A textbook of obstetrics (1899) (14774394321)

Identifier: textbt00hirs (find matches)

Title: A textbook of obstetrics

Year: 1899 (1890s)

Authors: Hirst, Barton Cooke, 1861-1935

Subjects: Obstetrics

Publisher: Philadelphia : Saunders

Contributing Library: Yale University, Cushing/Whitney Medical Library

Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

Text Appearing Before Image:

Hi ^W ^vJilK fhe i \l- Willi II it parts Il.IM i. rectu :ndat having b) i n removed (from a model in the Universit) ol Pennsylvania , the lower part of the parturienl tract in labor ami directing the nting part forward, OUtward, and upward under the pubican h. Hie levator am is by tar the most important muscle in thepelvic floor. It is a Strong, horseshoe shaped baud ol muscle, , onsisting of two s) mmetrical halves slung back from the anteriorpelvic wajl and surrounding the vagina and rectum. It is thechief factor in pushing the presenting part forward away from the THE ANATOMY OF THE PELVIS. 27 perineum and out through the vulvar orifice. It is thus the chiefconservator of the integrity of the pelvic floor in labor. Its injuryrobs the rectum and posterior vaginal wall of their strongest sup-port, allowing them to drop downward, outward, and forward mthe rectocele, with which the gynecologist has to deal in second-ary operations upon so-called lacerations of the perineum.

Text Appearing After Image:

g. 9.—The pelvic canal encroached upon by the soft structures (Veit). The ligamentous structures of the pelvis of greatest interest to the obstetrician are the obturator membranes and the sacrosciaticligaments, which close the pelvic walls, help to impart to thecanal its shape and direction, and, by their situation at either endof the oblique diameters, receive upon their yielding surfaces thegreatest pressure from the extremities of the long diameters ofthe fetal head,—an arrangement much more favorable for the child 28 PREGNANCY. than would be the compression of the longest diameters of thehead between bony pelvic walls. The Connective Tissue of the Pelvis.—An intimate knowledgeof the complex arrangement of the pelvic fascia is not essential

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1899

Whitney Medical Library

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public domain