File:Manual of gynecology (1883) (14594145119).jpg

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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s also attached on each side to the anterior bonypelvic wall, while the sacral segment is attached in a like manner to theposterior bony pelvic wall. Finally, these two segments blend with oneanother on the right and left sides of the vagina. The two segments are thus anatomically contrasted :— The pubic segment is made up of loose tissue and is loosely attached to thepubic symjihysis ; the sacral segment is made up of strong tissue and is firmlydovetailed into the sacrum and coccyx. They are further contrasted functionally:— The pubic segment is drawn up during labour ; the sacral segment isdriven down. 62 MANUAL OF GYNECOLOGY. The proof for this functional contrast is too elaborate to be given hereand will be found given in detail in Dr. Harts atlas. It may be brieflyexplained, however, that during labour the pubic and sacral segments actlike two folding doors. Uterine action pulls up the pubic segment, anddrives the child down against the sacral one. This action is analogous to
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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).

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