the passage – maternal pelvis
DESCRIPTION
The ppt covers basic about human female pelvis -- the passage to birth. Will work for undergraduates only.TRANSCRIPT
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The Passage – Maternal Pelvis
Vedant MurkeyBatch 2010
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The Journey through the Passage..!!!
• What is PASSAGE (pelvis) composed of..???• What is true and false pelvis..??• Inlet• Cavity• Outlet
BoundariesShapePlaneAxisDiameters
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True Pelvis
Inlet Cavity Outlet
Obstetrical Anatomical
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The Inlet…!!
• Boundaries --- The Brim• Shape ---
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Inlet…!! (contd…)
• Plane
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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)
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• Axis --- Downwards and backwards• Diameters ---
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Cavity – THE PLANE OF GREATEST PELVIC DIMENSIONS
• Boundaries --- anteriorly by the posterior
midpoint of pubic symphysisposteriorly by the junction of S2-S3laterally by the upper part of
obturator foramenabove by the brimbelow by the obstetrical outlet
• Shape --- Rounded
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• Plane of the greatest dimension (of pelvic cavity)
S2S3
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• Axis --- Downwards• Diameters --- later
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Obstetrical Outlet..!!!
• Boundaries – Anteriorly is deficientPosteriorly by lower sacral
segmentLaterally by the Ischial bonesAbove is Plane of the Least Pelvic
Dimension (also the plane of obstetrical outlet)Below by the anatomical outlet
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• 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.
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• Axis – Almost vertical formed by the line joining the centre of the plane to sacral promomtory.
• Diameters ---
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Anatomical outlet…!!!
• Boundaries ---
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• Shape --- Diamond shaped bcoz
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• Plane ---
• Axis --- Downwards and forwards
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Diameters of Pelvis..!!!!
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The Pelvic Inlet…!!!1)True Conjugate (TC) – 11cm2)Obstetric Conjugate (OC) – 10 cm3)Diagonal Conjugate (DC) – 12 cm
Only Diagonal Conjugate can be measured clinically by PV examination.OC = DC – 2 cmTC = DC – 1.2 cm
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4) Anatomical Transverse Diameter (13 cm)5) Obstetric Transverse Diameter
ATD
OTD
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6) Oblique Diameter (12 cm)7) Sacrotyloid Diameter (9.5 cm)
SI Joint
Iliopubic eminence
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The Cavity..!!!
• Round cavity of greatest dimensions.• Anteroposterior diameter• Oblique diameter• Transverse diameter
12 cm
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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)
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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)
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To summarize..!!!
Diameters Inlet Cavity Outlet - anatomical
Anteroposterior 11 12 13
Oblique 12 12
Transverse 13 12 11
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Pelvic Axes…!!!
• Anatomical Axis of Carus… Curved axis formed by joining the axis of inlet, cavity and outlet.
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• Obstetrical Axis… Goes downwards and backwards upto level
of ischial spine and abruptly turns forwards.
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I had an awesome journey through
the passage.!!Wish u luck for ur
baby…!! :-*