GROSS LAB IV PELVIS and PERINEUM -

General Introduction

From actual bodies almost all the ideas of anatomical theory developed, but to understand this theory it is easier to use lists and labelled diagrammatic PowerPoint images, which present a simplified view and one that ignores anatomical variation from one person to another. The purpose of the anatomy lab is for you to find out what bodies are really like to the extent that we can do this once they are dead.
Another linking of knowledge and experience comes when you join your cadaver-based knowledge with live surface anatomy, surgical exposure, imaging techniques, etc, on patients.
This guide to your lab experience relates certain PowerPoints used in the lecture to labelled views of lab dissections. The images are separate from the brief linking and explanatory text and you'll reach them via links. In this way, you do not have one huge file to download, and you can leave or move in the program at any time. But, remember - you are in a website, so use BACK, not the exit X, which will whisk you right out of this module.

However, what we are showing you here are images to prepare you for what to experience and learn in the lab. You absolutely have to put on the gloves, feel, and explore, moving organs out of the way, putting them back, using your mind all the time and talking things through with your clasmates at the table. Ideas on the experience and the thinking are at this site Cadaver
Read through it to prepare yourself.
In the lab, within your working group of three or four, someone needs to have brought a copy of Guy's Anatomy book, a list of the structures to be learned for the test, & whatever of this can usefully be printed out and brought. Although, the idea is to have most of this in your head when you come in. However, printing out the Figs in black and white of course loses the color used extensively to distinguish things. You can, later, go over the labels and leaders and restore them with colored highlighters.
For using this material at the computer, some may work from the screen just clicking the links, others may want a printed version to read along with going off for the images.


Gross dissection Views

The gross dissection images on this site were photographed in 2003 to 2006 by Dr Barbara Kraszpulska with the technical help of Jeffrey Altemus, under the auspices of the Department of Neurobiology & Anatomy, West Virginia University. She holds the author's copyright. Dissection views

(i) That you can see inside someone in this manner is only thanks to his/her generosity in allowing this use of his body after death. Respect the person's intent that you should be able to learn so as to be better at knowing and helping the living.

(ii) The appearance of the embalmed tissues and organs changes over time, so that in the lab you may meet darker shades of tan and brown.

(iii) In order to view the structures, usually several layers of connective tissue have had to be removed, so the images do not show how well and tightly our organs are packed in and fastened together.

(iv) One's first thought should be on orientation - How is the person lying? Face down/up/ or on side? What region am I looking at, and from what direction? Front back, left side, etc. [Know the technical names, supine, left lateral, etc.]

The first image of a series has a white stick figure to indicate orientation. Thorax & Abdomen (anterior) - Orientation

(v) Later Figs then are labelled to show major structures, vascular and nervous structures, and other items of interest.
Set in the text close to a dissection view may be a link to a relevant Powerpoint Fig from the Theory lectures.

(vi) At home, the images may take up to a minute to download, depending on your connection to the Web. They are in .jpg format which needs a viewer of some kind (Paint, Adobe, Camedia, etc.).
If you save the images all to one folder on your own computer, your viewer subsequently will give you a comprehensive showing of thumbnails or files that you can select from rapidly. Although, the links from the master text will not work, you can print that out and read along while looking at the images. Later, when I'm sure of how many .ppt and .jpg Figs I need to use, I may number them consecutively to connect them better with the text.


There is a little overlap with that for the Abdomen in this list of structures to be known for the test

NBAN 206 MODULE  IV  Pelvis, Urinary & Reproductive Systems
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PELVIS AND LOWER LIMB BLOOD SUPPLY (Same on both sides)
Common iliac aa.
Internal iliac aa. (to the pelvis). External iliac aa. (main blood supply to the lower limb)
Femoral aa.( continuation from the external iliac aa.)

SYSTEMIC (CAVAL) VEINS OF THE ABDOMEN & PELVIS i.e., not PORTAL draining to the liver

Most systemic veins that run with the arteries have the same adjective in the name. The systemic veins drain into the IVC from the lower limbs and abdomen.
Renal vv. (from kidneys)
Gonadal vv. (from gonads)
Lumbar vv.(from posterior abdominal walls)

Common iliac vv
Internal iliac vv.(from pelvis)
External iliac vv.(from lower limbs)
Femoral vv.(from lower limbs)

PORTAL SYSTEM
Venous blood from the digestive system drains into the portal vein, through the liver and into the IVC on the posterior side of the liver
Inferior mesenteric vein (from hindgut derivatives)
is the only portal drain from the pelvis
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URINARY SYSTEM (Lesson 37)
Kidneys - - ureters - - urinary bladder - - urethra<[p> Some structures: ( *Best seen on the models)
Renal cortex - - renal medulla ( pyramid) - - minor and major calyx - - renal pelvis

Renal arteries - - renal veins

Vessels inside kidney *:-
interlobar artery and vein - - arcuate artery - - interlobular artery - - afferent arteriole - - glomerulus - - efferent arteriole

Nephron structures*:-
Bowman's capsule - - proximal convoluted tubule - - descending limb of loop - - ascending limb of loop - - distal convoluted tubule - - collecting duct

MALE REPRODUCTION (Lesson 38) (* some detail better seen on the models)

Testis - - scrotum - - ductus deferens - - seminal vesicle - - ejaculatory duct* - - prostate gland* - - urethra:-
prostatic - - membranous * - - penile
corpora cavernosa penis - - corpus spongiosum - - spermatic cord - - testicular artery and vein - -

FEMALE REPRODUCTION (Lesson 39) (* best seen on the models)
ovary - - ovarian artery and vein* - - broad ligament - - uterine tube - isthmus, ampulla, infundibulum - - uterus - fundus, cervix - - round ligament of uterus*
fornix - - vagina - - labia majora - - labia minora - -

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EMBRYOLOGICAL MUSEUM - ROOM 4006
PowerPoint for Dodd's Embryo Collection Observe normal and abnormal development
What is an ectopic pregnancy?

Points to keep in mind for pelvis & perineum

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Pelvic hemisection, LEFT. Note the orientation from the stick Fig. and the thigh. Observe the curve of the cut sacrum, and where the lower and more anterior pubis has been cut at the join (symphysis). (Feeling the bones provides conviction.) Just below the copyright notice, one sees the smooth surface of the labia majora & minora, which, with the absence of penis and scrotum, show this to be female - adjust one's expectations accordingly . . Left female hemisection - orientation

This is the more conventional whole-cadaver view more familiar to you. Between the pubis and the fingers holding down the sigmoid colon is the pelvic basin. Note its small capacity, so that the uterus in pregnancy has to expand right out of it. Directly behind the pubis is the U bladder, sometimes flattened and initially hard to find. Look and feel. Note the order from pubis posteriorly: bladder, uterus, colon & rectum. [Already, from the breasts and vulva one would know that this is a woman, so that the absence of a uterus would have indicated surgery, not that this was man] . . Female pelvic organs - whole cadaver

Same view as the last, but the ovary, suspended on its own membrane, is marked. The uterine (Fallopian) tube extends past the ovary, before curving back to present its fimbria (fringe) . . Ovary, tube with fimbria

We return to the female left hemisection. From the pubis posteriorly we cannot match the bladder, uterus, and rectum with their corresponding passages through the perineum, because this is not an exact hemisection - the urethra and anal canal are not visible. To the side of the uterus is part of the broad ligament, with the attached ovary. The uterus has a cyst (abnormal), but its cervical canal also is not to be seen. Note the long course of the vagina past the uterine cervix, and the markedly different axes of vagina and uterus. . Organs & relations in female hemisection

Same view, but labelled to show the fundus (dome), corpus (body), and cervix of the uterus. About at the fundus-corpus divide, the uterine tube extends away toward the ovary. Where the vagina overshoots the cervix is the recess called the fornix. Note the thin walls separating vagina from rectum - see .ppt on prolapse and fistulae. Follow the vagina to its wide (no sphincter) opening between the labia - both left minora and majora can be seen to justify their 'small' and 'large' names. . Regions of uterus, Fornix; Labia

Male pelvic hemisection, left. We'll use the same orientation as the female's just seen. U badder lies behind the pubic bone; rectum is anterior to the sacrum. Penis has been cut into right and keft halves - both present, so confusing the first view. . . Male hemisection - general

The two halves of the penis are marked. The probe is in the prostatic urethra. Also coming and attached to the prostate are the long ductus deferens, curving round from the inguinal region, and the seminal vesicle ( feels small, firm, and corrugated) . . Prostate, urethra, seminal vesicle, & vas deferens

Whole cadaver for partially dissected male external genitalia. The scrotum is cut open; and the skin removed from the proximal penis. The wide spermatic cord has been opened, but the thick, firm ductus deferens can still only be clearly seen near the 'testis'. . . Spermatic cord & Ductus deferens

This view shows that, when one opens the external spermatic fascia, what was labelled 'testis' previously comprises the actual testis/testicle and the long atttached epididymis, only the head of which is visible . . Testicle & Epididymis

Similar view, but the layers of fascia around the cord are more intact, and can be seen to be multiple. The elaborate wrappings of the testicle and cord reflect their descent, via the inguinal canal, from the abdomen, with its peritoneal layers. . . Fascia of cord; & Inguinal canal

This longitudinal view of the bisected penis reveals the dark left corpus cavernosum. It does not end proximally in white connective tissue as it appears, but diverges laterally to become the crus attached to the pubis. The smaller corpus spongiosum urethrae on the ventral side has the urethra running its length, and continuing into the glans (here cut off) . . Corpus cavernosum & C. spongiosum; Penile urethra

Kidney, internal structure. Note the dark complexion, but not as dark as liver or spleen. The kidney has been split into halves along the thin white line. The system of calyces exists in 3D, and is hard to make out in a single section. Explore with a probe. Some of the minor calycesi> are indicated. The continuous outer region is the cortex. The medulla comprises the inwardly projecting pyramids. . Kidney - internal structure

Open abdomen and pelvic cavity from which most of the viscera have been removed. The U bladder might still be in place, but out of view. The ureter descends from its kidney, over the psoas muuscle, into the pelvic cavity, staying posteriorly (retroperitoneally), to enter the back of the bladder. Note the independent course of the ureters, running over vessels and other structures. On the cadaver, trace it from end to end - renal pelvis to bladder. . (IVC - inferior vena cava; AA - abdominal aorta) . . Kidneys & Ureters

A similar view, but the left ureter can be traced closer to its origin in the renal pelvis, still obscured by branches of the left renal vein. Where the kidney is indented to connect with vein, artery, & ureter is the hilus . . Left Ureter & Renal Vein

The . Spleen & Splenic A

Here, . Splenic vein & Pancreas