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Dissection of female pelvis from a lateral approach

Relations of blood vessels and nerves at ureterovesical junction

Image #160-4

KEYWORDS: Bones joints cartilage, Muscles and tendons, Peripheral nervous system, Urinary tract, Uterus, Vasculature, Bones joints cartilage, Central nervous system, Muscles and tendons, Peripheral nervous system, Vasculature.

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Dissection of female pelvis from a lateral approach

Relations of blood vessels and nerves at ureterovesical junction

The levator ani muscle (15) has been cut off near its insertion and the adjacent superior fascia of the pelvic diaphragm (17) has been partially removed to expose the mass of smooth muscle and fibrous tissue (14) that comprises the uterosacral ligament and the lateral cervical ligament or cardinal ligament of the uterus (of Mackenrodt). The pelvic plexus lies enmeshed in these ligaments. Branches from the plexus (11) are visible passing to the terminal part of the ureter and base of the bladder.

1 .	Superior gluteal artery (cut off)
2 .	Vesical artery
3 .	Vesical artery (2 and 3 are branches of uterine artery)
4 .	Inferior gluteal artery (cut off)
5 .	Inferior gluteal vein
6 .	Sacral plexus (pointer on junction of 2nd and 3rd sacral nerves)
7 .	Pelvic splanchnic nerve
8 .	Nerve to Levator ani muscle
9 .	Ureter
10 .	Vesical vein (plexiform)
11 .	Plexus vesical nerve
12 .	Coccygeus muscle (reflected)
13 .	Ureterovesical junction (note longitudinal smooth muscle of bladder continuing upward onto ureter)
14 .	Smooth muscle and fibrous tissue of uterosacral and lateral cervical ligaments of uterus (rectouterinus muscle)
15 .	Levator ani muscle (cut off)
16 .	External anal sphincter muscle
17 .	Superior fascia of pelvic diaphragm (continuous posteriorly with fascia on coccygeus muscle (12))
18 .	Branch of nerve to levator ani muscle
19 .	Branches of pelvis plexus to vaginal wall
20 .	Vesical venous plexus
21 .	Obturator artery (cut off)
22 .	Uterine artery and vein
23 .	Lateral umbilical ligament
24 .	Parietal peritoneum
25 .	Urinary bladder
26 .	Branch of obturator artery
27 .	Pubic symphysis