Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier.

  • Pierre Cazeaux
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Obstetrics : the theory and practice ; including the diseases of pregnancy and parturition, obstetrical operations, etc. / by P. Cazeaux ; remodelled and rearranged, with additions and revisions, by S. Tarnier. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    43/1140 (page 39)
    being twisted, in its course, somewhat like an italic/. Anatomists have subdivided it into the external and internal lips, and the intervening space. The anterior superior spinous process bounds it in front, and the posterior superior one behind. The inferior border is shorter than either of the others; it presents, how- ever, three parts for study. There is an oval surface above, for articulating with its fellow of the opposite side, forming the symphysis; below, it is terminated by the tuberosity of the ischium, and in the middle, we find the ischio-pubie ramus; this is a sharp ridge, formed superiorly by the descend- ing branch of the pubis, and inferiorly by the ascending portion of the ischium. The coxal bone is developed from the principal centres of ossification, which appear at the same time in the iliac fossa, the tuberosity of the ischium, and in the pubis. Owing to this mode of growth, it has been customary to divide the os innominatum into three portions: the superior one, styled the ilium, forms, in a great measure, the contour and prominence of the hip; the pubis, being anterior, supports the genital organs; and the inferior one, which sustains the body when seated, is named the ischium. Several years after birth, an osseous lamina resting upon the superior border of the bone, is developed to form the iliac crest, whilst a similar layer embraces the tuberosity of the ischium, and extends to its ramus; at the same time, a third centre of ossification appears for the anterior inferior spinous process of the ilium, and a fourth forms the angle of the pubis. ARTICLE II. ARTICULATIONS OF THE PELVIS. [The four bones just described are united by four articulations peculiar to the pelvis; one in front for the two pubic bones, two behind for the iliac bones and the sacrum, and that of the coccyx with the sacrum. All these articulations are usually termed symphyses; thus the articulation of the two pubic bones is styled the pubic symphysis, the junction of the iliac bone with the sacrum is called the sacro- iliac symphysis, and the connection of the sacrum and coccyx the sacro-coccygeal symphysis. It should be observed, however, that the symphyses or amphiarthroses are characterized by flat articular surfaces, united by a layer of fibrous tissue which allows a bending motion without any sliding of the bones upon each other. Now this sliding motion exists in the pelvic articulations of the female. It is, there- fore, a mistake to classify them amongst the amphiarthroses, and only by an abuse of language can they continue to be called symphyses. Lenoir's researches prove that some anatomists were near the truth in considering them as arthrodia. In twenty-two female subjects between the ages of eighteen and thirty-five years, Lenoir found that the four pelvic articulations are formed by the contact of sur- faces covered with cartilage and lined with synovial membranes; they present, therefore, all the characteristics of arthrodia, and have a simple, sliding motion. To the four articulations proper, of the pelvis, it is well to add in this connection, the articulation of the sacrum with the spinal column. Here we have really one of the amphiarthr JSCS or symphyses. The description of the sub-pubic ligament completes the history of the liga- mentous connections of the pelvis.]