ob

• 4bones
• 1. two innominante (coxal)bones
• ilium,ischium, pubis
• 2. sacrum
• 3. coccyx

• plane of division from superior sacrum to superior pubis symph
• separated true and false pelvis

aka greater or major pelvis above the brim

lesser or minor pelvis below the brim, pelvic cavity

• posteriolateral=piriformis and coccygeus muscles
• anteriolateral=obturator internus
• pelvic floor= levator ani coccygeus

• xiphoid process to symphasis pubis
• paired rectus abdominis muscles anterior
• external oblq , internal oblq, transversus abdominis antero laterally

psoas major and iliacus muscles to form iliopsoas muscles (do not enter true pelvis)

originates at transverse process of lumbar vert and descend to pelvic side walls

false pelvis from pelvic side wall joins with psoas to form iliopsoas

• anterior to the hip and inserts into lesser trochanter on posterior femur
• does not enter true pelvis
• echogenic center due to nerves, vessles, lymphatics

• piriformis
• obturator internus
• pelvic diaphragm muscles

flat triangular muscles from aterior sacrum and pass through greater sciatic notch to superior greater troochanter on femur

• triangular sheets of muscle that go from anteriolateral pelvic wall pass out of pelvic cavity to superior greater trochanter of femur
• supports bladder
• forms lateral side walls of pelvis

• 3 muscles like a hammock across pelvic floor
• coccygeus
• piriformis

• run anterior and medial
• aterior to psoas major muscle
• enter bladder at trigone
• anterior to internal illiac arteries
• posterior to ovarian/uterine arteries

• anterior wall 9cm
• posterior wall 10cm
• 90 degree angle with cervix
• mucosal lining

arch like recess at upper portion of vaginal canal, blind pockets, ring shaped space

• 6-8cm x 3-5 x 3-5
• fundus body cervix
• cornua- where fallop. tubes attach

• serosa or perimetrium
• myometrium
• endometrium

• broad
• round
• uterosacral
• cardinal

• double folds of peritoneum that drape over fallopian tubes, uterus, and ovaries
• lateral side walls of uterus to pelvis walls
• contains uterine blood vessles and nerves

upper fold of broad ligament that encloses fallopian tubes extends from cornua of uterus

posterior portion of broad ligamentthat encloses the ovaries

• fibrous cords below in layers of broad ligament
• insert into labia majora
• hold fundus and body forward

• holds cervix to pelvic walls
• spoke wheel shaped

• holds cervix to pelvic side walls
• cord like ligament

• 90 degrees
• most common

less than 90 degrees

180 degrees

greater than 180 degrees

3cm legnth

loss of support allows uterine cervix to drop into vagina

• uterine
• from day 1 of mensturation
• average 3-5 days
• FSH increasing causing follicular develop wich produces estrogen

• days 5-14
• corresponds with follicular phase
• estrogen increases as follicle develp
• estrogen makes uterine lining regenerate

• day 5 or completion of menst. or when there is enough estrogen to shut off FSH
• dominant follicle

• uterine
• day 15-28
• corresponds to luteal phase
• under influence of progesterone (corp lut) the endomet is edematous
• estrogen shuts off prior to ovulation causing FSH and LH surge
• LH causes follicle to rupture at day 14
• 14 days later is menstruation
• anovulatory women never experience this phase

• uterine
• day 22-28
• occurs if no fertilization
• progesterone and estrogen low
• FSH on the rise

cortex- outermost layer- ova develops- horomone production

medulla- innermost layer with blood vessles connective tissue nerves and lymphatics

• ovarian
• follicle develops under influence of FSH

• ovarian
• LH causes mature follicle to rupture at day 14
• egg survives 6-9 hrs after ovulation
• sperm survive 36-72 hours after ejac

• LRH- luetinizing releasing horomone
• GRH- gonadotrophin releasing horomone

• FSH- follicle stimulating horomone
• LH- luetinizing horomone
• prolactin

• when one is high the other is low
• negative feedback system

• cord like ligament that anchors ovaries
• runs from lateral to posterior portion of uterus to lower pole of ovary

removal of fallopian tubes and ovaries

• occurs in inner cortex and migrate out
• theca cells- outter
• granulosa cells- inner
• at birth 100,000-600,000 primary follicles, 500 will mature

• suspensory
• superior extension of broad ligament
• runs from upper pole of ovary to pelvis sidewalls

potential space anterior to bladder and posterior to pubic symphasis bone

aspiration of fluid from posterior cul de sac via puncture of posterior fornix of vagina

• vesicouterine pouch
• potential space located anterior to uterus and posterior to urinary bladder

hematomas post c-section

bleeding between periods

no peritoneal covering

support ovaries laterally from infundibulum of fallop tube

attach to posterior via mesovarium

• bladder
• uterus
• vagina
• rectum

• short light periods
• PCOS

menstration intervals less than 21 days