Levator pain and trigger points may be identified during the pelvic exam by pressing laterally on the levator complex in each quadrant of the vagina and at the ischial spines
Dissection is done until ischial spines
28) The tunnelers exited through the iliococcygeus muscle near the ischial spines
, and the deployed tape was sutured to the vaginal vault.
If you palpate the ischial spines
and continue to palpate medially and cephalad, you can usually palpate the coccygeus muscle-sacrospinous ligament complex transperitoneally because a portion of the uterosacral ligament inserts into the sacrospinous ligament.
Pua reported that the infant's head was at the ischial spines
or at the "O station.
Last, palpate the pudendal nerves at the ischial spines
2) The female gonads were considered to rest adjacent to ischial spines
above the pubic arch, which is also readily visible on plain pelvic radiographs.
Participants feel for the cervix, ischial spines
, sacral curve, and pubic arch.
Then, when the fetal head descends past the ischial spines
(+ 1 station), the mother feels the sudden strong urge to bear down.
Evaluation criteria for detecting rotation requires that both obturator foremen be symmetrical, the ischial spines
should be equally demonstrated and both iliac ala should be symmetrical.
The Gynecare Prosima Pelvic Floor Repair System (Ethicon) is the newest kit on the market, and via anterior compartment dissection to the ischial spines
, it is placed up against the arcus tendineus fascia pelvis rather than anchoring into it.
Because the basovertical diameter of the fetal head can be elongated, it is possible to palpate the leading edge of the skull below the ischial spines
and still have an unengaged fetal head.