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Pelvic inlet
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diameter of pelvic inlet
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Submodule
FetoPelvicRelationships
| Question | Answer |
|---|---|
| Pelvic inlet | upper border of the true pelvis |
| diameter of pelvic inlet | >= to 11 cm |
| pelvic outlet | lowe border of the true pelvis |
| characteristics? | viewed from below is ovoid/somewhat diamond shaped/bound by pubic arch anteriorly, ischial tuberosity laterally and tip of coccyx posteriorly. Latter part of pregnancy coccyx is movable |
| diameter of pelvic outlet? | >= to 8 cm |
| linea terminalis | line dividing upper (false) pelvis from lower (true pelvis) |
| function of linea terminalis | support the weight of enlarged uterus and direct presenting fetal part into the true pelvis below |
| pelvic cavity | curved passage with a short anterior wall and a much longer concave posterior wall (made up of true and false pelvis) |
| false pelvis | portion above the pelvic brim bounded by the lumbar vertebrae posteriorly, the iliac fossae laterally, and the lower abdominal wall anteriorly. |
| true pelvis | part involved in birth, divided in 3 planes: the inlet, or brim; midpelvis, or cavity; and outlet |
| anterior diameter | anterior diameter of the pelvis; true pelvis measures about 5 cm at its anterior wall at the symphysis pubis |
| posterior diameter | posterior diameter of the pelvis; true pelvis measures about 10 com at its posterior wall |
| brim of android pelvis | heart shaped, angulated heart |
| depth of android pelvis | deep |
| side walls of android pelvis | convergent |
| ischial spines of android pelvis | prominent, narrow interspinous diameter |
| sacrum android pelvis | slightly curved terminal portion often beaked |
| subpubic arch android pelvis | narrow |
| usual mode of birth android pelvis | C-sec (vaginal difficult w/ forceps) |
| gynecoid pelvis brim | slighlty ovoid or transversely rounded |
| depth of gynecoid | moderate |
| side walls of gynecoid | straight |
| ischial spines of gynecoid | blunt, somewhat widely separated |
| sacrum gynecoid | deep, curved |
| subpubic arch gynecoid | wide |
| mode of birth gynecoid | vaginal, spontaneous occipito anterior position |
| ischial spines | when presenting part is above or below the spines, it is expressed in terms of how far in cm. Ex: when presenting part is 1 cm above the spines, the station is ntoed as being minus 1. Level of spines (O), below (+1). Birth is imminent when statio |
| when is birth imminent in relationship to ischial spines? | when station is presenting at +4 or +5 |
| Diagonal conjugate | DC. radiographic measure of distance from inferior border of symphysis pubis (SP) to sacral promontory |
| how can diagonal conjugate may be obtained? | by vaginal exam |
| what is the diameter of the diagonal conjugate? | 12.5 to 13 |
| Conjugate vera | True conjugate. Radiographic measurement of distance from upper margin of symphysis pubis (SP) to sacral promontory |
| diameter of conjugate vera | 1.5 to 2 cm less than conjugate |
| inter-spinous diameter | the shortest diameter of the pelvic cavity located between the spines |
| inter-tuberous diameter | diameter between the ischial tuberosities |
| pelvimetry | measurement of dimensions and proportions of the pelvis to determine its capacity and ability to allow the passage of the fetus through the birth canal |
| fetal skull bones | composed of two parietal bones, two temporal bones, the frontal bone, and the occipital bone |
| sutures | these bones are united by membranous sutures |
| what are the sutures? | sagital, lambdoid, coronal and frontal |
| where is the sagital suture? | transverse from frontal bone to the occipital bone |
| where is the lambdoid suture? | between occipital and parietal |
| where is the coronal suture? | between parietal and frontal |
| where is the frontal suture | in the frontal bone |
| fontanels | intersections of the cranial sutrues allowing for moldign of the fetal head and help the clinican id the position of the fetal head during vag exam |
| Occiput | the area of the fetal skull occupied by the occipital bone, beneath the posterior fontanelle |
| occipitobregmatic diameter | diameter pertaining to the occiput and bregma (suboccipitobregmatic is the smallest anteroposterior diameter) |
| occipitomental diameter | largest diameter of the head/it extends from mentum (lower jaw) to the occiput |
| biparietal diameter | largest transverse diameter of the head |
| biparietal diameter extends from | one parietal bone to the other |
| suboccipitobregmatic | the smallest diameter of the head |
| suboccipitobregmatic diameter extends from | middle of the anterior fontanelle to the under surface of the occipital bone |
| fetal lie | relationship of the cephalocaudal axis (spinal column) of the fetus to the cephalocaudal axis of the woman |
| what are the types of lies | two: longitudinal and transverse |
| what does a longitudinal lie mean? | the fetus's cephalocaudal axis is parallel w/ mother's spine |
| what does transverse mean? | cephalocaudal axis of the baby is at right angle w/ mother's spine |
| w/ which of the lies birth cannot occur vaginally | transverse |
| fetal attitude | relation of the fetal parts to one another |
| how is a normal attidue described? | head fleed forward w/ the chin almost resting on the chest/arms and legs flexed |
| fetal presentation | determined by the fetal lie and by the body part of the fetus that enters the maternal pelvis |
| what is called a presenting part? | the portion of the fetus that enters the maternal pelvis first |
| what are the three presentations | chephalic, breech, shoulder |
| what is the most common presentation? | chephalic |
| further classifications of the cephalic presentation are | vertex, military, brow, face, |
| what is a vertex presentation? | most common type, fetal head completely flexed on chest, smallest diameter of the fetal head presents ot the maternal pelvis |
| what is the presenting part in a vertex presentation? | occiput |
| what is the military presentation? | fetal head is neither flexed nor extended |
| what kind of diameter presents in vertex presentation? | suboccipito bregmatic |
| what kind of diameter presents in military presentation? | occipitofrontal |
| what is the presenting part in the vertex presentation? | occiput |
| what is the presenting part in the military presentation? | top of the head |
| what is the presentation in brow presentation? | fetal head partially extended |
| that is the diameter presented in brown presentation? | occipitomental diameter (the largest diameter) |
| what is the presenting part of the face presentation? | the fetal head is hyperextended (complete extension) |
| what is the diameter presenting in the face presentation? | submentobregmatic |
| what is the presenting part of the fetus presenting in the face presentation? | the face |
| what are the three notations used to describe the fetal position? | R or L side of maternal pelvis, landmark of presenting part (O, M, S, A), Anterior (A), Posterior (P), and transverse (T) |
| what is the O of the presenting part | Occiput |
| what is the M | Mentum |
| what is the S | sacrum |
| what is the A | acromion process |
| what is another word for the frontal bone? | sinciput |
| what is Sc? | scapulla |
| obstretical conjugate is ... | in between the true conjugate and diagonal conjugate (middle of the symbphysis pubis) |
| station | relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis |
| if the presenting part is higher than the ischial spines the station is... | a negative number noted in cm above zero station |
| where is station -5? | at the inlet |
| where is station +4? | at the outlet |
| what does fetal position refer to? | the relationship of the landmark on the presenting fetal part ot the anterior, posterior sides (left or right) of the maternal pelvis |
| what does ballotment means? | mobability of a floating object, such as fetus/dx technique using palpation |
| how is it done? | a floating object when trapped or pushed moves away and then returns to touch the examiners hand |
| ballotment is what kind of sign of pregnancy? | objective |
| lightening | sensation of decreased abdominal distention produced by uterine descent into the pelvic cavity as the fetal presentating part settles into the pelvic inlet |
| how fast does it occur? | usually occurs 2 wks before the onset of labor in a nullipara |
| what is transition? | first stage of labor from a cervial dilation of 8 cm to 10 cm |
| what is the first stage of labor? | considering lasting from the onset of regular uterine contractions to the tiem when the cervix is fully dilated |
| what are its phases? | latent, active, transition |
| what happens in the latent phase? | there is more effacement of the cervix and little descent |
| how long does the latent phase last? | 8.6 hr in a nullipara, 5.3 hrs in a multipara |
| what is the cervical dilation during latent phase? | 0 to 3 cm |
| how frequent are the contractions? | 3 to 30 minutes |
| how long do they last? | 20 to 40 sec |
| what is their intensity? | begin as mild and progress to moderate; 25 to 40 mm Hg by intrauterine pressure catheter (IUPC) |
| how long does the active phase last? | 4.6 hr in a nullipara, 2.4 hrs in a multipara |
| what is the cervical dilation in the active phase? | 4 t 7 cm |
| how frequent are the contractions during active phase? | every 2 to 5 min |
| how long do they last? | every 40 to 60 seconds |
| what is their intensity? | begin as moderate nd progress to strong; 50 to 70 mmHg by IUPC |
| how long does transition stage last? | 3.6 ht in a nulipara, varies in multi |
| what is the cervial dilation in the transition stage? | 8 to 10 cm |
| how frequent are the contractions in the transition phase? | every 1 to 1/2 minutes |
| what is the duration of contraction in the transition phase? | 1 to 1/2 minute |
| how strong are the contractions in the transition phase? | strong by palpation, 70 to 90 mm Hg by IUPC |
| what is the second stage of labor? | it lasts from the time the cervix is fully dilated to the birth of the fetus |
| how long does it last (2nd stg)? | up to 3 hr in a nulipara, 0 to 30 min in a multipara |
| how frequent are the contractions? | every 1 1/2 to 2 min |
| how long they last? | 1 to 1/2 minute |
| how strong? | 70 to 100mmHg by IUPC/strong by palpation |
| what does the descent of the fetus in the pelvic cavity depends on? | pressure exerted by the amniotic fluid, direct pressure exerted by the contracting fundus on the fetus, forces of the contraction of the maternal diaphragm and abdominal muscles in the 2nd stage of labor |
| what is the third stage of labor? | last for about 2 hrs after delivery of the placenta |
| what is the forth stage of labor? | last for about 2 hours after delivery of the placenta |
| what happens during the forth stage? | homeostasis is reestablished, period to look for complic such as bleeding |
| what is engagement? | engagement of the presenting part occurs when the largest diameter of the presenting part reaches or passess thorugh the pelvic inlet |
| complete effacement means... | thining and shortening or obliteration of the cervix that occurs during late pregnancy or labor or both |
| complete dilation means... | stretching of the external os from an opening a few milimeters in size to opening large enough to allow the passage of the infant |
| what is crowning? | stage of birth when the top of the fetal head can be seen at the vaginal orifice |
| what are the mechanisms of labor? | engagement and descent, flexion, internal rotation, extension, external rotation and restitution, external rotation and expulsion |
| what happens during flexion? | fetal head descends, meets resistance,the chin is flexed onto the chest |
| during internal rotation? | fetal head must rotate to fit the diameter of the pelvic cavity, w/c is widest in the anteroposterior diameter. |
| how is the direction of internal rotation | as the occiput of the fetal head meets resistance, the occiput rotates from L to R, and the sagittal suture aligns in the A-P diameter |
| what is extension? | the resistance of the pelvic floor assists w/ the extension of the fetal head as it passes under the symphysis pubis |
| what is restitution? |
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