ABDOMEN 



Peritoneum 



Endo-pelvic 

 fascia 



Pelvic wall 



Levator ani 



the obturator artery, but the inferior vesical and middle 

 hsemorrhoidal veins are usually numerous, and, as they pass 

 to their termination, they ensheathe the lower part of the 

 ureter. The lateral sacral and gluteal veins end in the 

 hypogastric vein, but the ilio-lumbar vein is, usually, a 

 tributary of the common iliac vein. 



Endo -Pelvic Fascia. When the dissector has studied the 

 general position of the structures exposed by the removal of 

 the peritoneum and the extraperitoneal fat of the pelvis, he 

 should turn his attention to the endo-pelvic fascia. It con- 

 sists of two main parts : a parietal part, which forms part of 

 the pelvic wall, and a diaphragmatic part, which covers the 



.upper and lower surfaces 

 of the pelvic diaphragm. 

 The upper fascia of the 

 diaphragm is known as 

 the visceral layer of the 

 pelvic fascia, because it 

 enters into intimate rela- 

 tionship with the pelvic 

 viscera. The visceral part 

 of the pelvic fascia stretches 

 across the cavity, from side 

 to side and from front to 

 back, and helps to separate 

 the perineum from the 

 remainder of the pelvis. 



If the upper part of the parietal layer is examined it will 

 be found that it is continuous at the pelvic brim with the 

 fascia on the psoas major muscle, from which it descends 

 to the level of a line drawn from the lower part of the 

 back of the body of the pubis to the spine of the ischium. 

 At that level the visceral layer springs from the parietal 

 layer, its origin serving to separate the latter into lower 

 and upper parts. If the upper part of the parietal portion 

 is traced backwards it will be found to extend round the 

 lateral side of the hypogastric vessels and across the front 

 of the sacrum, behind the pelvic meso-colon and the rectum, 

 to the opposite side. If it is traced forwards, a short 

 distance below the brim, it will be found to blend with 

 the periosteum on the back of the superior ramus of the 

 pubis, along an oblique line which descends from the junction 



Perineum 



FIG. 193. Diagram of the Pelvic Wall 

 and Pelvic Floor. 



