PLATE LXXI. 

 FIRST SIDE VIEW OF A MALE PELVIS. 



In the dissection reprrsenti-il in the plate the right innominate bono was sawn 

 through the body of the pubis at the inner end of the thyroid foramen in order to save 

 the attachment of the pelvic fascia. The bone was then disarticulated from the sacrum, 

 the spine of the ischium being first severed at its base, and hooked up into 

 position. Thus the attachments of the coccygeus and levator ani are preserved in their 

 normal positions. The ischio-rectal fossa was then dissected from the .side, and a part of 

 the lateral wall of the bladder cleared to show the muscular coat. The so-called white 

 line of the pelvic fascia is not clearly shown. It extends from the spine of the ischium 

 to the body of the pubes, and is supposed to mark the limit of origin of the levator ani ; 

 but the fibres of this muscle often separate the obturator from the recto-vesical fascia 

 higher than this line. 



The plate also shows how, by distending the rectum and then inflating the bladder, 

 the anterior non-peritoneal surface of the latter is brought into contact with the 

 abdominal wall, and the peritoneum carried upwards. This fact is taken advantage of ii 

 doing a suprapubic lithotomy. 



The tissue between the bladder and posterior surface of the pubes is very lax, and 

 can be easily broken down by the finger, leaving a cavity, the space of Retains. 

 According to Braune, the transversalis fascia splits at the umbilicus, one layer following 

 the urachus down to the bladder, and the other passing over the abdominal wall to the 

 back of the pnbes ; and it is the interval between these layers that forms the space above 

 mentioned, and it is into this space that the bladder rises when distended. In the f<rtus 

 the bladder lies against the abdominal wall, and 'in the deficient wall of the rectal sheath 

 we have a trace of the original situation of the viscus, the upper border of which is marked 

 by the semilunar line of Douglas ' (Mitcalister). 



In a male child at birth the urethra enters the bladder opposite the upper border 

 of the symphysis, and the bladder occupies the lower two-thirds of the space between 

 umbilicus and pubes. The peritoneum extends far more to the base of the bladder than 

 in the adult, and this may account for the fact that in children the main cause of death 

 after perinea! lithotomy is due to injury of this membrane. 



