Colpoperineorrhaphy and the structures involved : the vagina and perineum and how to mend them.

  • Robinson, Byron, 1855-1910.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Colpoperineorrhaphy and the structures involved : the vagina and perineum and how to mend them. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    13/144 page 9
    muscle. The muscular bundles of the horseshoe loop join those of the opposite side of the levator ani pos- terior to the vagina and rectum without an interven- ing perineal tendon or raphe. In some dissections it is absolutely plain that no tendinous raphe exists, while in others it can not be told. The smaller portion of the levator ani of bony origin is from the ischial spine immediately anterior to the origin of the coccygeus muscle. Quite a distinct strip one-fourth to one-half inch wide comes from the ischial spine, and can be plainly followed by the eye to the horseshoe loop. The ligamentous origin is from the anterior liga- ment of the bladder (ligamentum pubo-vesicale) and from the arcus tendineus (white line). The fibers of the levator ani which arise from the ligamentum pubo- vesicale are of little practical importance. The white line extends in a slightly curved direction from the posterior lateral surface of the pubis, over the obtura- tor foramen to the spine of the ischium. The anterior end lies two and three-fourths inches below the ileo- pectineal line, with a length of about four inches. The white line (arcus tendineus) is a part or an ex- tension of the anterior true ligament of the bladder, a thickening of the levator ani fascia superior. In the white line, the muscular fibers arise as fine tendinous bands, and may show their reddish muscular nature at the white line or a short distance from it. The muscle may shade into a flat tendinous layer before it reaches the white line. The proximal tendon of tke levator ani muscle varies much as to its relations with the white line. It may arise below it as well as from it. , The white line may project into the pelvis as a tendinous fold, and be capable of being separated from the origiil of the muscle. The course of the fibers of the horseshoe loop of the levator ani muscle is backward and downward
    digitised image 1
    digitised image 2
    digitised image 3