. Diseases of women. A clinical guide to their diagnosis and treatment. cular tissue spreads out on each side like a fan to theperiphery of the pelvis. (Fig. 84.) The muscles of the pelvicfloor consist of (a) some comparatively unimportant prolon-gations of the uterine muscular fibre; (6) the levator ani;(c) some small perineal muscles. The levator ani is the chiefone, and it forms a plane running from near the middle lineupwards and outwards on each side, so that below it, betweenit and the pelvic wall, is a space, the ischio-rectal fossa, rilledwith cellular tissue. * For information as to t
. Diseases of women. A clinical guide to their diagnosis and treatment. cular tissue spreads out on each side like a fan to theperiphery of the pelvis. (Fig. 84.) The muscles of the pelvicfloor consist of (a) some comparatively unimportant prolon-gations of the uterine muscular fibre; (6) the levator ani;(c) some small perineal muscles. The levator ani is the chiefone, and it forms a plane running from near the middle lineupwards and outwards on each side, so that below it, betweenit and the pelvic wall, is a space, the ischio-rectal fossa, rilledwith cellular tissue. * For information as to the diseases of the retro-peritoneal connective tissuegenerally, see Brit. Med. Journal, Oct. 17, 1896. PARAMETRITIS. 255 Distinction between the pelvic and vulvar connectivetissue.—The muscles are enclosed in layers of fascia, whichare closely blended with the pelvic canals. That which coversthe levator ani is called the deep pelvic fascia; and thismuscle with its fascia forms a libro-muscular diaphragm,which separates what it is convenient to call the pelvic, from. Cervix uteri Levator ani Perineal muscles Fig. 84.—Muscular Structure of Pelvic Floor. (After Freund.) the vulvar connective tissue. Hence it is that parametritisnever, except where there has been injury to this fascia,spreads into the labia or into the ischio-rectal fossa. Nordoes bleeding into the pelvic cellular tissue thus extend. The pelvic cellular tissue.—Cellular tissue surrounds theuterus. Seen by itself, this cellular tissue would look like ahollow cylinder enclosing the uterus. Around the uterus itis close in texture, white and glistening in section. Behind 256 DISEASES OF WOMEN. and in front of it the cellular tissue is comparatively scantybecause the rectum and bladder are so close. Here thecellular tissue is gradually lost above, in the close attachmentof the peritoneum to the uterus. There is more in front Fallopian tubeOvarian and round ligaments
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