20 Spaces

Contents of the Pelvis

Fig. 20.1 Male pelvis
Parasagittal section, viewed from the right side.

Fig. 20.2 Female pelvis
Parasagittal section, viewed from the right side.

Peritoneal Relationships

Fig. 20.3 Peritoneal relationships in the pelvis: Female
Superior view.

Fig. 20.4 Peritoneal relationships in the pelvis: Male
Superior view.

Pelvis & Perineum

The pelvis is the region of the body inferior to the abdomen, surrounded by the cingulum pelvicum. The pelvis major (false pelvis) is immediately inferior to the cavitas abdominis, between the alae ossium iliorum, and superior to the apertura pelvis superior. The pelvis minor (true pelvis) is found between the aperturae pelvis superior and inferior and extends inferiorly to the diaphragma pelvis (mm. levator ani and ischio coccygeus), a muscular sling attached to the boundaries of the apertura pelvis inferior. The perineum is the inferior most portion of the trunk, between the thighs and buttocks, extending from the os pubis to the os coccygis and superiorly to the diaphragma pelvis. The compartimentum superficiale perinei lies between the stratum membranosum of the tela subcutanea perinei (Colles’ fascia) and the membrana perinei. The saccus profundus perinei lies between the membrana perinei and the fascia inferior diaphragmatis pelvis.

Table 20.1 Divisions of the pelvis and perineum

The levels of the pelvis are determined by bony landmarks (alae ossium iliorum and apertura pelvis superior/pelvic brim). The contents of the perineum are separated from the pelvis minor by the diaphragma pelvis and two fascial layers.
Crista iliaca
Pelvis	Pelvis major	• Ileum (coils)
		• Caecum and appendix vermiformis
		• Colon sigmoideum
		• Aa. and vv. iliacae communes and externae
		• Rr. plexus lumbalis
	Apertura pelvis superior
	Pelvis minor	• Distal ureteres
		• Vesica urinaria
		• Rectum
		: Vagina, uterus, tubae uterinae, and ovaria
		: Ductus deferens, gl. vesiculosa, and prostatea
		• A. and v. iliaca interna and rr.
		• Plexus sacralis
		• Plexus hypogastricus inferior
Diaphragma pelvis (mm. levator ani & ischio coccygeus)
Perineum	Saccus profundus perinei	• Mm. phincter urethrae and transversus perinei profundus
		• Pars intermedia urethrae
		• Vagina
		• Rectum
		• Gl. bulbourethralis
		• Fossa ischioanalis
		• A. and v. pudenda interna, n. pudendus and rr.
	Membrana perinei
	Compartimentum superficiale perinei	• Mm. ischiocavernosus, bulbospongiosus, and transversus perinei superficialis
		• Pars spongiosum urethrae
		• Clitoris and penis
		• A. and v. pudenda interna, n. pudendus and rr.
	Stratum membranosum telae subcutaneae perinei (Colles’ fascia)
	Saccus subcutaneus perinei	• Fat
Cutis

Fig. 20.5 Pelvis and regio urogenitalis

Fig. 20.6 Pelvis: Oblique section
Anterior view.