Episiotomies
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Episiotomies
Episiotomy, also known as perineotomy, is a surgical incision of the perineum and the posterior vaginal wall generally done by a midwife or obstetrician. Episiotomy is usually performed during second stage of labor to quickly enlarge the opening for the baby to pass through. The incision, which can be done from the posterior midline of the vulva straight toward the anus or at an angle to the right or left (medio-lateral episiotomy), is performed under local anesthetic (pudendal anesthesia), and is sutured after delivery. Its routine use is no longer recommended, as perineal massage is an alternative painless method of enlarging the opening for baby. Despite this, it is one of the most common surgical procedures specific to women. In the United States, as of 2012, it was performed in 12% of vaginal births. It is still widely practiced in many parts of the world, including Korea, Japan, Taiwan, China, and Spain. Uses Vaginal tears can occur during childbirth, most often at the ...
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Perineum
The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), including the perineal body and surrounding structures. There is some variability in how the boundaries are defined. The perineal raphe is visible and pronounced to varying degrees. The perineum is an erogenous zone. The word perineum entered English from late Latin via Greek περίναιος ~ περίνεος ''perinaios, perineos'', itself from περίνεος, περίνεοι 'male genitals' and earlier περίς ''perís'' 'penis' through influence from πηρίς ''pērís'' 'scrotum'. The term was originally understood as a purely male body-part with the perineal raphe seen as a continuation of the scrotal septum since masculinization causes the development of a large anogenital distance in men, in comparison to the corresponding lack ...
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Scalpel
A scalpel, lancet, or bistoury is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, podiatry and various arts and crafts (either called a hobby knife or an X-acto knife.). Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have permanently attached blades that can be sharpened or, more commonly, removable single-use blades. Disposable scalpels usually have a plastic handle with an extensible blade (like a utility knife) and are used once, then the entire instrument is discarded. Scalpel blades are usually individually packed in sterile pouches but are also offered non-sterile. Double-edged scalpels are referred to as "lancets". Scalpel blades are usually made of hardened and tempered steel, stainless steel, or high carbon steel; in addition, titanium, ceramic, diamond and even obsidian knives are not uncommon. For example, when performing surgery under MRI guidance, steel blades are unusable (the blades would be drawn ...
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Blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the circulatory system is also known as ''peripheral blood'', and the blood cells it carries, ''peripheral blood cells''. Blood is composed of blood cells suspended in blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume), and contains proteins, glucose, mineral ions, hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and blood cells themselves. Albumin is the main protein in plasma, and it functions to regulate the colloidal osmotic pressure of blood. The blood cells are mainly red blood cells (also called RBCs or erythrocytes), white blood cells (also called WBCs or leukocytes) and platelets (also called thrombocytes). The most abundant cells in vertebrate blo ...
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Postpartum Pelvic Floor Dysfunction
Pelvic floor dysfunction is a term used for a variety of disorders that occur when pelvic floor muscles and ligaments are impaired. The condition affects up to 50 percent of women who have given birth. Although this condition predominantly affects women, up to 16 percent of men are affected as well. Symptoms can include pelvic pain, pressure, pain during sex, urinary incontinence (UI), overactive bladder, bowel incontinence, incomplete emptying of feces, constipation, myofascial pelvic pain and pelvic organ prolapse. When pelvic organ prolapse occurs, there may be visible organ protrusion or a lump felt in the vagina or anus. Common treatments for pelvic floor dysfunction are surgery, medication, physical therapy and lifestyle modifications. The term "pelvic floor dysfunction" has been criticized since it does not represent a particular pelvic floor disorder. It has therefore been recommended that the term not be used in medical literature without additional clarification. Epid ...
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External Anal Sphincter
The external anal sphincter (or sphincter ani externus ) is a flat plane of skeletal muscle fibers, elliptical in shape and intimately adherent to the skin surrounding the margin of the anus. Anatomy The external anal sphincter measures about 8 to 10 cm in length, from its anterior to its posterior extremity, and is about 2.5 cm opposite the anus, the sphincter muscle retracts on defecating. It consists of two layers: ''superficial'' and ''deep''. * The superficial layer, constitutes the main portion of the muscle, and arises from a narrow tendinous band, the anococcygeal raphe, which stretches from the tip of the coccyx to the posterior margin of the anus; it forms two flattened planes of muscular tissue, which encircle the anus and meet in front to be inserted into the central tendinous point of the perineum, joining with the superficial transverse perineal muscle, the levator ani, and the bulbospongiosus muscle also known as the bulbocavernosus. * The deeper layer ...
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Internal Anal Sphincter
The internal anal sphincter, IAS, (or sphincter ani internus) is a ring of smooth muscle that surrounds about 2.5–4.0 cm of the anal canal; its inferior border is in contact with, but quite separate from, the external anal sphincter. It is myogenic in nature and playing phasic and tonic state for relaxation and contraction. This myogenic tone is based on Ca2+/Calmodulin/MLCK/RhoA/ROCK signaling cascade pathway. Recent studies suggested, BDNF is the member of the neurotrophin family; having next target for basal IAS and NANC relaxation. It is about 5 mm thick, and is formed by an aggregation of the involuntary circular fibers of the rectum. Its lower border is about 6 mm from the orifice of the anus. Actions Its action is entirely involuntary, and it is in a state of continuous maximal contraction. It helps the Sphincter ani externus to occlude the anal aperture and aids in the expulsion of the feces. Sympathetic fibers from the superior rectal and hypogastric p ...
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Bartholin's Gland
The Bartholin's glands (named after Caspar Bartholin the Younger; also called Bartholin glands or greater vestibular glands) are two pea sized compound alveolar glandsManual of Obstetrics. (3rd ed.). Elsevier. pp. 1-16. . located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vagina. They are homologous to bulbourethral glands in males. However, while Bartholin's glands are located in the superficial perineal pouch in females, bulbourethral glands are located in the deep perineal pouch in males. Their duct length is 1.5 to 2.0 cm and they open into navicular fossa. The ducts are paired and they open on the surface of the vulva. History Bartholin's glands were first described in the 17th century by the Danish anatomist Caspar Bartholin the Younger (1655–1738). Some sources mistakenly ascribe their discovery to his grandfather, theologian and anatomist Caspar Bartholin the Elder (1585–1629). Function B ...
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Tuberosity Of The Ischium
The ischial tuberosity (or tuberosity of the ischium, tuber ischiadicum), also known colloquially as the sit bones or sitz bones, or as a pair the sitting bones, is a large swelling posteriorly on the superior ramus of the ischium. It marks the lateral boundary of the pelvic outlet. When sitting, the weight is frequently placed upon the ischial tuberosity. The gluteus maximus provides cover in the upright posture, but leaves it free in the seated position.Platzer (2004), p 236 The distance between a cyclist's ischial tuberosities is one of the factors in the choice of a bicycle saddle. Divisions The tuberosity is divided into two portions: a lower, rough, somewhat triangular part, and an upper, smooth, quadrilateral portion. * The ''lower portion'' is subdivided by a prominent longitudinal ridge, passing from base to apex, into two parts: ** The outer gives attachment to the adductor magnus ** The inner to the sacrotuberous ligament * The ''upper portion'' is subdivided into ...
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Frenulum Of Labia Minora
The frenulum of labia minora (''fourchette'' or ''posterior commissure of the labia minora'') is a frenulum where the labia minora meet posteriorly. Pathology The fourchette may be torn during delivery due to the sudden stretching of the vulval orifice, or during copulation. To prevent this tearing in a haphazard manner, obstetricians and, less frequently, midwives may perform an episiotomy, which is a deliberate cut made in the perineum starting from the fourchette and continuing back along the perineum toward the anus. Sometimes this surgical cut may extend to involve the perineal body and thus reduce anal sphincter function. Thus some obstetricians have opted to perform a posterior-lateral cut in the perineum to prevent this potential complication from occurring. The fourchette may also be torn in acts of violence wherein forced entry occurs such as rape. When the fourchette is torn, the bleeding which ensues sometimes requires surgical suturing for containment. Etymology ...
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Blausen 0294 Delivery Crowning
Blausen Medical Communications, Inc. is the creator and owner of a library of two- and three-dimensional medical and scientific images and animations, a developer of information technology allowing access to that content, and a business focused on licensing and distributing the content. It was founded by Bruce Blausen in Houston, Texas, in 1991, and is privately held. Background Blausen Medical Communications, Inc. (BMC) is a privately held company founded by Bruce Blausen in Houston, Texas in 1991. BMC created and owns a library of medical and scientific images and animations, and has developed information technology tools allowing access to the library; as well, it licenses and otherwise works to distribute the content. As of this date, BMC's animation library comprised approximately 1,500 animations and over 27,000 two- and three-dimensional images designed for point-of-care patient education, which could be accessed by consumers or professional caregivers (primarily via h ...
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Blausen 0355 Episiotomy
Blausen Medical Communications, Inc. is the creator and owner of a library of two- and three-dimensional medical and scientific images and animations, a developer of information technology allowing access to that content, and a business focused on licensing and distributing the content. It was founded by Bruce Blausen in Houston, Texas, in 1991, and is privately held. Background Blausen Medical Communications, Inc. (BMC) is a privately held company founded by Bruce Blausen in Houston, Texas in 1991. BMC created and owns a library of medical and scientific images and animations, and has developed information technology tools allowing access to the library; as well, it licenses and otherwise works to distribute the content. As of this date, BMC's animation library comprised approximately 1,500 animations and over 27,000 two- and three-dimensional images designed for point-of-care patient education, which could be accessed by consumers or professional caregivers (primarily via h ...
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Cochrane Library
The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of systematic reviews and meta-analyses which summarize and interpret the results of medical research. The Cochrane Library aims to make the results of well-conducted controlled trials readily available and is a key resource in evidence-based medicine. Access and use The Cochrane Library is a subscription-based database, originally published by Update Software and now published by John Wiley & Sons, Ltd. as part of Wiley Online Library. In many countries, including parts of Canada, the United Kingdom, Ireland, the Scandinavian countries, New Zealand, Australia, India, South Africa, and Poland, it has been made available free to all residents by "national provision" (typically a government or Department of Health pays for the license). There are a ...
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