1906 



HUMAN ANATOMY. 



short distance above its lower border, backward to the ischial spine (page 1899). 

 On either side of the mid-line the anterior ends of these tendinous arches pass as 

 strong fascial bands, the pubo-prostatic ligaments, from the symphysis to the prostate, 

 blending with its capsule, and thence continue to the inferior surface of the bladder, 

 where they are lost in the outer fibrous coat of the vesical wall. In the female these 

 fascial bands pass directly to the bladder as the anterior true ligaments. After leaving 

 the symphysis, the tendinous arches send expansions — the lateral true liga7nents — to 

 the side of the bladder, which materially assist in fixing the organ. 



The cleft left between the medial borders of the two levator ani muscles is occupied in the 

 male by the rectum and prostate and in the female by the rectum, vagina, and urethra, over 

 some of which organs (rectum, vagina, and prostate) the pelvic fascia covering the upper sur- 

 face of the levator ani muscles (fascia diaphragma pelvis superior) sends more or less extensive 

 investments and thus binds them to the pelvic floor. 



Additional support is afforded by more or less definite processes of muscular tissue pro- 

 longed from the bladder to adjacent structures ; those passing within the arcus tendineus to be 

 attached on either side to the back of the symphysis constitute the pubo-vesical muscles, while 

 others, the recto-vesical iiiuscles, extend backward to blend with the rectal wall. 



Fig. 1621. 



Symphysis pubis 



Pubo-vesical space, cleaned out 



Pelvic line. 



Arcus tendineus 

 fascicc pelvis 



White line^g 

 (arcus tendineus ni. 

 levatoris ani) 



Pubo-vesical ligament 



Arcus tendineus 



Levator ani muscle 

 y^_^Obturator canal 



w-- White line 



Bladder, partly distended 



Anterior part of pelvis of female, viewed from above and behind, showing relations of bladder 

 to pelvic fascia ; bladder has been partly distended and pulled backward. 



Between the lateral pubo-prostatic ligaments, the symphysis, and the bladder lies a deep 

 recess (fovea pubovesicalis), traversed by the dorsal vein of the penis and filled with fatty areolar 

 tissue, the floor of which is formed by the fusion of the pelvic fascia with the transverse ligament 

 of the perineum. Above the level of the pubo-prostatic ligaments lies the prevesical space, or 

 space of Retzius, which is bounded in front by the anterior wall of the pelvis below and the 

 transversalis fascia above, and behind by a thin membranous condensation of areolar tissue, the 

 fascia umbilico-vesicalis (Farabeuf), that passes from the pelvic floor over the prostate and 

 bladder to the abdominal wall, to fuse with the transversalis fascia at a variable distance below 

 the umbilicus. Laterally the boundaries of this space, filled with areolar tissue loaded with fat, 

 are uncertain, since when distended, as when the seat of an abscess, it may embrace the sides of 

 the bladder below and extend above as far as the obliterated hypogastric arteries. Under usual 

 conditions, however, the space may be regarded as confined chiefly between the antero-inferior 

 surface of the bladder and the adjacent anterior pelvic wall. 



Relations. — When empty, or containing only a small quantity of fluid, the 

 bladder possesses two general surfaces, a superior and an inferior. The anterior two- 

 thirds of the the latter rests upon the prostate and the pelvic floor, and, according to 

 Dixon,' when hardened in situ presents a rounded median ridge which, together with 

 the ureters, outlines two forward, upward, and outward sloping infero-lateral areas. 

 These rest upon the pelvic floor and the posterior surface of the pubis, separated 



> Journal of Anatomy and Physiology, vol. xxxiv., 1900. 



