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Anatomy of the Pelvis
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
It connects the lower border of the symphyseal surface of pubic bones, extending laterally to attach to the inferior ramus of the pubic bone. It blends superiorly with inter pubic disc. Its base is separated from the anterior border of the urogenital diaphragm by an opening for the deep dorsal vein of the penis/clitoris.
The Reproductive System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
On either side of the labia minora are the labia majora (singular: labium majus), elevations of skin and fatty tela subcutanea, the loose connective tissue beneath the skin. When the legs are close together, the labia majora touch medially to form the pudendal cleft. The labia majora are homologous to the male scrotum and enclose and protect the other external genital organs. Superior to the pudendal cleft is the mons pubis (commonly called the pubic mound), a rounded elevation of tissue similar to the labia majora and covering the symphysis pubis (the joint of the pubic bones; symphysis = "growing together"). After puberty, the mons pubis and labia majora become covered with short coarse pubic hairs.
Torso trauma
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
An open book type mechanism causes one or both ilea to rotate externally (opening, like a book). A lateral compression mechanism causes the pelvis to collapse. An ‘open-book fracture’ is seen as a widening of the pubic symphysis or widening at the site of a fracture in the pubic ramus. Not only is there disruption of the bony pelvis, but also tearing of the pelvic floor and thus the pelvic venous plexus is at risk. The more unstable the pelvis, the more likely the structures are to be damaged. When the pelvis collapses from a lateral compression injury, the pubic bones usually fracture. Displacement of the anterior pelvis by greater than 2 cm indicates at least partial instability. A vertical shear disruption of the sacroiliac joint, with apparent shortening of the limb on the affected side implies significant energy of injury.
PNF- based Gait Rehabilitation-training after a Total Hip Arthroplasty in congenital pelvic malformation; A case report
Published in Physiotherapy Theory and Practice, 2022
Fred Smedes, Marianne Heidmann, James Keogh
A male patient of 44 years of age with a CPSA and CMDS underwent a THA operation one week prior to the start of the described episode of care. The patient’s history of complaints started about five months before surgery with pain and moments of blocking in his left hip. He then attended manual physical therapy via self-referral. The initial physical assessment and treatment revealed limited range of motion (ROM) of the left hip into flexion, internal rotation, and horizontal adduction. The combination of flexion and adduction of the hip provoked the patient’s most recognizable pain, as did the functional task of squatting, which was a required movement in his line of labor. A femoral-acetabular impingement (FAI) with either a cam or pincer was suspected (Cheatham, Enseki, and Kolber, 2016). An X-ray evaluation demonstrated: 1) a hip dysplasia; 2) a cyst in the top of the acetabulum; and 3) the absence of both sides of the pubic bones and symphysis (Figure 1a). The radiographic finding of hip dysplasia fit with a statement from the patient’s history, that he should have been prescribed “spreading diapers” similar to a Pavlik bandage or CAMP brace as a baby, which was not done at the time. Furthermore, during childhood the patient had been fitted with a permanent stoma for his digestive system malformation. These four issues together indicate the presence of CPSA and CMDS (Schierz et al., 2020).
Management of a nonathlete with a traumatic groin strain and osteitis pubis using manual therapy and therapeutic exercise: A case report
Published in Physiotherapy Theory and Practice, 2020
Kyle Feldman, Carla Franck, Christine Schauerte
Pubic joint dysfunction can also drive groin pain. Osteitis pubis typically occurs in runners and soccer players, and can occur concomitantly with a groin strain (Ekberg et al., 1988; Morelli and Smith, 2001). Repetitive stress on the joint from shear forces of the pubic bones, pelvic muscle imbalances, and limited hip internal rotation have all been shown as mechanisms for this joint pathology (Fricker, Taunton, and Ammann, 1991; Williams, 1978). Patient presentation typically includes pain in regions of the adductors, pubic symphysis, and scrotum as well as pain with active adductor muscle contraction and sit-ups (Fricker, Taunton, and Ammann, 1991; Morelli and Smith, 2001). This pathology is self-limiting but the typical average healing time has been reported as long as 9.6 months (Fricker, Taunton, and Ammann, 1991).
Staff awareness of pelvic floor muscle training (PFMT) in tertiary care – a qualitative cross-sectional study
Published in Journal of Obstetrics and Gynaecology, 2022
Kamalaveni Soundararajan, Manoj Dilruksha Chandrasiri, Pooja Balchandra
Pelvic floor encompasses a sheet of muscles which spans across the floor of pelvic bone between pubic bone at the front and sacrum at the back. These muscles support bladder, vagina and anus (Information 2021). There are many studies showing beneficial effects of PFMT in the prevention and treatment of incontinence (Dumoulin et al. 2014; Radzimińska et al. 2018; Woodley et al. 2020), POP (Hagen and Stark 2011; Bo 2012) and sexual dysfunction (Piassarolli et al. 2010; Braekken et al. 2015). Systematic review by Woodley et al., of 46 trials involving 10,832 women from 21 countries, showed continent pregnant women performing antenatal PFMT have a lower risk of developing UI in late pregnancy (Woodley et al. 2020). Hay-Smith et al. studied the different approaches to PFMT for women with UI, this systematic review included 21 trials with 1490 women and concluded that they suggest women to have reasonably frequent appointments during the training period (Hay-Smith et al. 2011). Another study by Hagen et al., involving systematic review of six trials involving 975 women concluded that there is evidence for positive effect of PFMT for prolapse symptoms and severity (Hagen and Stark 2011). Six months of supervised PFMT have benefits of symptomatic improvement immediately post intervention (Hagen and Stark 2011). These studies all support the role of pelvic floor exercise training to all women as a safe and effective health intervention. To date, there have been no studies about awareness of staff in the use of pelvic floor exercises. Without the adequate knowledge of what PFMT involves and the support resources, it is unrealistic to expect staff to counsel or support women in the pursuit of pelvic floor exercises.