Anatomical structure of the female pelvis. Female pelvis. The structure of the female pelvis. Female pelvic organs. Anatomy of the female pelvis. Internal dimensions of the pelvis

The structure of a woman’s bony pelvis is important in obstetrics, since in addition to its supporting function for internal organs, the pelvis serves as the birth canal through which the emerging fetus moves. The pelvis consists of four bones: two massive pelvic bones, the sacrum and the coccyx (Fig. 3). Each pelvic (nameless) bone is formed by fused bones: the ilium, pubis and ischium. The pelvic bones are connected through a pair of almost motionless sacroiliac joints, a sedentary semi-joint-symphysis and a mobile sacrococcygeal joint. The joints of the pelvis are strengthened by strong ligaments, and they contain cartilaginous layers. The ilium consists of a body and a wing, which is expanded upward and ends with a long edge - a crest. In front, the ridge has two projections - the anterosuperior and anterior-inferior spines. Similar projections are also present on the posterior edge of the crest - the posterosuperior and posteroinferior spines.

The ischium consists of a body and two branches. The superior branch runs from the body downwards and ends at the ischial tuberosity. The lower branch is directed anteriorly and upward. On its posterior surface there is a protrusion - the ischial spine.

Rice. 3. Female pelvis: 1 - sacrum; 2 - ilium (wing); 3 - anterosuperior spine; 4 - anterior inferior spine; 5 - acetabulum; 6 - obturator foramen; 7 - ischial tuberosity; 8 - lawn meadows; 9 - symphysis; 10 - entrance to the pelvis; 11 - unnamed line

The pubic bone has a body, superior and inferior branches. On the upper edge of the horizontal (superior) ramus of the pubic bone there is a sharp ridge, which ends in front with the pubic tubercle. The sacrum consists of five fused vertebrae and has the shape of a truncated cone. The base of the sacrum articulates with the V lumbar vertebra. On the anterior surface of the base of the sacrum a protrusion is formed - the sacral promontory (promontorium). The apex of the sacrum is movably connected to the coccyx, which consists of 4-5 undeveloped fused vertebrae.

There are two sections of the pelvis: large and small. Between them runs the border, or nameless, line. The large pelvis, unlike the small one, is accessible for external examination and measurement. The size of the small pelvis is judged by the size of the large pelvis.

The pelvis is the narrow part of the pelvis. During childbirth, it is the bony part of the birth canal. In the small pelvis there are an entrance, a cavity and an exit. The pelvic cavity has a narrow and a wide part. In accordance with this, four planes of the small pelvis are conventionally distinguished. The plane of entrance to the small pelvis is the boundary between the large and small pelvis. It has the shape of a transverse oval with a notch corresponding to the sacral promontory.

At the entrance to the pelvis the largest
the size is transverse. In the cavity of the small
The pelvis is conventionally divided into the plane of the wide part of the pelvic cavity, which has the shape of a circle, since its straight and transverse dimensions are equal, and the plane of the narrow part of the pelvic cavity, where the straight dimensions are slightly larger than the transverse ones. The plane of the exit of the small pelvis, like the plane of the narrow part of the pelvic cavity, has
the shape of a longitudinally located oval, where the direct dimension prevails over the transverse one.

It is practically important for the obstetrician to know the following dimensions of the small pelvis: true conjugate, diagonal conjugate and direct size of the pelvic outlet. The true, or obstetric, conjugate is the size of the entrance to the small pelvis, i.e., the distance from the sacral promontory to the most prominent point on the inner surface of the pubic symphysis. Normally it is 11 cm (Fig. 4).

The distance between the sacral promontory and the lower edge of the symphysis is called the diagonal conjugate, determined during vaginal examination and is on average 12.5-13 cm. The direct size of the pelvic outlet goes from the top of the coccyx to the lower edge of the symphysis: it is normally 9.5 cm During childbirth, as the fetus passes through the pelvis, this size increases by 1.5-2 cm due to the posterior deviation of the tip of the coccyx.

The born fetus passes through the birth canal in the direction of the wire axis of the pelvis, which is a line curved anteriorly (towards the symphysis) connecting the central

three of all direct pelvic sizes. Soft fabrics The pelvis covers the bony pelvis from the outer and inner surfaces. There are ligaments that strengthen the joints of the pelvis, as well as the muscles. The muscles located at the pelvic outlet are especially important. They cover the bony canal of the small pelvis from below and form the pelvic floor (Fig. 5). The part of the pelvic floor located between the posterior commissure of the labia and the anus is called the obstetric or anterior perineum. The part of the pelvic floor between the anus and the tailbone is called the posterior perineum. The pelvic floor muscles together with the fascia form three layers. This arrangement of muscles is of great practical importance during childbirth during expulsion of the fetus, since all three layers of muscles

The pelvic floor stretches and forms a wide tube, which is a continuation of the bony birth canal.

The most powerful is the upper (inner) layer of the pelvic floor muscles, which consists of the paired levator muscle. anus, and is called the pelvic diaphragm.

The middle layer of muscles is represented by the urogenital diaphragm, the lower (external) by several superficial muscles converging in the tendon center of the perineum: bulbospongiosus, ischiocavernosus, superficial transverse perineal muscle and external rectal sphincter.

The pelvic floor performs essential functions, being a support for the internal genital organs and other organs abdominal cavity. Incompetence of the pelvic floor muscles leads to prolapse and prolapse of the genital organs, Bladder, rectum.

12795 0

Main differences female pelvis from men are clearly detected in adults. The main ones are the following: the bones of the female pelvis, compared to the male, are thinner and smoother; the female pelvis is lower, more voluminous and wider, the wings of the iliac bones in women are deployed more strongly, as a result of which the transverse dimensions of the female pelvis are larger than those of the male; the entrance to the woman’s pelvis is wider and does not narrow downwards in a funnel-shaped manner, as in men, but, on the contrary, widens; as a result, the outlet from the pelvis of women is wider than that of men; the angle formed lower branches The pubic bones of the pelvis of women are more blunt (90-100 degrees) than those of men (70-75 degrees). Thus, the pelvis adult woman Compared to men's, it is more voluminous and wide, and at the same time less deep.

All connections pelvic bones motionless or weakly mobile, soften during pregnancy, and by the end of pregnancy they become so extensible that the pelvic bones, to a certain extent, become mobile in relation to each other; This is most pronounced in the sacrococcygeal joint.

Particularly important during childbirth is the pelvic floor of the female pelvis, which is included in the birth canal and promotes the birth of the fetus.

The superior aperture of the small pelvis - or the entrance to the pelvic cavity is limited by the border line, the promontory of the sacrum. The subpubic angle, the ischial tuberosities, the sacrotubercular ligaments, the apex of the sacrum and the coccyx delimit the inferior pelvic aperture (or the entrance to the pelvic cavity). The planes of entrance and exit, as well as the so-called “wide part of the pelvis” have special meaning in obstetric practice, they are assessed by straight and transverse, right and left oblique dimensions.

The direct size of the entrance - between the upper edge of the symphysis and the promontory is 11 cm; oblique size - from the pubic-crestal eminence to the sacroiliac joint - 12 cm; the direct size of the exit between the pubic angle and the coccyx is 9.5 cm; transverse between the ischial tuberosities - 11 cm; the transverse and straight dimensions of the pelvic cavity are 1-3 cm larger than the dimensions of the inlet; the line connecting the middle of the straight dimensions and the pelvic cavity is its axis (wire line in obstetrics). The entrance plane is inclined anteriorly and forms an angle of 54-55 degrees with the horizontal plane (inclination angle).

The lower wall is located at the outlet of the pelvis and belongs to the layers of the perineum, the deep muscles of which form the pelvic diaphragm and the genitourinary diaphragm: the levator ani muscle, the deep transverse perineal muscle; the anus passes through the first of them, the urethra and vagina pass through the second.

Rectum

Bladder and ureters

In the cavity of the female pelvis, the fascia of the bladder has similar relationships with the fascia of the cervix and vagina; here the most pronounced is the frontally located peritoneal-perineal aponeurosis (Denonvilliers) between the posterior wall of the vagina and the rectum.

The ureters in the female pelvis, as in the male pelvis, are located under the peritoneum and are surrounded by paraurethral tissue and have their own fascial sheath. In the pelvic cavity, the ureters of the sechala lie on the side wall of the pelvis, on the anterior surface of the internal iliac artery, anterior to the uterina, then in the thickness of the base of the broad ligaments of the uterus. Here the ureters are crossed again a. uterina, located under it and 1.5-2 cm from the internal os of the cervix. Further, the ureter is adjacent to the anterior wall of the vagina for a short distance and flows into the bladder at an acute angle.

V. D. Ivanova, A. V. Kolsanov, S.S. Chaplygin, P.P. Yunusov, A.A. Dubinin, I.A. Bardovsky, S. N. Larionova

The pelvis of an adult woman consists of four bones: two pelvic (nameless), the sacrum and the coccyx, connected to each other through cartilaginous layers and ligaments.

The pelvis is a closed bone ring and differs from the male one in its special shape and depth. From an obstetric point of view it has great importance the capacity of the woman’s small pelvis, which can vary slightly due to the limited mobility of the pubic, iliosacral and coccygeal joints.

Hip bone(os coxae) is formed from the fusion of three bones: the ilium (os ileum), the ischium (os ischii) and the pubic bone (os pubis). These three bones are immovably connected in the area of ​​the acetabulum (acetabulum) (Fig. 1).

The ilium has an upper section - wing and lower - body. The boundary between the wing and the body is defined on the inner side as arched or border line(lin. terminalis).

The upper thickened edge of the ilium wing forms iliac crest(crista iliaca). At the very front of the ridge there is a protrusion - anterior superior iliac spine(spina iliaca anterior superior); at the back the ridge ends in the same protrusion - posterior superior iliac spine(spina iliaca posterior superior). Directly below it is the large sciatic notch (incisura ischiadica major), ending in a sharp protrusion - ischial spine(spina ossis ischii s. spina ischiadica). Located below it, the small sciatic notch (incisura ischiadica minor) ends in a massive ischial tuberosity(tuber ischiadicum).

Sacrum bone(os sacrum) consists of 5-6 vertebrae motionlessly connected to each other, merging into one bone in adults. At the junction of two vertebrae, the first sacral with the last (V) lumbar vertebra, a bony protrusion is formed - a promontory.

Coccygeal bone(os coccygea) consists of 4-5 underdeveloped vertebrae fused together.
symphysis pubis or symphysis (symphisis ossis pubis), connects the pubic bones of both sides. The symphysis pubis is a semi-movable joint.

When the sacral bone joins each ilium, the sacroiliac joints (articulationes sacroiliacae) are formed.
The female pelvis is divided into two parts: large and small. The border is the plane of entrance to the small pelvis, passing through the upper edge of the symphysis pubis, the boundary lines and the apex of the promontory. Everything that lies above this plane makes up the large pelvis, below - the small pelvis.

There are 4 planes in the small pelvis:

plane of entry into the pelvis- bounded posteriorly by the sacral promontory, anteriorly by the anterior edge of the inner surface of the symphysis, and laterally by the innominate line. The plane has three dimensions: straight, transverse and two oblique.

· direct size - the distance from the sacral promontory to the most prominent point of the inner surface of the pubic fusion is 11 cm. The direct size of the entrance to the pelvis is also called true conjugate vera

· transverse size – the distance between distant points of the nameless line is 13 cm

· oblique dimensions (right and left) - the distance from the sacroiliac joint (articulatio sacroiliac) on the left to the pubic eminence on the right (and vice versa) is 12 cm.

plane of the wide part of the pelvic cavity– limited posteriorly by the junction of the II and III sacral vertebrae, laterally by the middle of the acetabulum, and anteriorly by the middle of the inner surface of the symphysis. In the wide part of the pelvic cavity there are two sizes:

· straight – connection of the II and III sacral vertebrae to the middle of the inner surface of the pubic fusion, equal to 12.5 cm

· transverse – between the middles of the acetabulum, equal to 12.5 cm

plane of the narrow part of the pelvis– limited in front by the lower edge of the pubic fusion, behind by the sacrococcygeal joint, on the sides by the spines of the ischial bones. In the narrow part there are two sizes:

· straight – from the sacrococcygeal joint to the lower edge of the symphysis, equal to 11 cm

· transverse – connects the spines of the ischial bones (inner surface), equal to 10.5 cm.

pelvic exit plane – limited in front by the lower edge of the pubic fusion, behind by the apex of the coccyx, on the sides by the ischial tuberosities, and the inner surface of the ischial tuberosities. Pelvic outlet dimensions:

· straight – from the lower edge of the pubic fusion to the apex of the coccyx, equal to 9.5 cm

· transverse size – between the inner surfaces of the tops of the ischial tuberosities, equal to 11 cm.

The large pelvis is more accessible for research than the small pelvis. Determining the size of the small pelvis makes it possible to indirectly judge its shape and size. The measurement is made with an obstetric caliper (pelvic meter) (Fig. 2). The tazomer has the shape of a compass equipped with a scale on which centimeter and half-centimeter divisions are marked. At the ends of the branches of the pelvis there are buttons that are applied to the protruding points of the large pelvis, somewhat squeezing the subcutaneous fatty tissue.

The pelvis is measured with the woman lying on her back with her stomach exposed and her legs together. The doctor stands to the right of the pregnant woman, facing her. The branches of the tazomer are picked up in such a way that fingers I and II hold the buttons. The graduated scale faces upward. Using your index fingers, feel for the points, the distance between which is to be measured, pressing the buttons of the spread pelvis meter branches against them. The value of the corresponding size is marked on the scale (Fig. 3).

Distantia spinarum– the distance between the anterosuperior iliac spines is 25-26 cm.

Distantia cristarum – the distance between the most distant points of the iliac crests is 28-29 cm.

Distantia trochanterica– distance between greater trochanters femur, equal to 31-32 cm.

Conjugata externa– the distance between the middle of the upper edge of the symphysis and the depression between the spinous process of the V lumbar and I sacral vertebrae is 20-21 cm. The external conjugate is important - by its size one can judge the size of the true conjugate (the direct size of the entrance to the small pelvis). To determine the true conjugate, subtract 9 cm from the length of the outer conjugate. For example, if the outer conjugate is 20 cm, then the true conjugate is 11 cm.

The fetal head has the greatest influence on the course of labor, since it is the most voluminous and dense part, which experiences the greatest difficulties when moving along the birth canal.

The head of a mature fetus consists of a brain and a facial part. The medulla has seven bones: two frontal, two temporal, two parietal and one occipital. The bones of the skull are connected by fibrous membranes - sutures (Fig. 4). The following seams are distinguished:

· frontal(s. frontalis), connects the frontal bones (in the fetus and newborn, the frontal bones have not yet fused together)

· swept(s.sagitahs) connects the right and left parietal bones, in front it passes into the large (anterior) fontanel, in the back - into the small (posterior)

· coronary(s.coronaria) – connects the frontal bones with the parietal bones, located perpendicular to the sagittal and frontal sutures

· occipital(s.lambdoidea) - connects the occipital bone with the parietal bones

At the junction of the sutures there are fontanelles, of which the large and small ones are of practical importance.

Large (anterior) fontanel located at the junction of the sagittal, frontal and coronal sutures. The fontanelle has a diamond shape.

Small (posterior) fontanel represents a small depression at the junction of the sagittal and occipital sutures. The fontanelle has a triangular shape.

Thanks to sutures and fontanelles, the fetal skull bones can shift and overlap each other. The plasticity of the fetal head plays an important role in various spatial difficulties for movement in the pelvis

FEMALE PELVIS from an obstetric point of view.

The bony pelvis consists of two pelvic bones, the sacrum and the coccygeal bone, which are firmly connected through cartilaginous layers and connections.

The pelvic bone is formed from the fusion of three bones: longitudinal, ischial and pubic. They connect at the acetabulum.

The sacrum consists of 5-6 motionlessly connected vertebrae that merge into one bone.

The coccygeal bone consists of 4-5 underdeveloped vertebrae.

The bony pelvis in the upper section is open forward. This part is called the large pelvis. Bottom part- This is a closed bone formation - the small pelvis. The border between the large and small pelvis is the terminal (nameless) line: in front - the upper edge of the symphysis and pubic bones, on the sides - the arcuate lines of the ilium, behind - the sacral prominence. The plane between the large and small pelvis is the entrance to the small pelvis. The large pelvis is much wider than the small pelvis, it is limited on the sides by the wings of the ilium, behind by the last lumbar vertebrae, and in front by the lower part of the anterior abdominal wall.

All women have their pelvis measured. There is a relationship between the sizes of the large and small pelvis. By measuring a large pelvis, we can draw conclusions about the size of a small one.

Normal sizes of the female pelvis:

• distantia spinarum - distance between the front upper bones longitudinal bone - 25-26cm;
• distantia cristarum - the distance between distant points of the iliac crests - 28-29 cm;
• conjugata externa - (external conjugate) - the distance from the middle of the upper edge of the symphysis to the upper corner of the Michaelis rhombus (measurements are carried out with the woman lying on her side) - 20-21 cm.

Michaelis rhombus- this is an expansion of the depression in the sacral region, the limits of which are: above - the fossa under the spinous process of the fifth lumbar vertebra(supracrigian fossa), below - points corresponding to the posterosuperior spine of the iliac bones. The average length of a rhombus is 11cm, and its diameter is 10cm.

Diagonal conjugate— the distance from the lower edge of the symphysis to the most protruding point of the promontory of the sacral bone is determined during vaginal examination. At normal sizes pelvis it is 12.5-13 cm.

The size of the true conjugate (direct size of the entrance to the small pelvis) is determined by subtracting 9 cm from the length of the external conjugate or subtracting 1.5-2 cm from the length of the diagonal conjugate (depending on the Solovyov index).

Solovyov index - the circumference of the wrist-carpal joint, divided by 10. The index allows you to have an idea of ​​​​the thickness of a woman’s bones. The thinner the bones (index = 1.4-1.6), the greater the capacity of the small pelvis. In these cases, 1.5 cm is subtracted from the diagonal conjugate to obtain the length of the true conjugate. With the Solovyov index

I, 7-1.8 - subtract 2 cm.

Pelvic tilt angle — the angle between the plane of the entrance to the small pelvis and the horizon is 55-60 °. Deviations in one direction or another can negatively affect the course of labor.

The normal height of the symphysis is 4 cm and is measured index finger during vaginal examination.
Pubic angle - with normal pelvic sizes is 90-100 °.

Small pelvis - This is the bony part of the birth canal. The posterior wall of the small pelvis consists of the sacrum and coccyx, the lateral ones are formed by the ischium, and the anterior wall is formed by the pubic bones and the symphysis. The small pelvis has the following sections: inlet, cavity and outlet.

In the pelvic cavity there are wide and narrow parts. In this regard, four planes of the pelvis are determined:

1 - plane of entrance to the small pelvis.
2 - plane of the wide part of the pelvic cavity.
3 - plane of the narrow part of the pelvic cavity.
4 - plane of exit from the pelvis.

The plane of entry into the pelvis passes through the upper inner edge of the pubic arch, the innominate lines and the apex of the promontory. The following dimensions are distinguished in the entrance plane:

1. Direct size - the distance from the sacral protrusion to the point that most protrudes on the upper inner surface of the symphysis - this is the obstetric, or true conjugate, equal to 11 cm.
2. Transverse size is the distance between the distant points of the arcuate lines, which is 13-13.5 cm.
3. Two oblique dimensions - from the iliosacral junction on one side to the iliopubic tubercle on the opposite side pelvis They are 12-12.5 cm.

The plane of the wide part of the pelvic cavity passes through the middle of the inner surface of the pubic arch, on the sides through the middle of the trochanteric cavity and behind - through the connection between the II and III sacral vertebrae.

In the plane of the wide part of the small pelvis there are:

1. Direct size - from the middle of the inner surface of the pubic arch to the junction between the II and III sacral vertebrae. It is 12.5 cm.
2. The transverse dimension runs between the middles of the acetabulum. It is 12.5 cm.

The plane of the narrow part is through the lower edge of the pubic junction, on the sides - through the gluteal spines, behind -
through the sacrococcygeal joint.

In the plane of the narrow part they are distinguished:

1. Straight size - from the lower edge of the symphysis to the sacrococcygeal joint. It is equal to II.5 cm.
2. Transverse size between distant points of the inner surface of the ischial spines. It is 10.5 cm.

The plane of exit from the small pelvis passes in front through the lower edge of the symphysis, from the sides - through the tops of the gluteal tuberosities, and from behind - through the crown of the coccyx.

In the plane of exit from the small pelvis there are:

1. Straight size - from the tip of the coccyx to the lower edge of the symphysis. It is equal to 9.5 cm, and when the fetus passes through the pelvis it increases by 1.5-2 cm due to the deviation of the apex of the coccyx of the presenting part of the fetus.

2. Transverse size - between distant points of the internal surfaces of the ischial tuberosities; it is equal to 11cm.

The line connecting the midpoints of the straight dimensions of all planes of the pelvis is called the leading axis of the pelvis, and has the shape of a concave line forward. It is along this line that the leading point passes through the birth canal.

The main differences between the female and male pelvis:

• The bones of the female pelvis are thin and smooth;
• The female pelvis is relatively wider, lower and larger in volume;
• The wings of the ilium in women are more developed, so the transverse dimensions of the female pelvis are larger than those of men;
• The entrance to the pelvis of a woman has a transverse oval shape, and in men it has the shape of a card heart;
• The entrance to the small pelvis in women is larger and the pelvic cavity does not narrow downward into a funnel-shaped cavity, as in men;
• The pubic angle in women is obtuse (90-100°), and in men it is acute (70-75°);
• The pelvic tilt angle in women is greater (55-60°) than in men (45°).

The pelvic organs in women are an important part in the structure of her internal organs. This is largely due to the presence in the pelvic cavity of the main female genital organs, which have a close anatomical connection with other structures. When any diseases appear, they can change the clinical picture.

This is the final department digestive tract. This organ is located in the pelvic area, nearby there are neuromuscular and vascular fibers. The uterus and ovaries are located in front of the rectum.

Due to this close arrangement, problems associated with the rectum or uterus can imitate each other, which sometimes complicates the clinical picture.

Structure of the rectum:

The rectum as an organ has few functions, among which the main one is excretion feces from the body into the environment:

1. Processed products nutrients after passing through the overlying sections of the large intestine, they accumulate in the ampullary section of the rectum.
2. After the accumulation of the required amount of feces occurs, a reflex irritation of the organ occurs, creating an evacuation reflex.

Bladder

It is a muscular organ that, when unfilled, has a sac-like formation, and when filled, it has the appearance of a ball. The volume of the organ can vary, depending on the degree of filling, water load, as well as the frequency of emptying and some health problems.

On average, the volume of the bladder is within 200 ml; when the urination reflex appears, the volume can reach up to 800 ml. At pathological conditions stretching of the organ is allowed, creating a volume of 1500 ml.

It consists of three components, which are the membranes of the organ:

1. This is a serous layer that covers the outside of the organ, and the degree of coverage depends on the filling.
2. The muscle layer, which is multidirectional muscle fibers that provide complete removal urine from the organ.
3. The mucous membrane, which is expelled from the inside of the organ, thereby preventing urine from irritating the structures.

Other components of the organ and their work:

1. Two ureters flow into the organ, which connect the kidneys and. They carry secondary urine, which accumulates in the organ and is subsequently removed to the outside.
2. The urethra also emerges from the organ. It is through this that urine is removed into the environment. The female urethra has some features compared to the male one. This is largely due to the structural features of the pelvic organs, as well as the genital organs. IN female body it is wider and shorter.
3. As the organ fills, the uterus gradually shifts relative to its physiological location.
4. If it is located typically, leaning forward, then when the bladder is full, it tends to straighten. In front of the bladder is the symphysis pubis

, which is a bone structure, and at the back is the uterus. There may be intestinal loops on the sides. Below is the urogenital diaphragm.

The main function of the bladder is to create a reservoir that allows urine to accumulate in its cavity, preventing its constant removal into the environment. It also removes urine from the body.

Uterus

This is one of the main organs located in the pelvic area of ​​a woman. It appears in girls from birth, reaching its required size by the time of puberty. Its dimensions are small, the average parameters are about 3-4-5 cm. However, they can vary significantly, depending on the reproductive function. If a woman has a history of a large number of

• childbirth, then the large size of the uterus will be considered physiological.
• The organ is externally pear-shaped. On the sides in the upper sections extend from it , and in the lower section the uterine cavity connects with the vagina and environment
• through one of the most important areas - .
  • The organ has a predominantly muscular structure: On the outside it is covered by a serous membrane
  • , which performs a protective function to some extent. They also have different directions, due to which a significant increase in the size of the organ during pregnancy is ensured, followed by a subsequent decrease.
  • The inner layer is the endometrium. It allows you to carry out one of the main functions - bearing a fetus. The structural element organ is hormonally dependent. That is why pathology endocrine system is also reflected in the functioning of the uterus.

The main function of the uterus is reproductive - birth of children.

Cervix

This is one of the main elements of the pelvic organs; this organ is the division between the internal and external genitalia.

It is a muscle ring that performs many functions:

• Among them, the most important is to prevent infection from entering the pelvic cavity,
• childbearing,
• Penetration of sperm from the vagina into the uterine cavity.

It has several components:

1. External os, opening into the vaginal cavity,
2. The cervical canal, which is the structure through which childbirth occurs, as well as the penetration of infection or sperm.
3. And the external pharynx, opening into the uterine cavity.

The cervix is ​​an important element of the pelvic organs, since it this area there is a collision of two functionally and anatomically important epithelia. It is cylindrical and multilayer flat.

Vagina

This organ, related to the external genitalia, is a connection with the internal genital organs located in the pelvis. It is a muscular tube that performs several functions at once.

Its structure is quite simple; from the vulva it passes into the cervix - the final section of the external genitalia.

Its structure also has several shells:

• The muscular membrane is functionally quite important, since sexual status and the birth of a child will depend on its condition.
• The mucous membrane plays one of the main roles; it contains bacteria that form the microflora of most of the genital organs.

The vagina is the most important element in the implementation of sexual function; the condition of the muscular system plays an important role. In addition, the function of childbirth is ensured; the vagina ensures the advancement of the fetus to the outside world.

Ovaries

This is one of the most important endocrine organs reproductive system women, consider its functions and structure:

1. It is a small formation consisting of germ cell primordia. This organ appears even before the girl is born, therefore the supply of eggs is formed even before birth. Therefore, it is so important not to be exposed to harmful factors that lead to possible death of the cellular apparatus.
2. Located in the pelvis, but unlike other pelvic organs, their location can be quite variable, and this is largely due to the peculiarities of their structure.
3. So the ovaries are in limbo, their location next to the uterus is ensured by the ligamentous apparatus, which attaches them to the uterus and fallopian tubes. Due to fibrin fallopian tubes close contact with the ovaries is ensured.
4. During each menstrual cycle several follicles are formed at once, of which only one or possibly several become full-fledged germ cells.
5. It is due to these pelvic organs that the implementation of sexual function is ensured, since in the ovaries it is provided in the only place where maturation of a woman’s reproductive cells is possible.
6. Depending on past diseases, the location of the ovaries may be atypical, this is due to the development of the adhesive process.

The fallopian tubes

Their structure is quite simple:

• They are tubular structures that are covered on the outside with a serous membrane,
• The middle lining of the fallopian tubes contains a muscular apparatus containing thin smooth muscle fibers.
• The inside of the fallopian tubes is covered with a mucous membrane.
• They depart from the uterine cavity, with which they have direct communication, and end in the ovarian region.
• Their terminal sections are outgrowths - fimbriae, which, due to their structure, make chaotic movements that facilitate the passage of the egg to the sperm.
• The fallopian tubes in the small pelvis have close communication with various ligaments; the main one for the ovaries is the round and proper ligament of the uterus.

Inflammatory processes greatly affect the condition of the fallopian tubes, leading to their soldering. It is this moment that is leading in the development of ectopic pregnancy.

Anomalies of the structure of the pelvic organs

A woman's genital organs are formed during intrauterine development. And subsequent reproductive function largely depends on the impact of harmful factors on the course of pregnancy.

Pathologies of the development of the pelvic organs may include:

• Pathologies associated with complete absence organ, this can be like agenesis of the ovaries, fallopian tubes, uterus, vagina, etc. Often such anomalies can be combined with each other.
• The most common defects are pathologies of the structure of organs; pathologies of the shape of the uterus are widely described in the literature. This could be a doubling of the given internal organ

, both complete and not. Changes in shape, the most commonly detected forms of duplication such as a saddle-shaped or horseshoe-shaped uterus.

In many cases, reproductive function can be realized, even with anomalies in the structure of these pelvic organs. The most difficult issue to resolve is the violation of the complete absence of an organ, in which fertilization and gestation are impossible even with the help of assisted reproductive technologies.

Defects are detected mainly in adolescence, when the active work of the reproductive system begins.

Pelvic muscles

The pelvic floor muscles are striated muscle tissue. That is why, under the influence of willpower and tension, they can be trained, unlike smooth muscle fibers. You can compress them with the help of the woman’s desire during sexual intercourse, as well as when performing physical exercise

or at rest.

• All pelvic floor muscles are divided into two main groups: The superficial muscles include the bulbospongiosus muscle and the anal sphincter muscle.
• These muscles compress the vaginal canal as well as the anus. The deep muscles include the levator ani muscle.

It is divided into several other muscles, but at the same time it does not lose its functional purpose. They are responsible for the development of such a condition as prolapse of the genital organs. In order to prevent this condition, exercises aimed at this group should be performed.

Vaginal muscles

These are smooth muscle fibers that are necessary to maintain the tone of one of the pelvic organs - the vagina. They cannot be consciously controlled, so very often women complain about the problem of their tone, etc.

The only way to train these muscles is to change intra-abdominal pressure. This requires an alternating increase and decrease in intra-abdominal pressure in order for secondary recruitment of smooth muscle fibers to occur.

How to strengthen the pelvic floor and vaginal muscles? Any muscle tissue human body

The muscles of the pelvic floor and vagina also require regular training and maintenance of tone. This is especially true for those women who have recently given birth to a child naturally. It is after childbirth that the muscles of the pelvic floor and vagina tend to decrease in tone after relaxation and strong stretching.

At this time, several rules regarding special exercises must be observed. Such sets of exercises are also called Kegel exercises or vumbiling.

Vumbiling or intimate gymnastics

In order to maintain normal muscle tone and avoid prolapse and prolapse of the pelvic organs, you should use gymnastics and perform exercises according to the following scheme:

• Lie on your back and relax. Your arms should be at your sides and your legs should be bent so that your feet are shoulder-width apart.
• At the same speed, you should raise and lower your pelvis at least 40 times. The exercises should be performed with a short break.
• When performing the next exercise, the position must be left the same, but to perform it you will need to tense the sphincter and all intimate muscles. This exercise should be performed 10 times.
• In the next exercise, you should tense the muscles of your thighs and buttocks, while your feet should be placed side by side. The exercise requires 25 repetitions.
• You can perform such exercises with the help of specialized tools aimed at enhancing the development of muscle fibers.

Diseases of the pelvic organs in women

The table below shows some of the main pathologies found among the pelvic organs.

Diagnostics

In order to identify pathologies of the pelvic organs, you must first consult a doctor.

In case of damage to the genital organs, a gynecologist can solve the problem:

Prevention

In many cases, in order to avoid complications from the pelvic organs, preventive measures should be followed, which consist of several rules for lifestyle changes.

Among them are: