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The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.
The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal. The levator ani is usually considered in three parts: pubococcygeus, puborectalis, and iliococcygeus. The pubococcygeus, the main part of the levator, runs backward from the body of the pubis toward the coccyx and may be damaged during parturition. Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling . Some regard them as a part of the sphincter ani externus. The iliococcygeus, the most posterior part of the levator ani, is often poorly developed.
The coccygeus, situated behind the levator ani and frequently tendinous as much as muscular, extends from the ischial spine to the lateral margin of the sacrum and coccyx.
The pelvic cavity of the true pelvis has the pelvic floor as its inferior border (and the pelvic brim as its superior border.) The perineum has the pelvic floor as its superior border.
Some sources do not consider “pelvic floor” and “pelvic diaphragm” to be identical, with the “diaphragm” consisting of only the levator ani and coccygeus, while the “floor” also includes the perineal membrane and deep perineal pouch. However, other sources include the fascia as part of the diaphragm. In practice, the two terms are often used interchangeably.
Inferiorly, the pelvic floor extends into the anal triangle.
When both mucosa and stroma are parts of the suspect lesion, a deep biopsy is needed. The Cervicore is designed to harvest samples from the cervix and vagina with minimal collateral injury to the surrounding tissues. The procedure is easy with minimal discomfort to the patient.
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A new well designed randomized study has suggested that long term baby aspirin usage may aid in fight against cancer. The suggested mechanism is that cancers induce inflammatory responses so the anti-inflammatory mechanism of prostaglandins inhibitors may cease the progress of many cancers. There are some concerns about the study because despite the well-designed randomized study; the study didn't include a satisfying number of female participants. The study was also conducted on esophageal, colorectal and lung cancers.
Identify the anatomy and explain the physiology of the scrotum on diagrams and sonograms.
Describe and demonstrate the protocol for sonographic scanning of the scrotum.
Identify and describe sonographic images of congenital abnormalities of the scrotum.
Identify and describe sonographic images of pathologies of the scrotum.
Identify and describe sonographic images of extratesticular disease processes.
Identify the anatomy and explain the physiology of the prostate on diagrams and sonograms.
Describe and demonstrate the protocol for transabdominal and endorectal sonographic scanning of the prostate.
Identify and describe sonographic images of benign and malignant pathologies of the prostate, including benign hyperplasia, prostatitis, carcinoma, and calculi.
Explain the technique for prostate biopsy.
Define the criteria for an ultrasound appearance of prostate tumor staging.
Explain the technique for radiation seed implantation.
Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).
Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in orthopaedics and other types of medical and veterinary surgery. They come in different sizes and are used to hold bone fragments together (pin fixation) or to provide an anchor for skeletal traction. The pins are often driven into the bone through the skin (percutaneous pin fixation) using a power or hand drill. They also form part of the Ilizarov apparatus.