Gynecological diagnosis . urn has its longaxis placed at a right angle to thelong axis of the vagina. The vagina in its course from thecervix to the introitus vaginae shows an S-shaped curve when seenin a median longitudinal section of the body, the forward bulgingportion of the S being in its lower portion opposite the underedge of the symphysis pubis. (See Fig. 85.) This prominentportion of the vagina is made by the presence at this point ofthe chief muscle masses of the levator ani and smaller musclesand fasciae making up the pelvic floor. It is the so-called perinealbody of the older gynec
Gynecological diagnosis . urn has its longaxis placed at a right angle to thelong axis of the vagina. The vagina in its course from thecervix to the introitus vaginae shows an S-shaped curve when seenin a median longitudinal section of the body, the forward bulgingportion of the S being in its lower portion opposite the underedge of the symphysis pubis. (See Fig. 85.) This prominentportion of the vagina is made by the presence at this point ofthe chief muscle masses of the levator ani and smaller musclesand fasciae making up the pelvic floor. It is the so-called perinealbody of the older gynecologists. By reference to the diagram(Fig. 84) it will be seen that this key-stone to the arch of the pelvicdiaphragm lies about midway between the lower border of thesymphysis and the coccyx. Injury to the muscles here naturallydestroys the sigmoid curve of the vagina, opens its outlet, anddiminishes the support to the structures lying above. The vagina,instead of being a flattened ribbon-like canal with walls in apposi-. Fig. 85.—S-shaped Curve andInclination of Vagina. Note thatthe Walls Are in Apposition.(Skene.) 220 MALPOSITIONS OF THE UTERUS tion and running almost transversely from the cervix to the hymen,now becomes a straighter open tube, leading almost directly down-ward from the cervix to the introitus. The pelvic floor, according to Hart and Barbour, may be dividedup into an anterior and a posterior segment. The anterior seg-ment is a relatively movable one, the posterior is relatively anterior or pubic segment consists of anterior vaginal wall,urethra, and bladder, all attached loosely to the symphysis pubisby retropubic deposits of fat. The posterior or sacral segmentis made up of posterior vaginal wall, the muscles and fasciae ofthe perineum, and the rectum, all firmly bound to the sacrum andcoccyx. During labor the anterior segment is drawn up; theposterior segment is driven down. In the formation of prolapsethe anterior segment, because of the injur
Size: 1569px × 1592px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
