The document provides an overview of the clinical anatomy of the female pelvis for obstetricians. It describes the bony pelvis, pelvic cavity, pelvic outlet, ligaments, diaphragm, perineum including the urogenital and anal triangles. It also details the uterus, cervix, vascular supply, and innervation of the pelvis. Key points include the divisions of the pelvis, diameters for fetal engagement, levator ani muscles, pudendal neurovascular bundle, layers of the uterus, vascular anastomoses supplying the uterus, and nerve routes for uterine and cervical pain.
HUMAN ANATOMY
regional anatomy
regional anatomy of pelvic
changsha medical university lecture
csmu lecture by an chen
uploaded by Prabesh raj jamkatel
pelvics
Antepartum haemorrhage (APH) is defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby. The most important causes of APH are placenta praevia and placental abruption, although these are not the most common.
Types 1 and 2 are classified as minor placental praevia as these typically result in minor antepartum haemorrhaging. Types 3 and 4 are referred to as major placental praevia due to the risk of heavy haemorrhaging in the case of a rupture due to the location of placental attachment.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
A review of clinical pelvimetry and its usefulness in determining if a operative vaginally delivery may be performed. Multiple types of forceps are reviewed. This is a must read for all obstetric providers.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
All eutherian mammals possess placenta. Human placenta is discoid, chorio-deciduate organ. Maternal and fetal tissue come in direct contact without rejection. It presents foetal and maternal surfaces and peripheral margins.
HUMAN ANATOMY
regional anatomy
regional anatomy of pelvic
changsha medical university lecture
csmu lecture by an chen
uploaded by Prabesh raj jamkatel
pelvics
Antepartum haemorrhage (APH) is defined as bleeding from or in to the genital tract, occurring from 24+0 weeks of pregnancy and prior to the birth of the baby. The most important causes of APH are placenta praevia and placental abruption, although these are not the most common.
Types 1 and 2 are classified as minor placental praevia as these typically result in minor antepartum haemorrhaging. Types 3 and 4 are referred to as major placental praevia due to the risk of heavy haemorrhaging in the case of a rupture due to the location of placental attachment.
Presentation on the description of normal and abnormal uterine bleeding, menstrual cycle, FIGO classification with PALM-COEIN, common differentials of AUB, assessment, diagnosis, and management.
Clinical pelvimetry and Forceps Assisted Vaginal DeliveryArthur Greenwood
A review of clinical pelvimetry and its usefulness in determining if a operative vaginally delivery may be performed. Multiple types of forceps are reviewed. This is a must read for all obstetric providers.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
All eutherian mammals possess placenta. Human placenta is discoid, chorio-deciduate organ. Maternal and fetal tissue come in direct contact without rejection. It presents foetal and maternal surfaces and peripheral margins.
ANATOMY OF UTERUS
ANATOMY OF OVARY
ANATOMY OF FALLOPIAN TUBES
ANATOMY OF UTERUS &ITS APPENDAGES
ANATOMY OF CERVIX
ANATOMY OF UTERUS PPT
BLOOD SUPPLY, NERVE SUPPLY, LYMPHATIC DRAINAGE
HISTOLOGY
Fundamentals of pelvis, perineum and male genitalia anatomy. contains short notes with atlas. easy for self study of preclinical and clinical students and residents. clinically important common correlations are included. well animated power point presentation.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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ASA GUIDELINE
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Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
5. The ileopectineal line
divides the pelvis into
the false and the true
pelvis
The normal female
pelvis is described as
“gynecoid” to be
differentiated from
the male “android
pelvis”.
6.
7. The pelvic inlet “pelvic brim”
13
cm
Antero-posterior
Transverse
12
cm
Engagement of the fetal head usually occurs through the
transverse diameter
8. The Pelvic Cavity
The pelvic cavity:
Is the curved canal
between inlet and
outlet.
In the normal
female pelvis the
cavity is circular in
shape and curves
forwards.
All its diameters
measureapproximat
ely 12 cm.
9.
10. The Pelvic Outlet
the two pubic bones make the pubic arch, which in the normal female pelvis forms an
angle not less than 90°. A narrow angle will force the fetal head at delivery posteriorly
and
12. The pudendal neurovascular bundle exits out of the greater sciatic foramen and
reenters the pelvis through the lesser sciatic foramen.
This is the site for administration of pudenal block for local anesthesia.
13. The two main muscles:
The levator ani muscle group:
Pubococcygeus, puborectalis, and iliococcygeus.
They muscles extend from the lateral pelvic walls
downward and medially to fuse with each other
posteriorly.
The levator hiatus lies anteriorly and accommodates the
urethra, vagina, and anus.
The coccygeus muscles
A triangular muscle arises from the ischial spine and
inserts onto the sacrum and coccyx
17. The Perineum
The perineum is divided into two parts (or
triangles):
Anterior or urogenital triangle:
Subdivided into:
A superficial and deep perineal spaces by a
fibromuscular septum called the urogenital
diaphragm
Posterior or anal triangle:
The midline attachment forms the fibromuscular
perineal body. between the anal canal and the
vagina
18.
19. The Superficial Perineal Space
Boundaries of the
Superficial Perineal
Space
Note that the superfial muscles of the urogenital triangle and the muscles of
the anal triangle all converge in the midline at the central tendon of perineum
(perineal body) .
20. During episiotomy :It is important to
recognize superficial transverse perineil-muscle
in order to ensure proper cooptation.
Is bounded by three sets of muscles:
•The ischiocavernosus:
•The bulbocavernosus (the sphincter of the Vagina):
•The superficial transverse perinei:
It also includes the Bartholin’s glands and the
vestibular bulbs.
The superfial muscles of the urogenital triangle and
the muscles of the anal triangle all converge in the
midline.
22. The Anal Triangle
The anal triangle is the area of the perineum behind an imaginary line
that extends between the ischial tuberosities.
23. The ischiorectal fossae :
•A potential space that allows distention of the
rectum during defecation and the vaginal wall during
second stage of labor.
•It is also a potential space for huge (up to one liter)
hematoma collection and abscess formation.
•The obturator nerve and internal pudendal
vessels: run alongside the lateral wall of the
ischiorectal fossa in the pudendal or Alcock’s canal.
This canal is formed from the splitting of the fascia
on the lateral wall of the ischiorectal fossa together
with the obturator fascia itself.
24. The external anal sphincter: The voluntary muscle which is responsible
for fecal continence is located within the anal triangle. Its total length is about 2 cm,
and it is composed
Tear of external anal sphincter is not uncommon during delivery particularly operative
one and should be carefully repaired. Failure to recognize tears of the external sphincter
or inappropriate repair can precipitate anal incontinence.
25. Nerve Supply of the Perineum
Ilioinguinal nerve (L1)
and genitofemoral
The Pudendal
nerve
(S2-4)
nerve (L1, 2)
Perineal branch of
posterior femoral
cutaneous nerve
Coccygeal and last sacral
nerves (S4, 5)
26. The Uterus
In 75% the uterus is in the anteverted, anteflexed position.
On rare occasion a retro-verted gravid uterus may get entrapped within the pelvis and
beneath the sacral promontory, giving rise to anterior sacculatoin of the uterus.
Clinically this presents with acute retention of urine.
27. The Isthmus is the short constricted area that marks the junction of the uterine
body with the cervix.
28.
29. The body of the uterus:
It has three layers: The endometrium, the myometrium and the perimetrium:
The myometrium: Has longitudinal, circular and oblique muscle fibers
and is very expansile. The oblique muscle fibers run “criss-cross” and compress
the blood vessels when the uterus is well contracted.
It is found mostly in the upper segment of the uterus, where the placenta normally
embeds.
The richness in muscle fibers and its criss-cross important to ensure proper
hemostasis following placental delivery.
In contrast to that is the lower uterine segment which is poor hemostasis following
placental delivery.
This explains why bleeding in the third stage is more difficult to control if the
placenta is implanted in the lower uterine segment as in cases of placenta
praevia.
The Endometrium: During pregnancy and childbirth, the endometrium
is referred to as the decidua.
The perimetrium: Is a layer of peritoneum that covers the uterus except
at the sides where It extends to form the broad ligaments.
Significant bleeding and hematoma can extend whithin the layers of the broad
ligament into the extra peritoneal space with serious consequences
30. The Cervix:
Consists predominantly of collagenous connective tissue and
mucopolysaccaride ground substance.
It communicates with the uterine cavity through the internal os
and with the vaginal canal through the external os.
The endocervical canal is about 2.5 to 3 cm in length. It is lined
by a single layer of specialized columnar epithelium and
secretes mucus to facilitate sperm transport.
During pregnancy the glands secretion forms a plug of mucus
which helps protect against infection.
This plug of mucous comes away stained with some blood just
before labor commences. Many women refer to this as the
“show”.
32. Note the anastomsis
between the ovarian and
uterine artery.
Therefore the uterus receive
blood supply from two
sources on each side
Note the Ureter Crosses
below the Uterine Artery
about 1 cm from the
cervix
35. Innervations of the
Pelvis Routes of Nerve Supply to
the uterus (visceral nerves).
Pain of uterine contractions
in the first stages is felt in
the abdomen, lower back
Routes of Nerve Supply to
cervix and upper vagina
(Somatic nerves)
In the second stage
additional source of pain
from cervical stretching and
perineal pressure.
Editor's Notes
It is traversed by the terminal portion of the anal canal with its surrounding external sphincter muscle. On both sides of the anal canal are the ischiorectal fossae,
which are potential cone shaped spaces, Which filled with fat. It lies between the skin and levator ani on each side of the anal canal. Together the two fossae make a
horse shoe shape; since they connect posteriorly with each other, anteriorly they are separated by the perineal body
The three muscles layers of the external sphincter. Midline or mediolateral episiotomy may damage this sphincter; proper reapproximation is essential for fecal continence. Of the three components; the subcutaneous, superficial and deep components running on top of each other originate posteriorly from the coccyx and are
inserted anteriorly into the perineal body. In between, they diverge to surround the anal canal.
The third component, the subcutaneous part, surrounds the anal canal and runs circumferentially around it.
Tear of external anal sphincter is not uncommon during delivery particularly operative one and should be carefully repaired. Failure to recognize tears of the external sphincter or inappropriate repair can precipitate anal incontinence.
The pudendal nerve (S2-4): It caries both motor fibers to the perineal pelvic floor muscles and sensory fibers to most of the perineal skin, vulva and clitoris. It terminates as the dorsal nerve of the clitoris.
Coccygeal and last sacral nerves (S4, 5): Supply skin posterior to the anus and over the tip of the coccyx.
Perineal branch of posterior femoral cutaneous nerve: Supply skin lateral to the anus and the most posterior and lateral portions of the labia majora.
Ilioinguinal nerve (L1) and genitofemoral nerve (L1, 2): These nerves descend from the anterior abdominal wall to supply the skin of the mons pubis and most of the anterior portion of the labia majora (except the clitoris).
The uterus has two main parts: The body and the cervix. The body forms the upper two thirds of the uterus.
The body of the uterus: Is formed of three major parts:
- The fundus is the dome of the uterus above the level of the tubal ostia.
- The body is the part of the uterus that lies below the entrance of the oviducts into the uterus.
- The Isthmus is the short constricted area that marks the junction of the uterine body with
the cervix. The isthmus becomes thinner and distends during pregnancy to form the lower uterine segment (Fig. 1-13)
Note that the perineal reflection of the bladder occurs at the level of the uterine isthmus