Exercising in Gynecology and Obstetrics

Female reproductive system includes the internal organs - the ovaries, fallopian tubes, uterus, vagina and external genitalia - vulva, small and large labia, clitoris, vagina (Fig. 148).

Female genitalia are associated with all body systems and are on them in their mutual dependence. Infectious diseases, diseases of the cardiovascular, nervous, digestive, endocrine and other systems are reflected in the most important functions of the female genitalia, and the latter in turn affects the state of the organism as a whole.

Gynecological diseases, there are areas of increased skin sensitivity, so-called zone Zakharyin-Ged, which spread from the breast to the X IV sacral plexus (Fig. 149).

Reflected the emergence of pain in certain areas of the skin in gynecological diseases is explained as follows. Pain impulses arriving at a certain segment of the posterior horns of the spinal cord, form the focus of increased excitability and spread to parts of the perception of pain sensitivity of certain segments of the skin.

Fig. 148.   Medisection female pelvis: 1 - prominence, promontory, 2 -

round ligament of the uterus, 3 - ovary, 4 - ligament of the ovary, 5 - bladder, 6 - pubic-vesical ligament, 7 - urethra, 8 - clitoris, 9 - small genital tube; 10 - oviduct; 11 - ureter; 12 - queen 13 - the opening of the uterus, 14 - posterior lip of the cervix; 15 - transverse fold of rectum, 16 - posterior part of vaginal fornix, 17 - lateral vaginal fornix; 18 - rectovaginal septum; 19 - big (Bartholin) glands vestibule of the urogenital diaphragm

Fig. 247. Areas of increased skin sensitivity in gynecologic diseases: a - in front, b - back

Therefore, in the central nervous system pain impulses are sent not only to neurons, which correspond to the genitals, but also along the nerves, corresponding to a specified segment (see fig.). Pain emanating from the genitals, can reflexively influence the function of the bladder, intestines, liver, kidney, adrenal gland, pituitary gland, cardiovascular system, etc. Prolonged pain accompanied by disorders of blood circulation, trophic and genital secretions.

Inflammatory diseases of the genital organs detected in 60-65% of patients seeking antenatal care. The emergence and development of the inflammatory process depends on the reactive properties of woman, her age, overall health, place of origin of the process, anatomical and physiological features of the affected parts of the reproductive system and the conditions in which inflammation occurs. In the development of the inflammatory process there are three stages: acute, under acute and chronic.

In addition to inflammatory processes lead to abnormalities in menstrual function, one of the most important indicators of women's health. Improper diet, stress, infections and other diseases in violation of general condition and vital functions of the body, often accompanied by disorders of the menstrual cycle.

Menstrual function can vary with a number of endocrine disorders, metabolic disorders. Obesity is associated with an incorrect way of life and excessive diets, and often leads to a decrease in ovarian function. Disruption of the menstrual cycle also occurs when infantilism, congenital hypoplasia or severe genital delay their formation.

Pathological processes in the body of a woman, especially gynecological diseases, often violate the normal position of internal organs. The most frequent displacement of the uterus and vagina.

Uterus, ovaries and fallopian tubes have physiological mobility within certain limits. Restriction of mobility or complete immobility - is pathological. The same - and excessive mobility of the uterus caused by a decrease in its tone and changes in the ligamentous apparatus.

Obstetrics studying specific physiological and pathological processes occurring in women during preconception, pregnancy, childbirth and the postpartum period.

Physiological processes in a woman's cyclical. Changes in puberty outwardly manifested in the premenstrual and menstrual days, even in healthy women a violation of thermoregulation (low-grade temperature), breast enlargement (increase in the parenchyma and engorgement), thyroid enlargement, changes in muscle strength, depth of respiration, blood pressure, mood and etc.  Physiological processes are often transformed into pathological. Timely delivery of therapeutic and preventive measures can eliminate the complications arising and to normalize the functional status of women and during pregnancy and childbirth.

With age, hormonal changes, puberty goes into menopause. Transition between these states - menopause - lasts from several months to several years. Its occurrence depends on the woman's mental state, conditions of labor, social factors, previous diseases, nutrition, physical activity, etc.

In the complex of rehabilitation measures include physiotherapy and gidroprotsedury, exercise therapy, massage, spa treatment, etc. (Scheme XVII).