326 TELVIC FASCIiE. 



symphysis pubis aiul to the rami of the pubic and ischial bones, and 

 extending in the middle line back to the central point of the perina3um, 

 is perforated about an inch from tlie symphysis by the urethra, imme- 

 diately before its cx]iansion into the bulb, and above and in front of 

 this by the dorsal vcjin of the penis in the middle line, and by the pudic 

 arteries and nerves on each side. At its posterior and inferior extremity 

 it is connected ^ith the deep layer, and with the recurved margin of 

 tlie perineal fascia. Between the two layers of the subpubic fascia are 

 placed the membranous portion of the urethra, the deep transverse and 

 constrictor muscles of the urethra, and Cow{)er's glands, together with 

 the ])udic arteries and nerves and the arteries of the bulb. The jwslerior 

 or doe]) Jcujor consists of a right and left lateral half, which are separated 

 in the middle line by the urethra close to the neck of the prostate, and 

 are continued into the capsule of that gland. This layer of fascia is 

 superficial to the anterior fibres of the levator ani muscle, which lie 

 between it and the pelvic fascia, and is connected with a thin web of 

 areolar tissue which extends backwards on the surface of the levator ani 

 muscle, and is distinguished as the anal fascia. 



In the female the sul)pubic fascia is divided in the middle by the 

 vagina. 



Fascia of the Pelvis. — The ftiscia lining the pelvis is described 

 in three parts, viz., the upper part, or undivided pelvic fascia, and 

 the two lower — the recto-vesical fascia, and the obturator fascia. The 

 first of these is divided into the other two at the level of a Avliite 

 band of fibres, stretched from the lower part of the symphysis pubis to 

 the spine of the ischium. The space between those two fasciie is 

 occupied by the levator ani and the fat and other contents of the ischio- 

 rectal fossa. 



a. The pelvic fascia is attached at tlie side superiorly for a short 

 space to the brim of the pelvis, but in front of the line of its osseous 

 attachment it inclines downwards towards the lower part of the sym- 

 physis pubis, following the margin of the obturator internus muscle. 

 Anterior to the spine of the ischium, it lies between the obturator 

 internus and the peritoneum, and at the back part of the pelvis is con- 

 tinued as a thin membrane over the pyriformis muscle and the sacral 

 nerves, and is perforated by branches of the internal iliac artery and 

 vein. 



h. The recto-vesical fascia is the direct continuation of the pelvic 

 fascia downwards and inwards to the viscera, below the level of the 

 white line previously mentioned ; ft descends, immediately in contact 

 with the inner surface of the levator ani muscle, to the prostate gland, 

 the urinary bladder, and the rectum. On reaching those organs it 

 spreads over them, and to some extent encases them. Close to the 

 symphysis pubis, a short band is directed backwards above the prostate 

 gland, to the bladder, with which it is intimately connected. A similar 

 band exists at the opposite side of the sym])hysis pubis, and the two 

 are separated by a narrow depression, in Avhich the dorsal veins of the 

 penis lie, after entering the pelvis. The bands in question are named 

 the anfcrior true ligaments of the nrinarij bladder. xVt the place where 

 it ^s reflected inwards to the side of the bladder, the recto-vesical 

 fascia forms the hferallnie vesical liijament. At the side of the bladder 

 and prostate, the fascia gives a ])rolongation forwards on the veins 

 which cover the prostate, and is firmly adherent to the capsule of 



