Pain is complained of in the hip, or is referred to the medial side of the knee, in the distribution of the obturator nerve.
In adolescents and adults, if the cleft is wide and the soft tissues of the palate are thin and atrophied, better physiological results may be obtained by the use of an artificial obturator or velum.
The head of the femur passes beneath the obturator internus, and this tendon, catching on its neck, checks its upward movement (Fig.
The capsule gives way at its medial and lower part, and the head of the femur comes to rest on the surface of the external obturator muscle, its articular surface looking forward, while the trochanter looks backward.
The head, thus brought to bear upon the lower and back part of the capsule, tears it and leaves the socket, passing upwards and coming to rest on the dorsum of the ilium, above and anterior to the tendon of the obturator internus (Fig.
Note relation of neck of femur to tendons of obturator internus and gemelli (diagrammatic).
Dislocation on to the pubes# is a further degree of the obturator form (Fig.
For the reduction of the forward varieties (obturator and pubic), the thigh is first fully flexed on the pelvis, but in the abducted position.
In some cases there is pain along the course of the obturator nerve.
In rare cases it passes through the sacro-sciatic foramen and forms a swelling in the buttock (sub-gluteal abscess); or it may pass through the obturator foramen and reach the adductor region of the thigh or even the perineum.
Note relation of neck of femur to tendons of obturator and gemelli, "Dislocation below the tendon" (diagrammatic).
The space between them is known as the obturator foramen.
There is a small obturator foramen between the ischium and pubis, which gives passage to the obturator nerve.
The pubis and ischium of each side unite with each other ventrally, so as completely to enclose the obturator foramen.
Many curious forms of obturator or artificial palate are employed to remedy congenital defects.
This opening communicated with the nasal fossa by a fracture of the palatine and maxillary bones; the employment of an obturator was necessary.
There is one case recorded, according to Debierre, in which the uterus was one of the constituents of an obturator hernia.
I also never saw a case of localised obturator paralysis.
Moller,[37] quoting Nocard, describes a case where fracture occurred through the region of the foramen ovale and paralysis of the obturator nerve followed.
Paralysis of the obturator nerve or nerves is met with rather frequently, notwithstanding, in mares, following dystocia.
In some cases of dystocia the obturator nerve, (or nerves, if the involvement is bilateral), becomes injured by being caught between the maternal pelvis and some dense part of the fetus.
When paralysis of the obturator nerve occurs as a post-partum complication, and other conditions are favorable, the subject should be raised to its feet without unnecessary delay.
The nerves (one or both) may become bruised at the brim of the obturator foramen by being caught between the pelvis and the body of the fetus in some cases of protracted labor.
This distribution of the artery, however, is rare, and can occur only when the epigastric and obturator arise by a long common trunk, and even then it may not encircle the neck of a hernia, as I have witnessed.
It is but rarely that the bowels protrude through the sacro-ischiatic notch, or through the obturator foramen, or by the side of the vagina, or betwixt the bladder and rectum.
This is a condition not infrequently observed when the callus has been formed on the floor of the pelvis near the obturator foramen, pressing upon the course or involving the obturator nerve.
This condition is owing to the interference of the callus with the functions of the obturator nerve, which it presses upon or surrounds.
It is generally admitted that the obturator artery, when derived from the epigastric, passes down much more frequently between the iliac vein and outer border of the ring.
Positions of the obturator artery when given off from the epigastric.
The researches of anatomists (Monro and others) in reference to this point have given rise to the question, "What determines the position of the obturator artery with respect to the femoral ring?
These peculiarities in the origin and course of the obturator artery, especially that of passing on the pubic side of the ring, behind Gimbernat's ligament and the conjoined tendon, E H, are fortunately very rare.
Numerical tables have also been drawn up to show the relative frequency in which the obturator descends on the outer and inner borders of the crural ring and neck of the sac.
If, on the other hand, the obturator artery descend external to the neck of the sac, the vessel will be comparatively remote from danger while the ligament is being divided.
Varieties of the obturator and epigastric arteries.
The Obturator Externus ariseth from the outward Circumference of the same Hole of one Ischion, and is terminated in the side of the other near the great Trochanter.
The Obturator Internus springs from the inner Circumference of the Oval Hole of the Ischion and its Tendons passing between the two Gemelli are inserted in a small Cavity at the Root of the great Trochanter or Rotator.
The obturator ridge is a short, blunt, longitudinal ridge forming the posterior edge of the trochanter.
The evidence is conclusive, it seems to me, that the obturator internus of Hudson is not homologous with the mammalian obturator internus.
Their obturator externus lies anterior and deep to the extrapelvic part of the obturator internus and inserts separately from the latter.
It appears to me that the dorsal part and a part of the ventral part of the obturator externus of Berger correspond to the extrapelvic fleshy part of the obturatorinternus of Hudson, et al.
Romer (1927), studying the development of the thigh musculature in chick embryos, concluded that the entire obturatorcomplex is homologous with the mammalian obturator externus plus quadratus femoris.
I shall follow Howell (1938) in naming the entire obturator complex M.
Several small branches (variable in number and arrangement) pass through the obturator foramen and supply pars ventralis, pars dorsalis, and pars antica of M.
He states that the former is homologous with the mammalianobturator internus and the latter with the obturator externus.
It has been customary to divide the obturator complex into two parts--an obturator internus and an obturator externus; the latter has often been further subdivided.
Deeply situated immediately posterior to head of femur; part extending through obturator foramen and lying inside pelvis; extrapelvic part deep to Mm.
By changing the obturator daily the patient can readily tell whether a washing out is required.
In order to extirpate the lymph glands, the peritoneum is divided upwards and the iliac vessels laid bare, and every enlarged gland from the division of the aorta to the obturator foramen is removed and the oozing vessels carefully secured.
The vulcanite obturator is better for establishing the canal; if removed too soon it may be difficult to replace it, and manipulation may set up severe neuralgia.
If several teeth be missing it is more comfortable to have the obturator and denture separate--the latter being made with a setting to receive the flange.
An india-rubber obturatoris in the maxillary antrum.
In cases where a cure has been obtained, the obturator is first discontinued during the night and is then exchanged for one of smaller size.
In patients who are too old or feeble to endure more radical measures, or who decline them, the obturator may be left in indefinitely.
The obturator foramen is remarkably small or even absent.
In the Pinnipedia the pelvic symphysis is little developed, or sometimes not developed at all, and the obturator foramina are remarkably large.
The acetabulum is deep and the obturator foramen large, and there is frequently a well-marked ischial tuberosity.
In some Labyrinthodonts the pubes as well as the ischia meet in a ventral symphysis, and in many there are no obturator foramina.
In some Theromorpha all the bones of the pelvis are completely fused, forming an os innominatum as in mammals; the pubes and ischia are so completely fused that sometimes as in Pariasaurus even the obturator foramina are closed.
A narrow band of cartilage connects the symphysis pubis with the symphysis ischii, and separates the two =obturator foramina= from one another.
In some Lacertilia and Chelonia there is a cartilaginous bar dividing the foramen cordiforme into two obturator foramina; in many Chelonia this bar is ossified.
For the greater part of their length the two bones are separated by the long narrow =obturator foramen=.
In the Sloths the pelvis is rather weak and slender, the obturator foramina are very large and the ischia do not meet in a symphysis.
The origin is from the anterior and ventral edges of the obturator foramen and the insertion is on the trochanter of the femur immediately distal and posterior to the insertion of the m.
The pars anticus has a semitendinous origin on a line that extends posteriorly from the posteroventral edge of the obturator foramen to a point half way across the membrane that covers the ischiopubic fenestra.
The larger ventral part arises directly from the anterior and ventral edges of the obturator foramen.
Anteriorly the fibers converge and form a strong tendon that passes through the obturator foramen and inserts on the posterolateral surface of the trochanter of the femur.
The dorsal part arises directly from the ischium along the dorsal edge of the obturator foramen.
Inwards then it must be; and little more need be said about it, were it not for the occasional existence of an abnormal course and distribution of the obturator artery.
Rough diagram of abnormal course of obturator and its relation to the neck of a hernia.
Obturator and internal circumflex with anastomotica and superior internal articular.
It is not likely that a diagnosis could be made, except in very emaciated patients, in whom pain at the obturator foramen was a prominent symptom, and in whom it could be ascertained positively that the crural ring was empty.
It is liable to be mistaken, according to its situation, for a tumour, a cyst, a pouched vein, or a femoral or obturator hernia.
The above list will hopefully give you a few useful examples demonstrating the appropriate usage of "obturator" in a variety of sentences. We hope that you will now be able to make sentences using this word.
