Adult Autopsy
Cristoforo Pomara, Vittorio Fineschi in Forensic and Clinical Forensic Autopsy, 2020
If the bladder needs to be removed, it is important to remember that it is a retroperitoneal organ. It is located in the front part of the pelvic fundus, behind the pubis, where it is attached by the pubic–vesical ligaments. In males, the bladder is located in front of the rectum. In females, this ligament is located in front of the uterus and vagina.11 To remove the bladder, grasp it with toothed forceps, and pull it superiorly and posteriorly while incising the peritoneum. Begin first at the bladder’s posterior concavity and the peritoneum where it extends from the anterior abdomen wall to cover the superior and lateral face of the bladder. Then, incise the middle and lateral umbilical ligaments. Holding the blade turned parallel to the bladder surface, enter the prevesical space of Retzius (the extraperitoneal space between the pubic symphysis and urinary bladder), and incise the two pubic–vesical ligaments, which constitute the floor of this space.
The Reproductive System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
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.
Pelvis and perineum
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The hip (innominate) bone - superiorly lies the crest of the ilium, which terminates anteriorly as the anterior superior iliac spine and just inferior to which is the anterior inferior iliac spine (Figs. 7.1, 7.2). On the inner aspect of the ilium, level with the acetabulum, lies an edge, the arcuate line. The pubic bone anteriorly has on its superior edge a swelling, the pubic tubercle, and two extensions projecting laterally - the superior and inferior rami. Posteriorly and inferior to the ilium lies the ischium, formed by a tubercle, on which we sit, a spine projecting medially and an inferior ramus. The large opening within is the obturator foramen, mostly closed by the obturator membrane, which has a small gap, the obturator canal, superiorly. Posteriorly between the ischium, ilium and sacrum lies the greater and lesser sciatic notches, turned into foramina by the sacro- spinous and sacrotuberous ligaments.
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
This case report emphasized the challenge of differential diagnosis and treatment of an acute groin strain. Current literature supports difficultly in hypothesizing a single diagnosis of the underlying pathology in an acute groin strain (Ekstrand and Hilding, 1999; Garvey and Hazard, 2014; Hegedus et al., 2013; Hölmich et al., 2014; Meyers et al., 2000; Morelli and Smith, 2001; Serner et al., 2015). During the examination the patient presented with pain and subjective reports that fit into multiple diagnosis categories. Key subjective reports the patient mentioned were pain with hip internal rotation, pain with sexual intercourse, tenderness along the hip adductors, and a history of groin injuries. Hip osteoarthritis, adductor longus strain, adductor magnus strain, and sacroiliac joint dysfunction are all potential causes of painful hip internal rotation (Garvey and Hazard, 2014; Morelli and Smith, 2001; Sutlive et al., 2008). Pain with hip thrusting and pressure to the pubic region during intercourse is more often seen in abdominal strains, adductor longus strains, adductor magnus strains, adductor brevis strains, osteitis pubis, and groin disruption (Morelli and Smith, 2001). Local muscle strain, groin disruption, and osteitis pubis became the most likely diagnosis for the patient’s pain based on the pattern presented during the examination.
Study of the X-Ray Diagnosis of Unstable Pelvic Fracture Displacements in Three-Dimensional Space and its Application in Closed Reduction
Published in Journal of Investigative Surgery, 2019
Chengdi Shi, Leyi Cai, Wei Hu, Junying Sun
One case in this study with pelvic X-ray showed obvious separation of the symphysis pubis, and upper and lower dislocation. Because the posterior ring bone line was blurred and the displacement was not obvious, at another hospital, this was mistaken for vertical upward displacement of the contralateral half pelvis. Thus, lower limb traction was invalid when applied and it failed. After reexamination of the X-rays, CT measurements, and image reconstruction, a Tile C1.1 fracture with pronation displacement was confirmed. The anterior and posterior axial displacements and sagittal rotation displacement were clearly present on pelvic entrance X-rays. The pelvic outlet X-ray clearly showed the sacral foramen and the L5 transverse process, allowing vertical displacement to be distinguished from sagittal plane displacement.
Related Knowledge Centers
- Abdominal Wall
- Pubic Symphysis
- Pubic Tubercle
- Hip Bone
- Mons Pubis
- Fat
- Hypogastrium
- Urethral Sponge
- Pubic Crest
- Tubercle