1 PELVIC ANATOMY PELVIC ANATOMY AND AND FEMALE REPRODUCTIVE ORGAN FEMALE REPRODUCTIVE ORGAN dr. Udin S, SpOG (K), MM dr. Udin S, SpOG (K), MM Depart. of Obstetrics & Gynecology Faculty of Medicine, Padjadjaran University Hasan Sadikin Hospital B A N D U N G BAGIAN LAB ANATOMI FK UNILA 2012
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PELVIC ANATOMY PELVIC ANATOMY AND AND
FEMALE REPRODUCTIVE ORGANFEMALE REPRODUCTIVE ORGAN
dr. Udin S, SpOG (K), MMdr. Udin S, SpOG (K), MM
Depart. of Obstetrics & GynecologyFaculty of Medicine, Padjadjaran University
Hasan Sadikin HospitalB A N D U N G
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THE BONY PELVISTHE BONY PELVISThe pelvis is composed of four bonesThe pelvis is composed of four bones SacrumSacrum CoccyxCoccyx Two innominate bonesTwo innominate bones
–– Fusion of the iliumFusion of the iliumischiumischiumpubispubis
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SACRUMSACRUM
Foramina sacralia anteriora Foramina sacralia anteriora passed by passed by plexus sacralis plexus sacralis pain and leg cramp pain and leg cramp until the baby head descent to the pelvic until the baby head descent to the pelvic cavitycavity
COCCYGISCOCCYGISDuring labor pushed posteriorlyDuring labor pushed posteriorly out let pelvic widerout let pelvic widerBAGIAN LAB ANATOMI FK
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PELVIC JOINTSPELVIC JOINTS
Anterior Anterior Joined together by the symphisis pubisJoined together by the symphisis pubis
Consists of fibrocartilageConsists of fibrocartilagesuperior pubic ligamentssuperior pubic ligamentsinferior pubic ligamentsinferior pubic ligaments(arcuate ligament of the(arcuate ligament of the pubis)pubis)
Has a certain degreeHas a certain degree of mobilityof mobilityPosteriorPosterior Sacro iliac jointsSacro iliac jointsHave a certain degree of mobilityHave a certain degree of mobilityBAGIAN LAB ANATOMI FK
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PELVIC ANATOMYPELVIC ANATOMYTHE FALSE PELVISTHE FALSE PELVIS Above the linea terminalisAbove the linea terminalis Bounded Bounded Posteriorly by lumbar vertebraePosteriorly by lumbar vertebrae
Laterally by iliac fossaeLaterally by iliac fossaeAnteriorly by lower portion of the Anteriorly by lower portion of the
anterior abdominal wallanterior abdominal wall
THE TRUE PELVISTHE TRUE PELVIS Important in child bearing (melahirkan)Important in child bearing (melahirkan) Bounded above by : Bounded above by :
The promontory and alae of the sacrum The promontory and alae of the sacrum Linea terminalisLinea terminalis Upper margins pubic bonesUpper margins pubic bonesBelow : pelvic out letBelow : pelvic out let 9BAGIAN LAB ANATOMI FK
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TRUE PELVIS :TRUE PELVIS :
Describe as having four imaginary Describe as having four imaginary planesplanes
Mid pelvisMid pelvis(Cannot be assessed clinically)(Cannot be assessed clinically) The interspinous diameter The interspinous diameter >> 10 cm)10 cm) The AThe A--P diameter P diameter >> 11.5 cm11.5 cm
Pelvic outletPelvic outlet The AThe A--P diameter 9.5 P diameter 9.5 –– 11.5 cm11.5 cm The transverse diameter 11 cmThe transverse diameter 11 cmBAGIAN LAB ANATOMI FK
Intermediate Intermediate –– type pelves/ mixed types type pelves/ mixed types of pelves of pelves more frequent than pure more frequent than pure typestypes BAGIAN LAB ANATOMI FK
A canal of plain muscule extending from the A canal of plain muscule extending from the vestibule to the uterusvestibule to the uterus
Nulliparous adult : H shapedNulliparous adult : H shapedTransverse ridges or rugae Transverse ridges or rugae Permit great distension during parturitionPermit great distension during parturition
The epithelium is rich in glycogen, converted The epithelium is rich in glycogen, converted by Doderlein’s bacillus into lactic acidby Doderlein’s bacillus into lactic acid
pH 4,5 pH 4,5 barrier against infectionbarrier against infectionBAGIAN LAB ANATOMI FK
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UTERUSUTERUS
Hollow viscus composed of plain muscle,Bulb Hollow viscus composed of plain muscle,Bulb shapeshape
Corpus or Body : the upper twoCorpus or Body : the upper two--thirdthirdCervix or Neck : the lower thirdCervix or Neck : the lower third
Length Length : 7.5 cm: 7.5 cmThickness Thickness : 2.5 cm: 2.5 cmLength of cavity : 6 cmLength of cavity : 6 cmThickness of muscle wall is 1.2 cmThickness of muscle wall is 1.2 cm
Ratio corpusRatio corpus : cervix: cervixChildren Children : 1 : 2: 1 : 2Teen ageTeen age : 1 : 1: 1 : 1Adult Adult : 2 : 1: 2 : 1
Isthmus uteriIsthmus uteri BAGIAN LAB ANATOMI FK UNILA 2012
Interstitialis partInterstitialis part1 cm long and verry narrow (< 1 mm)1 cm long and verry narrow (< 1 mm)
IsthmusIsthmus2 cm long, straight and cord like (2 cm long, straight and cord like ( 1 mm)1 mm)
AmpulaAmpula5 cm long, thin walled and convoluted5 cm long, thin walled and convoluted
InfundibulumInfundibulum2 cm long, the terminal expansion with 2 cm long, the terminal expansion with fimbrial processes which help to attract the fimbrial processes which help to attract the ovumovum BAGIAN LAB ANATOMI FK
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OVARYOVARY
3 cm long and 1.5 cm wide3 cm long and 1.5 cm wideRoughly the size and shapeRoughly the size and shape
Attached to the cornu of the uterusAttached to the cornu of the uterusBy the ovarian ligament (ovarii propium lig)By the ovarian ligament (ovarii propium lig)
Divided intoDivided into -- a vascular medullaa vascular medulla-- cortexcortex