The Passage – Maternal Pelvis

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The ppt covers basic about human female pelvis -- the passage to birth. Will work for undergraduates only.

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The Passage – Maternal Pelvis

  1. 1. The Passage – Maternal Pelvis Vedant Murkey Batch 2010
  2. 2. The Journey through the Passage..!!! • What is PASSAGE (pelvis) composed of..??? • What is true and false pelvis..?? • Inlet • Cavity • Outlet Boundaries Shape Plane Axis Diameters
  3. 3. True Pelvis Inlet Cavity Outlet Obstetrical Anatomical
  4. 4. The Inlet…!! • Boundaries --- The Brim • Shape ---
  5. 5. Inlet…!! (contd…) • Plane
  6. 6. Angle of inclination of pelvic inlet : It is the angle made by plane of the inlet with the horizontal and is normally 55 degrees. Clinical significance : (In diagram)
  7. 7. • Axis --- Downwards and backwards • Diameters ---
  8. 8. Cavity – THE PLANE OF GREATEST PELVIC DIMENSIONS • Boundaries --- anteriorly by the posterior midpoint of pubic symphysis posteriorly by the junction of S2-S3 laterally by the upper part of obturator foramen above by the brim below by the obstetrical outlet • Shape --- Rounded
  9. 9. • Plane of the greatest dimension (of pelvic cavity) S2 S3
  10. 10. • Axis --- Downwards • Diameters --- later
  11. 11. Obstetrical Outlet..!!! • Boundaries – Anteriorly is deficient Posteriorly by lower sacral segment Laterally by the Ischial bones Above is Plane of the Least Pelvic Dimension (also the plane of obstetrical outlet) Below by the anatomical outlet
  12. 12. • Shape --- Vertically oval • Plane --- plane of least pelvic dimensions. Extends from lower border of Pubic Symphysis Ischial Spines Tip of the Sacrum. Clinical Significance : 1. Internal rotation of head. 2. Marks the beginning of forward curve of the pelvis. 3. Landmark used for pudendal block.
  13. 13. • Axis – Almost vertical formed by the line joining the centre of the plane to sacral promomtory. • Diameters ---
  14. 14. Anatomical outlet…!!! • Boundaries ---
  15. 15. • Shape --- Diamond shaped bcoz
  16. 16. • Plane --- • Axis --- Downwards and forwards
  17. 17. Diameters of Pelvis..!!!!
  18. 18. The Pelvic Inlet…!!! 1)True Conjugate (TC) – 11cm 2)Obstetric Conjugate (OC) – 10 cm 3)Diagonal Conjugate (DC) – 12 cm Only Diagonal Conjugate can be measured clinically by PV examination. OC = DC – 2 cm TC = DC – 1.2 cm
  19. 19. 4) Anatomical Transverse Diameter (13 cm) 5) Obstetric Transverse Diameter ATD OTD
  20. 20. 6) Oblique Diameter (12 cm) 7) Sacrotyloid Diameter (9.5 cm) SI Joint Iliopubic eminence
  21. 21. The Cavity..!!! • Round cavity of greatest dimensions. • Anteroposterior diameter • Oblique diameter • Transverse diameter 12 cm
  22. 22. Obstetrical Outlet..!!! • Anteroposterior diameter – from midpoint of sacral promontory to the junction of S2-S3. (11cm) • Transverse diameter – between two ischial spines. (10.5 cm)
  23. 23. Anatomical Outlet..!! • Anteroposterior diameter – from the lower border of pubis symphysis ti the tip of coccyx. (13 cm in 2nd stage of labor.) • Transverse diameter – between two ischial tuberosities. (11 cm)
  24. 24. To summarize..!!! Diameters Inlet Cavity Outlet - anatomical Anteroposterior 11 12 13 Oblique 12 12 Transverse 13 12 11
  25. 25. Pelvic Axes…!!! • Anatomical Axis of Carus… Curved axis formed by joining the axis of inlet, cavity and outlet.
  26. 26. • Obstetrical Axis… Goes downwards and backwards upto level of ischial spine and abruptly turns forwards.

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