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    Physical Therapy in Obstetrics and Gynaecology: Lecture 1-Anatomy

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    Iqra Razzaq
    This document provides an overview of anatomy related to physical therapy in obstetrics and gynecology. It defines key terms and describes the pelvis, pelvic floor muscles, and female reproductive system. The pelvis has a bony ring structure forming an inlet and outlet. The female pelvis is shallower with a larger outlet than the male pelvis. The pelvic floor spans the pelvic outlet and supports abdominal and pelvic organs. It has layers including levator ani muscles which are important for continence and maintaining urethral closure, especially during stress.

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    Physical Therapy in Obstetrics and Gynaecology: Lecture 1-Anatomy

    Uploaded by

    Iqra Razzaq
    36 views19 pages
    This document provides an overview of anatomy related to physical therapy in obstetrics and gynecology. It defines key terms and describes the pelvis, pelvic floor muscles, and female reproductive system. The pelvis has a bony ring structure forming an inlet and outlet. The female pelvis is shallower with a larger outlet than the male pelvis. The pelvic floor spans the pelvic outlet and supports abdominal and pelvic organs. It has layers including levator ani muscles which are important for continence and maintaining urethral closure, especially during stress.

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    physiotherapy

    Original Title

    Gynae Lecture 1

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    This document provides an overview of anatomy related to physical therapy in obstetrics and gynecology. It defines key terms and describes the pelvis, pelvic floor muscles, and female reproductive system. The pelvis has a bony ring structure forming an inlet and outlet. The female pelvis is shallower with a larger outlet than the male pelvis. The pelvic floor spans the pelvic outlet and supports abdominal and pelvic organs. It has layers including levator ani muscles which are important for continence and maintaining urethral closure, especially during stress.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    36 views19 pages

    Physical Therapy in Obstetrics and Gynaecology: Lecture 1-Anatomy

    Uploaded by

    Iqra Razzaq
    This document provides an overview of anatomy related to physical therapy in obstetrics and gynecology. It defines key terms and describes the pelvis, pelvic floor muscles, and female reproductive system. The pelvis has a bony ring structure forming an inlet and outlet. The female pelvis is shallower with a larger outlet than the male pelvis. The pelvic floor spans the pelvic outlet and supports abdominal and pelvic organs. It has layers including levator ani muscles which are important for continence and maintaining urethral closure, especially during stress.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 19

    Physical therapy in Obstetrics and

    Gynaecology
    Lecture 1- Anatomy
    Terminology
    • Obstetrics : Care of pregnant women
    • Gynecology : study of any pathology related to
    female reproductive system
    Anatomy
    • The pelvis
    • Pelvic floor and muscles of pelvic floor
    • The perineum
    • The abdominal muscles
    • The breast
    • Reproductive tract
    • Urinary tract
    • Anorectal region
    Pelvis
    • The innominates and the sacrum articulate at the
    symphysis pubis, and at the right and left
    sacroiliac joints, to form a firm bony ring.
    • The ring of bone is deeper posteriorly than
    anteriorly and forms a curved canal.
    • Pelvic Inlet at the level of the sacral
    promontory and superior aspect of the pubic
    bones.
    • Pelvic outlet  formed by the pubic arch, ischial
    spines, sacrotuberous ligaments and the coccyx.
    • True pelvis  The enclosed space between the
    inlet and outlet.
    Female Vs Male pelvis
    • Female pelvis  shallow, straight sides, large
    pelvic outlet, greater sub-pubic angle
    • Male Pelvis  Android
    Ideal Pelvis
    • Ideal Pelvis  gynecoid
    – Well-rounded , oval inlet
    – Longest dimension of inlet is from side to side
    – Longest dimension of outlet is AP

    Significance
    Types of pelvis
    • Difficulties can be
    experienced in
    childbirth from such
    adverse features as in
    pelvis types other than
    gynaecoid.
    Sacral rotation and lumber lordosis
    • Sacrum is pushed down
    and forward, rotates on
    a transverse axis due to
    loading in pregnancy.
    • Causing lordosis of
    lumber spine, forward
    head posture, thoracic
    kyphosis, hip/knee
    flexion
    • Anterior pelvic tilt may
    remain constant
    SI joints and Pubic symphysis
    • small range of movement
    • Movements are interrelated
    • Increased laxity of ligaments in pregnancy
    increased level of estrogen,progesterone and
    relaxin
    • Pelvic girdle returns to pre pelvic state 3-6
    months post partal
    • Hypermobility may lead to SI joint pain
    After the break ….

    Pelvic floor and pelvic floor muscles


    • The pelvic floor acts as a dynamic platform
    that spans the outlet of the pelvis to support
    the abdominal and pelvic organs;
    Layers of pelvic floor
    Deepest to superficial:
    • Endopelvic fascia collagen, elastin and smooth muscles, connects
    pelvic organs to pelvic side walls, major ligaments are cardinal and
    uterosacral. Not under stress when levator ani works properly.
    • Levator ani  pelvic diaphragm/ pubovisceralis (pubococcygeus) and
    iliococcygeus, covered by fascia superiorly and inferiorly.
    • Perineal membrane urogenital diaphragm, inferior to levator ani,
    attached to the edges of vagina to ischipubic ramus, provides attachment
    to perineal body and supports urethra, it has a greater supportive function
    when levator ani is relaxed,
    • External genital muscles ischiocavernosus, bulbocavernosus
    • External genitilia and skin
    Function of Pelvic floor
    • Chief function  support of abdominal and
    pelvic viscera
    • Maintenance of continence or urine and
    faeces
    Importance of Levator ani
    • Levator ani is of major importance
    • Supplied by perineal branch of pudendal
    nerve (s2-4) or from sacral nerve roots S3-5.
    • Puborectalis, pubococcygeous, illiococcygeous
    • Contains type I and II fibers:
    • Type –I resting tone,
    • Type-II  under stress maintain urethral
    closure, fatigueable
    Role of other muscles

    • Coccygeous can influences SI joint


    • Obturator internus and piriformis pelvic side
    walls.
    Perineal body
    • central cone-shaped
    fibromuscular structure
    which lies just in front of
    the anus
    • 4 cm in diameter
    • the superficial transverse
    perineal muscles, the
    perineal membrane and
    the levator ani muscles
    insert into it.
    • Supports pelvic floor

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