Maternal Anatomy Williams

8/18/2019 Maternal Anatomy Williams

1/52

MATERNALANATOMY

Adia TSupport by :William’s book


2/52

ANTERIOR ABDOMINAL

WALL Ski

Sub!uta lay"r

R"!tus s#"at#


3/52

ANTERIOR ABDOMINAL

WALL

FIGURE 2-1 Mus!l"s ad blood $"ss"ls o% t#" at"rior

abdomial &all


4/52

INNER'ATION t#" abdomial "(t"sios o% t#" it"r!ostal "r$"s )T*+,,-

t#" sub!ostal "r$" )T,.- t#" ilio#ypo/astri! ski o$"r t#" suprapubi! ar"a0ad t#" ilioi/uial "r$"s )L,- ski o% t#" lo&"rabdomial &all0 upp"r portio o% t#" labia ma1ora0m"dial portio o% t#" t#i/# t#rou/# its i/uial bra!#

). to 2 !m m"dial to t#" at"rior sup"rior ilia! spi"ad !ours" b"t&"" t#" lay"rs o% t#" r"!tus s#"at#-

T#" T,3 d"rmatom" appro(imat"s t#" l"$"l o% t#"umbili!us4


5/52

OR5AN 5ENITALIA

E6TERNA 'ul$a : i!lud"s all stru!tur"s $isibl" "(t"rally %romt#" pubis to t#" p"ri"al body

Mos 7ubis

Labia Mayora 8 ma’s s!rotum

Labia Miora


6/52

OR5AN 5ENITALIA

E6TERNA ).- 9litoris

'"stibulum

9"l"1ar+k"l"1ar '"stibular : T#" pair o% Bart#oli/lads0 paraur"t#ral /lads

M"atus r"t#ra


7/52

OR5AN 5ENITALIA

E6TERNA )2- Bulbus '"stibuli: !orr"spod to t#" !orpus spo/iosumo% t#" p"is4 T#"s" ar" almod+s#ap"d a//r"/atios o%$"is0 2 to ; !m lo/0 , to . !m &id"0 ad 34< to , !mt#i!k0 i!# li" b""at# t#" bulbo!a$"rosus mus!l"o "it#"r sid" o% t#" $"stibul"4

'a/ia da =ym"


8/52

FIGURE 2-2 E(t"ral %"mal" r"produ!ti$"or/as4


9/52

'A5INA mus!ulom"mbraous stru!tur" "(t"ds %rom t#" $ul$ato t#" ut"rus ad is it"rpos"d at"riorly adpost"riorly b"t&"" t#" bladd"r ad t#" r"!tum

T#" upp"r portio aris"s %rom t#" m>ll"ria du!ts0 adt#" lo&"r portio is %orm"d %rom t#" uro/"ital sius

At"riorly0 t#" $a/ia is s"parat"d %rom t#" bladd"rad ur"t#ra by !o"!ti$" tissu"?t#" $"si!o$a/ial

s"ptum


10/52

'A5INA 7ost"riorly0 b"t&"" t#" lo&"r portio o% t#"$a/ia ad t#" r"!tum0 t#"r" ar" similartissu"s t#at to/"t#"r %orm t#" r"!to$a/ials"ptum4

T#" upp"r %ourt# o% t#" $a/ia is s"parat"d%rom t#" r"!tum by t#" r"!to+ut"ri" pou!#0also !all"d t#" !ul+d"+sa! o% Dou/las4

'a/ial l"/t# $ari"s !osid"rably0 but!ommoly0 t#" at"rior ad post"rior $a/ial&alls ar"0 r"sp"!ti$"ly0 @ to !m ad * to ,3!m i l"/t#


11/52

'A5INA =istolo/i : T#" $a/ial lii/ is !ompos"d o%ok"ratii"d stratiC"d suamous "pit#"lium adud"rlyi/ lamia propria4 B"lo& t#is t#"r" is amus!ular lay"r0 i!# !osists o% smoot# mus!l"0!olla/"0 ad "lasti


12/52

7EMBL= DARA= DAN

SISTEM LIMATI9 'A5INA T#" pro(imal portio !"r$i!al bra!# o% t#"ut"ri" art"ry ad by t#" $a/ial art"ry4

post"rior $a/ial &all T#" middl" r"!talart"ry

t#" distal &alls it"ral pud"dal art"ry4

Lymp#ati!s %rom t#" lo&"r t#ird i/uial

lymp# od"s4 middl" t#ird it"ral ilia! od"s

pp"r t#ird "(t"ral0 it"ral0 ad!ommo ilia! od"s4


13/52

I5RE .+2 t"ri" ad $a/ial blood supply4 T#" ori/i o% t#"$a/ial art"ry $ari"s ad may aris" %rom t#" ut"ri"0 i%"rior $"si!al0or it"ral ilia! art"ry4


14/52

7ERINEM•Mar/is : t#" pubi! symp#ysis at"riorly0 is!#iopubi! rami adis!#ial tub"rositi"s at"rolat"rally0 sa!rotub"rous li/am"tspost"rolat"rally0 ad !o!!y( post"riorly4

•

Trigonum Anterior:- Superfcial Space o the Anterior Triangle.

s"$"ral importat stru!tur"s : t#" is!#io!a$"rosus0bulbo!a$"rosus0 ad sup"rC!ial tras$"rs" p"ri"al mus!l"sF

Bart#oli /ladsF $"stibular bulbsF !litoral body ad !ruraF ad

bra!#"s o% t#" pud"dal $"ss"ls ad "r$"

+ eep Space o the Anterior Triangle.

!otais t#" !ompr"ssor ur"t#ra" ad ur"t#ro$a/ialsp#i!t"r mus!l"s0 "(t"ral ur"t#ral sp#i!t"r0 parts o%ur"t#ra ad $a/ia0 bra!#"s o% t#" it"ral pud"dalart"ry0 ad t#" dorsal "r$" ad $"i o% t#" !litoris


15/52

7ERINEM• Tri/oum 7ost"rior :

+ !otais t#" is!#ior"!tal %ossa0 aal !aal0 aal

sp#i!t"r !ompl"(0 ad bra!#"s o% t#" it"ralpud"dal $"ss"ls ad pud"dal "r$"

+ Is!#ior"!tal ossa"4


16/52

7DENDAL NER'E AND

'ESSELS• T#" pud"dal "r$" t#" at"rior rami o% t#" s"!odt#rou/# %ourt# sa!ral "r$"s

+ T#" dorsal "r$" o% t#" !litoris t#" ski o% t#"!litoris4

+ T#" p"ri"al "r$" mus!l"s o% t#" at"riortria/l" ad labial ski4

+ T#" i%"rior r"!tal bra!# t#" "(t"ral aalsp#i!t"r0 t#" mu!ous m"mbra" o% t#" aal !aal0

ad t#" p"riaal ski• T#" ma1or blood supply to t#" p"ri"um is $ia t#"it"ral pud"dal art"ry ad its bra!#"s4 T#"s" i!lud"t#" i%"rior r"!tal art"ry ad post"rior labial art"ry4


17/52

FIGURE 2-! 7"ri"al aatomy4 At"rior ad post"rior tria/l"s ar"d"C"d by a li" dra& b"t&"" t#" is!#ial tub"rositi"s4 T#" sup"rC!ial

spa!" o% t#" at"rior tria/l" ad its !ot"ts ar" s#o& abo$" t#is li"4


18/52

FIGURE 2-" 7"ri"al aatomy4 At"rior ad post"rior tria/l"s ar" s#o&4Wit#i t#" at"rior tria/l"0 t#" !ot"ts o% t#" d""p spa!" ar" s#o& o t#"ima/"’s ri/#t0 "r"as t#os" o% t#" sup"rC!ial spa!" ar" o t#" l"%t4


19/52

ANS•E(t"ral Aal Sp#i!t"r )EAS-4

It maitais a !ostat stat" o% r"sti/ !otra!tio t#at

pro$id"s i!r"as"d to" ad str"/t# " !oti"!"is t#r"at""d0 ad it r"la("s %or d"%"!atio

•It"ral Aal Sp#i!t"r )IAS-4

t#" IAS may b" i$ol$"d i %ourt#+d"/r"" la!"ratios


20/52

ANS

I5RE .+@ Aatomy o% t#" aor"!tum0 dra& to s#o& r"latios o% t#"it"ral aal sp#i!t"r0 t#" "(t"ral aal sp#i!t"r0 ad t#" l"$ator aimus!l"s4 T#" boudari"s o% t#" is!#ior"!tal %ossa ar" s#o&4 T#" is!#ior"!tal%ossa is boud"d d""ply by t#" i%"rior %as!ia o% t#" l"$ator ai mus!l"s0sup"rC!ially by t#" p"ri"al ski0 at"rolat"rally by t#" %as!ia o% t#"obturator it"rus mus!l"s ad is!#ial tub"rositi"s0 post"rolat"rally by t#"


21/52

7ERINEAL BODY T#" m"dia rap#" o% t#" l"$ator ai0 b"t&"" t#" ausad t#" $a/ia0 is r"i%or!"d by t#" !"tral t"do o%t#" p"ri"um4 T#" bulbo!a$"rosus0 sup"rC!ialtras$"rs" p"ri"al0 ad "(t"ral aal sp#i!t"rmus!l"s also !o$"r/" o t#" !"tral t"do4

T#" p"ri"al body is i!is"d by a "pisiotomy i!isioad is tor &it# s"!od+0 t#ird+0 ad %ourt#+d"/r""la!"ratios


22/52

7ERINEAL BODY TABLE .+,4 7"ri"al Body

u!tio

A!#ors t#" aor"!tum

A!#ors t#" $a/ia

="lps maitais uriary ad %"!al !oti"!"

Maitais t#" or/asmi! plat%orm

7r"$"ts "(pasio o% t#" uro/"ital #iatus

7ro$id"s a p#ysi!al barri"r b"t&"" t#" $a/ia ad

r"!tum

7ot"tial Morbidity

Episiotomy may i1ur" t#" p"ri"al body

7ud"dal "r$" i1ury may b" asso!iat"d &it# !o!urr"t

p"ri"al body i1ury

Adapt"d %rom Woodma ad 5ra"y ).33.-4


23/52

OR5AN RE7ROD9SI

INTERNA

FIGURE 2-# '"rti!al s"!tio t#rou/# t#" ut"ri"

"d o% t#" ri/#t broad li/am"t4 )s"d &it#p"rmissio %rom G"i%"r


24/52

TERS B"t&"" t#" bladd"r at"riorly ad t#" r"!tumpost"riorly4

Almost t#" "tir" post"rior &all o% t#" ut"rus is!o$"r"d by s"rosa0 t#at is $is!"ral p"rito"um4

T#" lo&"r portio o% t#is p"rito"um%orms t#"at"rior boudary o% t#" r"!to+ut"ri" !ul+d"+sa!0 orpou!# o% Dou/las4


25/52


26/52

TERS body or !orpus0 ad a lo&"r0 !ylidri!al portio?t#"!"r$i(0 i!# pro1"!ts ito t#" $a/ia4

T#" ist#mus is t#at portio o% t#" ut"rus b"t&"" t#"it"ral !"r$i!al os ad t#" "dom"trial !a$ity

T#" %allopia tub"s0 also !all"d o$idu!ts

T#" %udus


27/52

TERS T#" ut"rus o% adult ulliparous &om"m"asur"s @ to !m il"/t# as !ompar"d &it# H to ,3 !m i multiparous &om"4 Ioparous &om"0 t#" ut"rus a$"ra/"s


28/52


29/52

JER'I6 T#" upp"r s"/m"t o% t#" !"r$i(?t#" portiosupra$a/ialis

Jo$"r"d by p"rito"um o its post"rior sur%a!"0 t#" !ardial li/am"ts atta!# lat"rally

s"parat"d %rom lo&"r $a/ial portio o% t#" !"r$i( portio $a/ialis


30/52


31/52


32/52

LI5AMENTS Roud Li/am"t

Broad Li/am"t

i%udibulop"l$i! li/am"t or susp"sory li/am"t o%t#" o$ary0

!ardial li/am"t?also !all"d t#" tras$"rs" !"r$i!alli/am"t orMa!k"rodt li/am"t


33/52

I5RE .+,< Blood supply to t#" l"%t o$ary0 l"%t %allopia tub"0 ad l"%t sid" o%t#" ut"rus4 T#" o$aria ad ut"ri" $"ss"ls aastomos" %r""ly4 Not" t#"

ut"ri" art"ry ad $"i !rossi/ o$"r t#" ur"t"r t#at li"s imm"diat"lyad1a!"t to t#" !"r$i(4 )s"d &it# p"rmissio %rom G"i%"r =uls"y4-


34/52

I5RE .+,@ 7"l$i! blood supply4


35/52

TBA ALO7II

I5RE .+,* T#" %allopia tub" o% a adult &oma &it# !ross+s"!tio"dillustratios o% t#" /ross stru!tur" i s"$"ral portios: )A- ist#mus0 )B-ampulla0 ad )J- i%udibulum4 )s"d &it# p"rmissio %rom Dr4 9"ll"y S4


36/52

I5RE .+,* T#"s" ar" p#oto/rap#s o% !orr"spodi/#istolo/i!al s"!tios4 )s"d &it# p"rmissio %rom Dr4 9"ll"y S4Jarri!k4-


37/52

O'ARIES

Duri/ !#ildb"ari/ y"ars %rom .4< to < !m il"/t#0 ,4< to 2 !m i br"adt#0 ad 34@ to ,4< !m it#i!k"ss4

T#" !ort"( !otais oo!yt"s ad d"$"lopi/ %olli!l"s4

T#" m"dulla is t#" !"tral portio0 i!# is !ompos"do% loos" !o"!ti$" tissu"0 a lar/" umb"r o% art"ri"sad $"is i t#" m"dulla ad a small umb"r o%

smoot# mus!l" Cb"rs4


38/52

MSJLOS9ELETAL

7EL'IJ ANATOMY 7"l$i! Bo"s

FIGURE 2-1# Sa/ittal $i"& o% p"l$i! bo"s


39/52

7EL'IJ BONE

T#" p"l$is is !ompos"d o% %our bo"s: t#" sa!rum0!o!!y(0 ad t&o iomiat" bo"s4

Ea!# iomiat" bo" is %orm"d by t#" %usio o% t#"ilium0 is!#ium0 ad pubis

T#" %als" p"l$is li"s abo$" t#" li"a t"rmialis

T#" tru" p"l$is b"lo& t#is aatomi!al boudary0 T#"tru" p"l$is is t#" portio importat i !#ildb"ari/


40/52

T=E TRE 7EL'IS

T#" post"rior boudary is t#" at"rior sur%a!" o% t#"sa!rum

t#" lat"ral limits ar" %orm"d by t#" i"r sur%a!" o%t#" is!#ial bo"s ad t#" sa!ros!iati! ot!#"s adli/am"ts4

I %rot0 t#" tru" p"l$is is boud"d by t#" pubi! bo"s0t#" as!"di/ sup"rior rami o% t#" is!#ial bo"s0 ad

t#" obturator %oram"4


41/52

T=E TRE 7EL'IS

T#" is!#ial spi"s ar" o% /r"at obst"tri!al importa!"b"!aus" t#" dista!" b"t&"" t#"m usually r"pr"s"tst#" s#ort"st diam"t"r o% t#" p"l$i! !a$ity0 as $aluabl"

ladmarks i ass"ssi/ t#" l"$"l to i!# t#"pr"s"ti/ part o% t#" %"tus #as d"s!"d"d ito t#"tru" p"l$is


42/52

7EL'IJ GOINTS

Symp#ysis 7ubis

Sa!roilia! Goits


43/52

I5RE .+,H At"ropost"rior $i"& o% a ormal %"mal" p"l$is4

At"ropost"rior )A7- ad tras$"rs" )T- diam"t"rs o% t#" p"l$i!il"t ar" illustrat"d


44/52

7LANES AND DIAMETERS

O T=E 7EL'IS T#" p"l$is is d"s!rib"d as #a$i/ %ourima/iary pla"s:

,4 T#" pla" o% t#" p"l$i! il"t?t#" sup"riorstrait4

.4 T#" pla" o% t#" p"l$i! outl"t?t#" i%"riorstrait4

24 T#" pla" o% t#" midp"l$is?t#" l"ast p"l$i!dim"sios4

;4 T#" pla" o% /r"at"st p"l$i! dim"sio?o%o obst"tri!al si/iC!a!"4


45/52

7EL'IJ INLET


46/52


47/52

MID7EL'IS

T#" midp"l$is is m"asur"d at t#" l"$"l o% t#" is!#ialspi"s

importat %ollo&i/ "/a/"m"t o% t#" %"tal #"ad iobstru!t"d labor4

T#" it"rspious diam"t"r0 ,3 !m or sli/#tly /r"at"r0 isusually t#" small"st p"l$i! diam"t"r4

T#" at"ropost"rior diam"t"r t#rou/# t#" l"$"l o% t#"

is!#ial spi"s ormally m"asur"s at l"ast ,,4< !m4


48/52


49/52

7EL'IJ OTLET


50/52

7EL'IJ S=A7ES


51/52

OTOT+OTOT DASAR

7EL'IS


52/52

Date post:	07-Jul-2018
Category:	Documents
Upload:	irfan-mohammad
View:	214 times
Download:	0 times

Maternal Anatomy Williams

Documents