Prostatic venous plexus of Santorini which lies between the
These are thin walled valveless veins
It receives the deep dorsal vein of the penis
It commun'icates with vesical venous plexus
o lt drains into the internal iliac v. which communicates with
int. vertebral venous plexus (valveless lateral sacral veins).
SuRCtmt lUp0Rtmcf: Cancer prostate reaches vertebral
column rapidly through valveless veins of Bateson
Subdivision of the cloaca (the blind end of the hindgut) into :
The uroqenital sinus receives the mesonephric duct and which has
The ureteral orifice migrates upwards and laterally.
The mesonephric duct orifice moves downwards and medially
Miller's tubercle differentiates to form the bladder and the part of the
prostatic urethra proximal to the seminal colliculus in the male or the
bladder and the entire urethra in the female
The rest of the male urethra is formed by fusion of the urethral folds on the
ventral surface of the oenital tubercle.
ln the female, the genital folds remain separate and form the labia minora.
[nEamuml (trepructafic] Fart sf ir*thra
lfltsffnedlalB {rnsmkBn0ls} pafl ol uralhr0
o Urethra is 16-20 cm (8 inch) long.
1) The preprostatic part: ( 0.5 to 1 .5 cm)
.tr._c..U.fe.th.fa (1 inch long)
It is heavily muscular & sphincteric
It is the widest and most dilatable
It receives the ejaculatory duct
lh.e....Mem-b.ta.ng_U.g...Uf.ejhf.a, (0.5 inch long) is within the urogenital
diaphragm and is surrounded by the striated external sphincter. lt is the
narrowest and least dilatable part.
+) Lh.e..PenjJe.Ur.e.thf.e. (6.5" long) is poorly
muscularized & traverses the corpus
spongiosum to open at the tip of the
Begins at bladder neck and ends as the external orifice, in the vaginal
1) Anterior: pubovesical ligament.
2) Posterior : anterior wall of the vagina
It is muscular in its proximal4/5.
The striated external sphincter surrounds the middle third of the urethra.
Normally, Epididymrs ,s attached to posterior border of the
lnversion of the testis means alteration of the normal position of
It is a cord-like duct 45 cm long.
It begins as a continuation of the tail of the epididymis
It lies in the center of other constituents of the spermatic cord
It leaves the scrotum & passes through the inguinal canal
It enters the pelvis through the deep inguinal ring lateral to inferior
ln the pelvis rT passes downwards & backwards on the side of /esser pelvis
On the bladder base, it runs along the medial side of seminal vesicle, then it
unites with the duct of seminal vesicle to form ejaculatory duct , which opens
Arterial supply: artery of the vas deferens form superior (usually) or inf
It can be identified by its hard & cord-like character when rolled between the
Bf CIUS: opposite to 53 as the continuation of sigmoiO cotonlfrL
ENpS: 1 inch below & in front of the coccyx by bending sharply backwards &
downwards to form the anal canal (at the level of pelvic diaphragm)
oppositetositebending,themucosaformsmucosalfolds
which are called valves of Houston'
diaphragm(commonestsiteforcancerrectuminEgypt)
ailf . Rectum has NO appendices epiploicae T
o Rectum has NO teniae coli (teniae coli are nothing but longitudinal muscle
PeRlfOrugUU : it is a retroperitoneat structure
*r. Upper third ) front & side.
Lower third ) no (so no transcelomic implantation).
From the 3rd sacral piece to the sides of the rectum
containing the middle rectalvessels, nervi erigentes (Sz,s).
Posterior to the rectum (behind the fascia there is the presacral venous
{f ffi (attached to the prostate).
SURglCnt lilpgRflUEf : derays the spread of cancer
1) Attachment of the levator ani between the external & internal sphincters.
2) The fascia around the rectum.
3) The rectouretheralis muscle.
4) The fatty tissue of the pelvis & ischiorectal fossa,
. WCoils of ileum & sigmoid colon (in the rectovesical
- Base of the bladder and related structures :
o The terminal parts of the 2 ureters.
- Coils of ileum & sigmoid colon (in the Douglas pouch)
- Uterus and upper part of the vagina (separated from the
rectum by the rectouterine pouch).
Lower 1/3: Lower part of the vagina (no peritoneum inbetween).
. Fmm lho s0tsrbrsb{bmlnal wall fI}
. 0n lhe s$pe{ior sxrtac8 ol the ornary Hadde{ 13)
. f{om $e Uadder to fis dens.loming lio yeslco|trrhs
' 0n the lundus and Dody o, me uteruE, p0sterior lomk. aft,
' B0twsa0 lh0 roctum ald ut€rus, lormh0 $s rscl0ut0rh6
. 0n lhs anlsilor and lelernl sid€6 0l lhe rectun A
. P06t6riorly to 0oc0m6 fi6 shmold mgsocolon /8)
. 3 Bones & Liqaments: lower 1A of the sacrum, coccyx & anococcygeal
. /W!gS; Piriformis, coccygeus & levator ani (of both sides ) in front
. 3 Vesse/s. Median sacral, lateral sacral & superior rectal vs
t 1) The 2 sympathetic trunks and the ganglion impar.
III- On each side (common in ? & 3t:
1) Pararectal fossa with its content of sigmoid colon or ileum.
2) lnferior hypogastric plexus.
3) Levator ani and coccygOus muscles.
a' Superior rectal artery and vein (continuation of inf. mesenteric artery and
v.); it gives three branches at3,7,'l 1 O'clock.
suRgtcat lupnRtauct: Mother pires at these sites.
b- Middle rectal artery and vein (from int. iliac artery and vein).
c- lnferior rectal artery and vein (from int. pudendal artery and vein).
lnffitur trafisl.ffea r#ol tf, ld
lr$mnlpdmddifil fttumal nudogfil *stl
laHlrrcllnffiy Eectd remue ptrxaa
l*cftioeEd to6cn ffitrhrnotulroh
. Usually in upward direction.
o Pararectal LNs (2) posterior to the rectum.
. lntermediate LNs along the superior rectalvessels,especially the group which
lies just ab_ove the levalor ani & close to the rectal wail in th<i region of,the
. Central node at the Inferior Mesenteric artery (1).
o To a minor extent, some lymphatics pass along the middle rectal vessels )
Lymphatics mainly drain upwards so, removal of 2 cm below
the tumour is enough in cancer rectum.
BECINS as a continuation of the rectum 1 inch below & in front of the tip of
E ru OS at anal verge (sunray appearance due to corrugator cutis ani muscle)
LerucrH 4 cm directed downwards & backwards.
A- lnternql sphincter (inuoluntqry)
o It surrounds the upper Ta of the anal canal
o lt is the lower border of the inner circular muscles
o lt is involuntary (smooth muscle) ) White color
- lt shows spasm in any painful anal condition (e.9. anal fissure)
- lts division (sphincterotomy) removes the spasm & pain and
improves the drainage without bad effects
{f B- Externql Sphincter (voluntory)
o lt is voluntary (striated muscle).
. !!grc_Wp$: Somatic nerve (lnferior
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