Beruflich Dokumente
Kultur Dokumente
LEARNING OBJECTIVES
* Surgical intervention
* Fertility potential
* Obstetrics-progress of pregnancy
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OTHER IMPORTANT LANDMARKS
1. INGUINAL LIGAMENT
2. INGUINAL CANAL
3 FEMORAL TRIANGLE
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FETAL SKULL
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MALE GENITAL ORGANS
Prostate- shaped like chestnut
Perineum
Mons pubis Floor- skin
Urogenital triangle Room-pelvic diaphragm(Levator
labia majora ani and coccygeous muscles
labia minora
Clitoris -glans, body and
two crura
Vestibule Urogenital triangle Anal triangle
vagina---HYMEN superficial fascia anal canal
urethra Colles fascia lateral ischio
ostia of bartholin glands superficial perineal rectal fossa
pouch Sphincter ani
Deep perineal pouch muscle
Hymen Pudendal
Annular, Semilunar or neurovascular
crescentic, Septate bundle 15
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COMPONENTS OF LEVATOR ANI MUSCLE
Muscle Origin Insertion Function
LIGAMENTS
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NERVES OF LESSER PELVIS
Lumbar plexus
Iliohypogastric nerve( L1, T12)
Ilioinguinal (L1)
Genitofemoral(L1, L2)
Femoral ( L2, L3, L4)
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THE AUTONOMIC NERVOUS SYSTEM
* Sympathetic pathway
paravertebral ganglia sympathetic trunk
prevertebral ganglia pelvic organs
* Parasympathetic system
preganglionic fibres from S2, S3, and S4
(Nervi erigentes). Postganglionic fibres supply
urinary bladder, descending colon, the rectum and
reproductive organs
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Anterior abdominal wall
• Layers:
skin
subcutaneous tissue (fat)
fascia and muscle
peritoneum
• Nerve supply
• Blood supply and lymphatic drainage
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Landmarks
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Skin
• Scars
• Striae - secondary to stretching
• Natural folds and creases - important for
surgical scars
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Rectus sheath
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Hernias 1
• Incisional
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Muscles
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Muscles 2
• Pyramidalis
lies between anterior layer of sheath
and rectus abdominis
attaches to pubis and linea alba
• Muscles supplied by lower six thoracic
spinal nerves (through intercostal and
subcostal) and first lumbar (ilio-
hypogastric and ilio-inguinal)
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Fascia transversalis
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Blood vessels and lymphatics
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The Abdominal incision: Integrity and aesthetic nature of scar
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Breast anatomy
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Breast
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Structure of breast
• Consists of:
a) fat
b) glandular tissue
• Glandular tissue is arranged in 15-20
radial lobes
• Suspensory ligaments of Cooper
• Duct of each lobe opens onto nipple
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Changes in pregnancy
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Breast milk
• 88% water
• 7% lactose
• 4% fat
• 1% protein
• Ca, NA, K, Cl, phospate, antibodies
(IgA)
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Breast blood supply
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Lymphatics
• Mainly to axillary lymph nodes
• Five groups:
lateral (axillary vein)
posterior (subscapular)
medial (pectoral)
• Drain into central group, thence apical group
• Medial tissue drains to anterior end of
intercostal spaces
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Additional lymphatic connections
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Pituitary and Hypothalamus
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Significanceof anatomy and physiology of the
1.Pituitary
The structure, location and relations
2. Components
* Neurohypophysis
* Adenohypophysis
i Follicle Stimulating hormone (FSH)
ii Lutuinising Hormone ( LH)
iii Prolactin (PRL)
iv Growth Hormone (GH)
v Thyroid Stimulating Hormone ( TSH)
vi Adreno-corticoid Stimulating Hormone
(ACTH)
3. Endocrine control of pituitary function
4. Clinical significance of the pituitary
* Hyperprolactinaemia and infertility
* Hypopituitarism
* Pituitary necrosis- Shehan Syndrome 57
Ovulation, Menstrauation and Conception
1. Physiology of menstrual cycle-: Involves a complex interaction between the
hypothalamus , pituitary, ovaries and the endometrium.
* Proliferative phase
*Secretory phase
2. Ovarian control of the menstrual cycle
* Follicular phase- oestrogen priming
* Ovulation
* Luteal phase- progestational
3 Normal menstrual cycle
Onset- Menarche 10-16 years of age
Cyclicity : 22-35 days
Duration of Menstruation : 3-7 days
Total amount of blood loss: 80 ml
4. Management of menstruation
5 Disorders of menstruation: amenorrhoea
Oligomenorrhoea
Polymenorrhoea
Menorrhagia
Metrorrhagia
6. Fertilisation and Implantation
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