Asynclitism during labor can be assessed by palpating
A. Sagittal suture
B. Coronal sutures
C. Lambdoid sutures
D. Frontal suture
Ans. A. Sagittal suture
Digital palpation of sagittal suture during internal examination in
labor gives an idea of the manner of engagement of the head (asynclitism or synclitism), degree of internal rotation of the head and degree of molding of the head.
Which of the following represents a quadrangular area
Ans. C. Vertex
Vertex is a quadrangular area bounded anteriorly by the bregma and coronal sutures behind by the lambda and lambdoid sutures and laterally by lines passing through the parietal eminences. The shape of anterior fontanel or bregma is like a diamond, whereas posterior fontanel or lambda is triangular in shape.
Largest of the following
Ans. D. Occipitofrontal
Occipitofrontal diameter extends from the occipital eminence to the root of the nose (Glabella), it measures 11.5 cm (4 1⁄2″) with Marked deflexion of head in Vertex presentation.
Suboccipito-frontal – 10 cm (4″)
Suboccipitobregmatic- 9.5 cm (3 3⁄4″)
Submentobregmatic – 9.5 cm (3 3⁄4″)
Occipitofrontal- 11.5 cm (4 1⁄2″)
Mento-vertical – 14 cm (5 1⁄2″)
Not true of normal delivery process
A. Caput succedaneum is not limited by the suture line
B. In well flexed head suboccipitobregmatic diameter is compressed
C. Caput can occur before rupture of the membranes
D. High inclination pelvis favors occipitoposterior position
Ans. C. Caput can occur before rupture of the membranes
Risk factors for caput succedaneum included a protracted active labor course, operative vaginal delivery, oligohydramnios, primigravida pregnancy, Braxton-Hicks contractions, and premature rupture of membranes.
All are features of pelvis except
A. The narrowest plane in the pelvis is obstetric outlet which is anteroposteriorly oval
B. Upper limitations of the cavity of pelvis marks the junction of second and third sacral vertebrae posteriorly
C. Symphysis pubis is a fibrocartilaginous joint where the articular surfaces are covered with fibrous cartilage with a synovial cavity
D. Anatomical Outlet is a diamond shaped cavity
Ans. C. Symphysis pubis is a fibrocartilaginous joint where the articular surfaces are covered with fibrous cartilage.
Symphysis pubis is a secondary fibrocartilaginous joint. It has got no capsule and
no synovial cavity. The articular surfaces are covered with hyaline cartilage. Due to softening of the ligaments during pregnancy, there is considerable amount of gliding movement.
Not true of angle of inclination of inlet is
A. High inclination tends to delay engagement
B. Sacralization of the fifth lumbar vertebra causes high inclination
C. High inclination favors occipitoposterior position
D. Flat sacrum interferes with internal rotation in low inclination pelvis
Ans. D. Flat sacrum interferes with internal rotation in low inclination pelvis
Long pelvis and flat sacrum interfere with internal rotation in high inclination pelvis.
The angle of inclination may be lessened in case of lumbarization of first piece of sacral
vertebra and is called low inclination. It has got no obstetric significance. It actually facilitates early engagement.