視頻：女性盆底的解剖

     盆底超聲檢查幾年來比較熱門，但是盆底解剖不太容易理解，今天與大家分享的這個(gè)視頻是“Radiography”上的一個(gè)講座中的。我努力聽了幾遍，譯成中文配音后分享給大家。

（之注意：59秒處有口誤，應(yīng)該是“尿道膀胱交界處”，不是“陰道膀胱交界處”）

      英文原版視頻無法通過微信平臺(tái)的審核，我已經(jīng)將其上傳到“金醫(yī)橋”，有興趣的朋友可以參看（根據(jù)金醫(yī)橋的規(guī)定，象征性收費(fèi)1元）。【金醫(yī)橋進(jìn)入方案參看下圖】

      英文視頻內(nèi)容聽寫如下，大家參考。個(gè)別內(nèi)容聽了好幾遍也沒有聽出來，錯(cuò)誤之處請(qǐng)大家?guī)兔χ刚?br>

The pubocervical fascia or fiber-muscular coat surrounding the anterior vaginal wall forms the visceral connective tissue hammock upon which the bladder passively rests.

This supporting cam extends from the urethrovesical junction. Laterally to the pelvic side walls and then posteriorly to the Urethrocervical ligament at the level of the ischial spine.

Lateral supports are thickened fascia lines overlying the levator ani muscles. And extend from the pubic arch posteriorly to each ischia spine, a distance of 7.5 to 9.5 cm. The fascia white lines hark extended near pelvis traverse the diameter of each obturator foramen. and are in a near vertical direction, when a patient is placed in the dorsal lithotomy position.

From medial to lateral the following layers are encountered from each fascia white line,  levator ani muscle, obturator internal muscle, obturator membrane filling obturator foramen.

Obturator externus muscle. Adductor magnus muscle. Adductor brevis muscle. Gracilis muscle. Fasial latii,subcutaneous tissue and skin.

The obturator foramen is approximately three centimeters in diameter and is bounded immediately by the inferior pubic ramus, body of the pubic and superior pubic ramus. The obturator nerve and vessels traverse the obturator Canal and exit two and a half to three centimeters of lateral and superior from the inferior pubic ramus. The obturator nerve bifurcate into anterior and posterior branches. The anterior branches located between the adductor longus  and adductor brevis muscles. The posterior branch is located between the adductor brevis muscle and adductor magnus muscles. The obturator vessels also branch into anterior and posterior branches. The anterior branches are located along and protected by the bony Ram of the medial border of the obturator foramen while the posterior branches are located on the posteriorly Ram of the obturator foramen.

The vesical support for the posterior vaginal wall depends upon the intact rectovaginal fascia, which is responsible for the more horizontal orientation of the upper two-thirds of the  vagina, over the muscular vader plate.

Directive vaginal fascia is located in the rector of vaginal space and underneath the posterior vaginal epithelium. This layer supports the upper vagina from the apex of the perennial body laterally along the iliococcygeus muscles and posteriorly to the uterosacral ligaments and call the sacristan iam（？沒聽出來）。

The directive vaginal fascia continues to the level of the ischial spines and thus overlays sacrospinous ligaments. The perennial body is shaped like a pyramid with a square base between the anus and vaginal introitus. Its height is three to four centimeters with the apex located between the lower third and middle third of the posterior vaginal wall.

The elevator plate is the tind support formed by the fusion in the midline between the recto-anal junction and the coccyx, the levator ani muscles, pubococcygeus  Puborectalis and iliococcygeus. It is approximately 4cm long.

And establishes a strong dynamic platform against which the upper vagina and rectum are compressed during the ourselves stress in order to prevent ureterovesical prolapse. Inferior or below the  levator ani muscles on each side is the issue and fascia.

This area is filled with fatty a or tissue and bounded laterally by the obturator internus muscle immediately by the rectum and anal Canal posteroirly by the sacrotuberous ligament and ineriorly by the skin of the buttocks.

The pudendal nerve and internal pudendal vessels are located along the side wall of obturator interns muscle in the pudendl Alcock’s Canal. The  pudenda nerve and vessels give rise to the inferior rectal or perineal branches. Which traverse across the issue, anal fossa to service the anal Canal sphincter anal muscle and anus.