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Fetal Skull
Fetal Skull
Fetal Skull
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Fetal skull to some extent compressible, and
made mainly of thin pliable tabular (flat)
bones forming the vault this is anchored to
the rigid and incompressible bones at the
base of the skull.
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BASE
FACE
VAULT
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F
A
C
E
BASE
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VAULT BASE FACE
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Bones
Sutures
Fontanels
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8
NAME OF THE BONE OSSIFICATION CENTRE
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Frontal Boss
Parietal Eminence
Occipital protuberance
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SUTURES
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CLINICAL IMPORTANCE OF SUTURE
These suture permit gliding movement of one bone over other during
moulding of the head in the vertex presentation , as a result the
diameter of the head get smaller so passage of head through the birth
canal become easier.
From the digital palpation of the sagittal suture during labour, degree
of internal rotation and degree of moulding of the head can be noticed.
Clinical importance:-
1. Degree of flexion can be assessed from its position. If on vaginal examination
it is felt easily, it indicates the head is not well flexed.
2. It helps in the moulding of head.
3. From its position, internal rotation of the head can be assessed.
4. ICP can be roughly assessed from its condition after birth. Depression in
dehydration and bulging in raised ICP.
5. CSF can be collected from its lateral angles from the lateral ventricles.
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Posterior fontanelle or lambda:-
It is the triangular depressed area at the junction of the three suture.
The suture are:-
Anteriorly:-sagittal suture
Posteriorly:- lambdoid sutures
It gets closed at 6 Weeks ossifies
It is otherwise known as Lambda
Clinical importance:-
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Glabella :- Centre point of Orbital ridges.
Sub occiput:- it is the junction fetal neck and Occiput
below to Occipital protuberance.
Sub mentum:- it is the junction between neck and chin.
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The engaging diameter of the fetal skull Diameter of skull
depends on the degree of the flexion of the
presenting part.
Clinical importance:-
Smallest diameter.
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Diameter of skull
2.Suboccipito frontal:-
of nose.
Length:-10cm
Presentation:-Vertex. 21
3.Occipito-frontal:-
Diameter of skull
Length:-11.5cm
Attitude:-Marked deflexion
Presentation:-vertex
Clinical importance:-
to prolonged labour. 22
4.Mento-vertical:-
Diameter of skull
Length:-14cm
Presentation:- Brow
Clinical importance:-
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5.Sub-mento vertical:-
Diameter of skull
Length:-11.5cm
Presentation:-Face
Clinical importance:-
centre of bregma.
Length:-9.5cm
S
Attitude:-Complete extension
M
Presentation:-Face B
Clinical importance:-
1. Bi parietal diameter:-
eminences.
B
Length:-9.5cm P
Attitude:-irrespective of position of
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Diameter of skull
2. Bi temporal diameter:-
S
Lines extends between two coronal MB
B
suture point or between two temporal T
bone
Length:- 8.5 cm
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FETAL SKULL CHANGES IN LABOUR
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Mechanism
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GRADING
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CAPUT SUCCEDANEUM
It is localized area of edema on
fetal scalp on vertex presentation
due to pressure effect of dilating
cervical ring and vaginal introitus.
Characteristics:-
1. It is physiological, present at
birth and disappears within 24
hours.
2. It is soft, diffuse and pits on
pressure.
3. No underlying skull bone
fracture.
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MECHANISM
Stagnation of fluid
Characteristics:-
Appears after 12 hours of birth.
Limited by suture lines.
Tends to grow larger.
Disappears within 6-8 weeks.
It is circumscribed, soft and non pitting.
May be associated with skull bone fracture.
1. Present at birth on normal vaginal 1. Appears within a few days after birth
delivery. on normal or forceps delivery.
2. May lie on sutures, not well defined. 2. Well defined by suture, gradually
developing hard edge.
5. Size largest at birth , gradually 5. Become largest after birth and then
subsides within a day. disappears within 6-8 weeks to few
months.