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Levator ani "defects"
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(a)
(b)
(c)
(d)
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May 2010
For the next
course we will be "on tour" at St Georges Medical School,
London on 16th and 17th September, 2010.
The "old" St Georges was, of course, the place where Henry
Gray and Robert Lee did their great work in the nineteenth
century. Again, the course is directed at consultant colleagues
though we will keep six of the 24 places for senior trainees. Full
details are available on www.bristolanatomycourse.blogspot.com.
Apply to anatomycourse@btinternet.com
to secure your place. Places are reserved strictly on a
"first come, first served" basis. Course fee remains at
£495.
February 2010
The peer
reviewed account of "Autonomic denervation and the origins of
chronic Western diseases" is now published. It provides
reasons for DP Burkitt's observations in the 1960-70's with respect to
the epidemiology of Western diseases, and, differences in transit time
and daily stool weights between Africans and Europeans. This abbreviated
form of the paper offers a mechanism for these
observations through injuries to branches of the three great plexi of
the ANS; the cardiac (thorax), coeliac (abdomen) and hypogastric
(pelvis). See right panel for reminders of their anatomy on www.bartleby.com
November 2009
To
receive further information about courses in 2010 contact the
course organiser at anatomycourse@btinternet.com
The anatomy of
the lower genital tract and its disruption by vaginal delivery are
important topics on the course. Injuries result in anatomical "deficits"
or "defects" (in the USA). At present we know about
vaginal defects that give rise to prolapse and incontinence. It is
clear there are also levator, uterosacral, neurological and vascular
"defects" that contribute to many gynaecological
symptoms. In the left panel there are examples of levator defects (x4) - see below for physical
findings. See July
newsletter for illustrations of the range of uterosacral
and levator defects
October 2009
At different
places on the website you will find new, peer reviewed explanations of endometriosis,
fibroids and adenomyosis, Type
1 diabetes mellitus, and chronic
Western diseases.
The gynaecological matters relating to the causes of adenomyosis,
endometriosis, are published as peer reviewed items in AJOG and the red
journal. A clear understanding of the mechanisms of symptoms in
endometriosis may reassure you considerably in terms of its day-to-day
management.
LEVATOR
"DEFECTS" in the left column of the browser are all taken at
the level of the proximal urethra. They demonstrate:
(a) Normal levator ani
(b) Avulsion of pubic origin of R levator
defect (LAd 1)
(c) Avulsion of obturator origins of both levator ani (LAd 2)
(d) Denervation of levator ani with LAd 1 and LAd 2 (LAd 3)
See "Levator injuries in chronic pelvic pain" J Obstet
Gynaecol, 2008 for full descriptions.
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Anatomy of autonomic
nerves
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The three "great" autonomic ganglia
are the cardiac, coeliac and hypogastric plexi.
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Autonomic ganglia and nerves "suspend"
the viscera.
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