By Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP, PhD (auth.)
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Extra resources for Basic Sciences for Obstetrics and Gynaecology
They communicate with the sacral canal through the intervertebral foramina and transmit the dorsal and ventral rami of the first four sacral spinal nerves. Sacral Canal. The sacral canal is formed by the vertebral foramina of the sacral vertebrae; the lower opening is the sacral hiatus. As the spinal cord ends at the first lumbar vertebra, the sacral canal only contains'nerveroots (cauda equina) 54 Anatomy and the filum terminale. The subarachnoid space extends to the lower border of the second sacral vertebra and below this the dura mater and arachnoid form a closely applied covering of the filum terminale as it descends to its attachment on the first coccygeal segment.
The other major oestrogens (oestrone, oestradiol) are also secreted by the placenta but have a major contribution from maternal precursors. The minor compound oestetrol is dependent exclusively on fetal precursors. Maternal levels of oestriol (blood and urine) rise progressively throughout pregnancy; the increase continues till term, when oestrogen levels are more than 100 times those in the non-pregnant state. Progesterone Progesterone is directly synthesised by the trophoblast. The major excretion product in the mother is pregnanediol.
The levator muscles have sphincteric action for the vagina. The nerve supply is from the third and fourth sacral nerves. The most medial portion of the levator ani is referred to as the pubococcygeus and is inserted in front of the rectum. coccygeus Fig. 3. The levator ani muscles viewed from below. The Perineum 45 rectalis, which inserts into the rectum and the first part of the raphe behind the rectum. The most posterior portion is the ilio-coccygeus, which inserts into the ano-coccygeal raphe and the coccyx.
Basic Sciences for Obstetrics and Gynaecology by Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP, PhD (auth.)