Applied Anatomy Flashcards
(25 cards)
Boundaries of the anterior abdominal wall?
Superiorly: costal cartilages 7-12 and xiphoid process
Inferiorly: pelvic bone and iliac crest
Laterally: midaxillary line
Layers of the abdominal wall?
- Skin
- Superficial fascia
- Camper’s fascia (superficial fatty layer)
- Scarpa’s fascia (membranous deep layer) - External oblique muscle
- Internal oblique muscle
- Transverse abdominal muscle
- Transversalis fascia(deep fascia)
- Extraperitoneal fat
- Parietal peritoneum
Functions of the anterior abdominal wall?
- Protects abdominal viscera from trauma.
- Assists in forceful expiration.
- Enables the trunk to bend forward or laterally.
- Assists in parturition.
- Help maintain position of abdominal organs
Abdominal incisions during c section?
- Pfannenstiel
- Joel-Cohen
- Maylard
- Midline vertical - historically preferred because of the speed and ease of entry ,access high on the uterus is preferred.
The pelvic skeleton?
- Two Hip bones; one hip bone made up of fusion of
- Ilium
- Ischium
- Pubis - Sacrum – 5 fused sacral vertebrae
- Coccyx – 4 fused coccygeal vertebrae
Pelvic joints?
- Pubic symphysis – joins two hip bones together
- Sacroiliac joint – joins hip bones to sacrum
- Lumbosacral joint
- Sacrococcygeal joint
The pelvic muscles?
- Levator ani
- Pubococcygeus
- Puborectalis
- Iliococcygeus - Coccygeus
- Obturator internus
- Piriformis
Greater pelvis?
aka false pelvis
located superiorly, provides support for the lower abdominal viscera such as the ileum and sigmoid colon. It has little obstetric relevance.
Lesser pelvis?
aka true pelvis
- located inferiorly
- Within the lesser pelvis resides the pelvic cavity and pelvic viscera
- bound anteriorly by pubic symphysis (3.5cm) and posteriorly by sacrum (12cm)
Pelvic inlet?
The junction between the greater and lesser pelvis is known as the pelvic inlet
- The outer bony edges of the pelvic inlet are called the pelvic brim.
Functions of the pelvis?
- Weight transfer
- Provides attachment for muscles
- Contains and protects the abdominopelvic viscera.
- Assists in parturition
The 4 pelvic types?
- gynecoid (40-50%)
- arthropoid (25-40%)
- android (15-32%)
- platypelloid (<3%)
Gynecoid pelvis?
round inlet
wide outlet
- favorable for vaginal delivery
Anthropoid pelvis?
oval inlet
slightly narrow outlet
delivery outcome:
1. Direct Occiput anterior or Occiput 2. Posterior Position
3. Non-rotation common
4. Face-to-pubis delivery
Android pelvis?
triangular inlet
narrow outlet
delivery outcome:
1. Male type pelvis
2. Delay in engagement
3. Increases risk of C/section
Platypelloid pelvis?
transversally oval inlet
very wide outlet
delivery outcome:
1. Favourable for Vaginal delivery
2. Ant. Rotation occurs late
3. Face presentation common
Features of male pelvis?
thick and heavy
deep GP
narrow and deep LP
heart shaped inlet
small outlet
round obturator foramen
narrow subpubic angle <90
Features of a female pelvis?
thin and light
shallow GP
wide and shallow LP
oval and rounded inlet
large outlet
oval obturator foramen
wide subpubic angle > 90
Measurements of the pelvis?
- anatomical/true conjugate
- obstetric conjugate
- diagonal conjugate
True conjugate?
Measured between the sacral promontory and the upper edge of the pubic symphysis and measures an average of 11.0 cm
Obstetric conjugate?
Measured from the sacral promontory to the point bulging the most on the back of the symphysis pubis. It measures 10.5 cm on average; it is the lesser anteroposterior diameter.
Diagonal conjugate?
Measured between the sacral promontory and the lower edge of the pubic symphysis, measuring an average of 12.5
Subpubic angle?
formed by rami of pubic bones
How to measure/calculate measurements of the pelvis?
- True conjugate cannot be measured clinically but can be estimated by subtracting 1.5-2cm from the diagonal conjugate.
- Obstetric conjugate cannot be measured clinically subtract 1.5 to 2 from diagonal conjugate.
