The document provides information on the anatomy of the female pelvis and fetal skull. It describes the bones that make up the pelvis, measurements and variations. The female pelvis is shallower and wider than the male pelvis to accommodate childbirth. Key differences between the fetal and adult skull are the fetal skull's large size relative to other bones, small facial skeleton, and fontanels and sutures between unfused skull bones that allow for molding during birth.
HUMAN ANATOMY
regional anatomy
regional anatomy of pelvic
changsha medical university lecture
csmu lecture by an chen
uploaded by Prabesh raj jamkatel
pelvics
female reproductive organ, gross anatomy of uterus, its parts,position, internal structure, its attachments, supports of uterus, blood supply and lymphatic drainage.
HUMAN ANATOMY
regional anatomy
regional anatomy of pelvic
changsha medical university lecture
csmu lecture by an chen
uploaded by Prabesh raj jamkatel
pelvics
female reproductive organ, gross anatomy of uterus, its parts,position, internal structure, its attachments, supports of uterus, blood supply and lymphatic drainage.
**Ethical Considerations in Anatomy Practice:**
1. **Respect for Donors:**
- **Ethical Aspect:** Acknowledging the humanity of donors and their altruistic contribution.
- **Implications:** Fostering a culture of gratitude and reverence among practitioners and students toward those who donated their bodies for educational purposes.
2. **Cadaver Treatment:**
- **Ethical Aspect:** Ensuring humane and respectful treatment of cadavers during dissection and study.
- **Implications:** Establishing guidelines for proper handling, avoiding disrespectful behavior, and emphasizing the educational purpose without compromising dignity.
3. **Communication and Consent:**
- **Ethical Aspect:** Maintaining clear communication about the use of cadavers and obtaining explicit consent.
- **Implications:** Creating an environment that promotes openness and transparency, ensuring that donors and their families fully understand the educational and research aspects of body donation.
4. **Sensitive Content Handling:**
- **Ethical Aspect:** Approaching sensitive anatomical content with empathy and cultural sensitivity.
- **Implications:** Recognizing diverse perspectives on death and the human body, ensuring educational materials and practices are respectful of different cultural and religious beliefs.
5. **Educational Integrity:**
- **Ethical Aspect:** Ensuring that anatomical education is conducted with professionalism and academic integrity.
- **Implications:** Discouraging any behavior that goes beyond the scope of educational necessity, emphasizing the ethical responsibility of practitioners to uphold the integrity of their profession.
**Legal Considerations in Anatomy Practice:**
1. **Consent Laws:**
- **Legal Aspect:** Adhering to laws governing the consent process for body donation.
- **Implications:** Ensuring that consent procedures comply with legal requirements to avoid potential legal issues and protect the rights of donors.
2. **Occupational Health and Safety:**
- **Legal Aspect:** Complying with regulations to ensure the health and safety of those working with cadavers.
- **Implications:** Implementing measures such as proper storage, use of personal protective equipment, and disposal protocols to prevent occupational hazards and adhere to legal standards.
3. **Facility Accreditation:**
- **Legal Aspect:** Meeting accreditation standards set by relevant authorities for anatomy facilities.
- **Implications:** Ensuring that facilities adhere to legal requirements regarding infrastructure, sanitation, and overall conditions to maintain accreditation.
4. **Record-Keeping and Documentation:**
- **Legal Aspect:** Maintaining accurate records of donor information, consent, and cadaver use.
- **Implications:** Legal documentation helps in tracking the legal status of body donations, ensuring compliance with laws, and facilitating transparency in case of audits or legal inquirie
The female pelvis is ideal for childbearing. Complete knowledge on it helps a obstetrician or midwife to conduct normal labour as well as detect any abnormalities related to abnormal pelvis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
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
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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
2. OBJECTIVES
To learn about:
1) Applied anatomy of female pelvis
- Basic anatomy
- Classification
- Pelvic inlet & outlet
- Pelvic measurement
- Variation in pelvis
2) Fetal/newborn skull
- Features of fetal/newborn skull
- Sutures & fontanelles
3. BONY PELVIS
Bony pelvis is formed by
1) 2 Hip bones
formed by fusion of 3 bones – ilium, ischium and pubis
2) Sacrum
formed by fusion of 5 sacral vertebrae
3) Coccyx
formed by fusion of 4-5 coccygeal vertebrae
Pelvic girdle = hip bones + sacrum
4. FUNCTIONS OF BONY PELVIS
1) To protect pelvic viscera
2) To support the weight of the body - transfer the
weight of the upper body from the axial to the lower
appendicular skeleton
3) Provides attachment for muscles
4) In females, it provide bony support for the birth canal
5. HIP BONE
2 hip bones are joined at the
pubic symphysis
Hip bones articulate with the
sacrum at the sacroiliac joints
Ilium, ischium and pubis fused at
acetabulum
7. HIP BONE: ILIUM
Ala of ileum
Body of ileum
Iliac crest
Iliac fossa
Anterior superior iliac spine (ASIS)
Anterior inferior iliac spine (AIIS)
Posterior superior iliac spine (PSIS)
Posterior inferior iliac spine (PIIS)
8. HIP BONE: ISCHIUM
Body of ischium
Ramus of ischium
Ischial spine
Ischial tuberosity
9. HIP BONES: PUBIS
Body of pubis
Superior ramus of pubis
Inferior ramus of pubis
Pubis crest
Pubic tubercle
Pecten pubis
(pectineal line of pubis)
Subpubic angle
10. SACRUM
Is made up of 5 fused vertebrae
Triangular in shape
Is divided into central mass and
lateral mass
Central
mass
Lateral
mass
Tranverse
ridge
11. SACRUM: ANTERIOR SURFACE
Ala (wing)- upper part of
lateral mass
4 anterior sacral foramina
Sacral promontory
Ala Ala
Sacral promontory
15. APERTURES OF TRUE PELVIS
Pelvic inlet ( = pelvic brim)
– also called superior pelvic aperture
Pelvic outlet
– also called inferior pelvic aperture
– closed by the pelvic diaphragm
Pelvic inlet
Pelvic outlet
16. PELVIC INLET
Pelvic inlet is bounded by:
1. Superior margin of pubic
symphysis
2. Pubic crest
3. Iliopectineal line
4. Anterior border of ala of sacrum
5. Sacral promontory
17. MEASUREMENTS OF PELVIC INLET
Four diameters of pelvic inlets
1) Anteroposterior (true conjugate)
2) Diagonal conjugate
– can be measured clinically
3) Obstetric conjugate
4) Transverse diameter
Transverse
18. DIAMETER OF PELVIC INLET
Measurement Extension Diameter
Anterior-posterior
( True
conjugate )
From the sacral promontory → superior
margin of pubic symphysis
11.5 cm
Diagonal conjugate Sacral promontory → inferior margin of
the pubic symphysis
12.0 cm
Obstetric conjugate Sacral promontary → nearest point on
posterior surface of pubic symphysis
10.5 cm
Transverse diameter The widest distance across pelvic brim 13.5 cm
The largest diameter of pelvic inlet = Transverse diameter
19. Obstetric conjugate is clinically
important – It is shortest AP
diameter through which the
head must pass. But cannot
be measured clinically
Diagonal diameter can be
measured clinically
For clinical purposes, obstetric
conjugate is estimated indirectly
by subtracting 1.5 to 2 cm from
diagonal conjugate
MEASUREMENTS OF PELVIC INLET
20. Vaginal Examination to Determine
Diagonal Conjugate
Obstetric Conjugate = Subtracts 1.5 – 2.0 cm from Diagonal Conjugate
21. PELVIC OUTLET
Diamond shaped
Is bounded by:
1) Inferior margin of the pubic
symphysis
2) Inferior rami of the pubis
3) Ischial tuberosities
3) Sacrotuberous ligaments
4) Tip of coccyx
22. MEASUREMENTS OF PELVIC OUTLET
• Three diameters of pelvic
outlet are usually described:
1) Anteroposterior
2) Transverse (intertuberous)
- can be estimated
3) Posterior sagittal
Pelvic outlet viewed from below
Sacrococcygeal joint
23. DIAMETER OF PELVIC OUTLET
Measurement Extension Diameter
Anteroposterior
diameter
From lower margin of pubic symphysis
→ sacrococcygeal joint
12.5 cm12.5 cm
Transverse
diameter
(intertuberous)
Between the ischial tuberosities
(Diameter > 8 cm – normal)
11 cm11 cm
The largest diameter of pelvic outlet = AP diameter
24. ROTATION OF FETAL HEAD
Widest diameter of pelvic canal changes from transverse
diameter at pelvic inlet to AP diameter at pelvic outlet
To obtain best fit of fetal head, the longest diameter of the
fetal head passes through the widest diameter of the
pelvis. Therefore the head must rotate during labour
25. WALL OF PELVIC CAVITY
The wall of the true pelvis is
formed by:
Anteriorly by pubic
symphasis, body of pubis,
pubic rami , rami of ischium
and obturator membrane
Laterally by ischial bone &
sacrosciatic ligaments
Posteriorly by sacrum &
coccyx
27. PELVIC FLOOR
Pelvic floor is formed by
pelvic diaphragm which is
composed of
1) Levator ani
• Puborectalis
• Pubococcygeus
• Iliococcygeus
2) Coccygeus
(Ischiococcygeus)
28. LEVATOR ANI MUSCLE
Contraction of levator ani muscles raises the entire pelvic
floor
Functions:
1) Control of urination & defecation
Relaxation of levator ani muscle allow urination & defecation to
occur
2) Support for viscera (eg. uterus, bladder)
3) Helps direct fetal head toward birth canal at parturition
29. LEVATOR ANI INJURY
Levator ani muscle often stretch and
can be injured during childbirth
Of these, pubococcygeus muscle is
more commonly damage
These injuries may predispose
women to greater risk of pelvic
organ prolapse and urinary
incontinence
30. MALE VS FEMALE PELVIS
There are a large number of differences between male and
female pelvis. These differences are basically related to 2
factors :
1) In male - the heavier build and stronger muscles in the
males accounting for the stronger bone structure and better
defined muscle markings
2) In females - comparatively wider and shallower pelvic
cavity in female correlated with its role as bony part of the
birth canal
31. FEMALE MALE
• Bones are lighter, thinnerBones are lighter, thinner
• False pelvis is shallowFalse pelvis is shallow
• Pelvic cavity is wide & shallowPelvic cavity is wide & shallow
• Pelvic inlet round/ovalPelvic inlet round/oval
• Pelvic outlet comparatively largePelvic outlet comparatively large
• Subpubic angle largeSubpubic angle large
• Coccyx more flexible, straighterCoccyx more flexible, straighter
• Ischial tuberosities more evertedIschial tuberosities more everted
• Bones heavier, thickerBones heavier, thicker
• False pelvis is deepFalse pelvis is deep
• Pelvic cavity is narrow & deepPelvic cavity is narrow & deep
• Pelvic inlet heart-shaped + smallerPelvic inlet heart-shaped + smaller
• Pelvic outlet comparatively smallPelvic outlet comparatively small
• Subpubic angle more acuteSubpubic angle more acute
• Coccyx less flexible, more curvedCoccyx less flexible, more curved
• Ischial tuberosities longer, faceIschial tuberosities longer, face
more mediallymore medially
33. VARIATIATION OF PELVIC SHAPE
Female pelvis shapes may be subdivided as follows
(after Caldwell and Moloy)
1. Normal and its variants
- Gynaecoid – most common type , suited for delivery
- Android – the masculine type of pelvis
- Platypelloid – flat pelvis; short AP diameter & wide transverse
diameter
- Anthropoid – resembling that of anthropoid ape, AP diameter is
greater than the transverse
2. Symmetrically contracted pelvis
- That of a small women but with a symmetrical shape
34. 3. Rachitic pelvis
- This deformity is caused by rickets (due to
Vit D deficiency)
- Sacrum is rotated so that the sacral
promontory projects forward and coccyx tips
backward
- AP diameter of inlet is therefore narrowed
but the outlet is increased
4. Asymmetrical pelvis
- Asymmetry pelvis can be due to variety of
causes such as scoliosis, poliomyelitis, pelvic
fracture, congenital abnormality due to
thalidomide etc
Rachitic pelvis
Asymmetrical pelvis
36. PELVIC TYPES BASED ON CALDWELL-MALLOY
CLASSIFICATION
Note: Many pelvis are not
pure but mixed type. For
example – gynaecoid
pelvis with android
tendency
37. GYNAECOID PELVIS
Is a typical female pelvis. Ideal for vaginal delivery
Found in 80 % of Asian women; 50-70 % white women
Rounded or slightly oval inlet
Straight pelvic sidewalls with roomy pelvic cavity
Ischial spines are not prominent
- wide interspinous diameter
Good sacral curve
Subpubic arch is wide
38. ANDROID PELVIS
Present in most male and also in few females
0.6 % in Asian women; 2-8% in white women
Heart shaped (or triangular) pelvic inlet - due to prominent
sacrum
Pelvis funnels from above downwards (convergent
sidewalls)
Prominent ischial spines
Sacrum inclining forward
Narrow subpubic arch
39. ANTHROPOID PELVIS
Present in some males and females
15% in Asian women; 15-30% in white women
Pelvic inlet is long oval
AP diameter > tranverse diameter
Long & narrow sacrum
(often with 6 sacral segments)
Straight pelvic sidewalls
40. PLATYPELLOID PELVIS
Uncomon in both sexes
6 % of Asian women; 8-13% in white women
Pelvic inlet appears slightly flattened (kidney shape)
Transverse diameter is greater than AP diameter
Sacral promontory pushed forwards
Straight pelvic sidewalls
Subpubic angle &
interspinous diamater
are wide
41. Gynaecoid Android Anthropoid Platypelloid
Shape of inlet Round Heart-shaped /
triangular
Long oval Flat
Sacrosciatic
notch
Wide Narrow Wide Narrow
Side walls Straight Convergent Straight Straight
Ischial spine Not prominent Prominent Not prominent Not prominent
Subpubic
angle
Wide Narrow Medium Wide
Incidence in
Asian women
80 % 0.6 % 15 % 6 %
NORMAL PELVIC VARIANTS
46. THE SKULL
Skull is divided into 2 parts:
1) Neurocranium:
Calvaria (skullcap)
Cranial base (basicranium)
2) Viscerocranium (Facial
skeleton)
47. REGIONS OF FETAL SKULL
Regions of the fetal skull have been designated to aid in
the description of the presenting part felt at vaginal
examination during labour
Occiput = the area lying behind posterior fontanelle
Vertex = the area between anterior and posterior
fontanelles and between parietal eminences
Bregma = area around anterior fontanelle
Sinciput = area lying in front of anterior fontanelle.
This is subdivided into 2 part – the brow and the face
Brow = area between anterior fontanelle and root of
the nose
Face = area below the root of the nose
48.
49. FETAL SKULL
Skull of a term fetus or newborn infant is
disproportionately large compared with other parts of the
skeleton
Facial skeleton is relatively small compared to that in
adult and calvaria is relatively large
Adult
Term Fetus
50. FACIAL SKELETON OF TERM FETUS
Facial skeleton is relatively small
In adult, facial skeleton forms 1/3 of the
skull but in the newborn, facial skeleton
only forms 1/8 of the skull
Smallness of the face is due to:
– rudimentary development of the maxillae,
mandible and paranasal sinuses
– absence of erupted teeth
– the small size of the nasal cavities
Nose lies almost entirely between
the orbits
Orbits appears relatively large
51. CALVARIA OF TERM FETUS
Calvaria is relatively large
At birth, the bones of the calvaria
are smooth and unilaminar ( no
diploë is present)
Bones of calvaria do not fuse
Have fibrous sutures between bones
At birth, frontal and parietal
eminences are prominent
52. OTHER CHARACTERISTICS
OF FETAL SKULL
Other characteristics of a term fetal skull
1) Mastoid proces is absent
Mastoid process forms during the 1st
year as sternocleidomastoid
muscles complete their development and pull on the petromastoid
parts of the temporal bones
2) Styloid process is absent
3) Stylomastoid foramen is exposed on the lateral surface
of the skull – (facial nerve is vulnerable to injury)
4) Glabella and superciliary arches are not developed
53. 5) Paranasal sinuses are rudimentary or absent
- only maxillary sinus are usually identifiable. Frontal sinus
is absent
6) External acoustic meatus is short, straight and wholly
cartilagenous
7) Ossification is incomplete – many bones are still in several
pieces united by fibrous tissue or cartilage
- frontal bone is in 2 halves joined by metopic suture
- mandible is in 2 halves
- occipital bone is in 4 parts (squamous, lateral and basilar parts of
occipital bone are all separate)
54. 2 halves of frontal bone
are still separated by
suture
Orbit is
relatively large
Mandible is rudimentary
and still separated by
suture
Calvaria is relatively large
Facial skeleton is
relatively small
55. SUTURES
Sutures = fibrous joint between
flat bones of calvaria
Sutures allow the bones to
move during the birth process
(moulding)
Sutures allows brain to enlarge
during infancy and childhood.
59. CLOSURE OF SUTURES
Cranial sutures starts to ossify by age of 8
Sutures on facial skeleton ossify earlier. Example- metopic sutures
closes as early as 3 months of age (between 3-9 months)
Obliteration (union of bone) of cranial sutures progresses
with age, usually starting between 20 to 30 years , often
before the age of 40
Obliteration usually begins in the coronal suture, and then
extends into sagittal and lambdoid sutures
60. CRANIOSYNOSTOSIS
Craniosynostosis = premature fusion
of cranial sutures (by ossification)
This premature sutural closure change the growth pattern
of the skull.
Because skull cannot expand perpendicular to the fused
suture, it compensates by growing more in other
direction perpendicular to the open sutures. The resulting
growth pattern provides the necessary space for the
growing brain, but results in an abnormal head shape
and sometimes abnormal facial features
In cases in which the compensation does not effectively
provide enough space for the growing brain,
craniosynostosis results in increased intracranial
pressure
61. Types of craniosynostosis
1) Scaphocephaly (boat head)
- due to premature closure of sagittal
suture
2) Brachycephaly (short head)
- premature closure of coronal suture on
both sides (bilaterally)
3) Plagiocephaly (asymmetry head)
- due to unilateral
closure of coronal suture (or lambdoid
suture)
62. 4) Trigonocephaly (triangular head)
- premature closure of metopic suture
5) Pansynostosis
- premature closure of multiple suture
63. FONTANELLES
Fontanelle = Areas of
fibrous tissue membrane
separating the bones of the
calvaria
Major fontanelles:
1) Anterior
2) Posterior
3) Anterolateral
(Sphenoidal)
4) Posterolateral (Mastoid)
65. ANTERIOR FONTANELLE
Diamond or rhomboid in shaped
Located at the junction of the
sagittal, coronal and frontal sutures
The future site of bregma
Is closed (ossify) by 18 months of
age
Anterior fontanelle
66. POSTERIOR
FONTANELLE
Triangular in shape
Located at the junction of the
lambdoid and sagittal sutures
The future site of lambda
Begins to close during first 2 to
3 months after birth
67. CLINICAL USE OF FONTANELLES
During vaginal examination (during birth):
• To indicate in which direction the occiput is pointing
• The degree of flexion or extension of the head
Degree of hydration
Level of intracranial pressure
To obtain blood sample from underlying superior
sagittal sinus
Progress of growth of the frontal and parietal bones
68. MOLDING OF FETAL SKULL
Molding = adaptation of fetal head to the pelvic cavity
during birth
To reduce head circumference
69. MOULDING
During the passage though the birth
canal, the head can be squeezed
because of slight movement at the
fontanelle & sutures and slight
overriding of bones also occur
Frontal bones slip under parietal bones
Parietal bones override each other
Occipital bone slip under the parietal bones
The resilience of the bones of the fetal skull allows it to
resist forces that would produce a fracture in adults