SlideShare una empresa de Scribd logo
1 de 64
Descargar para leer sin conexión
Female Pelvic 
Applied Anatomy 
Dr. SHASHWAT JANI 
M.S. ( GYNEC ) 
DIPLOMA IN ADVANCED ENDOSCOPY. 
Assistant Professor Smt. N.H.L. MUNICIPAL 
MEDICAL COLLEGE , AHMEDABAD. 
Mob : +91 99099 44160. 
E-mail : drshashwatjani@gmail.com
Basic Facts of Anatomy 
do not Change 
But our understanding does… 
Exploration of specific anatomic relationships and the 
development of new clinical and surgical correlation 
continue to evolve….
Comprehensive understanding of 
Anatomy is essential for .. 
 Avoiding visceral injuries : About 75 % iatrogenic 
injuries to ureter result from Gynecological 
surgeries….  
 Understanding of interrelation ship of Bony pelvis, 
ligaments , muscles, fasciae , nerves , blood vessels 
and pelvic viscera for safe and effective management 
of Pelvic floor Disorders. 
 Understanding and managing the normal and 
abnormal Obstetric conditions.
Topics Covered.. 
 Bony Pelvis 
 Organ anatomy 
 Spaces 
 Vascular anatomy 
 Neuroanatomy
Nomenclature used here reflects current slandered 
nomenclature according to 
the Nomina Anatomica*. 
*International Anatomical Nomenclature Committee: Edinburg, Scotland. 
(founded in 1989)
Female Pelvis : Evolvement 
•Forms a bony ring through with body weight is transmitted to lower 
extremities. 
•Adopts to child bearing.
Pelvic Structure 
Sacrum 
Coccyx 
Paired Hip Bones ( Os Coxae, innominate )
Sacrum and Coccyx 
Extension of Vertebral Column: 
Fused 5 sacral and 4 coccygeal vertebrae
Os Coxae ( Hip Bones )
Pelvic Bone Articulation 
Sacro-illiac Joint : 
Synchondroses 
Symphysis pubis 
Cartilaginous 
symphyseal joint
Important Landmarks 
 Symphysis Pubis and Pubic Tubercle: Pelvimetry, 
Symphysotomy etc… 
 Sacral Promontory: Landmark in Laparoscopy, Bifurcation 
of Major Vessels, Prolapse repair 
 Sacral hiatus 
 Iliac Crest 
 Anterior Superior iliac Spine: Surgical Landmark 
 Ischial Spine: Pudendal Block , Clinical Pelvimetry 
 Ischial Tuberosity
Sacral Promotory Fixation
Pudendal Nerve Block
Pelvic Inlet 
False Pelvis 
True Pelvis 
Linea Terminalis
Boundaries of False Pelvis 
 Posterior : Lumber Vertebrae 
 Anterior: Lower portion of Anterior abdominal wall 
 Laterally: iliac Fossa
Boundaries of True Pelvis 
 Upper: Pelvic Inlet 
 Lower : Pelvic Outlet 
SSPP AASS 
LLTT 
PPuubbiicc BBoonnee 
•Obliquely Truncated 
•Bent Cylinder 
•Greatest Height Posteriorly
Pelvic Planes and Axis
Conjugates
Symphisis pubis 
Outlet 
Coccyx
Four Ligaments 
 Inguinal Ligament 
• Important for repair of Inguial Hernia 
 Cooper’s Ligament 
• Frequently used in Bladder suspension 
procedures. 
 Sacrospinous Ligament 
• For Vaginal Suspension 
 Sacrotubourous Ligament
Sacrospinous fixation
Bladder Suspension Procedure 
on cooper’s Ligament
Normal Variants
Pelvic Viscera
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
Peritoneal Orientation
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
Hystero Laparo Scopy
Pelvic Floor
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
Levator Ani muscle
Pelvic Floor
Vascular anatomy 
The common iliac bifurcation is at the level of sacral 
promontory.
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
Ext Iliac Artery 
2 branches : 
Inf Epigastric 
Deep Circumflex iliac A.
Inferior Epigastric
 The external iliac artery lies lateral to external iliac 
vein. 
 The inferior epigastric artery is the only branch of 
external iliac artery. 
 The inferior epigastric vein drains into the external 
iliac vein.
Vasclar Anatomy : 
Internal Iliac 
The internal iliac ( Hypogastric )artery divides into 
anterior and posterior divisions.
Internal iliac 
(Hypogastric) artery 
 10 branches
Internal Iliac Ligation
Uterine Artery 
The uterine artery is the first branch of anterior division 
of internal iliac artery. It originates about 6”(six 
inches) distal to the bifurcation of common iliac artery
Internal Iliac & Uterine A. 
 Thus, there is sufficient length of internal artery 
available for ligation. After giving out uterine artery, 
the internal iliac artery continues further as obliterated 
hypogastric artery. 
 The uterine artery traverses through the Para rectal 
space and crosses above the ureter from lateral to 
medial side to enter the uterus.
FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI
Uterine Artery
Uterine Artery & Vein 
 The Uterine vein, contrary to popular belief, comes 
from below the ureter to join the internal iliac vein. 
 Thus, the ureter lies in the fork with the uterine artery 
above and the uterine vein below.
SPACES 
There are four important spaces: 
 Retro pubic space 
 Para vesical space 
 Pouch of Douglas 
 Para rectal space
Para rectal space 
The Para rectal space lies… 
 lateral to the ureter 
 medial to the internal iliac vessels. 
It continues downwards upto the levator ani muscle. 
The only structures crossing this space are 
 Uterine artery 
 Uterine vein.
Pararectal space 
ureter 
Internal Iliac A. 
Obliterate umbilical A. 
Uterine A 
Exterrnal Iliac vs.
Paravesical space 
The paravesical space lies medial to the obliterated 
hypogastric artery and is bounded caudally by the 
pubic bone. 
The retro pubic space can be entered through this 
space.
Pararectal & Paravesical 
spaces
Retro pubic space 
The retro pubic space is bounded by the obliterated 
hypogastric artery on either side, the pubic 
symphysis anteriorly and the urinary bladder 
posteriorly.
Pouch of Douglas 
The pouch of Douglas is bounded by cardinal and 
uterosacral ligaments on either side, the uterus 
anteriorly and rectum posteriorly.
 The veins run in the uterosacral and cardinal 
ligaments. Likewise, the lymphatics also run in these 
ligaments along the veins. Hence, the ligaments are 
cut as laterally as possible in cancer surgery. 
 The small veins run in the paracolpos.
 The circumflex iliac vein, which drains into external 
iliac vein from medially, is very liable to get damaged 
during nodal dissection. 
 The obturator artery and vein run parallel to the 
obturator nerve. 
 The obturator nerve originates at the bifurcation of 
common iliac vessels and then runs caudally between 
the external and internal iliac vessels.
Lymphatic Drainage 
TThhee llyymmpphhaattiiccss ffrroomm tthhee uutteerruuss ttrraavveell aalloonngg tthhee iinnffuunnddiibbuullooppeellvviicc 
lliiggaammeenntt aanndd ddrraaiinn iinnttoo tthhee ppaarraa--aaoorrttiicc ggrroouupp ooff nnooddeess..
Lymphatics 
 Lymphatics from cervix and upper vagina go along 
the paracolpos and cardinal ligament and drain into 
the ileo-obturator nodes. The obturator node is the 
first echelon of spread from the cervical cancers. 
 Lymphatics from the ovaries go along the infundibulo-pelvic 
ligaments and drain into the Para-aortic group 
of nodes.
Innervations of Reproductive Organs
Innervation of 
Pelvic Viscera
T H A N K 
Y O U . . . ! 
! !

Más contenido relacionado

La actualidad más candente

Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, AligarhUreteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, AligarhNeha Jain
 
Non descent vaginal hysterectomy
Non descent vaginal hysterectomyNon descent vaginal hysterectomy
Non descent vaginal hysterectomyRajni Singh
 
Abdominal Incisions and sutures
Abdominal Incisions and sutures Abdominal Incisions and sutures
Abdominal Incisions and sutures AlaaZeineh
 
Lymphadenectomy for gynecological cancers
Lymphadenectomy for gynecological cancersLymphadenectomy for gynecological cancers
Lymphadenectomy for gynecological cancersDr./ Ihab Samy
 
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIMANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIDR SHASHWAT JANI
 
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE,  Mob: 7289915...OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE,  Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...Pradeep Garg
 
Step wise pelvic devascularisation
Step wise pelvic devascularisationStep wise pelvic devascularisation
Step wise pelvic devascularisationNiranjan Chavan
 
URETERIC INJURY IN OBGY
URETERIC INJURY IN OBGYURETERIC INJURY IN OBGY
URETERIC INJURY IN OBGYMohit Satodia
 
Uterus preserving surgeries for prolapse
Uterus preserving surgeries for prolapseUterus preserving surgeries for prolapse
Uterus preserving surgeries for prolapseRajesh Gajbhiye
 
Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)Yapa
 
Placenta Accreta Spectrum
Placenta Accreta SpectrumPlacenta Accreta Spectrum
Placenta Accreta SpectrumRajesh Gajbhiye
 
Vault prolapse, Pelvic organ Prolapse, Supports Of Uterus
Vault   prolapse, Pelvic organ Prolapse, Supports Of UterusVault   prolapse, Pelvic organ Prolapse, Supports Of Uterus
Vault prolapse, Pelvic organ Prolapse, Supports Of UterusJograjiya Gelabhai Raghubhai
 
Doppler in gyneacology Dr. Muhammad Bin Zulfiqar
Doppler in gyneacology Dr. Muhammad Bin ZulfiqarDoppler in gyneacology Dr. Muhammad Bin Zulfiqar
Doppler in gyneacology Dr. Muhammad Bin ZulfiqarDr. Muhammad Bin Zulfiqar
 
Office hysteroscopy
Office hysteroscopyOffice hysteroscopy
Office hysteroscopyYamal Patel
 

La actualidad más candente (20)

Radical hysterectomy
Radical hysterectomyRadical hysterectomy
Radical hysterectomy
 
Ureteric injury in Gyenec Surgery
Ureteric injury in Gyenec SurgeryUreteric injury in Gyenec Surgery
Ureteric injury in Gyenec Surgery
 
Laparoscopy and fertility
Laparoscopy and fertilityLaparoscopy and fertility
Laparoscopy and fertility
 
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, AligarhUreteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
 
Non descent vaginal hysterectomy
Non descent vaginal hysterectomyNon descent vaginal hysterectomy
Non descent vaginal hysterectomy
 
Abdominal Incisions and sutures
Abdominal Incisions and sutures Abdominal Incisions and sutures
Abdominal Incisions and sutures
 
Lymphadenectomy for gynecological cancers
Lymphadenectomy for gynecological cancersLymphadenectomy for gynecological cancers
Lymphadenectomy for gynecological cancers
 
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANIMANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
MANAGEMENT OF VAULT PROLAPSE BY DR SHASHWAT JANI
 
Pop q (new)
Pop q (new)Pop q (new)
Pop q (new)
 
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE,  Mob: 7289915...OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE,  Mob: 7289915...
OPERATIONS FOR NULLIPAROUS PROLAPSE AND VAGINAL VAULT PROLAPSE, Mob: 7289915...
 
Step wise pelvic devascularisation
Step wise pelvic devascularisationStep wise pelvic devascularisation
Step wise pelvic devascularisation
 
URETERIC INJURY IN OBGY
URETERIC INJURY IN OBGYURETERIC INJURY IN OBGY
URETERIC INJURY IN OBGY
 
Uterus preserving surgeries for prolapse
Uterus preserving surgeries for prolapseUterus preserving surgeries for prolapse
Uterus preserving surgeries for prolapse
 
Vaginal Hysterectomy
Vaginal HysterectomyVaginal Hysterectomy
Vaginal Hysterectomy
 
Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)Manchester repair (Fothergill’s Operation)
Manchester repair (Fothergill’s Operation)
 
Laparoscopy in gynecology
Laparoscopy in gynecologyLaparoscopy in gynecology
Laparoscopy in gynecology
 
Placenta Accreta Spectrum
Placenta Accreta SpectrumPlacenta Accreta Spectrum
Placenta Accreta Spectrum
 
Vault prolapse, Pelvic organ Prolapse, Supports Of Uterus
Vault   prolapse, Pelvic organ Prolapse, Supports Of UterusVault   prolapse, Pelvic organ Prolapse, Supports Of Uterus
Vault prolapse, Pelvic organ Prolapse, Supports Of Uterus
 
Doppler in gyneacology Dr. Muhammad Bin Zulfiqar
Doppler in gyneacology Dr. Muhammad Bin ZulfiqarDoppler in gyneacology Dr. Muhammad Bin Zulfiqar
Doppler in gyneacology Dr. Muhammad Bin Zulfiqar
 
Office hysteroscopy
Office hysteroscopyOffice hysteroscopy
Office hysteroscopy
 

Destacado

Anatomi panggul 2010
Anatomi panggul 2010Anatomi panggul 2010
Anatomi panggul 2010sistenia123
 
Anatomy of the female pelvis
Anatomy of the female pelvisAnatomy of the female pelvis
Anatomy of the female pelvisraj kumar
 
1 chapter 1 applied clinical obstetric anatomy
1 chapter 1 applied clinical obstetric anatomy 1 chapter 1 applied clinical obstetric anatomy
1 chapter 1 applied clinical obstetric anatomy nasrat1949
 
Review of pelvic_anatomy_by- dr. armaan singh
Review of pelvic_anatomy_by- dr. armaan singhReview of pelvic_anatomy_by- dr. armaan singh
Review of pelvic_anatomy_by- dr. armaan singhDr. Armaan Singh
 
Female pelvic anatomy and urinary continence
Female pelvic anatomy and urinary continenceFemale pelvic anatomy and urinary continence
Female pelvic anatomy and urinary continenceAhmed Eliwa
 

Destacado (9)

Anatomi panggul 2010
Anatomi panggul 2010Anatomi panggul 2010
Anatomi panggul 2010
 
Anatomy2009
Anatomy2009Anatomy2009
Anatomy2009
 
Anatomy of the female pelvis
Anatomy of the female pelvisAnatomy of the female pelvis
Anatomy of the female pelvis
 
1 chapter 1 applied clinical obstetric anatomy
1 chapter 1 applied clinical obstetric anatomy 1 chapter 1 applied clinical obstetric anatomy
1 chapter 1 applied clinical obstetric anatomy
 
Obstetric anatomy
Obstetric anatomyObstetric anatomy
Obstetric anatomy
 
Pelvis By Dr. Fernandez
Pelvis By Dr. FernandezPelvis By Dr. Fernandez
Pelvis By Dr. Fernandez
 
Review of pelvic_anatomy_by- dr. armaan singh
Review of pelvic_anatomy_by- dr. armaan singhReview of pelvic_anatomy_by- dr. armaan singh
Review of pelvic_anatomy_by- dr. armaan singh
 
Female pelvic anatomy and urinary continence
Female pelvic anatomy and urinary continenceFemale pelvic anatomy and urinary continence
Female pelvic anatomy and urinary continence
 
Female pelvis ppt
Female pelvis pptFemale pelvis ppt
Female pelvis ppt
 

Similar a FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI

Surgical Anatomy of female pelvis.pptx
Surgical Anatomy of female pelvis.pptxSurgical Anatomy of female pelvis.pptx
Surgical Anatomy of female pelvis.pptxSonuKumarPlash
 
4337896.ppt
4337896.ppt4337896.ppt
4337896.pptSUBINSA2
 
Anatomy of pelvic floor,perineum,perineal pouches and its fascia
Anatomy of pelvic floor,perineum,perineal pouches and its fasciaAnatomy of pelvic floor,perineum,perineal pouches and its fascia
Anatomy of pelvic floor,perineum,perineal pouches and its fasciaking4047
 
Pelvic anatomy
Pelvic anatomyPelvic anatomy
Pelvic anatomyraj kumar
 
Lecture For Lady Health Visitors
Lecture For Lady Health VisitorsLecture For Lady Health Visitors
Lecture For Lady Health VisitorsFizaNasirKhan
 
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdf
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdfFEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdf
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdfEkranthkumar
 
Surgical Anatomy of Urinary bladder.pptx
Surgical Anatomy of Urinary bladder.pptxSurgical Anatomy of Urinary bladder.pptx
Surgical Anatomy of Urinary bladder.pptxDurgaPrasadM10
 
Pelvic anatomy
Pelvic anatomyPelvic anatomy
Pelvic anatomyMahesh Raj
 
VENTRAL WALL HERNIA.pptx
VENTRAL WALL      HERNIA.pptxVENTRAL WALL      HERNIA.pptx
VENTRAL WALL HERNIA.pptxDr Razia Banoo
 
Anatomy of epidural space
Anatomy of epidural spaceAnatomy of epidural space
Anatomy of epidural spaceKarthavya S L
 
Surgical anatomy anal canal
Surgical anatomy  anal canalSurgical anatomy  anal canal
Surgical anatomy anal canalBilal Mansoor
 
Inguinal Hernia
Inguinal Hernia Inguinal Hernia
Inguinal Hernia Mohsin Khan
 
Inguinal hernia ppt
Inguinal hernia pptInguinal hernia ppt
Inguinal hernia pptViswa Kumar
 

Similar a FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI (20)

Surgical Anatomy of female pelvis.pptx
Surgical Anatomy of female pelvis.pptxSurgical Anatomy of female pelvis.pptx
Surgical Anatomy of female pelvis.pptx
 
4337896.ppt
4337896.ppt4337896.ppt
4337896.ppt
 
Anatomy of pelvic floor,perineum,perineal pouches and its fascia
Anatomy of pelvic floor,perineum,perineal pouches and its fasciaAnatomy of pelvic floor,perineum,perineal pouches and its fascia
Anatomy of pelvic floor,perineum,perineal pouches and its fascia
 
Pelvic anatomy
Pelvic anatomyPelvic anatomy
Pelvic anatomy
 
Lecture For Lady Health Visitors
Lecture For Lady Health VisitorsLecture For Lady Health Visitors
Lecture For Lady Health Visitors
 
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdf
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdfFEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdf
FEMORAL_SHEATH_AND_FEMORAL_HERNIA(2).pdf
 
Surgical Anatomy of Urinary bladder.pptx
Surgical Anatomy of Urinary bladder.pptxSurgical Anatomy of Urinary bladder.pptx
Surgical Anatomy of Urinary bladder.pptx
 
Pelvic anatomy
Pelvic anatomyPelvic anatomy
Pelvic anatomy
 
Hernia
Hernia Hernia
Hernia
 
Inguinal canal
Inguinal canalInguinal canal
Inguinal canal
 
Ureter
UreterUreter
Ureter
 
hernia.pptx
hernia.pptxhernia.pptx
hernia.pptx
 
VENTRAL WALL HERNIA.pptx
VENTRAL WALL      HERNIA.pptxVENTRAL WALL      HERNIA.pptx
VENTRAL WALL HERNIA.pptx
 
Anatomy of epidural space
Anatomy of epidural spaceAnatomy of epidural space
Anatomy of epidural space
 
Surgical anatomy anal canal
Surgical anatomy  anal canalSurgical anatomy  anal canal
Surgical anatomy anal canal
 
Inguinal hernia
Inguinal herniaInguinal hernia
Inguinal hernia
 
Inguinal Hernia
Inguinal Hernia Inguinal Hernia
Inguinal Hernia
 
Inguinal hernia ppt
Inguinal hernia pptInguinal hernia ppt
Inguinal hernia ppt
 
uterus-180307171200.pdf
uterus-180307171200.pdfuterus-180307171200.pdf
uterus-180307171200.pdf
 
Gross Anatomy of Uterus
Gross Anatomy of UterusGross Anatomy of Uterus
Gross Anatomy of Uterus
 

Más de DR SHASHWAT JANI

STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptxSTANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptxDR SHASHWAT JANI
 
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANIEARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANIDR SHASHWAT JANI
 
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANITHYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANIIMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
DENGUE IN PREGNANCY BY DR SHASHWAT JANI
DENGUE IN PREGNANCY BY DR SHASHWAT JANIDENGUE IN PREGNANCY BY DR SHASHWAT JANI
DENGUE IN PREGNANCY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDR SHASHWAT JANI
 
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANIVASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANIDR SHASHWAT JANI
 
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANITRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANIDR SHASHWAT JANI
 
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANIPREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANIDR SHASHWAT JANI
 
ECTOPIC PREGNANCY - FOGSI GUIDELINES BY DR SHASHWAT JANI
ECTOPIC PREGNANCY -  FOGSI GUIDELINES BY DR SHASHWAT JANIECTOPIC PREGNANCY -  FOGSI GUIDELINES BY DR SHASHWAT JANI
ECTOPIC PREGNANCY - FOGSI GUIDELINES BY DR SHASHWAT JANIDR SHASHWAT JANI
 
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANIOVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANIOBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANIDR SHASHWAT JANI
 
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANINONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...DR SHASHWAT JANI
 
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANI
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING  BY DR SHASHWAT JANIMEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING  BY DR SHASHWAT JANI
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANIDR SHASHWAT JANI
 
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANIMANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANIDR SHASHWAT JANI
 
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANIMANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANIDR SHASHWAT JANI
 
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANIMANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANIDR SHASHWAT JANI
 
GENITAL TB - HOW TO DIAGNOSE & WHEN TO TREAT BY DR SHASHWAT JANI
GENITAL TB - HOW TO DIAGNOSE  & WHEN TO TREAT  BY DR SHASHWAT JANIGENITAL TB - HOW TO DIAGNOSE  & WHEN TO TREAT  BY DR SHASHWAT JANI
GENITAL TB - HOW TO DIAGNOSE & WHEN TO TREAT BY DR SHASHWAT JANIDR SHASHWAT JANI
 
EXAMINATION OF MALE IN INFERTILITY - WHAT NOT TO MISS BY DR SHASHWAT JANI
EXAMINATION OF MALE IN INFERTILITY  - WHAT NOT TO MISS BY DR SHASHWAT JANIEXAMINATION OF MALE IN INFERTILITY  - WHAT NOT TO MISS BY DR SHASHWAT JANI
EXAMINATION OF MALE IN INFERTILITY - WHAT NOT TO MISS BY DR SHASHWAT JANIDR SHASHWAT JANI
 

Más de DR SHASHWAT JANI (20)

STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptxSTANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
STANDARD TECHNIQUES OF BREAST FEEDING BY DR SHASHWAT JANI.pptx
 
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANIEARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
EARLY PREGNANCY CHALLENGES IN ART BY DR SHASHWAT JANI
 
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANITHYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
THYROID DISEASES IN PREGNANCY BY DR SHASHWAT JANI
 
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANIIMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
IMPACT OF DEEP ENDOMETRIOSIS ON PREGNANCY & DELIVERY BY DR SHASHWAT JANI
 
DENGUE IN PREGNANCY BY DR SHASHWAT JANI
DENGUE IN PREGNANCY BY DR SHASHWAT JANIDENGUE IN PREGNANCY BY DR SHASHWAT JANI
DENGUE IN PREGNANCY BY DR SHASHWAT JANI
 
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANI
 
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANIVASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
VASOMOTOR PROBLEMS IN MENOPAUSE BY DR SHASHWAT JANI
 
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANITRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
TRANSFER OF A CRITICALLY ILL MOTHER BY DR SHASHWAT JANI
 
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANIPREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
PREVENTION OF PRETERM LABOUR - EVIDENCES FOR PROGESTERONE BY DR SHASHWAT JANI
 
ECTOPIC PREGNANCY - FOGSI GUIDELINES BY DR SHASHWAT JANI
ECTOPIC PREGNANCY -  FOGSI GUIDELINES BY DR SHASHWAT JANIECTOPIC PREGNANCY -  FOGSI GUIDELINES BY DR SHASHWAT JANI
ECTOPIC PREGNANCY - FOGSI GUIDELINES BY DR SHASHWAT JANI
 
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANIOVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
OVARIAN REJUVENATION - ROLE OF PLATELET RICH PLASMA THERAPY BY DR SHASHWAT JANI
 
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANIOBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
OBSTETRIC PRACTICES IN PRESENT SCENARIO BY DR SHASHWAT JANI
 
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANINONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
NONHORMONAL DRUGS FOR MALE INFERTILITY BY DR SHASHWAT JANI
 
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
F.I.G.O. GUIDELINES & MEDICAL MANAGEMENT OF A.U.B. ( FOCUS ON PROGESTERONE ) ...
 
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANI
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING  BY DR SHASHWAT JANIMEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING  BY DR SHASHWAT JANI
MEDICAL MANAGEMENT OF ABNORMAL UTERINE BLEEDING BY DR SHASHWAT JANI
 
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANIMANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
MANAGEMENT OF PREECLAMPSIA BY DR SHASHWAT JANI
 
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANIMANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
MANAGEMENT OF GESTATIONAL DIABETES MELLITUS BY DR SHASHWAT JANI
 
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANIMANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
MANAGEMENT OF COMPLICATIONS OF HYSTEROSCOPY BY DR SHASHWAT JANI
 
GENITAL TB - HOW TO DIAGNOSE & WHEN TO TREAT BY DR SHASHWAT JANI
GENITAL TB - HOW TO DIAGNOSE  & WHEN TO TREAT  BY DR SHASHWAT JANIGENITAL TB - HOW TO DIAGNOSE  & WHEN TO TREAT  BY DR SHASHWAT JANI
GENITAL TB - HOW TO DIAGNOSE & WHEN TO TREAT BY DR SHASHWAT JANI
 
EXAMINATION OF MALE IN INFERTILITY - WHAT NOT TO MISS BY DR SHASHWAT JANI
EXAMINATION OF MALE IN INFERTILITY  - WHAT NOT TO MISS BY DR SHASHWAT JANIEXAMINATION OF MALE IN INFERTILITY  - WHAT NOT TO MISS BY DR SHASHWAT JANI
EXAMINATION OF MALE IN INFERTILITY - WHAT NOT TO MISS BY DR SHASHWAT JANI
 

Último

SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.whalesdesign
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
World-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxWorld-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxsumanchaulagain3
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...Ganesan Yogananthem
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
Microbiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxMicrobiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxkitati1
 
Pregnacny, Parturition, and Lactation.pdf
Pregnacny, Parturition, and Lactation.pdfPregnacny, Parturition, and Lactation.pdf
Pregnacny, Parturition, and Lactation.pdfMedicoseAcademics
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
Physiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisPhysiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisNilofarRasheed1
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptPradnya Wadekar
 

Último (20)

SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.MedMatch: Your Health, Our Mission. Pitch deck.
MedMatch: Your Health, Our Mission. Pitch deck.
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
World-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxWorld-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptx
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
Microbiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxMicrobiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptx
 
Pregnacny, Parturition, and Lactation.pdf
Pregnacny, Parturition, and Lactation.pdfPregnacny, Parturition, and Lactation.pdf
Pregnacny, Parturition, and Lactation.pdf
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
Physiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisPhysiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid Arthritis
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
ayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologypptayurvedic formulations herbal drug technologyppt
ayurvedic formulations herbal drug technologyppt
 

FEMALE PELVIC APPLIED ANATOMY BY DR SHASHWAT JANI

  • 1. Female Pelvic Applied Anatomy Dr. SHASHWAT JANI M.S. ( GYNEC ) DIPLOMA IN ADVANCED ENDOSCOPY. Assistant Professor Smt. N.H.L. MUNICIPAL MEDICAL COLLEGE , AHMEDABAD. Mob : +91 99099 44160. E-mail : drshashwatjani@gmail.com
  • 2. Basic Facts of Anatomy do not Change But our understanding does… Exploration of specific anatomic relationships and the development of new clinical and surgical correlation continue to evolve….
  • 3. Comprehensive understanding of Anatomy is essential for ..  Avoiding visceral injuries : About 75 % iatrogenic injuries to ureter result from Gynecological surgeries….   Understanding of interrelation ship of Bony pelvis, ligaments , muscles, fasciae , nerves , blood vessels and pelvic viscera for safe and effective management of Pelvic floor Disorders.  Understanding and managing the normal and abnormal Obstetric conditions.
  • 4. Topics Covered..  Bony Pelvis  Organ anatomy  Spaces  Vascular anatomy  Neuroanatomy
  • 5. Nomenclature used here reflects current slandered nomenclature according to the Nomina Anatomica*. *International Anatomical Nomenclature Committee: Edinburg, Scotland. (founded in 1989)
  • 6. Female Pelvis : Evolvement •Forms a bony ring through with body weight is transmitted to lower extremities. •Adopts to child bearing.
  • 7. Pelvic Structure Sacrum Coccyx Paired Hip Bones ( Os Coxae, innominate )
  • 8. Sacrum and Coccyx Extension of Vertebral Column: Fused 5 sacral and 4 coccygeal vertebrae
  • 9. Os Coxae ( Hip Bones )
  • 10. Pelvic Bone Articulation Sacro-illiac Joint : Synchondroses Symphysis pubis Cartilaginous symphyseal joint
  • 11. Important Landmarks  Symphysis Pubis and Pubic Tubercle: Pelvimetry, Symphysotomy etc…  Sacral Promontory: Landmark in Laparoscopy, Bifurcation of Major Vessels, Prolapse repair  Sacral hiatus  Iliac Crest  Anterior Superior iliac Spine: Surgical Landmark  Ischial Spine: Pudendal Block , Clinical Pelvimetry  Ischial Tuberosity
  • 14. Pelvic Inlet False Pelvis True Pelvis Linea Terminalis
  • 15. Boundaries of False Pelvis  Posterior : Lumber Vertebrae  Anterior: Lower portion of Anterior abdominal wall  Laterally: iliac Fossa
  • 16. Boundaries of True Pelvis  Upper: Pelvic Inlet  Lower : Pelvic Outlet SSPP AASS LLTT PPuubbiicc BBoonnee •Obliquely Truncated •Bent Cylinder •Greatest Height Posteriorly
  • 20. Four Ligaments  Inguinal Ligament • Important for repair of Inguial Hernia  Cooper’s Ligament • Frequently used in Bladder suspension procedures.  Sacrospinous Ligament • For Vaginal Suspension  Sacrotubourous Ligament
  • 22. Bladder Suspension Procedure on cooper’s Ligament
  • 37. Vascular anatomy The common iliac bifurcation is at the level of sacral promontory.
  • 40. Ext Iliac Artery 2 branches : Inf Epigastric Deep Circumflex iliac A.
  • 42.  The external iliac artery lies lateral to external iliac vein.  The inferior epigastric artery is the only branch of external iliac artery.  The inferior epigastric vein drains into the external iliac vein.
  • 43. Vasclar Anatomy : Internal Iliac The internal iliac ( Hypogastric )artery divides into anterior and posterior divisions.
  • 44. Internal iliac (Hypogastric) artery  10 branches
  • 46. Uterine Artery The uterine artery is the first branch of anterior division of internal iliac artery. It originates about 6”(six inches) distal to the bifurcation of common iliac artery
  • 47. Internal Iliac & Uterine A.  Thus, there is sufficient length of internal artery available for ligation. After giving out uterine artery, the internal iliac artery continues further as obliterated hypogastric artery.  The uterine artery traverses through the Para rectal space and crosses above the ureter from lateral to medial side to enter the uterus.
  • 50. Uterine Artery & Vein  The Uterine vein, contrary to popular belief, comes from below the ureter to join the internal iliac vein.  Thus, the ureter lies in the fork with the uterine artery above and the uterine vein below.
  • 51. SPACES There are four important spaces:  Retro pubic space  Para vesical space  Pouch of Douglas  Para rectal space
  • 52. Para rectal space The Para rectal space lies…  lateral to the ureter  medial to the internal iliac vessels. It continues downwards upto the levator ani muscle. The only structures crossing this space are  Uterine artery  Uterine vein.
  • 53. Pararectal space ureter Internal Iliac A. Obliterate umbilical A. Uterine A Exterrnal Iliac vs.
  • 54. Paravesical space The paravesical space lies medial to the obliterated hypogastric artery and is bounded caudally by the pubic bone. The retro pubic space can be entered through this space.
  • 56. Retro pubic space The retro pubic space is bounded by the obliterated hypogastric artery on either side, the pubic symphysis anteriorly and the urinary bladder posteriorly.
  • 57. Pouch of Douglas The pouch of Douglas is bounded by cardinal and uterosacral ligaments on either side, the uterus anteriorly and rectum posteriorly.
  • 58.  The veins run in the uterosacral and cardinal ligaments. Likewise, the lymphatics also run in these ligaments along the veins. Hence, the ligaments are cut as laterally as possible in cancer surgery.  The small veins run in the paracolpos.
  • 59.  The circumflex iliac vein, which drains into external iliac vein from medially, is very liable to get damaged during nodal dissection.  The obturator artery and vein run parallel to the obturator nerve.  The obturator nerve originates at the bifurcation of common iliac vessels and then runs caudally between the external and internal iliac vessels.
  • 60. Lymphatic Drainage TThhee llyymmpphhaattiiccss ffrroomm tthhee uutteerruuss ttrraavveell aalloonngg tthhee iinnffuunnddiibbuullooppeellvviicc lliiggaammeenntt aanndd ddrraaiinn iinnttoo tthhee ppaarraa--aaoorrttiicc ggrroouupp ooff nnooddeess..
  • 61. Lymphatics  Lymphatics from cervix and upper vagina go along the paracolpos and cardinal ligament and drain into the ileo-obturator nodes. The obturator node is the first echelon of spread from the cervical cancers.  Lymphatics from the ovaries go along the infundibulo-pelvic ligaments and drain into the Para-aortic group of nodes.
  • 64. T H A N K Y O U . . . ! ! !