By Carlos Rotellar
A short, transparent, useful, and funny method of acute renal insufficiency.
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Additional resources for Acute renal insufficiency made ridiculously simple
The Pubourethral Ligament (PUL) The pubourethral ligament (PUL) (figs 2-03 & 2-04) originates from the lower end of the posterior surface of the pubic symphysis and descends like a fan to insert (fig 2-03) medially (M) into the midurethra and laterally (L) into the pubococcygeus muscle and vaginal wall (Zacharin 1963, Petros 1998). The external urethral ligament (EUL) (fig 2-03 and fig 2-04) anchors the external urethral meatus to the anterior surface of the descending pubic ramus. It extends upwards to the clitoris and downwards to PUL.
Fig. 1-05 Fascial attachments and tensioning mechanism. Anteriorly, the fascia connects the vaginal membrane to the pubourethral ligaments (PUL) laterally to the Arcus Tendineus Fascia Pelvis, posteriorly to the cardinal/uterosacral ligament complex (USL) and inferiorly, to the perineal body (PB) and its tensor, the external anal sphincter (EAS). The pubocervical fascia (PCF) and rectovaginal fascia (RVF) are tensioned by the three directional muscle forces (PCM, LP and LMA arrows) to provide structural support to the vagina.
Discovery of a muscle spindle (fig 2-25, Petros PE, Kakulas B and Swash MM - unpublished data) indicates the presence of a complex, balanced, finely-tuned control system. Muscle spindles (fig 2-25) found in the anterior portion of pubococcygeus muscle suggest that a precise feedback system controls the tension in the vaginal membrane. Adequate tension of the tissues is essential if the woman is to maintain continence at rest. Fig. 2-25 Vaginal tension is controlled by muscle spindles. Muscle spindle found in the anterior portion of the pubococcygeus muscle.
Acute renal insufficiency made ridiculously simple by Carlos Rotellar