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Pelvis and Perineum

  1. Epithelium lining the urinary bladder & urethra is derived from endoderm, as both are derivatives of urogenital sinus.
  2. Lower 2/3 of vagina develops from endoderm of urogenital sinus.
  3. Gubernaculum is attached to 'caudal end' of the gonads aids in the descent of the gonads
  4. Gartner’s cyst arises from the remnant of mesonephric duct.
  5. Genital (Urethral) folds form labia minora.
  6. Pain of external hemorrhoids is carried by Inferior rectal nerve (Pudendal nerve branch).
  7. Structures passing through lesser sciatic foramen are PIN :
    P – Pudendal nerve
    I – Internal pudendal vessels
    N – Nerve to obturator internus
  8. Ante-verted position of uterus is maintained by the utero-sacral ligament (posterior pull) &ante-flexion position is maintained by the round ligament of uterus (anterior pull).
  9. Internal urethral sphincter is absent in females.
  10. Distal Spongy part of male urethra mainly drains into the deep inguinal lymph nodes.
  11. Lymphatic drainage of uterine cervix:           
    1. Internal iliac lymph nodes
    2. External iliac lymph nodes     
    3. Obturator lymph nodes
  12. Broad ligament is a poor (weak) support of uterus.
  13. The female pelvis is less massive, the subpubic angle is greater (almost 900), and the pelvic inlet more ovoid than the male pelvis.
  14. The obstetric conjugate is the least anteroposterior diameter of the pelvic inlet from the sacral promontory to a point a few millimeters below the superior margin of the pubic symphysis.
  15. The transverse midplane diameter, measured between the ischial spines, is the smallest dimension of the pelvic outlet.
  16. The levator ani muscle forms most of the pelvic floor and its puborectalis portion (rectal sling) is the principal mechanism for maintenance of fecal continence when the rectum is full.
  17. Each uterine artery crosses immediately superior to a ureter in the transverse cervical ligament-an important surgical consideration.
  18. Normal uterine position is ante flexed (uterus bent forward on itself at the level of the internal os) and anteverted (angled approximately 90° anterior to the vagina), lying on the urinary bladder.  In the female, palpable per vagina are the cervix and ostium of the uterus, the body of the uterus if retroverted, the rectouterine fossa, and variably the ovary and uterine tubes.
  19. The lymphatic drainage from the vagina is by three routes: the external and internal iliac nodes from the upper portion of the vagina; and the internal iliac nodes as well as the superficial inguinal nodes from the lowest third.


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