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. The Principles and practice of gynecology : for students and practitioners. TIONS OF THE PERINEUM AND PERINEAL REGION. Injuries of the vaginal outlet and pelvic floor caused by parturi-tion, and usually designated as lacerations of the perineum, areamong the most frequent of gynecological lesions, and even thoughthe importance of these injuries sometimes may be overestimated, thefact is undeniable that they give rise to many serious disorders andinconveniences. It is not always possible to avoid the accident, but itis possible to recognize it when it occurs and, by a timely operation,prevent
. The Principles and practice of gynecology : for students and practitioners. TIONS OF THE PERINEUM AND PERINEAL REGION. Injuries of the vaginal outlet and pelvic floor caused by parturi-tion, and usually designated as lacerations of the perineum, areamong the most frequent of gynecological lesions, and even thoughthe importance of these injuries sometimes may be overestimated, thefact is undeniable that they give rise to many serious disorders andinconveniences. It is not always possible to avoid the accident, but itis possible to recognize it when it occurs and, by a timely operation,prevent evil consequences. A laceration tliat does not extend intoand destroy the functions of the sphincter ani muscle is laceration is complete if the sphincter is injured sufficiently toimpair its functions—i. e., if the patient has lost power to retain thecontents of the bowel. ANATOMY OF THE PERINEUM AND PERINEAL REGION, The perineum is the converging point where many of the mostimportant parts of the pelvic floor come together; these parts are : Figure 1. Erector clitoridis. 2. Bulbocavernous muscle. 3. Constrictor vaginse muscle. 4. Tri-angular ligament. 5. Transversus pejinei muscle. 6. Sphincter ani muscle. 7. Fascia of thelevator ani muscle. 8. Perineal fascia. 9. Levator ani muscle. the bulbocavernosus muscle ; the transversus perinei muscles, super-ficial and deep fascia : the external sphincter ani muscle; the inter-nal sphincter ani muscle; and the levator ani muscle. The muscles 524 LACERATIONS OF THE PERINEUM. 525 are surrounded tuul hound together by deep and superficial fascia;the fascia in some places, fur example, in the triangular ligament, isquite dense, and resisting. All the perineal muscles, through themedium of tendon and fascia, are directly or indirectly strongly con-nected with the pubic bones. The muscles, ligaments, and fasciae Figure 263.
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1