General survey pregnant

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When curvature of the spine in hand (scoliosis) distance from the curved section of the spine to plumb measure with a ruler (by Sh. I. the Mikeladze).
When viewed from the rear surface of the trunk celebrate vastanie the spinous processes of the vertebrae. The line corresponding to the spinous processes, represented in the form of the furrow, walking along the middle line along the back. In sacral area this groove enters the cavity, which gradually expands and takes the form of a rhombus Michaelis (Fig. 10).


Fig. 10. Diamond Michaelis.
The dashed line is a line that connects its obtuse angles, cross - upper corner of a rhombus (the point where you put the button of a compass in the measurement of outer compared).

Diamond Michaelis from above and outside limited ledges mm. erectores trunci (seu longissimi dorsi). Both sides obtuse angle correspond to the rear upper awn Ilium (spinae posterior superior ossium ilei).
Nizhnedarya boundaries correspond to the lower edges of the sacrum bone, and the lower the acute angle - the top of it.
Nizhnedarya side of the diamond is limited tabs gluteal muscles. On the surface of the diamond can be felt spinous processes V lumbar and I sacral vertebrae. Between these projections include a link that when measuring external direct size of the pelvis put one leg of a compass. However, spinous processes are not always clearly defined even with the sharp bending of the body to the front. In this case, spend a horizontal line at the level zadavina awn iliac bone, then approximately 3-4 cm (approximately corresponding to the width of two cross fingers) above this line probes spinous processes of the last lumbar and I sacral vertebrae and in the recess between them, i.e. in the upper corner of a rhombus of Michaelis, put the leg of a compass (Fig. 14).


Fig. 11. The diamond shape Michaelis in norm and in pathology.
and - in the normal pelvis; b - flat when the pelvis; in - cassurina the pelvis.

The definition of the diamond Michaelis is of great practical importance in the evaluation forms of the pelvis (Fig. 11). The change of the diamond in the vertical and horizontal size gives representation about a specific form of the pelvis. Ideal for basin is considered to be diamond shaped approaching the square.
Horizontally held between zadziorne awns line divides the diamond on two triangles composed their bases. The wider the sacrum, the more diameter of a diamond; usually it equals 11 see
The vertical axis of the diamond (the distance from necrectomy holes before buttock crease) in norm equal to 11 cm; it becomes shorter if the sacrum is omitted, which is observed in flat rachitic the pelvis.
Under normal pelvis both triangle comprising the diamond Michaelis, almost identical, with narrow pelvis noticeable difference in their sizes. Moreover, the sharper changed against the normal pelvis, the more reduced the top triangle.
When flat rachitic the basin of the upper point of the diamond often coincides with the bottom of the top triangle. Along with the reduction of the vertical dimension, can be a rapprochement side points of the diamond in the direction of the line of the spinous processes (robertowi the pelvis). When colouring the basins side point of the diamond accordingly shift - one is above, the other below.
After defining the diamond Michaelis put his hands to the scallops Ilium, determine hotelgaste, their arrangement and shape of scallops. Then I touch my trochanters, paying attention to their situation and the level - are they at one level or at different; significant extension trochanters peculiar rachitic the basins.