
					 Sympathetic trunk  6
						.
					 Sacral venous plexus  7
						.
					 Pelvic surface of sacrum  8
						.
					 Sacral nerve I  9
						.
					 Sacral nerve II  10
						.
					 Piriform muscle  11
						.
					 Sacral nerve IV  12
						.
					 Sacral nerve III  13
						.
					 Muscular branch of sacral nerve IV to levator ani muscle  14
						.
					 Sacral plexus  15
						.
					 Left pointer: Internal pudendal artery (cut off) Right pointer: Inferior gluteal artery  16
						.
					 Iliococcygeus muscle  17
						.
					 Pubococcygeus muscle  18
						.
					 Puborectalis muscle (16-18 comprise the levator ani muscle)  19
						.
					 Urethra  20
						.
					 Iliolumbar vein (note accompanying artery)  21
						.
					 Obturator nerve  22
						.
					 Psoas major muscle  23
						.
					 Iliac fascia  24
						.
					 Ilium (covered by periosteum)  25
						.
					 Superior gluteal artery and vein  26
						.
					 Obturator artery  27
						.
					 External iliac vein (approaching vascular lacuna deep to inguinal ligament)  28
						.
					 Pectineal ligament  29
						.
					 Pubic symphysis


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity; parietal blood vessels; sacral plexus; pelvic diaphragm
										The pelvic organs have been cut across at the pelvic outlet and have been removed to expose the pelvic diaphragm and the major blood vessels and nerves of the lateral wall of the pelvic cavity.

														 1
						.
					 Middle sacral artery  2
						.
					 Sympathetic trunk  3
						.
					 Right pointer: Ganglion of sympathetic trunk (note ramus communicans) Left pointer: Sacral nerve  4
						.
					 Articular surface of sacrum  5
						.
					 Left piriform muscle  6
						.
					 Sacral nerve II (note ramus communicans from sympathetic trunk)  7
						.
					 Sacral nerve III  8
						.
					 Sacral nerve IV  9
						.
					 Internal pudendal artery and vein  10
						.
					 Coccyx  11
						.
					 Upper pointer: Inferior gluteal artery Lower pointer: Pelvic diaphragm  12
						.
					 Anal canal  13
						.
					 Vagina  14
						.
					 Urethra  15
						.
					 Labium minus  16
						.
					 Glans of clitoris  17
						.
					 Lateral sacral artery  18
						.
					 Common iliac artery  19
						.
					 Left pointer: Internal iliac artery Right pointer: External iliac artery  20
						.
					 Transversus abdominis muscle (covered by transversalis fascia)  21
						.
					 Superior gluteal artery  22
						.
					 Uterine artery (cut off)  23
						.
					 Branch of obturator artery to iliopsoas muscle  24
						.
					 Anterior superior iliac spine  25
						.
					 Obturator nerve (at entrance to obturator canal)  26
						.
					 Pubic symphysis


Dissection of female pelvis from a lateral approach
										 Blood vessels and nerves of uterus, vagina and neck of bladder, anterior view
										The bladder has been transected close to the internal urethral opening and has been removed, together with the ureter, from the dissection. The anterior surfaces of the uterus and vagina are exposed to view.

														 1
						.
					 Left sympathetic trunk  2
						.
					 Middle sacral artery  3
						.
					 Middle sacral vein  4
						.
					 Intervertebral disc L. V - S. I  5
						.
					 Right sympathetic trunk  6
						.
					 Lateral sacral artery  7
						.
					 Sacral nerve IV  8
						.
					 Pelvic diaphragm (right half, cut close to sacral and coccygeal attachment)  9
						.
					 Uterine vein  10
						.
					 Uterus  11
						.
					 Uterine venous plexus  12
						.
					 Pelvic ganglion  13
						.
					 Vaginal venous plexus  14
						.
					 Vagina  15
						.
					 Vesical venous plexus  16
						.
					 Cervix of urinary bladder  17
						.
					 Inferior vesical artery  18
						.
					 Pubic branch of obturator artery  19
						.
					 Pectineal ligament  20
						.
					 Superior hypogastric plexus  21
						.
					 Common iliac artery  22
						.
					 Internal iliac artery and vein  23
						.
					 Psoas major muscle  24
						.
					 Lateral umbilical ligament  25
						.
					 Left pointer: Internal pudendal artery Right pointer: Inferior gluteal artery  26
						.
					 Vaginal artery  27
						.
					 Uterine artery  28
						.
					 Pelvic diaphragm  29
						.
					 External iliac artery and vein  30
						.
					 Obturator nerve  31
						.
					 Ligamentum teres (of uterus)


Dissection of female pelvis from a lateral approach
										 Blood vessels and nerves of uterus, vagina and bladder, medial view
										The uterus and vagina have been retracted posteriorly and the bladder has been drawn forward to expose the vessels and nerves as they approach the left borders of these organs.

														 1
						.
					 Ureter:  2
						.
					 Uterine artery (note vaginal artery branching off slightly below level of pointer)  3
						.
					 Superior hypogastric plexus  4
						.
					 Uterine veins  5
						.
					 Inferior hypogastric plexus (pelvic plexus)  6
						.
					 Parietal pelvic fascia  7
						.
					 Uterus  8
						.
					 Uterine venous plexus  9
						.
					 Vaginal venous plexus  10
						.
					 Vagina  11
						.
					 Vesicovaginal septum (cut edge)  12
						.
					 Wall of vagina (cut in median plane)  13
						.
					 Anal canal  14
						.
					 Urethra  15
						.
					 Vesical venous plexus  16
						.
					 Dorsal vein of clitoris  17
						.
					 Crus of clitoris  18
						.
					 External iliac artery and vein  19
						.
					 Obturator nerve  20
						.
					 Obturator artery and vein  21
						.
					 Upper pointer: Pelvic diaphragm Lower pointer: Pelvic ganglion  22
						.
					 Ligamentum teres (of uterus) (cut across)  23
						.
					 Superior vesical artery (branch of uterine artery)  24
						.
					 Ureter (at junction with wall of bladder)  25
						.
					 Vesical nerve plexus  26
						.
					 Urinary bladder  27
						.
					 Pubic symphysis


Dissection of female pelvis from a lateral approach
										 Blood vessels and nerves of uterus, vagina and bladder, anterior view
										In this dissection the relations of blood vessels and nerves are shown as these approach the pelvic urogenital organs from the pelvic wall on the left side. The ureter (14) lies in situ. The left lateral umbilical ligament (20), representing the obliterated umbilical artery, has been dissected free of connective tissue. It is noteworthy that in this body there is no vesical artery branching from the proximal part of the umbilical artery. Instead, the left half of the bladder is supplied by two branches from the uterine artery and a small branch from the obturator artery.

														 1
						.
					 Middle sacral artery  2
						.
					 Sympathetic trunks  3
						.
					 Pelvic surface of sacrum  4
						.
					 Coccyx  5
						.
					 Uterine vein  6
						.
					 Uterine venous plexus  7
						.
					 Uterus  8
						.
					 Vesical venous plexus  9
						.
					 Vesical arteries  10
						.
					 Urinary bladder  11
						.
					 Umbilicovesical fascia  12
						.
					 Superior hypogastric plexus  13
						.
					 Common iliac artery  14
						.
					 Ureter  15
						.
					 Upper pointer: Ureteral branch of internal iliac artery Lower pointer: Internal iliac vein  16
						.
					 External iliac artery and vein  17
						.
					 Psoas major muscle  18
						.
					 Inferior gluteal artery  19
						.
					 Upper pointer: Vaginal artery Lower pointer: Uterine artery  20
						.
					 Lateral umbilical ligament  21
						.
					 Upper pointer: Tendinous arch of pelvic fascia Lower pointer: Superior fascia of pelvic diaphragm  22
						.
					 Obturator nerve  23
						.
					 Ligamentum teres (of uterus) (cut off)  24
						.
					 Inferior epigastric artery and vein (covered by transversalis fascia)


Dissection of female pelvis from a lateral approach
										 Nerves and vessels related to pelvic surface of sacrum
										The specimen has been placed in a supine position. The view into the pelvic cavity is directed from below and to the right. The uterus and vagina have been retracted toward the pubic symphysis.

														 1
						.
					 Common iliac artery  2
						.
					 Intervertebral disc L. V - S. I  3
						.
					 Femoral nerve  4
						.
					 Obturator nerve  5
						.
					 Sympathetic trunk  6
						.
					 Pelvic surface of sacrum  7
						.
					 Articular surface of sacrum  8
						.
					 Sacral plexus (cut across)  9
						.
					 Piriform muscle (cut across)  10
						.
					 Ganglion of sympathetic trunk  11
						.
					 Anterior (pelvic) sacral foramen II  12
						.
					 Sacral splanchnic nerve (sympathetic)  13
						.
					 Sacral nerve IV  14
						.
					 Superior fascia of pelvic diaphragm  15
						.
					 Middle sacral vein  16
						.
					 Middle sacral artery  17
						.
					 Promontory  18
						.
					 Superior hypogastric plexus  19
						.
					 Internal iliac vein  20
						.
					 Internal iliac artery  21
						.
					 Ureter  22
						.
					 External iliac artery  23
						.
					 External iliac vein  24
						.
					 Obturator nerve  25
						.
					 Obturator artery  26
						.
					 Upper pointer: Lateral sacral artery Lower pointer: Ramus communicans (gray)  27
						.
					 Upper pointer: Sacral nerve I Lower pointer: Piriform muscle (covered by parietal pelvic fascia)  28
						.
					 Pelvic splanchnic nerve (from sacral nerve II)  29
						.
					 Pelvic splanchnic nerve (from sacral nerve III)  30
						.
					 Vagina


Dissection of female pelvis from a lateral approach
										 Pelvic plexus and ganglion; vaginal artery
										The uterus and vagina have now been deflected anteriorly. The uterosacral and cardinal ligaments, which are shown in 162-2, have been dissected so that the pelvic plexus and the vaginal and uterine blood vessels are exposed.

														 1
						.
					 Internal iliac artery and vein  2
						.
					 Superior hypogastric plexus  3
						.
					 Ganglion of sympathetic trunk  4
						.
					 Articular surface of sacrum  5
						.
					 Pelvic splanchnic nerves  6
						.
					 Piriform muscle (cut across)  7
						.
					 Pelvic ganglion  8
						.
					 Middle sacral artery  9
						.
					 Inferior hypogastric plexus (pelvic plexus)  10
						.
					 Vaginal artery (branch of uterine artery)  11
						.
					 Superior fascia of pelvic diaphragm  12
						.
					 Pelvic diaphragm (sectioned near midline)  13
						.
					 Rectum  14
						.
					 Vagina  15
						.
					 Urethra  16
						.
					 Ureter  17
						.
					 External iliac artery and vein  18
						.
					 Uterine veins  19
						.
					 Obturator nerve  20
						.
					 Lateral umbilical ligament  21
						.
					 Ligamentum teres (of uterus)  22
						.
					 Pubic symphysis  23
						.
					 Uterus


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity.
										Removal of the left ovary and uterine tube has exposed the structures that lie immediately lateral to the ovarian fossa. Lymphatic vessels (21) can be seen passing to the external iliac nodes from the uterus and vagina. The obliterated part of the umbilical artery (16) lies lateral to these vessels against the pelvic wall.

														 1
						.
					 Iliac lymph nodes  2
						.
					 Right pointer: External iliac artery (cut off) Left pointer: Internal iliac artery  3
						.
					 Femoral nerve  4
						.
					 Obturator nerve  5
						.
					 Articular surface of sacrum  6
						.
					 Superior hypogastric plexus  7
						.
					 Parietal pelvic fascia  8
						.
					 Uterine vein  9
						.
					 Ureter  10
						.
					 Rectouterine muscle (uterosacral ligament)  11
						.
					 Rectum (cut across)  12
						.
					 Uterus  13
						.
					 External iliac lymph node  14
						.
					 Psoas major muscle (covered by fascia)  15
						.
					 Obturator artery  16
						.
					 Lateral umbilical ligament  17
						.
					 External iliac artery and vein  18
						.
					 External iliac lymph node  19
						.
					 Internal iliac lymph node  20
						.
					 Ligamentum teres (of uterus)  21
						.
					 Lymph vessel (from uterus and vagina)  22
						.
					 Uterine tube (cut across)  23
						.
					 Proper ovarian ligament (cut off)  24
						.
					 Uterine artery


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity.
										The specimen shown in the preceding photograph has been turned so that it is now viewed from in front and slightly to the right. The ovary, ovarian vessels and uterine tube have been pulled anteriorly.

														 1
						.
					 Superior hypogastric plexus  2
						.
					 Sympathetic trunk  3
						.
					 Promontory (pointer on intervertebral disc L. V - S. I)  4
						.
					 Common iliac artery (pointer at level of bifurcation into internal and external iliac arteries)  5
						.
					 Iliac lymph node  6
						.
					 Middle sacral artery  7
						.
					 Internal iliac artery  8
						.
					 Pelvic surface of sacrum  9
						.
					 Parietal pelvic fascia  10
						.
					 Rectouterinus muscle (uterosacral ligament)  11
						.
					 Rectum  12
						.
					 Iliac lymph node  13
						.
					 Ovarian artery  14
						.
					 Upper pointer: Internal iliac vein (pointer indicates level at which vein originates from common iliac vein) Lower pointer: Ureteral branch of internal iliac artery  15
						.
					 Psoas major muscle (covered by fascia)  16
						.
					 Iliac fascia  17
						.
					 External iliac artery  18
						.
					 External iliac lymph node  19
						.
					 Ovary  20
						.
					 Ureter  21
						.
					 Upper pointer: Uterine artery Lower pointer: Ovarian branch of uterine artery  22
						.
					 Ligamentum teres  23
						.
					 Uterine venous plexus  24
						.
					 Fundus of uterus


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity.
										The peritoneum has been removed from the posterior and left lateral walls of the pelvic cavity. The fascial investments of extraperitoneal structures have been stripped away. A large ureteric artery (22), which originates from the internal iliac artery, supplies the lower part of the ureter and communicates inferiorly with the ovarian branch of the uterine artery.

														 1
						.
					 Superior hypogastric plexus  2
						.
					 Sympathetic trunk (pointer on ganglion)  3
						.
					 Sacrum (upper pointer, articular surface; lower pointer, lateral crest)  4
						.
					 Coccyx  5
						.
					 Rectouterinus muscle (uterosacral ligament)  6
						.
					 Rectum (cut across)  7
						.
					 Vagina  8
						.
					 Uterus  9
						.
					 Urinary bladder  10
						.
					 Internal iliac lymph node  11
						.
					 Ovarian artery  12
						.
					 Ureter  13
						.
					 Internal iliac artery and vein  14
						.
					 Iliac lymph node  15
						.
					 External iliac artery and vein  16
						.
					 Fimbria of uterine tube  17
						.
					 Ovary  18
						.
					 Internal iliac lymph node (note associated lymphatic vessels)  19
						.
					 External iliac lymph node  20
						.
					 Pubic symphysis  21
						.
					 Lateral umbilical ligament  22
						.
					 Ureteral branch of internal iliac artery  23
						.
					 Uterine vein


Dissection of female pelvis from a lateral approach
										 Uterosacral ligament and cardinal ligament of uterus, medial view
										The peritoneal covering of the rectouterine fold previously illustrated (161-4) has now been removed. The uterus and vagina have been pulled anteriorly to expose the smooth muscle and fibrous tissue (4) that occupies this fold and extends from the uterus and vaginal wall to the lateral and posterior walls of the pelvic cavity. Although it appears as a continuous sheet, this tissue has usually been subdivided into uterosacral and cardinal (or lateral cervical) ligaments. The former is also identified as the m. rectouterinus and the latter as Mackenrodt's ligament. In subsequent dissections of this series it may be seen that the pelvic plexus of nerves as well as several blood vessels are incorporated within these ligaments.

														 1
						.
					 Coccyx  2
						.
					 Pelvic diaphragm  3
						.
					 Superior rectal artery  4
						.
					 Upper pointer: Rectouterinus muscle (uterosacral ligament) Lower pointer: Cardinal ligament (of Mackenrodt)  5
						.
					 Rectum  6
						.
					 External anal sphincter muscle  7
						.
					 Longitudinal muscle of anal canal  8
						.
					 Central tendon of perineum  9
						.
					 Vestibule of vagina  10
						.
					 External urethral opening  11
						.
					 Superior hypogastric plexus (note that these fibers become incorporated below in the uterosacral ligament)  12
						.
					 Internal iliac vein  13
						.
					 Internal iliac artery  14
						.
					 Ureter  15
						.
					 External iliac vein  16
						.
					 Internal iliac lymph node  17
						.
					 Ovary (retracted anteriorly)  18
						.
					 Uterus  19
						.
					 Posterior wall of vagina  20
						.
					 Urinary bladder  21
						.
					 Pubic symphysis  22
						.
					 Vagina


Dissection of female pelvis from a lateral approach
										 Interior of anal canal and lower part of rectum, close-up view
										The lower part of the dissection shown in the preceding photograph is shown in more detail in this close-up view centered on the anal canal.

														 1
						.
					 Levator ani muscle  2
						.
					 Mucosal tunic of rectum (note numerous small depressions or pits in mucosa marking the sites of lymphatic nodules (folliculi Iymphatici))  3
						.
					 Anal columns  4
						.
					 Pectinate line  5
						.
					 Anal verge  6
						.
					 Hemorrhoidal zone  7
						.
					 Internal anal sphincter muscle  8
						.
					 External anal sphincter muscle  9
						.
					 Plicae transversales of rectum  10
						.
					 Opening of uterus  11
						.
					 Anterior labium  12
						.
					 Posterior wall of vagina  13
						.
					 Vagina  14
						.
					 Upper pointer: Anterior wall of vagina Lower pointer: Vesicovaginal septum  15
						.
					 Muscular tunic of urinary bladder  16
						.
					 Urinary bladder  17
						.
					 Vesical sphincter muscle  18
						.
					 Posterior vaginal wall posterior  19
						.
					 Hymenal caruncles  20
						.
					 Vestibule of vagina  21
						.
					 Levator ani muscle (puborectalis muscle, inserting into wall of anal canal)  22
						.
					 Central tendon of perineum


Dissection of female pelvis from a lateral approach
										 Interior of rectum and anal canal, general view
										A longitudinal incision has been made through the anterior wall of the anal canal and rectum from the anus to the level of the sacral flexure. The wall to the right of the incision has been pulled aside to reveal the lumen of the lower end of the intestinal tract.

														 1
						.
					 Internal iliac artery  2
						.
					 Articular surface of sacrum  3
						.
					 Piriform muscle  4
						.
					 Parietal pelvic fascia  5
						.
					 Sacral flexure of rectum  6
						.
					 Longitudinal layer of muscular tunic of rectum  7
						.
					 Coccyx  8
						.
					 Circular layer of muscular tunic of rectum  9
						.
					 Mucosal tunic of rectum  10
						.
					 Terminal segment of coccyx  11
						.
					 Transverse fold of rectum  12
						.
					 Levator ani muscle (cut off)  13
						.
					 Vagina  14
						.
					 Perineal flexure of rectum  15
						.
					 Anal column  16
						.
					 Anal valve  17
						.
					 Anal bend  18
						.
					 Internal anal sphincter muscle  19
						.
					 External anal sphincter muscle (cut across, slightly to right of midline)  20
						.
					 Vestibule of vagina  21
						.
					 Sigmoid colon  22
						.
					 Mesosigmoid colon  23
						.
					 Rectouterine fold  24
						.
					 Upper pointer: Ovary Lower pointer: Uterine tube  25
						.
					 Uterus  26
						.
					 Urinary bladder  27
						.
					 Pubic symphysis  28
						.
					 Urethra  29
						.
					 Clitoris


Dissection of female pelvis from a lateral approach
										 Rectum viewed from right side
										The peritoneal covering of the rectum (16) has been elevated. The uterus, vagina and bladder have been pulled anteriorly. The fascia of the rectum has been removed to expose the longitudinal layer of muscle of the rectal wall. Note the fluted infolding of this layer at the site of the lowest transverse rectal fold (5).

														 1
						.
					 Coccyx  2
						.
					 Coccygeus muscle  3
						.
					 Parietal pelvic fascia  4
						.
					 Rectum  5
						.
					 Transverse fold of rectum (external aspect)  6
						.
					 Superior branches rectal artery  7
						.
					 Superior fascia of pelvic diaphragm  8
						.
					 Pubococcygeus muscle (cut across)  9
						.
					 External anal sphincter muscle (divided)  10
						.
					 Puborectalis muscle (cut off near junction with wall of anal canal)  11
						.
					 Anus  12
						.
					 Anal canal  13
						.
					 Perineal flexure of rectum  14
						.
					 Central tendon of perineum  15
						.
					 Vestibule of vagina  16
						.
					 Parietal peritoneum (reflected from anterior wall of rectum)  17
						.
					 Rectouterine fold  18
						.
					 Ovary  19
						.
					 Uterus  20
						.
					 Uterovesical pouch (pointer on reflection of peritoneum from uterus to wall of bladder)  21
						.
					 Urinary bladder  22
						.
					 Upper pointer: Vesicovaginal septum Lower pointer: Vagina  23
						.
					 Pubic symphysis  24
						.
					 Urethra


Dissection of female pelvis from a lateral approach
										 Arteries and nerves of sigmoid colon and rectum, right anterolateral view
										The sigmoid mesocolon has been dissected and the rectum and sigmoid colon have been retracted anteriorly and to the left. Peritoneum has been removed from the right surface of the rectum.

														 1
						.
					 Superior rectal artery  2
						.
					 Strand of inferior mesenteric plexus (note other nerve filaments interlaced among branches of arteries)  3
						.
					 Promontory  4
						.
					 External iliac artery (cut off)  5
						.
					 Internal iliac artery  6
						.
					 Superior hypogastric plexus  7
						.
					 Parietal pelvic fascia  8
						.
					 Superior branches rectal artery  9
						.
					 Rectum (longitudinal layer of muscular tunic)  10
						.
					 Ampulla of rectum  11
						.
					 Vagina  12
						.
					 Uterus  13
						.
					 Urinary bladder  14
						.
					 Pubic symphysis  15
						.
					 Sigmoid artery  16
						.
					 Fascia overlying external iliac vessels and lymph nodes  17
						.
					 Sigmoid colon


Dissection of female pelvis from a lateral approach
										 Interior of left side of pelvic cavity with peritoneum intact
										The uterus and bladder have been retracted toward the pubic symphysis to reveal the peritoneum lining the left half of the pelvic cavity. The rectouterine fold (5) is clearly visible extending laterally and superiorly from the uterus toward the sacrum. The ridge produced by the ureter (2) blends with the lateral part of the rectouterine fold.

														 1
						.
					 Internal iliac artery  2
						.
					 Position of left ureter (indicated by raised fold of peritoneum)  3
						.
					 Obturator nerve  4
						.
					 Articular surface of sacrum  5
						.
					 Rectouterine fold (continuous inferiorly with broad ligament (11))  6
						.
					 Rectum (longitudinal layer of muscle exposed)  7
						.
					 Parietal pelvic fascia  8
						.
					 Opening of uterus  9
						.
					 Levator ani muscle (cut off)  10
						.
					 Vagina  11
						.
					 Broad ligament of uterus  12
						.
					 Urinary bladder  13
						.
					 Fundus of uterus  14
						.
					 Pubic symphysis  15
						.
					 Sigmoid colon  16
						.
					 Mesosigmoid colon  17
						.
					 Fimbria of uterine tube  18
						.
					 Suspensory ligament of ovary (covered by peritoneum)  19
						.
					 Ampulla of uterine tube  20
						.
					 Position of external iliac vein (indicated on specimen by bluish area of peritoneum)  21
						.
					 Left pointer: Ovary Right pointer: Mesovarium  22
						.
					 Ovarian fossa  23
						.
					 Ligamentum teres (of uterus)  24
						.
					 Upper pointer: Uterine tube Lower pointer: Proper ovarian ligament


Dissection of female pelvis from a lateral approach
										 Median section of bladder, urethra, uterus and vagina, right lateral view
										The bladder, urethra, uterus and vagina have been sectioned in the median plane. The rectum and anal canal have been exposed but not opened. Peritoneum remains intact in the left half of the pelvic cavity.

														 1
						.
					 Rectouterine fold  2
						.
					 Lateral sacral crest  3
						.
					 Uterine cavity  4
						.
					 Levator ani muscle (cut off)  5
						.
					 Upper pointer: Posterior labium uterine opening Middle pointer: Opening of uterus Lower pointer: Anterior labium uterine opening  6
						.
					 Vagina  7
						.
					 Left pointer: Lamina of connective tissue forming vesicovaginal septum Right pointer: Internal urethral opening  8
						.
					 Left pointer: Posterior wall of vagina Right pointer: Anterior wall of vagina  9
						.
					 External anal sphincter muscle  10
						.
					 Anal canal (pointer on muscular tunic)  11
						.
					 Central tendon of perineum  12
						.
					 Vestibule of vagina  13
						.
					 External urethral opening  14
						.
					 Labium minus  15
						.
					 Sigmoid colon  16
						.
					 Left pointer: Fimbria of uterine tube Right pointer: Suspensory ligament of ovary  17
						.
					 Ampulla of uterine tube  18
						.
					 Left pointer: Ovarian fossa Right pointer: Ovary  19
						.
					 Mesosigmoid colon  20
						.
					 Appendices epiploicae  21
						.
					 Fundus of uterus  22
						.
					 Ligamentum teres (of uterus)  23
						.
					 Apex of urinary bladder  24
						.
					 Pubic symphysis  25
						.
					 Body of urinary bladder  26
						.
					 Upper pointer: Vesical sphincter muscle Lower pointer: Urethra  27
						.
					 Clitoris


Dissection of female pelvis from a lateral approach
										 Interior of bladder, right anterolateral view
										The bladder has been opened by a sagittal cut placed just lateral to the point of entrance of the right ureter into the bladder wall.

														 1
						.
					 Uterine artery  2
						.
					 Ureter  3
						.
					 Parametrium  4
						.
					 Fundus of urinary bladder  5
						.
					 Uterine opening  6
						.
					 Upper pointer: Interureteric fold Lower pointer: Trigone of urinary bladder  7
						.
					 Rectum  8
						.
					 Vagina (opened)  9
						.
					 Internal urethral opening  10
						.
					 Urethra (surrounded by vesical sphincter muscle)  11
						.
					 Branch of obturator artery  12
						.
					 Upper pointer: Vesical venous plexus Lower pointer: Dorsal vein of clitoris  13
						.
					 Pubic symphysis  14
						.
					 Retropubic space  15
						.
					 Rectum (covered by peritoneum)  16
						.
					 Ligamentum teres (of uterus) (cut across)  17
						.
					 Fundus of uterus (depressed area close to pointer was occupied by small fibroma)  18
						.
					 Ovary  19
						.
					 Uterine tube  20
						.
					 Proper ovarian ligament  21
						.
					 Ligamentum teres (of uterus)  22
						.
					 Uterovesical pouch  23
						.
					 Apex of urinary bladder  24
						.
					 Parietal peritoneum  25
						.
					 Transversalis fascia


Dissection of female pelvis from a lateral approach
										 Interior of vagina, viewed from right side
										The vagina has been opened along its right border. Its walls have been separated to permit a view of the interior.

														 1
						.
					 Fornix of vagina  2
						.
					 Middle rectal artery  3
						.
					 Opening of uterus  4
						.
					 Posterior wall of vagina  5
						.
					 Superior fascia of pelvic diaphragm  6
						.
					 Rectum  7
						.
					 Vaginal venous plexus  8
						.
					 Levator ani muscle (cut off)  9
						.
					 External anal sphincter muscle (superficial and deep portions, partially removed)  10
						.
					 Upper pointer: Urethral carina Lower pointer: Posterior neck fold  11
						.
					 Muscular tunic of anal canal (longitudinal layer)  12
						.
					 External anal sphincter muscle (subcutaneous part)  13
						.
					 Central tendon of perineum  14
						.
					 Hymenal caruncles  15
						.
					 Vestibule of vagina  16
						.
					 External urethral opening  17
						.
					 Urogenital diaphragm  18
						.
					 Labium minus  19
						.
					 Labium majus  20
						.
					 Vaginal artery  21
						.
					 Inferior vesical artery  22
						.
					 Posterior labium uterine opening  23
						.
					 Anterior labium uterine opening  24
						.
					 Left pointer: Posterior vaginal wall anterior Right pointer: Anterior wall of vagina  25
						.
					 Urinary bladder  26
						.
					 Vesical venous plexus  27
						.
					 Vesical sphincter muscle  28
						.
					 Pubic arcuate ligament (cut in midline)  29
						.
					 Dorsal vein of clitoris  30
						.
					 Commissure of vestibular bulb  31
						.
					 Body of clitoris  32
						.
					 Glans of clitoris


Dissection of female pelvis from a lateral approach
										 Rectum, vagina, bladder and ureter, right lateral view
										The uterosacral and lateral cervical ligaments have been resected along with parts of the pelvic plexus to expose the vagina and rectum.

														 1
						.
					 Articular surface of sacrum  2
						.
					 Uterine artery  3
						.
					 Ureter  4
						.
					 Rectum (sacral flexure)  5
						.
					 Vaginal artery  6
						.
					 Coccygeus muscle (cut across)  7
						.
					 Coccyx  8
						.
					 Upper pointer: Inferior vesical artery Lower pointer: Vagina (external aspect)  9
						.
					 Middle rectal artery (note vaginal branch)  10
						.
					 Pelvic plexus (cut across)  11
						.
					 Rectum (perineal flexure)  12
						.
					 Upper pointer: Levator ani muscle (note continuity with longitudinal muscle of anal canal) Lower pointer: Longitudinal layer of muscular tunic of anal canal  13
						.
					 External anal sphincter muscle (partially resected)  14
						.
					 Anus  15
						.
					 Central tendon of perineum  16
						.
					 Major vestibular gland  17
						.
					 Urogenital diaphragm  18
						.
					 Vestibule of vagina  19
						.
					 Promontory  20
						.
					 Sigmoid colon  21
						.
					 Uterus  22
						.
					 Urinary bladder  23
						.
					 Pubic symphysis  24
						.
					 Cervix of bladder  25
						.
					 Clitoris


Dissection of female pelvis from a lateral approach
										 Interior of pelvic cavity with uterus and bladder in situ, right anterolateral view
										The right ovary, uterine tube and round ligament have been detached and removed. The uterine artery (10) has been elevated slightly to demonstrate its passage across the ureter as it approaches the lateral border of the uterus. The uterosacral and lateral cervical (cardinal) ligaments have been dissected to reveal the pelvic plexus and ganglia (11).

														 1
						.
					 External iliac artery  2
						.
					 Psoas major muscle  3
						.
					 Articular surface of sacrum  4
						.
					 Superior gluteal artery  5
						.
					 Piriform muscle  6
						.
					 Lateral umbilical ligament  7
						.
					 Upper pointer: Uterine tube (cut across) Lower pointer: Ligamentum teres (of uterus) (cut across)  8
						.
					 Rectum (covered by peritoneum)  9
						.
					 Ureter  10
						.
					 Uterine artery  11
						.
					 Pelvic plexus (pointer on pelvic ganglion)  12
						.
					 Urinary bladder (reflected downward)  13
						.
					 Sigmoid colon  14
						.
					 Upper pointer: Suspensory ligament of ovary Lower pointer: Infundibulum of uterine tube  15
						.
					 Pelvic cavity (pointer on rectouterine fold)  16
						.
					 Ovary  17
						.
					 Ligamentum teres (of uterus)  18
						.
					 Uterovesical pouch  19
						.
					 Broad ligament of uterus (dissected)


Dissection of female pelvis from a lateral approach
										 Lateral view of ligaments, vessels and nerves of right ovary
										The peritoneum has been removed from the lateral pelvic wall. The hilum of the ovary (26) and the broad ligament of the uterus (36) have been dissected. The ovary has been elevated for better exposure of the dissection.

														 1
						.
					 Obturator nerve (cut off)  2
						.
					 Sigmoid colon  3
						.
					 Upper pointer: Superior gluteal vein Lower pointer: Obturator artery  4
						.
					 Superior gluteal artery  5
						.
					 Articular surface of sacrum  6
						.
					 Sacral nerve I  7
						.
					 Lateral umbilical ligament  8
						.
					 Piriform muscle  9
						.
					 Upper pointer: Inferior gluteal artery (internal pudendal artery was a branch of this trunk) Lower pointer: Coccygeal branch of inferior gluteal artery (see 159-1)  10
						.
					 Uterine artery (note vesicular branches)  11
						.
					 Uterine vein  12
						.
					 Superior vesical arteries  13
						.
					 Ureter  14
						.
					 Inferior vesical artery  15
						.
					 Vesical venous plexus  16
						.
					 Vesical nerve plexus  17
						.
					 Uterosacral ligament  18
						.
					 Urinary bladder  19
						.
					 Psoas major muscle  20
						.
					 External iliac vein  21
						.
					 External iliac artery  22
						.
					 Ovarian nerve plexus  23
						.
					 Ovarian artery  24
						.
					 Suspensory ligament of ovary  25
						.
					 Fimbria of uterine tube  26
						.
					 Upper pointer: Right ovary (elevated) Lower pointer: Hilus of ovary (dissected)  27
						.
					 Peritoneum lining pelvic cavity (in background)  28
						.
					 Infundibulum of uterine tube (in background)  29
						.
					 Left ovary (in background)  30
						.
					 Ligamentum teres (of uterus) (elevated)  31
						.
					 Proper ovarian ligament  32
						.
					 Ligamentum teres (of uterus) (in background)  33
						.
					 Left uterine tube (in background)  34
						.
					 Ovarian branch of uterine artery  35
						.
					 Uterus  36
						.
					 Broad ligament of uterus (dissected)


Dissection of female pelvis from a lateral approach
										 Relations of blood vessels and nerves at ureterovesical junction
										The levator ani muscle (15) has been cut off near its insertion and the adjacent superior fascia of the pelvic diaphragm (17) has been partially removed to expose the mass of smooth muscle and fibrous tissue (14) that comprises the uterosacral ligament and the lateral cervical ligament or cardinal ligament of the uterus (of Mackenrodt). The pelvic plexus lies enmeshed in these ligaments. Branches from the plexus (11) are visible passing to the terminal part of the ureter and base of the bladder.

														 1
						.
					 Superior gluteal artery (cut off)  2
						.
					 Vesical artery  3
						.
					 Vesical artery (2 and 3 are branches of uterine artery)  4
						.
					 Inferior gluteal artery (cut off)  5
						.
					 Inferior gluteal vein  6
						.
					 Sacral plexus (pointer on junction of 2nd and 3rd sacral nerves)  7
						.
					 Pelvic splanchnic nerve  8
						.
					 Nerve to Levator ani muscle  9
						.
					 Ureter  10
						.
					 Vesical vein (plexiform)  11
						.
					 Plexus vesical nerve  12
						.
					 Coccygeus muscle (reflected)  13
						.
					 Ureterovesical junction (note longitudinal smooth muscle of bladder continuing upward onto ureter)  14
						.
					 Smooth muscle and fibrous tissue of uterosacral and lateral cervical ligaments of uterus (rectouterinus muscle)  15
						.
					 Levator ani muscle (cut off)  16
						.
					 External anal sphincter muscle  17
						.
					 Superior fascia of pelvic diaphragm (continuous posteriorly with fascia on coccygeus muscle (12))  18
						.
					 Branch of nerve to levator ani muscle  19
						.
					 Branches of pelvis plexus to vaginal wall  20
						.
					 Vesical venous plexus  21
						.
					 Obturator artery (cut off)  22
						.
					 Uterine artery and vein  23
						.
					 Lateral umbilical ligament  24
						.
					 Parietal peritoneum  25
						.
					 Urinary bladder  26
						.
					 Branch of obturator artery  27
						.
					 Pubic symphysis


Dissection of female pelvis from a lateral approach
										 Vaginal and urethral orifices, close-up view through vestibule of vagina
										The labia of the right side have been removed.

														 1
						.
					 External urethral opening  2
						.
					 Vestibule of vagina  3
						.
					 Urethral carina  4
						.
					 Vaginal opening  5
						.
					 Upper pointer: Wall of vagina (cut across) Lower pointer: Opening of duct of greater vestibular (Bartholin's) gland (7)  6
						.
					 Hymenal caruncle  7
						.
					 Greater vestibular (Bartholin's) gland  8
						.
					 Posterior neck fold  9
						.
					 Labium minus (cut across)  10
						.
					 Labium minus  11
						.
					 Labium majus


Dissection of female pelvis from a lateral approach
										 Vestibule of vagina, opened and viewed from right side
										The labia have been removed from the right side. The view is from below and to the right.

														 1
						.
					 Upper pointer: Pubic symphysis (cut through) Lower pointer: Urinary bladder  2
						.
					 Crus of clitoris (note branches of deep artery of clitoris on cut section of ems)  3
						.
					 Vesical venous plexus  4
						.
					 Dorsal vein of clitoris  5
						.
					 Branch of obturator artery  6
						.
					 External urethral opening  7
						.
					 Parietal pelvic fascia (continuous anteriorly with transversalis fascia)  8
						.
					 Vaginal opening  9
						.
					 Perineal membrane (inferior fascia of urogenital diaphragm)  10
						.
					 Greater vestibular (Bartholin's) gland  11
						.
					 Levator ani muscle (cut across)  12
						.
					 Hymenal caruncles  13
						.
					 Central tendon of perineum  14
						.
					 Anterior labial commissure  15
						.
					 Body of clitoris  16
						.
					 Glans of clitoris  17
						.
					 Labium majus  18
						.
					 Labium minus  19
						.
					 Vestibule of vagina (opened by removal of right labia)


Dissection of female pelvis from a lateral approach
										 Fascial layers related to bladder, close-up view
										The fascial layers associated with the anteroinferior aspect of the bladder have been separated from each other. The umbilicovesical fascia (14) divides to cover both surfaces of the bladder. Superiorly this layer is related to the subserosa of the peritoneum and extends laterally to the lateral umbilical ligament (11). An intermediate fascial plane, the umbilical prevesical fascia (15), intervenes between the umbilicovesical fascia behind the transversalis fascia (13) in front. The bladder in this specimen has a large posterolateral recess that has been infolded to permit display of nearby structures in the photograph.

														 1
						.
					 Superior vesical artery  2
						.
					 Uterine artery (uncolored)  3
						.
					 Vesical vein  4
						.
					 Rectouterinus muscle  5
						.
					 Urinary bladder (see text above)  6
						.
					 Levator ani muscle (reflected)  7
						.
					 Dorsal artery of clitoris (cut off)  8
						.
					 Obturator artery  9
						.
					 Parietal peritoneum (pointer on tela subserosa)  10
						.
					 Ligamentum teres (of uterus)  11
						.
					 Lateral umbilical ligament  12
						.
					 Upper pointer: Fibrous cord connecting lateral umbilical ligament with a branch of obturator artery Lower pointer: Branch of obturator artery  13
						.
					 Transversalis fascia  14
						.
					 Umbilicovesical fascia  15
						.
					 Umbilical prevesical fascia  16
						.
					 Pubic symphysis


Dissection of female pelvis froma lateral approach
										 General view of pelvic contents with right hip bone removed
										The entire right hip bone has been removed from the specimen. The pelvic diaphragm has been split and reflected downward. The pelvic peritoneum (17, 19) remains intact on the right side and is seen from its external aspect.

														 1
						.
					 Upper pointer: Iliacus muscle Lower pointer: Psoas major muscle (cut off)  2
						.
					 Impression remaining after removal of posterior part of ilium (pointer on periosteum)  3
						.
					 Femoral nerve (cut off)  4
						.
					 Articular surface of sacrum  5
						.
					 Upper pointer: Superior gluteal artery Lower pointer: Piriform muscle  6
						.
					 Sciatic nerve  7
						.
					 Inferior gluteal artery  8
						.
					 Sacrospinous ligament (reflected posteriorly)  9
						.
					 Superior vesical artery  10
						.
					 Rectouterine muscle (uterosacral and cardinal ligaments, consisting of smooth muscle intermingled with fibrous tissue and pelvic plexus of nerves)  11
						.
					 Levator ani muscle (reflected)  12
						.
					 Urinary bladder (redundant pocket which extended posterolaterally has been pulled downward and partly invaginated into bladder)  13
						.
					 External anal sphincter muscle  14
						.
					 Ileocolic artery (cut off in margin of mesentery)  15
						.
					 Root of mesentery (cut across)  16
						.
					 External iliac artery  17
						.
					 Parietal peritoneum (pointer on tela subserosa)  18
						.
					 Parietal peritoneum (interior of anterior abdominal wall, pointer on tunica serosa)  19
						.
					 Upper pointer: Ligamentum teres (of uterus) Lower pointer: Parietal peritoneum (external aspect)  20
						.
					 Lateral umbilical ligament  21
						.
					 Upper pointer: Obturator nerve Lower pointer: Obturator artery  22
						.
					 Pubic symphysis  23
						.
					 Body of clitoris  24
						.
					 Labium minus


Dissection of female pelvis froma lateral approach
										 Sphincter ani externus muscle, close-up view
										The specimen shown in the previous view is here seen in a close-up centered on the sphincter ani externus muscle.

														 1
						.
					 Levator ani muscle (pointer on puborectalis muscle)  2
						.
					 Inferior rectal artery (small branch cut off)  3
						.
					 Anococcygeal nerve  4
						.
					 Anococcygeal ligament  5
						.
					 Area of communication between ischiorectal fossae of two sides  6
						.
					 Deep part  7
						.
					 Superficial part  8
						.
					 Subcutaneous part (6-8 refer to the external anal sphincter)  9
						.
					 Anus  10
						.
					 Longitudinal muscle layer of anal wall  11
						.
					 Central tendon of perineum  12
						.
					 Vaginal wall  13
						.
					 Vestibule of vagina (opened by removal of labia on right side)  14
						.
					 Ischiorectal fossa (remnant of anterior recess)  15
						.
					 Obturator fascia  16
						.
					 Dorsal artery of clitoris  17
						.
					 Crus of clitoris  18
						.
					 artery of vestibular bulb  19
						.
					 Vestibular bulb  20
						.
					 Major vestibular gland


Dissection of female pelvis from a lateral approach
										 Levator ani and coccygeus muscles; sphincter ani externus, lateral view
										The pudendal vessels and nerves have been cut away to reveal the lateral aspect of the levator ani muscle, the sacrospinous ligament and the coccygeus muscle. The component parts of the sphincter ani externus (13, 14, 15) are also visible.

														 1
						.
					 Superior gluteal artery  2
						.
					 Sciatic nerve  3
						.
					 Inferior gluteal artery  4
						.
					 Piriform muscle (cut across)  5
						.
					 Inferior gluteal nerve  6
						.
					 Middle cluneal nerve (from dorsal branch of 2nd sacral nerve)  7
						.
					 Coccyx (periosteum removed)  8
						.
					 Sacrospinous ligament (coccygeus muscle fused with ligament, the latter rather indistinct)  9
						.
					 Ischial spine  10
						.
					 Coccyx (tip)  11
						.
					 Levator ani muscle (pointer on pubococcygeal part of muscle)  12
						.
					 Anococcygeal ligament  13
						.
					 Deep part  14
						.
					 Superficial part  15
						.
					 Subcutaneous part (1315 refer to the external anal sphincter)  16
						.
					 Anus  17
						.
					 Longitudinal muscle of anal canal  18
						.
					 Superior gluteal nerve  19
						.
					 Left pointer: Lymph node Right pointer: Margin of greater sciatic notch  20
						.
					 Ala of ilium  21
						.
					 Origin of rectus femoris muscle  22
						.
					 Acetabulum  23
						.
					 Obturator nerve  24
						.
					 Tendinous arch of levator ani muscle (indistinct, see discussion with 158-7)  25
						.
					 Levator ani muscle (pointer on puborectalis muscle)  26
						.
					 Body of pubic bone (partially removed)  27
						.
					 Obturator fascia  28
						.
					 Body of clitoris  29
						.
					 Vestibular bulb  30
						.
					 Major vestibular gland  31
						.
					 Central tendon of perineum


Dissection of female pelvis froma lateral approach
										 Pelvic diaphragm, lateral view with pudendal vessels and nerves in situ
										In an earlier view of this specimen (158-7) the pelvic diaphragm was partially visible through a window cut in the lateral pelvic wall. The exposure of the diaphragm has been increased by resection of more of the ischium. The pudendal vessels and nerves have been retained in place, although the fascia (25) that formed the walls of the pudendal canal has been nearly completely removed from around them.

														 1
						.
					 Greater sciatic notch  2
						.
					 Ischial spine  3
						.
					 Inferior gluteal nerve (cut off)  4
						.
					 Internal pudendal artery and vein  5
						.
					 Pudendal nerve  6
						.
					 Inferior rectal nerve  7
						.
					 Inferior rectal artery  8
						.
					 Anococcygeal ligament  9
						.
					 External anal sphincter muscle  10
						.
					 Anus  11
						.
					 Perineal artery  12
						.
					 Dorsal artery of clitoris  13
						.
					 Central tendon of perineum  14
						.
					 Greater vestibular (Bartholin's) gland  15
						.
					 Vestibular bulb  16
						.
					 Vestibule of vagina  17
						.
					 Tendinous arch of levator ani muscle (atypical, see discussion of 158-7)  18
						.
					 Acetabulum (remnant)  19
						.
					 Obturator artery  20
						.
					 Femoral artery  21
						.
					 Femoral vein  22
						.
					 Inguinal ligament  23
						.
					 Levator ani muscle  24
						.
					 Body of pubic bone (partially cut away)  25
						.
					 Obturator fascia (forming medial wall of pudendal canal)  26
						.
					 Body of clitoris


Dissection of female pelvis froma lateral approach
										 Close-up view of clitoris
										The structure and relations of the clitoris are shown in this close-up view of the specimen illustrated in the previous photograph. The ischiocavernosus and bulbospongiosus muscles have been removed from the dissection. The right crus, body and glans of the clitoris are exposed. A fibrous commissural extension (4) from the pars intermedia of the vestibular bulb, joined by its fellow of the opposite side, passes forward to fuse with the clitoris.

														 1
						.
					 Crus of clitoris  2
						.
					 Vestibular bulb (cavernous spaces within erectile tissue filled with blue latex)  3
						.
					 Intermediate part of bulb of vestibule  4
						.
					 Commissure of vestibular bulb (joined anteriorly with body of clitoris)  5
						.
					 Labium minus (dissected)  6
						.
					 Vestibule of vagina  7
						.
					 Labium minus  8
						.
					 Frenulum of clitoris  9
						.
					 Glans of clitoris  10
						.
					 Pubic bone (partially resected)  11
						.
					 Tendon of origin of gracilis muscle (cut off)  12
						.
					 Dorsal nerve of clitoris  13
						.
					 Cutaneous branch of dorsal nerve of clitoris  14
						.
					 Dorsal artery of clitoris  15
						.
					 Pubic symphysis  16
						.
					 Suspensory ligament of clitoris  17
						.
					 Body of clitoris  18
						.
					 Skin of mons pubis  19
						.
					 Prepuce of clitoris


Dissection of female pelvis froma lateral approach
										 Pudendal nerve and branches in situ
										The course of the pudendal nerve is shown in this close-up view of the pudendal canal.

														 1
						.
					 Ischial spine  2
						.
					 Position of coccyx (covered by ligaments)  3
						.
					 Pudendal nerve (passing through lesser sciatic foramen; inferior rectal nerve lying medially is shown in view 159-4)  4
						.
					 Sacrotuberous ligament  5
						.
					 Upper pointer: Dorsal nerve of clitoris (in pudendal canal) Lower pointer: Perineal nerve  6
						.
					 Upper pointer: Obturator fascia Lower pointer: Periosteum  7
						.
					 Posterior labial nerves  8
						.
					 Anus  9
						.
					 Major vestibular gland  10
						.
					 Vestibular bulb  11
						.
					 Upper pointer: Crus of clitoris Lower pointer: Intermediate part and commissure of vestibular bulb  12
						.
					 Labium minus  13
						.
					 Internal pudendal artery and vein (in pudendal canal)  14
						.
					 Branch of pudendal nerve passing to region of mons pubis  15
						.
					 Obturator internus muscle (remnant of origin of muscle, cut across)  16
						.
					 Acetabulum  17
						.
					 Obturator nerve (in obturator canal)  18
						.
					 Femoral vein  19
						.
					 Superior pubic ramus (area of origin of pectineus muscle)  20
						.
					 Levator ani muscle  21
						.
					 Body of pubic bone (partially resected)  22
						.
					 Inferior pubic ramus  23
						.
					 Suspensory ligament of clitoris  24
						.
					 Dorsal nerve of clitoris  25
						.
					 Dorsal artery of clitoris  26
						.
					 Body of clitoris  27
						.
					 Glans of clitoris


Dissection of female pelvis froma lateral approach
										 Contents of greater sciatic foramen, close-up lateral view
										The specimen has been rotated slightly and is viewed here from a somewhat posterolateral direction.

														 1
						.
					 Lateral sacral crest  2
						.
					 Piriform muscle (emerging through greater sciatic foramen)  3
						.
					 Inferior gluteal artery (cut off)  4
						.
					 Inferior gluteal veins  5
						.
					 Upper pointer: Nerve to obturator internus muscle (cut off) Lower pointer: Inferior gluteal nerve  6
						.
					 Left pointer: Middle cluneal nerve (traced from dorsal ramus of 2nd sacral nerve) Right pointer: Coccygeal branch of inferior gluteal artery  7
						.
					 Left pointer: Sacrotuberous ligament Right pointer: Sacrospinous ligament  8
						.
					 Pudendal nerve (passing through lesser sciatic foramen)  9
						.
					 Internal pudendal artery  10
						.
					 Superior gluteal artery  11
						.
					 Superior gluteal vein  12
						.
					 Superior gluteal nerve  13
						.
					 Parietal pelvic fascia (completing closure of greater sciatic foramen)  14
						.
					 Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  15
						.
					 Margin of greater sciatic foramen  16
						.
					 Acetabular labrum  17
						.
					 Levator ani muscle  18
						.
					 Margin of lesser sciatic foramen


Dissection of female pelvis froma lateral approach
										 Pudendal canal; obturator fascia; pelvic diaphragm
										The obturator internus muscle, shown in view 158-4, has been completely removed from the field of dissection. The obturator fascia (9) which covered the medial surface of the muscle has been excised to open the pudendal canal (Alcock's canal). The pudendal nerve (6) and the internal pudendal artery and vein (8) lie within the canal. Part of the obturator fascia above and anterior to the pudendal canal has been cut away to expose the levator ani muscle. The origin of the levator ani in this case is closer to the terminal line of the pelvis than usual and the tendinous arch usually associated with this origin is indistinct. View 163-5 demonstrates a similar arrangement on the opposite side of the pelvis.

														 1
						.
					 Superior gluteal artery  2
						.
					 Piriform muscle (cut off)  3
						.
					 Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  4
						.
					 Inferior gluteal artery  5
						.
					 Sacrotuberous ligament  6
						.
					 Pudendal nerve (passing anteriorly through lesser sciatic foramen to enter pudendal canal)  7
						.
					 Ischial tuberosity  8
						.
					 Internal pudendal artery and vein (within pudendal canal)  9
						.
					 Upper pointer: Obturator fascia Lower pointer: Periosteum  10
						.
					 External anal sphincter muscle  11
						.
					 Ala of ilium  12
						.
					 Anterior superior iliac spine  13
						.
					 Margin of acetabulum (pointer on acetabular labrum)  14
						.
					 Iliopsoas muscle (cut off)  15
						.
					 Inguinal ligament  16
						.
					 Obturator nerve  17
						.
					 Femoral vein  18
						.
					 Levator ani muscle  19
						.
					 Body of pubic bone  20
						.
					 Dorsal nerve of clitoris  21
						.
					 Body of clitoris  22
						.
					 Labium minus  23
						.
					 Labium majus


Dissection of female pelvis froma lateral approach
										 Superficial perineal space, close-up lateral view
										The membranous layer of the superficial fascia (shown in view 158-3) has been cut off at the labium majus (17) and removed. The underlying deep perineal fascia has also been trimmed away to expose structures within the superficial perineal space. A margin of the fascia remains anteriorly (15). The contents of the superficial space include the ischiocavernosus and bulbospongiosus muscles (14), the crus of the clitoris (not visible), the bulb of the vestibule (16), the greater vestibular gland (6), the superficial transverse perineal muscle (3) and branches of the pudendal nerve and vessels (6, 8). The posterior labial veins are somewhat dilated and plexiform in appearance.

														 1
						.
					 Upper pointer: Ramus of ischium Lower pointer: Obturator fascia (pointer indicates location of pudendal canal, note branch of obturator vein passing through this fascia to join internal pudendal vein)  2
						.
					 Inferior rectal nerves  3
						.
					 Superficial transverse perineal muscle (poorly developed)  4
						.
					 External anal sphincter muscle (covered by fascia)  5
						.
					 Anus  6
						.
					 Left pointer: Posterior labial branch internal pudendal artery Right pointer: Major vestibular gland  7
						.
					 Central tendon of perineum  8
						.
					 Posterior labial nerve  9
						.
					 Obturator internus muscle  10
						.
					 Pubic bone (partially resected)  11
						.
					 Inferior pubic ramus  12
						.
					 Tendon of origin of gracilis m:  13
						.
					 Suspensory ligament of clitoris  14
						.
					 Upper pointer: Ischiocavernosus muscle Lower pointer: Bulbospongiosus muscle  15
						.
					 Deep perineal fascia (removed posteriorly to expose contents of superficial space of perineum)  16
						.
					 Vestibular bulb  17
						.
					 Superficial perineal fascia (membranous layer or Colles' fascia)  18
						.
					 Labium majus


Dissection of female pelvis from a lateral approach
										 Superficial perineal space; obturator internus muscle; contents of obturator canal
										The contents of the superficial space of the perineum have been exposed by excision of the membranous layer of superficial fascia (Colles' fascia) and of part of the deep perineal fascia (24). The obturator internus muscle, together with branches of the obturator vessels, has been uncovered in situ by removal of the obturator membrane and portions of the pubic and ischial bones that bordered the obturator foramen.

														 1
						.
					 Acetabulum  2
						.
					 Body of ischium (dissected)  3
						.
					 Piriform muscle (cut off)  4
						.
					 Sciatic nerve (note emergence of tibial portion through piriform muscle)  5
						.
					 Tendon of obturator internus muscle (elevated from lesser sciatic notch and cut off)  6
						.
					 Obturator internus muscle (exposed by removal of obturator membrane and parts of ischium and pubic bone)  7
						.
					 Ischial tuberosity  8
						.
					 Muscular branch of obturator artery to obturator internus  9
						.
					 Ramus of ischium  10
						.
					 External anal sphincter muscle (muscle fibers indistinct)  11
						.
					 Posterior labial branch internal pudendal artery  12
						.
					 Posterior labial nerve  13
						.
					 Posterior labial vein (plexiform)  14
						.
					 Major vestibular gland  15
						.
					 Obturator nerve, artery, and vein (emerging from pelvis through obturator canal)  16
						.
					 Femoral artery and vein (surrounded by femoral sheath)  17
						.
					 Inguinal ligament  18
						.
					 Area of origin of pectineus muscle from superior pubic ramus  19
						.
					 Pubic tubercle  20
						.
					 Body of pubic bone (partially cut away)  21
						.
					 Pubic symphysis  22
						.
					 suspensory ligament of clitoris (note continuation of tendons of ischiocavernosus and bulbospongiosus muscles into this area)  23
						.
					 Ischiocavernosus muscle  24
						.
					 Deep perineal fascia (partially removed)  25
						.
					 bulbospongiosus muscle  26
						.
					 Labium majus  27
						.
					 Vestibular bulb


Dissection of female pelvis from a lateral approach
										 Right obturator internus muscle, general lateral view
										The obturator membrane and neighboring parts of the pubic and ischial bones have been resected.

														 1
						.
					 Gluteus minimus muscle  2
						.
					 Gluteus medius muscle  3
						.
					 Gluteus maximus muscle  4
						.
					 Piriform muscle  5
						.
					 Sciatic nerve (upper pointer, tibial nerve; lower pointer, common peroneal nerve)  6
						.
					 Sacrotuberous ligament  7
						.
					 Tendon of obturator internus muscle (cut off close to lesser sciatic foramen gemelli muscles removed)  8
						.
					 Obturator internus muscle (exposed in situ area of origin from bone lies anterior to muscular branches of obturator vessels)  9
						.
					 Ischial tuberosity (partially cut away)  10
						.
					 External anal sphincter muscle  11
						.
					 Posterior labial branch internal pudendal artery  12
						.
					 Body of ilium  13
						.
					 Anterior inferior iliac spine (origin of rectus femoris visible)  14
						.
					 Acetabular labrum  15
						.
					 Upper pointer: Iliopsoas muscle Lower pointer: Inguinal ligament  16
						.
					 Femoral vein  17
						.
					 Obturator nerve  18
						.
					 Pubic symphysis  19
						.
					 Labium majus


Dissection of female pelvis from a lateral approach
										 Pubis, ischium and external genitalia, close-up view of right lateral aspect
										The lower portion of the dissection shown in the preceding view is displayed in this close-up photograph. The superficial fascia of the perineum has been dissected. The membranous layer of the fascia (25) consists in part of a fan-like series of fibrous bands which radiate into the labium majus from a bony attachment along the inferior ramus of the pubic bone.

														 1
						.
					 Acetabulum  2
						.
					 Ligamentum teres femoris (cut off)  3
						.
					 Ligamentum transversum of acetabulum  4
						.
					 Posterior branch of obturator artery  5
						.
					 Obturator internus muscle (cut off)  6
						.
					 Gluteus maximus muscle  7
						.
					 Sciatic nerve  8
						.
					 Sacrotuberous ligament  9
						.
					 Ischial tuberosity (tendons of hamstring muscles divided close to bone)  10
						.
					 Coccyx (covered by ligaments)  11
						.
					 Ramus of ischium  12
						.
					 Branch of inferior rectal artery  13
						.
					 External anal sphincter muscle (covered with fascia)  14
						.
					 Femoral vein  15
						.
					 Anterior branch of obturator nerve  16
						.
					 Superior pubic ramus  17
						.
					 Posterior branch of obturator nerve  18
						.
					 Pubic tubercle (covered by fibers of inguinal ligament)  19
						.
					 Anterior branch of obturator artery  20
						.
					 Body of pubic bone  21
						.
					 Obturator membrane (obturator internus muscle visible through membrane)  22
						.
					 Location of pubic symphysis  23
						.
					 Inferior pubic ramus  24
						.
					 Origin of gracilis muscle (cut off)  25
						.
					 Superficial perineal fascia (membranous layer or Colles' fascia; note the radiating fibers firmly attached to the inferior ramus of pubis)  26
						.
					 Labium majus  27
						.
					 Labium minus (redundant)


Dissection of female pelvis from a lateral approach
										 Exterior of pelvis with femur removed, right lateral view
										The right thigh has been detached by disarticulating the femur at the hip joint. Muscles of the gluteal region have been cut off in various ways to demonstrate their interrelations. The obturator externus and pectineus muscles have been completely removed. The periosteum has been stripped from the rami of the pubis and ischium. In succeeding views of this sequence the dissection of the specimen is continued into the interior of the pelvis.

														 1
						.
					 Gluteus medius muscle  2
						.
					 Gluteus maximus muscle  3
						.
					 Piriform muscle  4
						.
					 Obturator internus muscle (cut off)  5
						.
					 Sciatic nerve  6
						.
					 Ischial tuberosity  7
						.
					 Ramus of ischium  8
						.
					 Anus  9
						.
					 External oblique muscle  10
						.
					 Iliac crest  11
						.
					 Gluteus minimus muscle  12
						.
					 Aponeurosis External oblique muscle  13
						.
					 Rectus femoris muscle (origin, cut off)  14
						.
					 Iliopsoas muscle (cut off)  15
						.
					 Joint capsule of coccyx  16
						.
					 Femoral artery and vein  17
						.
					 Acetabulum (pointer on ligamentum teres)  18
						.
					 Pubic bone  19
						.
					 Obturator membrane  20
						.
					 Superficial perineal fascia (membranous layer)  21
						.
					 Labium majus


Female perineum
										 Inferior aspect of levator ani muscle
										The left half of the urogenital diaphragm has been resected to open the anterior recess of the ischiorectal fossa and to display the levator ani muscle. The inferior fascia of the pelvic diaphragm (anal fascia) has been stripped from the levator ani. Portions of the obturator fascia (13) are visible in the deep part of the dissected area.

														 1
						.
					 Labium minus  2
						.
					 External urethral opening  3
						.
					 Dorsal nerve of clitoris  4
						.
					 Vagina  5
						.
					 Levator ani muscle (pointer on puborectalis muscle)  6
						.
					 Central tendon of perineum  7
						.
					 Anus  8
						.
					 Anococcygeal ligament  9
						.
					 Coccyx  10
						.
					 Clitoris  11
						.
					 Inferior pubic ramus  12
						.
					 Femoral vein (cut across)  13
						.
					 Obturator fascia  14
						.
					 Obturator externus muscle  15
						.
					 Upper pointer: Deep artery of clitoris Lower pointer: Internal pudendal vein  16
						.
					 Quadratus femoris muscle  17
						.
					 Ischial tuberosity  18
						.
					 Inferior rectal nerve (other branches previously removed)  19
						.
					 Sacrotuberous ligament (cut across  20
						.
					 Levator ani muscle (pointer on pubococcygeus muscle)


Female perineum
										 Superficial perineal space (continued).
										The bulbospongiosus and ischiocavernosus muscles have been removed on the left side of the specimen. The left bulb of the vestibule has been slightly retracted from its position against the wall of the vestibule. Several small, aberrant bundles of muscle (18) pass across the superficial perineal space in close apposition to the inferior surface of the perineal membrane.

														 1
						.
					 Body of clitoris  2
						.
					 Glans of clitoris  3
						.
					 Prepuce of clitoris  4
						.
					 Labium minus  5
						.
					 External urethral opening  6
						.
					 Vaginal opening  7
						.
					 Ischiorectal fossa  8
						.
					 Anus  9
						.
					 Suspensory ligament of clitoris  10
						.
					 Pubic symphysis  11
						.
					 Crus of clitoris  12
						.
					 Adductor longus muscle (cut off)  13
						.
					 Adductor brevis muscle  14
						.
					 Gracilis muscle (cut off)  15
						.
					 Pectineus muscle  16
						.
					 Bulbus vestibuli  17
						.
					 Upper pointer: Wall of vagina (cut across) Lower pointer: Duct of greater vestibular gland  18
						.
					 Upper pointer: Greater vestibular gland Lower pointer: Aberrant muscle fasciculus  19
						.
					 Perineal membrane  20
						.
					 Ramus of ischium  21
						.
					 Ischial tuberosity  22
						.
					 Superficial transverse perineal muscle  23
						.
					 Levator ani muscle


Female perineum
										 Superficial perineal space (continued).
										The bulbospongiosus and ischiocavernosus muscles have been elevated to display perineal branches of the pudendal nerve that enter the deep surfaces of the muscles.

														 1
						.
					 Vaginal opening  2
						.
					 Deep perineal fascia  3
						.
					 Greater vestibular (Bartholin's) gland  4
						.
					 Perineal raphe  5
						.
					 External anal sphincter muscle  6
						.
					 Anus  7
						.
					 Superficial transverse perineal muscle  8
						.
					 Inferior rectal artery (cut off)  9
						.
					 Ischial tuberosity  10
						.
					 prepuce of clitoris  11
						.
					 Labium minus  12
						.
					 Ischiocavernosus muscle  13
						.
					 Crus of clitoris  14
						.
					 Inferior pubic ramus (covered by fibrous tissue)  15
						.
					 Bulbospongiosus muscle  16
						.
					 Nerves entering bulbospongiosus muscle  17
						.
					 Inferior fascia of urogenital diaphragm (perineal membrane)  18
						.
					 Nerve entering ischiocavernosus muscle


Female perineum
										 Superficial perineal space.
										The ischiocavernosus (9), bulbospongiosus (10) and superficial transverse perineal muscles (12) have been exposed within the superficial perineal space, or compartment, by the removal of the fascial investment of these muscles shown in the preceding view.

														 1
						.
					 Gracilis muscle  2
						.
					 Labia minora  3
						.
					 Deep perineal fascia (intact)  4
						.
					 Adductor magnus muscle  5
						.
					 Ischiorectal fossa (pointer indicates lunate fascia)  6
						.
					 Gluteus maximus muscle  7
						.
					 Anus  8
						.
					 Tendons of insertion of bulbospongiosus muscle and ischiocavernosus muscle blending with suspensory ligament of clitoris  9
						.
					 Upper pointer: Crus clitoridis Lower pointer: Ischiocavernosus muscle  10
						.
					 Upper pointer: bulbospongiosus muscle Lower pointer: Labium majus (partially cut away)  11
						.
					 Posterior labial artery and nerve  12
						.
					 Superficial transverse perineal muscle  13
						.
					 Levator ani muscle


Female perineum
										 Posterior labial nerves and vessels
										The deep perineal fascia has been resected from the left half of the dissection. The major branches of the posterior labial nerves and vessels (12) that lay deep to this layer have been freed of their connective tissue investments. Still remaining in place is a layer of fascia (14) that covers the ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles.

														 1
						.
					 Prepuce of clitoris  2
						.
					 Labium minus  3
						.
					 Labium majus (cut off)  4
						.
					 Upper pointer: Vaginal opening Lower pointer: Deep perineal fascia  5
						.
					 Ischial tuberosity  6
						.
					 Gluteus maximus muscle  7
						.
					 External anal sphincter muscle  8
						.
					 Anus  9
						.
					 Suspensory ligament of clitoris  10
						.
					 Gracilis muscle  11
						.
					 Superficial perineal fascia (cut edge)  12
						.
					 posterior labial nerves (accompanied by posterior labial arteries)  13
						.
					 Deep perineal fascia (cut edge)  14
						.
					 Deep layer of deep perineal fascia  15
						.
					 Levator ani muscle


Female perineum
										 Deep perineal fascia
										The superficial fascia has been removed from the perineum. A narrow remnant of the membranous layer of the superficial fascia (16) has been retained along the line of its fusion with the fascia lata close to the ischiopubic rami. The deep perineal fascia (17) appears as a distinct membranous layer that covers the main trunks of the posterior labial nerves in this specimen. In the following view this layer is dissected.

														 1
						.
					 Labium minus  2
						.
					 Gracilis muscle  3
						.
					 Upper pointer: Vestibule of vagina Lower pointer: External urethral opening  4
						.
					 Upper pointer: Labium majus Lower pointer: Vaginal opening  5
						.
					 Ramus of ischium (covered by fibrous tissue)  6
						.
					 Adductor magnus muscle  7
						.
					 Ischial tuberosity  8
						.
					 Ischiorectal fossa (pointer indicates posterior recess)  9
						.
					 Gluteus maximus muscle  10
						.
					 Inferior fascia of pelvic diaphragm  11
						.
					 Anococcygeal ligament  12
						.
					 Coccyx  13
						.
					 Anococcygeal nerve  14
						.
					 Prepuce of clitoris  15
						.
					 Adductor longus muscle  16
						.
					 Cut edge of superficial perineal fascia (Colles' fascia)  17
						.
					 Deep perineal fascia  18
						.
					 posterior perineal branches femoral cutaneous nerve  19
						.
					 Upper pointer: Anus Lower pointer: External anal sphincter muscle  20
						.
					 Inferior rectal artery (cut off)  21
						.
					 Levator ani muscle


Female perineum
										 Female external genitalia; superficial fascia
										The skin and subcutaneous tissue have been removed from both thighs and from the left half of the perineum. The labia have been retracted to expose the vestibule of the vagina.

														 1
						.
					 Anterior labial commissure  2
						.
					 Frenulum of clitoris  3
						.
					 Gracilis muscle  4
						.
					 Vaginal opening (in depth of vestibule of vagina)  5
						.
					 Skin overlying right side of perineum  6
						.
					 Hymenal caruncle  7
						.
					 Posterior labial commissure  8
						.
					 Fascia lata  9
						.
					 Labium majus  10
						.
					 Labium minus  11
						.
					 External urethral opening  12
						.
					 Superficial perineal fascia (membranous layer or Colles' fascia)  13
						.
					 Perineal branch posterior femoral cutaneous nerve  14
						.
					 Posterior labial nerve


Female perineum
										 Female external genitalia

														 1
						.
					 Anterior labial commissure  2
						.
					 Mons pubis  3
						.
					 Labium majus  4
						.
					 Labium minus  5
						.
					 Frenulum labiorum pudendi  6
						.
					 Posterior labial commissure  7
						.
					 Perineal raphe  8
						.
					 Anus


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Pubic symphysis, sectioned

														 1
						.
					 Superior pubic ligament  2
						.
					 Pubic tubercle (sectioned)  3
						.
					 Pubic symphysis (no cavity present in central area of symphysis)  4
						.
					 Body of pubic bone  5
						.
					 Superior pubic ramus  6
						.
					 Inferior pubic ramus  7
						.
					 Pubic arcuate ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Pubic symphysis, posterior aspect

														 1
						.
					 Superior pubic ligament  2
						.
					 Pubic symphysis  3
						.
					 Pectineal ligament (ligament of Cooper)  4
						.
					 Body of pubic bone  5
						.
					 Pubic arcuate ligament  6
						.
					 Superior pubic ramus  7
						.
					 Obturator membrane (cut off near body of pubic bone)  8
						.
					 Area of origin of levator ani muscle  9
						.
					 Inferior pubic ramus  10
						.
					 Ramus of ischium


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Pubic symphysis, anterior aspect

														 1
						.
					 Pubic tubercle  2
						.
					 Pectineal ligament (ligament of Cooper)  3
						.
					 Superior pubic ramus  4
						.
					 Body of pubic bone  5
						.
					 Inferior pubic ramus  6
						.
					 Ramus of ischium (cut across)  7
						.
					 Superior pubic ligament  8
						.
					 Pubic symphysis  9
						.
					 Area of origin of pectineus muscle  10
						.
					 Area of origin of gracilis muscle  11
						.
					 Obturator canal  12
						.
					 Pubic arcuate ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Sacroiliac joint opened; interosseous sacroiliac ligament, left lateral view
										The left ilium has been detached to display the auricular surface of the sacrum and the interosseous sacroiliac ligaments.

														 1
						.
					 Interosseous sacroiliac ligament (pointer indicates only a small part of the area occupied by the numerous bands that comprise these ligaments which have been cut at their attachments to the ilium)  2
						.
					 Iliolumbar artery  3
						.
					 Lumbosacral trunk  4
						.
					 Articular surface of sacrum  5
						.
					 Ventral sacroiliac ligament  6
						.
					 Sacral nerve I  7
						.
					 Piriform muscle (cut across)  8
						.
					 Spinous process vertebra L. V  9
						.
					 Supraspinous ligament  10
						.
					 Interspinous ligament L. V - S. I (convex in shape due to compression by extension of vertebra on sacrum)  11
						.
					 Middle sacral crest  12
						.
					 Dorsal sacroiliac ligament (cut across)  13
						.
					 Iliac branch of iliolumbar artery  14
						.
					 Area of articular surface in which fibrocartilage has been damaged (remainder of auricular surface intact)  15
						.
					 Joint capsule (lined internally by synovial membrane)


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Sagittal section of lumbosacral spine; transverse section through sacroiliac joint
										The specimen shown in the preceding view (155-7) has been cut in the median plane and the right half subsequently has been cut in a plane transverse to the sacroiliac joint and approximately at right angles to the long axis of the sacrum. The sectioned parts have been separated from each other and are viewed from in front.

														 1
						.
					 Upper pointer: Intervertebral foramen Lower pointer: Dorsal sacral foramen  2
						.
					 Interosseous sacroiliac ligament  3
						.
					 Sacroiliac joint (pointer on cavity and fibrocartilage covering articular surfaces of both bones)  4
						.
					 Body of ilium (cut across)  5
						.
					 Anterior (pelvic) sacral foramina  6
						.
					 Greater sciatic foramen  7
						.
					 Body of ischium  8
						.
					 Bony ridge at site of exit of tendon of obturator internus from pelvis (note other parallel ridges)  9
						.
					 Lesser sciatic foramen  10
						.
					 Ventral sacrococcygeal ligament  11
						.
					 Sacrococcygeal junction (articular cavity present in this specimen)  12
						.
					 Coccyx  13
						.
					 Sacrospinous ligament  14
						.
					 Ischial spine (pointer indicates facet for attachment of coccygeus muscle)  15
						.
					 Sacrotuberous ligament  16
						.
					 Supraspinous ligament  17
						.
					 Interspinous ligament  18
						.
					 Spine of vertebra L. IV  19
						.
					 Arch of vertebra L. IV (facing vertebral canal)  20
						.
					 Ligamentum flavum  21
						.
					 Anulus fibrosus  22
						.
					 Body of vertebra L. V  23
						.
					 Anterior longitudinal ligament  24
						.
					 Nucleus pulposus  25
						.
					 Dura mater  26
						.
					 Promontory  27
						.
					 Lateral part of sacrum  28
						.
					 Inferior limit of dural sac  29
						.
					 Sacroiliac joint (reinforced by ventral sacroiliac ligament)  30
						.
					 Transverse line of sacrum (note remnant of intervertebral disk in cut section)  31
						.
					 Upper pointer: Hiatus sacral canal Lower pointer: Superficial dorsal sacrococcygeal ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Ligaments of pelvic girdle, anterior view
										The pubic bones have been removed.

														 1
						.
					 Iliolumbar ligament  2
						.
					 Lateral part of sacrum  3
						.
					 Promontory  4
						.
					 Pectineal ligament (ligament of Cooper)  5
						.
					 Superior pubic ramus (cut across)  6
						.
					 Joint capsule of coccyx (pointer overlies head of femur)  7
						.
					 Ischiofemoral ligament  8
						.
					 Ischial tuberosity  9
						.
					 Ramus of ischium (cut across)  10
						.
					 Lateral sacrococcygeal ligament  11
						.
					 Coccyx  12
						.
					 Body of vertebra L. V  13
						.
					 Intervertebral disc L. V - S. I  14
						.
					 Transverse process vertebrae L. V  15
						.
					 Iliac fossa  16
						.
					 Sacroiliac joint (covered by ventral sacroiliac ligament)  17
						.
					 Pelvic (anterior) sacral foramina  18
						.
					 Greater sciatic foramen  19
						.
					 Sacrospinous ligament  20
						.
					 Lesser sciatic foramen  21
						.
					 Obturator membrane (cut across)  22
						.
					 Sacrotuberous ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Iliolumbar ligaments, anterior view
										Muscles within the pelvic cavity have been preserved. The main constituents of the sacral plexus have been left intact on the right side.

														 1
						.
					 Body of vertebra L. IV (covered by anterior longitudinal ligament)  2
						.
					 Transverse process vertebrae L. IV  3
						.
					 Iliolumbar ligament  4
						.
					 Lumbosacral trunk  5
						.
					 Sacral nerve I (ventral branch)  6
						.
					 Arcuate line  7
						.
					 Obturator fascia  8
						.
					 Tendinous arch of levator ani muscle  9
						.
					 Intervertebral disc L. IV-V  10
						.
					 Promontory  11
						.
					 Iliac fossa  12
						.
					 Lateral part of sacrum  13
						.
					 Sacroiliac joint (pointer indicates ventral sacroiliac ligament)  14
						.
					 Piriform muscle (cut across)  15
						.
					 Greater sciatic foramen  16
						.
					 Inguinal ligament  17
						.
					 Superior fascia of pelvic diaphragm  18
						.
					 Pelvic surface of sacrum  19
						.
					 Levator ani muscle


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Ligaments of pelvic girdle, posterior view
										Muscles, blood vessels and nerves have been removed from this specimen of a young adult male.

														 1
						.
					 Supraspinous ligament  2
						.
					 Inferior articular process of vertebra L. V  3
						.
					 Joint capsule  4
						.
					 Iliac crest  5
						.
					 Posterior superior iliac spine  6
						.
					 Middle sacral crest  7
						.
					 Greater sciatic foramen  8
						.
					 Sacrotuberous ligament  9
						.
					 Sacrospinous ligament (at attachment to ischial spine)  10
						.
					 Lesser sciatic foramen  11
						.
					 Ischial tuberosity  12
						.
					 Transverse process vertebrae L. IV  13
						.
					 Transverse process vertebrae L. V  14
						.
					 Iliolumbar ligament  15
						.
					 Ala of ilium  16
						.
					 Dorsal sacroiliac ligament  17
						.
					 Body of ilium  18
						.
					 Joint capsule of coccyx  19
						.
					 Sacral horn  20
						.
					 Superficial dorsal sacrococcygeal ligament  21
						.
					 Coccyx  22
						.
					 Lateral sacrococcygeal ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Ligaments of coccygeal region, close-up posterior view

														 1
						.
					 Dorsal branch of coccygeal nerve  2
						.
					 Dorsal branch of sacral nerve V  3
						.
					 Connecting ioop between fifth sacral nerve and coccygeal nerve  4
						.
					 Piriform muscle (transected)  5
						.
					 Sciatic nerve  6
						.
					 Lateral border of sacrum  7
						.
					 Inferior gluteal artery  8
						.
					 Internal pudendal vein (cut off)  9
						.
					 Upper pointer: Pudendal nerve Lower pointer: Internal pudendal artery  10
						.
					 Inferior rectal nerve  11
						.
					 Ischial spine (covered by fibers of coccygeus muscle)  12
						.
					 Coccygeus muscle (overlying sacrospinous ligament)  13
						.
					 Levator ani muscle (pointer on iliococcygeus muscle)  14
						.
					 Obturator internus muscle  15
						.
					 Upper pointer: Inferior rectal artery Lower pointer: Perineal artery  16
						.
					 Obturator fascia (reflected to expose perineal vessels and nerves in pudendal canal)  17
						.
					 Levator ani muscle (pointer on pubococcygeus muscle)  18
						.
					 Anococcygeal nerve  19
						.
					 Sacral horn  20
						.
					 Coccygeal horn  21
						.
					 Aperture for dorsal ramus of fifth sacral nerve  22
						.
					 Superficial dorsal sacrococcygeal ligament  23
						.
					 Upper pointer: Deep dorsal sacrococcygeal ligament Lower pointer: Sacrotuberous ligament  24
						.
					 Coccyx (terminal segment)  25
						.
					 Lunate fascia  26
						.
					 Inferior fascia of pelvic diaphragm  27
						.
					 Anococcygeal ligament  28
						.
					 External anal sphincter muscle  29
						.
					 Anus


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Ligaments of sacral region, posterior view
										The central area of the dissection shown in the preceding view is illustrated in this close-up photograph.

														 1
						.
					 Supraspinous ligament  2
						.
					 Transverse process vertebrae L. V (periosteum removed)  3
						.
					 Iliolumbar ligament  4
						.
					 Iliac crest  5
						.
					 Posterior superior iliac spine  6
						.
					 Dorsal sacral foramina (partially obscured by ligamentous bands note vessels and nerves emerging between bands)  7
						.
					 Superior gluteal artery (cut off)  8
						.
					 Sciatic nerve (exposed by excision of piriform muscle)  9
						.
					 Inferior gluteal artery (cut off)  10
						.
					 Internal pudendal artery  11
						.
					 Sacrospinous ligament (blended with coccygeus muscle)  12
						.
					 Spinous process vertebrae L. V  13
						.
					 Intervertebral joint capsule  14
						.
					 Gluteus medius muscle  15
						.
					 Dorsal sacroiliac ligament  16
						.
					 Middle sacral crest  17
						.
					 Piriform muscle  18
						.
					 Sacrotuberous ligament  19
						.
					 Sacral horn  20
						.
					 Superficial dorsal sacrococcygeal ligament


Ligaments and joints of lumbosacral spine and pelvic girdle
										 Ligaments of lumbosacral region, posterior view
										The erector spinae and gluteus maximus muscles have been removed. On the left the gluteus medius has been cut away.

														 1
						.
					 Erector spinae muscle (cut across)  2
						.
					 Supraspinous ligament  3
						.
					 Intertransverse ligament  4
						.
					 Quadratus lumborum muscle (covered by middle layer of thoracolumbar fascia)  5
						.
					 Left kidney (faintly visible through thoracolumbar and renal fascia)  6
						.
					 Transverse process vertebrae L. IV  7
						.
					 Latissimus dorsi muscle (cut edge)  8
						.
					 Iliolumbar ligament  9
						.
					 Iliac crest  10
						.
					 Area of origin of gluteus medius muscle  11
						.
					 Gluteus minimus muscle  12
						.
					 Piriform muscle (cut across)  13
						.
					 Sciatic nerve (emerging through greater sciatic foramen)  14
						.
					 Upper pointer: Internal pudendal artery Lower pointer: Pudendal nerve  15
						.
					 Obturator internus muscle (tendon of insertion)  16
						.
					 Greater trochanter  17
						.
					 Thoracolumbar fascia (posterior layer, reflected)  18
						.
					 Intervertebral joint capsule L. IV-V  19
						.
					 Middle sacral crest  20
						.
					 Posterior superior iliac spine  21
						.
					 Gluteus medius muscle  22
						.
					 Dorsal sacroiliac ligament  23
						.
					 Piriform muscle  24
						.
					 Sacrotuberous ligament  25
						.
					 Ischiorectal fossa  26
						.
					 Superficial dorsal sacrococcygeal ligament  27
						.
					 Coccyx


Radiography
										 Anteroposterior radiograph of female pelvis
										This film was obtained through the courtesy of Dr. Grant Melvin Stevens of the Palo Alto Clinic.

														 1
						.
					 Body of vertebra L. IV  2
						.
					 Spinous process  3
						.
					 Transverse process  4
						.
					 Sacroiliac joint  5
						.
					 Ilium  6
						.
					 Lateral part of sacrum  7
						.
					 Anterior (pelvic) sacral foramen  8
						.
					 Acetabulum  9
						.
					 Ischium  10
						.
					 Pubic bone  11
						.
					 Pubic symphysis


Osteology
										 Coccyx, anterior view
										This specimen consists of three segments, the terminal one of which comprises two small terminal pieces fused together.

														 1
						.
					 Transverse process  2
						.
					 Coccygeal horn  3
						.
					 Articular surface for sacrum


Osteology
										 Sacrum, left lateral view

														 1
						.
					 Base of sacrum  2
						.
					 Promontory  3
						.
					 Lateral part  4
						.
					 Articular surface  5
						.
					 Pelvic surface  6
						.
					 Apex  7
						.
					 Superior articular process  8
						.
					 Middle sacral crest  9
						.
					 Sacral tuberosity (note accessory articular facet on posterior part of tuberosity)  10
						.
					 Lateral sacral crest


Osteology
										 Sacrum, posterior view

														 1
						.
					 Base  2
						.
					 Mamillary process  3
						.
					 Lateral part  4
						.
					 Articular surface  5
						.
					 Dorsal sacral foramen (pelvic foramen in background)  6
						.
					 Intermediate sacral crest  7
						.
					 Sacral horn  8
						.
					 Apex  9
						.
					 Sacral canal  10
						.
					 Superior articular process  11
						.
					 Sacral tuberosity  12
						.
					 Accessory articular facet (of sacroiliac joint)  13
						.
					 Middle sacral crest  14
						.
					 Lateral sacral crest  15
						.
					 Sacral hiatus


Osteology
										 Sacrum, anterior view

														 1
						.
					 Base of sacrum (pointer on Promontory)  2
						.
					 Superior articular process  3
						.
					 Lateral part  4
						.
					 Anterior (pelvic) sacral foramina  5
						.
					 Transverse lines (note lack of fusion between first and second sacral bodies in this young specimen)  6
						.
					 Apex of sacrum


Osteology
										 Left coxal bone, medial aspect

														 1
						.
					 Iliac tuberosity  2
						.
					 Accessory facet of sacroiliac articulation  3
						.
					 Articular surface  4
						.
					 Posterior superior iliac spine  5
						.
					 Greater sciatic notch  6
						.
					 Body of ischium  7
						.
					 Ischial spine  8
						.
					 Lesser sciatic notch  9
						.
					 Ischial tuberosity  10
						.
					 Ramus of ischium  11
						.
					 Inferior pubic ramus  12
						.
					 Iliac fossa  13
						.
					 Anterior superior iliac spine  14
						.
					 Anterior inferior iliac spine  15
						.
					 Body of ilium  16
						.
					 Iliopubic eminence  17
						.
					 Superior pubic ramus  18
						.
					 Body of pubic bone  19
						.
					 Symphyseal surface  20
						.
					 Obturator foramen


Osteology
										 Articulated female pelvis, left lateral view

														 1
						.
					 Gluteal surface of ilium  2
						.
					 Anterior superior iliac spine  3
						.
					 Anterior inferior iliac spine  4
						.
					 Lunate surface  5
						.
					 Fossa of acetabulum  6
						.
					 Iliopubic eminence  7
						.
					 Notch of acetabulum  8
						.
					 Superior pubic ramus  9
						.
					 Body of pubic bone  10
						.
					 Obturator foramen  11
						.
					 Posterior superior iliac spine  12
						.
					 Posterior inferior iliac spine  13
						.
					 Sacrum  14
						.
					 Greater sciatic notch  15
						.
					 Ischial spine  16
						.
					 Lesser sciatic notch  17
						.
					 Ischial tuberosity


Osteology
										 Articulated female pelvis, posteroinferior view

														 1
						.
					 Posterior superior iliac spine  2
						.
					 Posterior inferior iliac spine  3
						.
					 Ala of ilium  4
						.
					 Greater sciatic notch  5
						.
					 Ischial spine  6
						.
					 Lesser sciatic notch  7
						.
					 Ischial tuberosity  8
						.
					 Ramus of ischium  9
						.
					 Inferior pubic ramus  10
						.
					 Body of pubic bone  11
						.
					 Left pointer: Lateral sacral crest Right pointer. Pelvic surface of sacrum  12
						.
					 Sacral horn  13
						.
					 Sacral hiatus  14
						.
					 Coccygeal horn  15
						.
					 Coccyx  16
						.
					 Acetabulum  17
						.
					 Minor pelvis (viewed through inferior pelvic aperture)