Identifier: manualofgynecolo01hart (find matches)
Title: Manual of gynecology
Year: 1883 (1880s)
Authors: Hart, D. Berry (David Berry), 1851-1920 Barbour, A. H. Freeland (Alexander Hugh Freeland), 1856-
Subjects: Gynecology Gynecology
Publisher: New York : Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Fig. 56. Pelvic floor differentiated in parturition (Braune). The pubic segment is drawn up and the sacral onedriven down. Note position of bladder and its peritoneum: for lettered description, see Fig. 43. the way one passes out through two folding doors, where he pulls the onedoor towards him and pushes the other from him. As the result of this elevation of the pubic segment, the bladder isdrawn above the pubis and its peritoneum stripped off (Fig. 56). ANATOMY OF THE FEMALE PELVIC ORGANS. 63 In addition to the retropubic fat deposit, it should be noted that— a. The posterior wall of the bladder is loosely attached to the ante- rior vaginal wall; b. The urethra and anterior vaginal wall are closely blended ; c. The posterior vaginal wall and anterior rectal wall are loosely con- nected, as far down as the apex of the perineal body (Fig. 35).There are three lines of cleavage in the pelvic floor (Fig. 57).
Text Appearing After Image:
Fig. 57. Lines of cleavage indicated by dotted lines. From before backwards they are—1, physiological; 2, path-ological; 3, bi-manual (Hart). 1. Physiological, between the vaginal walls ; all in front of this line is drawn upwards in parturition. 2. Pathological, between the posterior vaginal and anterior rectal walls ; all in front of this is displaced downwards in Prolapsusuteri. 3. Bi-manual, between the anterior and posterior rectal walls ; all in front of this is displaced on bi-manual recto-vaginal examina-tion.From the structural arrangement of the pelvic floor, it results, as willbe shown more fully afterwards, that— 1. There is a definite opening up of the pelvic floor during parturi- 64 MANUAL OF GYNECOLOGY. tion and when a woman assumes the genupectoral posture withthe vaginal orifice opened up ;2. There are produced definite displacements of the pelvic floorwhen the various specular means of exploring it are employedand under excessive intra-abdominal pressure or hyper

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