AUTHOR’S ABSTRACT OF THIS P A P E R ISSUED B Y T H E B I B L I O G R A P I i I C B E R V I C E , F E B R U A R Y 26 REFERENCE MODELS OF THE FEMXIE PELVIS 13. SPECTOR Anatomical Laboralory, Bellevup Medical Cdley-, New York UnaversLty SEVEN FIGURES Bellevue Model No. III consists of casts of five dissections of a female pelvis. It js the third of a series planned by Prof. H. D. Senior, and the dissections for it were executed, with the exception of that reproduced in cast D, figure 3, by Dr. S. Rrock in 1917. The subject which served for this model was twenty-two years old and had had one child. The date of parturition was not given in the hospital record, which states that she died of septicemia. Upon pelvic examination shortly before death, the uterus was found t o be freely movable and there was no evidence of adnexal pathology. Prof. W. E. Studdiford noted that the pelvic floor was well formed, and suggested that it would make an excellent specimen for demonstration. After having injected the cadaver with 50 per cent formalin, the pelvic floor was dissected and cast (fig. 1, A). This cast proved so successful that it was decided t o make others in order t o show the arrangement of the viscera, the peritoneum, the fasciae, and the muscles of the pelvis. Therefore the viscera which were removed in order to make cast A were replaced and the whole pelvis divided in the midsaggital plane Models B, C, and E were then cast from dissections of the right half and model D of the left half of the bisected pelvis. The features of each of the casts belonging t o the series are as follows: I n cast A, figure 1, the pelvic floor is dissected from both sides. The postero-inferior aspect of the right and left ischiorectal fossae and the antero-inferior aspect of the urogenital triangle is shown in figure 1. The internal pudendal artery, the 95 T H E ANATOMICAL R E C O R D , Y O L U M E 25, NUMBER 3 APRIL 1023 96 B. SPECTOR perineal nerve, and the dorsal nerve of the clitoris were dissected out of the canal on the lateral wall of the left jschiorectal fossa. The right ischio- and bulbocavernosus muscles were removed and the crus clitoridis and vestibular bulb displayed. The irregularity at the left side of the vaginal orifice is probably the result of a tear which occurred during the time of labor; there is no evidence, however, that the tear involved the levator ani muscle. The bladder and vagina were cut transversely and removed; the former at its base, the latter about an inch below its fornices. The large vascular area in this region, namely the pudendal, the vesical, and the uterovaginal plexuses of veins, and the common place of origin of the vesical, the rectovesical, and the rectal divisions of the visceral pelvic fascia are clearly in evidence. Cast B, figure 6, is made from the right side of the bisected pelvis with the viscera and peritoneum in situ. The uterosacral ligament is recognized easily as a ridge runnjng posterolateral from the cervix of the uterus to the sacrum. The round ligament comes well into view. The fundus of the uterus is about on a level with the upper margin of the symphysis pubis, the external 0s of the cervix’on a level with the ischial spine and directed towards the posterior vaginal wall. While this topographical relationship of the uterus holds for the average case and is considered the usual one, the uterus itself appears somewhat subinvoluted. The fimbriated end of the uterine tube is prolapsed into the recto-uterine pouch-the result, in all probability, of a previous gonorrheal salpingjtis, regarding which a definite history is obtainable. The plane of separation of the bladder wall from the anterior vaginal wall is well indicated. Cast C, figure 7, also represents tha right half of the bisected pelvis. It is similar to cast B except that the peritoneum was removed locally to display the following : the ovarian artery, the pampiniforni plexus of veins, the suspensory ligament of the ovary, and the lower end of the right ureter. The uterus was cut transversely at the level of the internal 0s and removed; a separate cast, figure 5 , was made of the body and fundus. Along the lateral aspect of the cervix, a thick mass of cellular tissue REFERENCE MODELS OF FEMALE PELVIS Figures 1 t,o 7 97 98 B. SPECTOR can be seen; this surrounds the great vessels in this area and constitutes the parametrium. The uterine artery crosses the ureter obliquely, just before reaching the side of the uterus at the level of the internal os of the cervix. Cast D, figure 3, demonstrates the general arrangement of the parietal pelvic fascia and the component layers of the visceral pelvic fascia, arising in common from the arcus tendineus, the thickened portion of the obturator fascia; it also shows definitely the area occupied by the pudendal, the vesical, and the uterovaginal plexuses of veins and the structures which pierce the pelvic diaphragm. This cast is really made up of two parts, an anterior and a posterior, made after the prepared specimen was cut through vertically from the left iliopectineal eminence to the middle of the ischial tuberosity. Figure 2 is a cast of the anterior segment of the preparation viewed from behind and shows the obturator fascia, the obturator internus muscle having been removed, with two laminae arising from it; the superior lamina covers the upper surface of the levator ani muscle, while the inferior lamina covers its lower surface. 1he left vestibular bulb and the left ischio- and bulbocavernosus muscles also were removed to display the inferior layer of the urogenital diaphragm. Cast E, figure 4,is made from the right half of the pelvis and illustrates the muscles which constitute the pelvic floor, devoid of their fascia and peritoneum. d very striking example is afforded of the manner in which the urogenital diaphragm bridges the interval that exists between the free anteromedjal margins of the right and left levator ani muscles when casts D and I3 are placed together.