anatomy of the female reproductive system david shveiky, m.d. department of obstetrics &...
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Anatomy of the Female Reproductive System
David Shveiky, M.D.Department of Obstetrics & Gynecology
Hadassah Medical Center, Ein KeremJerusalem
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מקרה הצגת
ולפתע 22בת • לבנק בתור לפניך עומדתמתמוטטת.
Ruptured ectopic pregnancyהאבחנה – •
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LAPAROSCOPY
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להיכנס לא היכן
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עוברים מה ?דרך
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Panoramic view of the pelvis
Inspection of the pelvis should include the lower anterior and lateral abdominal wall, anterior cul-de-sac, uterus and supporting ligaments, adnexae, pelvic sidewalls, posterior cul-de-sac, rectosigmoid and posterior abdominal wall up to the bifurcation of the aorta. Use the uterine manipulator to aid in pelvic inspection.
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מומים מולדים של הרחם והנרתיק
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מומים מולדים של הרחם והנרתיק
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Urinary bladder
Uterus
Left round ligament
Medial umbilical ligament
Internal inguinal ring
Right round ligament
Right fallopian tube
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Note the relative positions of the three structures: The right fallopian tube, round ligament and ovary.
Fallopian tube
Ovary
Hypogastric
Ureter
Round ligament
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מומים מולדים של הרחם והנרתיק
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Use the probe to manipulate the ovary superior and laterally for inspection of the inferior surface and the ovarian fossa.
Evaluating the Right Adnexa and Pelvic Sidewall
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Right Pelvic Sidewall
Uterus
Fallopian tube
I-P ligament Uterosacral ligament
Ureter
Hypogastric artery
Sigmoid colon
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Cannula
Uterosacral ligaments
Posterior cul-de-sac
Sigmoid colon
Posterior cul-de-sac
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Posterior cul-de-sac
Use the suction/irrigation cannula as a probe and to maintain a clear field.
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Posterior cul-de-sac - Endometriosis
The posterior cul-de-sac appears normal.
Inspection cannot be considered to be complete until all hidden areas are clearly visualized with the aid of the cannula.
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Uterus – Blood Supply
• Uterine Vessels• Ovarian Vessels
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Where is the uterus here?
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, לימפתי , ורידי ניקוז דם אספקתועצבוב
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שנתיים ...לאחר
חוסר • בשל יולדת להעריך לידה לחדר נקראתהתקדמות
שנתיים • לפני לבנק מהתור אותך מזהה היולדתהראש – • גמורה פתיחה ללא SP+1בבדיקה
.3התקדמות שעות
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גרמי אגן
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שעות 24כעבור ...
בשל • יולדת להעריך יולדות למחלקת נקראתקיסרי ניתוח לאחר ימין במותן כאבים
• / עמיתתך, את מזהה ה את שוב להפתעתך. בבנק לתור
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, לימפתי , ורידי ניקוז דם אספקתועצבוב
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מומים מולדים של הרחם והנרתיק
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Note the relative positions of the three structures: The right fallopian tube, round ligament and ovary.
Fallopian tube
Ovary
Hypogastric
Ureter
Round ligament
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שנה 30כעבור ...
בת • אישה למרפאה של 54מגיעה בתלונותהמיני בתפקוד וירידה האגן איברי צניחת
• , את ליטול שכחת אך לך מוכרת האישההיום לאלצהיימר התרופות
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Pelvic Floor Levator Ani
Inferior View
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VIEW OF LEVATOR ANI MUSCLES FROM ABOVE WITH PELVIC ORGANS REMOVED. NOTE ATTACHMENTS TO PUBIC SYMPHISIS,
ARCUS TENDINEUS , AND ISCHIAL SPINES
Superior view
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