Volume 1

A treatise on the science and practice of midwifery / by W. S. Playfair.

  • William Smoult Playfair
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the science and practice of midwifery / by W. S. Playfair. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    0 Liga- ments of coccyx. Sacro- iliac synchon drosis. Posterior sacro-iliac ligaments. sacrum, and is tlie part on which the finger generally im- pinges in vaginal examinations. The anterior common vertebral ligament passes over the surface of the joints, and we also find the ligamenta subflava and the inter-spinous ligaments, as in the other vertebraa. The articular processes are joined together by a fibrous capsule, and there is also a peculiar ligament, the lumbo-sacral, extending from the transverse process of the vertebra on each side, and attach- ing itself to the sides of the sacrum and the sacro-iliac synchondrosis. The sacrum is joined to the coccyx, and, in some cases at least, the separate bones of the coccyx to each other, by small cartilaginous disks like that connecting the sacrum with the last lumbar vertebra. They are further united by anterior and posterior common ligaments, the latter being much the thicker and more marked. In the adult female a syno%dal membrane is found between the sacrum and coccyx, and it is supposed that this is formed under the influence of the movements of the bones on each other. ^ The opposing articular sui'faces of the sacrum and ilium are each covered by cartilages, that of the sacrum being the thicker. These are firmly united, but, in the female, ac- cording to Mr. Wood,' they are always more or less sepa- rated by an intervening synovial membrane. Posterior to these cai’tilaginous convex surfaces there are strong inter- osseous ligaments, passing directly from bone to bone, filling up the interspace between them, and uniting them firmly. There are also accessory ligaments, such as the superior and anterior sacro-iliac, which are of secondary consequence. The posterior sacro-iliac ligaments, however, are of gi-eat obstetric importance. They are the very strong attachments which unite the rough surfaces on the posterior iliac tuber- osities to the posterior and lateral surfaces of the sacrum. They pass obliquely downwards from the former points, and suspend, as it were, the sacrum from them. According to Duncan, the sacrum has nothing to prevent its being depressed by the weight of the body but these ligaments, and it is mainly through them that the weight of the body is t]-ansmitted to the sacro-cotyloid beams and the heads of the femora. ' Todd’s CydoiJadia of Anatomy and Physiology, article 'I'elvis,’ p. 123.
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