Chapter 2 Maternal Anatomy

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WILLIAMS OBSTETRICS

Chapter 2: Maternal Anatomy

Anterior Abdominal Wall

A. Skin, Subcutaneous Layer, Fasciaa. Skin Langer lines Pfannenstiel incision

b. Subcutaneousi. Camper fascia (superficial, fatty) mons pubis labia major ischioanal

fossaii. Scarpa fascia ( eep, membranous) Colles fascia

c. !usclesi. "#ternal obli$ue apo.%m. rectus sheath linea alba

ii. &nternal obli$ue apo.%m. rectus sheath linea albaiii. 'rans ersus ab ominis apo.%m. rectus sheath linea albai . Arcuate line

. Cephala * aponeuroses (i+iii) both orsal entral rectus ab ominis

m.-. Cau al* aponeuroses entral only

. 'rans ersalis fasciai. Preperitoneal fat

ii. Peritoneumiii. Pyrami alis m. (orig. Pubic crest, insert. Linea alba)


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. loo Supplya. Femoral triangle (&nguinal lig., Sartorius m., A uctor longus m.) femoral a. .

superficial inferior epigastric a. ., superficial circumfle# a. ., superficial e#ternal

pu en al a. . supply skin / subcutaneous layers (Camper / Scarpa) b. "#ternal iliac a. . eep inferior epigastric a. . / eep circumfle# iliac a. .

supply muscle / fasciac. 0eep inferior epigastric a. . anastomoses 1ith superior epigastric a. . internal

thoracic a. .. 2esselbach3s triangle (inferior epigastric a. ., &nguinal lig., rectus ab ominis m.)

irect inguinal%2esselbach3s herniae. Lateral to 2esselbach3s triangle eep inguinal ring superficial inguinal ring

in irect inguinal hernia


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C. &nner ationa. 'horacic spinal nn. anterior rami intercostal n. (' 4+ ) / subcostal n. (' -) in

transvers s abdominis plane pierce rectus ab ominis m. at lateral bor er skin b. L spinal n. anterior ramus iliohypogastric n. / ilioinguinal n. psoas m.

$ua ratus lumborum iliac crest pierce trans ersus ab ominis m. me ial to

S&AS pierce internal obli$ue m. mi linec. &liohypogastric n. lateral rectus bor er pierce e#ternal obli$ue apo. skin o er

suprapubic area. &lioinguinal n. inguinal canal superficial inguinal ring skin of mons pubis,

upper labia majora, an me ial upper thigh

E!ternal "enerative Or#ans


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A. 5ul a (Pu en a)a. !ons pubis (mons eneris)

i. Fat o erlying simphysis pubisii. "scutcheon hair in erte triangle

b. Labia majorai. Superior !ons pubis termination of roun ligament

ii. Posterior perineal bo y Posterior commissureiii. 2air on outer surface apocrine, eccrine sebaceous glan s in the skin

elastic fibers a ipose tissue as connecti e tissue enous ple#us

5aricositiesc. Labia minora

i. Superior t1o lamellae. Lo1er lamellae Frenulum of clitoris

-. 6pper lamellae Prepuce loo * orsal a. of clitorisii. &nferior Fourchette

iii. 7eratini8e stratifie s$uamous epithelium 2art line 9on+keratini8e

s$uamous epitheliumi . Sebaceous glan s

. Clitorisi. :lans

. Stratifie s$uamous epithelium-. loo * orsal a. of clitoris

ii. Corpus. Corpora ca ernosa

-. loo * eep a. of clitorisiii. Crura

. Along ischiopubic ramus, eep to ischioca ernosus m.

e. 5estibulei. artholin glan s (greater estibular glan s). &nferior to estibular bulb, eep to inferior en of bulboca ernosus

m.-. ;pens istal to hymeneal ring < o3clock 4 o3clock =. 'rauma%infecton cyst infecte abscess

ii. !inor estibular glan s. !ucin+secreting epithelium along 2art line

iii. Paraurethral glan s. Along entire inferior aspect of urethra

-. Largest* Skene glan s=. &nflammation%obstruction urethral i erticulum

. 5agina 2ymenC. Perineum

Chapter 2 Maternal Anatomy

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