Labour
Debbie Holmes, Phil Baker in Midwifery by Ten Teachers, 2006
The female pelvis is adapted for childbearing and, owing to its features, does not cause any problems in labour if the pelvis is adequate and the baby’s size is normal. The pelvic brim or inlet The pelvic brim is the inlet of the pelvis and is bounded anteriorly by the symphysis pubis (the joint separating the two pubic bones), on each side by the upper Labour and delivery is the focus and climax of the reproductive process. It is both a physical and emotional challenge for the mother. There is interplay between the ‘powers’ of the uterus (the contractions), the ‘passages’ of the birth canal (the bony pelvis and the soft tissues of the pelvic floor and perineum) and the ‘passenger’ (the fetus). Each contraction promotes dilatation of the uterine cervix and descent of the fetus.
Female ARM preoperative and operative management: Case study
Victoria A. Lane, Richard J. Wood, Carlos A. Reck-Burneo, Marc A. Levitt in Pediatric Colorectal and Pelvic Surgery, 2017
This chapter explains the key principles in the management of complex pediatric colorectal diagnoses. It provides case-based presentations, radiographic images, operative images with multiple choice questions to test knowledge. The chapter presents a case study of a 10-month-old female infant with an anorectal malformation. She has been managed with a divided sigmoid colostomy and mucous fistula. A cystoscopy and cloacagram are recommended in order to establish the length of the common channel, the length of the urethra (from the common channel to the bladder neck), and the distance the vagina needs to be mobilized to the perineum. If there is doubt about the feasibility of mobilizing the urethra and the vagina to the perineum, they would suggest that the surgeon elects to preserve the common channel as the urethra and minimizes disruption to its blood supply from the outset.
Lower limb
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The lower limb accounts for 10" of the body weight. The delicate pirouette of the ballet dancer and the relentless plod of the marathon runner are different examples of lower limb movement and control of the centre of body mass. The two hip bones are firmly united anteriorly, in the midline by the pubic symphysis, and posteriorly each articulates with the sacrum at the sacroiliac joints, so forming the bony pelvis. Muscles passing anterior to the hip are the flexors of the hip joint and are closely associated with the femoral vessels and nerve. The femoral pulse can be felt at a point midway between the anterior superior iliac spine and the pubic tubercle. A loop of intestine may protrude through the ring with a peritoneal covering into the canal, so forming a femoral hernia. Inguinal nodes may become involved as a result of disease in the perineum and gluteal region and from the lower limb and lower abdominal wall.
Localized lipomatosis of the perineum in a 58-year-old male patient – case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2015
Mathias Ndhlovu, Amro Amr, Thomas Schoeller, Frank Werdin
Lipomatosis of the perineum is an extremely rare condition. We report a localized hypertrophy of adipose tissue of the perineum in a 58-year-old man. The cause of enlargement could not be revealed. Nonetheless, preoperative workup and exclusion of possible malign tumors is essential.
Microbiology Of The Urethra and Perineum and Its Relationship To Bacteriuria In Community-Residing Men With Spinal Cord Injury
Published in The Journal of Spinal Cord Medicine, 2004
Ken B. Waites, Kay C. Canupp, Michael J. DeVivo
Objective: Reasons why some persans with spinal cord injury (SCI) experience recurrent urinary tract infections more than others are poorly understood. We performed a prospective study of bacterial flora of the urethra and perineum in men with and without bacteriuria to understand more completely the relationship between bacterial colonization and invasion of the urinary tract. Methods: Urine, urethra, and perineum cultures were obtained from 70 men. Microbial flora of these sites was compared formen with and without bacteriuria. Results: Urine colony countwas 0 in 1 6 (22 .9%) men. Perinea in 2 men (1 2.5%) and urethras in 6 men (3 7.5%) were colonized with various gram-negative bacilli, enterococci, and/ or Staphylococcus aureus. Among 54 (77.1 %) men with bacteriuria, uropathogens were shown in the perineum in 31 (5 7.4%) andin the urethra in 46 (85 .2%) . ln 40 (7 4.1 %) of men with bacteriuria, at least one bacterial species present in the urinewas also found in the urethra and/ or perineum. Differences in the occurrence of uropathogens in men with and without bacteriuria were statistically significant, and organisms were present in higher numbers in men with bacteriuria. Conclusion: Men with SCI who have bacteriuria are significantly more likely to be colonized in the distal urethra and perineum with uropathogens that are often present in the urine in comparison with men without bacteriuria.
Effect of Perineal Compression on Vesical Motor Activity
Published in Scandinavian Journal of Urology and Nephrology, 2003
Ahmed Shafik, Olfat El-Sibai, Ismail Ahmed
Objective: It has been reported that digital pressure on the perineum inhibits bladder contraction; however, the mechanism is not fully understood. We investigated the hypothesis that this mechanism may be reflex in nature. Material and Methods: A total of 21 healthy volunteers (13 males; mean age 42.3 ± 11.8 years) were studied. A barostat system consisting of a balloon-ended catheter connected to a strain gauge and air-injection system was used to assess vesical tone. The catheter was introduced into the urinary bladder and the balloon was inflated with 150 ml of air. Digital pressure was exerted on the perineum and the vesical tone was simultaneously assessed by recording the balloon volume variations, expressed as the percentage change from the baseline volume. The test was repeated after separate anesthetization of the perineum and bladder with xylocaine and after using normal saline instead of xylocaine. Results: Digital pressure on the perineum effected a significant decrease in vesical tone, which ranged from 42% to 84% (mean 67.5% ± 12.5%) of the baseline value. The mean latency was 18.6 ± 2.6 ms. There was no significant difference between men and women in terms of vesical tone response to perineal pressure. Digital perineal pressure applied 20 min after individual anesthetization of the perineum and bladder produced no significant changes in vesical tone. The response returned after the anesthetic effect had waned. The vesical tone response following saline administration was similar to that before administration. Conclusions: Vesical tone decrease in response to digital pressure on the perineum suggests a reflex relationship which was absent on individual anesthetization of the two possible arms of the reflex arc: the perineal skin and urinary bladder. We call this relationship the "perineovesical reflex". This reflex may have the potential to be used as an investigative tool in the diagnosis of vesical motor disorders.
Related Knowledge Centers
- Coccyx
- Pelvic Floor
- Vagina
- Scrotum
- Anus
- Peritoneum
- Pubic Symphysis