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FEMALE PELVIS
INTRODUCTION
 The pelvis is a basin like structure which connects the
spine to lower limbs.
 It is an important part of the skeletal system.
 It transmits the weight of the trunk to the legs.
 It takes the weight of the sitting body.
 It allows movements of walking and running.
 It protects the pelvic organs.
 In addition the female pelvis is adapted for
childbearing with an increased width and rounded
brim.
DEFINITION
 It is a skeletal ring formed by two innominate or hip
bones & the sacrum & the coccyx.
TYPES OF PELVIC
BONES
 There are four pelvic bones that form pelvis:
 Two Hip bones (Innominate or nameless)
 One Sacrum
 One Coccyx
1.TWO INNOMINATE
BONES
innominate bone is made up of three bones
 Ilium
 ischium
 pubic bone
ILIUM
 The ilium is the flared out part of the hip bone.
It has following parts-
 Iliac crest as upper border
 Concave border is iliac fossa
 Anterior superior iliac spine
 Anterior inferior iliac spine
 Posterior superior iliac spine
 Posterior inferior iliac spine
ISCHIUM
 The ischium is the thick lower part of the hip bone. It
has following parts-
 Acetabulum
 Ischial tuberosity
 Ischial spine: location in relation to fetal head, i.e.
above (-), below (+) or at (zero station)
 Greater sciatic Notch: extends from Sacro iliac joint to
ischial spine
 Lesser Sciatic Notch: extends from ischial spine to
ischial tuberosity
 Obturator foramen: passage of pelvic nerve fibres
PUBIC
BONE
 The two pubic bones form the anterior part of the hip bone. It
has following parts-
 Inferior rami of Pubic bone (a)
 Superior rami of pubic bone (b)
 Symphysis pubis (a+b): It is formed at the junction of two
pubic bones.
 Sub pubic angle: angle between the inferior rami of the pubic
bone.
2.SACRUM
 It is a wedge shaped bone made up of five fused bones.
It has following parts-
 Sacral promontory: it is prominent upper margin of first
sacral vertebrae, projects inwards
 Sacro iliac joint
 Wings of Sacrum or Ala of Sacrum
 Hollow of the Sacrum: concave
3.COCCY
X
 It is a vestigial tail consists of four fused vertebrae forming a
small triangular bone.
 It is articulated with the sacrum
 Coccyx moves backward during childbirth
PELVIC
JOINTS
 There are four pelvic joints:
 Two sacroiliac joints
 One pubic symphysis joint
 One sacrococcygeal joint
TWO SACROILIAC
JOINTS
 These are slightly movable joints
formed where the ilium joints,
first two sacral vertebrae on
either side.
 They connect the spine to the
pelvis & are the strongest joints
in body.
ONE PUBIC SYMPHYSIS
JOINT It is a cartilaginous joint
between two pubic
bones.
ONE SACROCOCCYGEAL
JOINT
 It is a hinge joint between
sacrum & coccyx.
PELVIC
LIGAMENTS
 The pelvic bones are held together with ligaments.
 Sacro iliac ligament- it pass in front of and behind
each sacroiliac joint.
 Pubic ligament- it connect the top of pubic bones.
 Sacro tuberous ligament- one ligament on each side ,
run from sacrum to the ischial tuberosity
 Sacro spinous ligament- one ligament on each side of
the sacrum & the ischial spine.
 Sacro coccygeal ligament-one ligament on each side
from sacrum to coccyx.
STRUCTURE OF PELVIS
FALES PELVIS
TRUE PELVIS
FALSE
PELVIS
 It is formed by the upper flared out portion of the
ilium.
 Laterally- iliac fossae, Posterior- fifth lumbar
vertebrae, Anteriorly – the abdominal wall and
inguinal ligament
 It protects the abdominal organs. It has no obstetrical
importance except that it provides certain landmarks
for external pelvimetry.
TRUE PELVIS
 The true pelvis is the bony canal through which
the fetus passes during birth.
 It has three parts-
BRIM CAVITY OUTLET
THE PELVIC BRIM OR
INLET
 It is formed by the sacrum posteriorly, the iliac
bones laterally and the pubic bones anterior.
 Shape: it is almost rounded with anterio
posterior diameter being the shortest.
 Its boundaries are the sacral promontory and
wings of the sacrum behind the iliac bones on
the sides and the pubic bones in front.
LANDMARKS OF THE
BRIM
 Sacral promontory
 Sacral ala or sacral
wing
 Sacroiliac joint
 Iliopectineal line
 Iliopubic eminence
 Pectineal line
 Pubic tubercle
 Pubic Crest
 Symphysis pubis
DIAMETERS OF THE
BRIM
 Anterio posterior
 Transverse
 Oblique
ANTERIO POSTERIOR (11CM)
 it is a line from the sacral promontory to the upper
border of symphysis pubis. This diameter is of three
types-
 Diagonal conjugate- distance between lower border of
symphysis pubis to mid point on sacral promontory it is
12 cm.
 Obstetrical conjugate- it is distance between midpoint of
sacral promontory to prominent bony projection in mid
line of symphysis pubis. it measures 10 cm
 True conjugate - it extends from the sacral promontory to
the top of the symphysis pubis. Its normal measurement is
11 cm or more.
Transverse (13cm) –
it is the distance between the two farthest points on
the pelvic brim over the Iliopectineal lines.
Oblique (12cm) –
it starts from the sacroiliac joint to the opposite
iliopubic eminence.
THE PELVIC
CAVITY
 The cavity extends from the brim above to the
outlet below.
 Shape: its shape is almost rounded. It consist of
-
 Anterior border: Symphysis pubis
 Posterior border: Sacral hollow
 Lateral border: Soft tissues
 All diameters- measure 12cms.
THE PELVIC
OUTLET
ANATOMICAL OUTLET:
 It consists of the lower border of all bones and
Sacro tuberous ligament.
 It consists of lower border of symphysis pubis,
Sacro coccygeal joint and Sacro ischial spine.
 Shape: it is antero – posteriorly oval.
OBSTETRICAL OUTLET:
 This outlet has greater practical significance, because
it includes the narrow pelvic strait through which the
fetus must pass.
 It is otherwise known as bony outlet.
 Shape: it is diamond shaped.
DIAMETERS OF OUTLET:
 Antero-posterior diameter (13cm): it Extend
from lower border of symphysis pubis to the tip
of coccyx.
 Oblique diameter (12): it extend from Rt. & Lt.
Sacro spinous ligament to Obturator
foramen
 Transverse diameter (11cm): between the
ischial spines.
TYPES OF
PELVIS
GYNAECOID ANTHROPOID ANDROID
PLATYPELLOID
1.Gynaecoid pelvis: (50%)
 It is commonly known as the
female pelvis because that
type occurs most frequently
in women.
 Most suitable for childbirth.
 Wider brim.
 Ischial spines are blunt
 Sub pubic angle is 90º
2.Anthropoid pelvis: (25%)
 It favors a posterior position of
the fetus.
 Oval in shape
 Transverse diameter is shorter
 Seen in tall women with
narrow shoulders
3.Android pelvis: (20%)
 It is commonly known as
male pelvis because it occurs
more frequently in men.
 Heart shaped brim
 Anterior posterior diameter
is shorter
 Transverse diameter is
wider
 Childbirth is difficult
4.Platypelloid (flat) pelvis:
(5%)
 This type of pelvis is rare.
 Kidney shaped brim
 Anterior posterior diameter
is smaller
 Transverse diameter is
wider
 Not conductive to vaginal
delivery
DEFORMITIES OF
PELVIS
 Contracted pelvis
 Rachitic pelvis
 Asymmetrical pelvis
 Roberts pelvis
 Nageles pelvis
 Osteomalacis / maacosteon pelvis
 Assimilation pelvis
 Others- Kyphosis, scoliosis, spondylosisthesis

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PELVIS.pptx

  • 2. INTRODUCTION  The pelvis is a basin like structure which connects the spine to lower limbs.  It is an important part of the skeletal system.  It transmits the weight of the trunk to the legs.  It takes the weight of the sitting body.  It allows movements of walking and running.  It protects the pelvic organs.  In addition the female pelvis is adapted for childbearing with an increased width and rounded brim.
  • 3. DEFINITION  It is a skeletal ring formed by two innominate or hip bones & the sacrum & the coccyx.
  • 4. TYPES OF PELVIC BONES  There are four pelvic bones that form pelvis:  Two Hip bones (Innominate or nameless)  One Sacrum  One Coccyx
  • 5.
  • 6. 1.TWO INNOMINATE BONES innominate bone is made up of three bones  Ilium  ischium  pubic bone
  • 7. ILIUM  The ilium is the flared out part of the hip bone. It has following parts-  Iliac crest as upper border  Concave border is iliac fossa  Anterior superior iliac spine  Anterior inferior iliac spine  Posterior superior iliac spine  Posterior inferior iliac spine
  • 8.
  • 9. ISCHIUM  The ischium is the thick lower part of the hip bone. It has following parts-  Acetabulum  Ischial tuberosity  Ischial spine: location in relation to fetal head, i.e. above (-), below (+) or at (zero station)  Greater sciatic Notch: extends from Sacro iliac joint to ischial spine  Lesser Sciatic Notch: extends from ischial spine to ischial tuberosity  Obturator foramen: passage of pelvic nerve fibres
  • 10. PUBIC BONE  The two pubic bones form the anterior part of the hip bone. It has following parts-  Inferior rami of Pubic bone (a)  Superior rami of pubic bone (b)  Symphysis pubis (a+b): It is formed at the junction of two pubic bones.  Sub pubic angle: angle between the inferior rami of the pubic bone.
  • 11. 2.SACRUM  It is a wedge shaped bone made up of five fused bones. It has following parts-  Sacral promontory: it is prominent upper margin of first sacral vertebrae, projects inwards  Sacro iliac joint  Wings of Sacrum or Ala of Sacrum  Hollow of the Sacrum: concave
  • 12.
  • 13. 3.COCCY X  It is a vestigial tail consists of four fused vertebrae forming a small triangular bone.  It is articulated with the sacrum  Coccyx moves backward during childbirth
  • 14. PELVIC JOINTS  There are four pelvic joints:  Two sacroiliac joints  One pubic symphysis joint  One sacrococcygeal joint
  • 15. TWO SACROILIAC JOINTS  These are slightly movable joints formed where the ilium joints, first two sacral vertebrae on either side.  They connect the spine to the pelvis & are the strongest joints in body.
  • 16. ONE PUBIC SYMPHYSIS JOINT It is a cartilaginous joint between two pubic bones.
  • 17. ONE SACROCOCCYGEAL JOINT  It is a hinge joint between sacrum & coccyx.
  • 18. PELVIC LIGAMENTS  The pelvic bones are held together with ligaments.  Sacro iliac ligament- it pass in front of and behind each sacroiliac joint.  Pubic ligament- it connect the top of pubic bones.  Sacro tuberous ligament- one ligament on each side , run from sacrum to the ischial tuberosity  Sacro spinous ligament- one ligament on each side of the sacrum & the ischial spine.  Sacro coccygeal ligament-one ligament on each side from sacrum to coccyx.
  • 19.
  • 20. STRUCTURE OF PELVIS FALES PELVIS TRUE PELVIS
  • 21. FALSE PELVIS  It is formed by the upper flared out portion of the ilium.  Laterally- iliac fossae, Posterior- fifth lumbar vertebrae, Anteriorly – the abdominal wall and inguinal ligament  It protects the abdominal organs. It has no obstetrical importance except that it provides certain landmarks for external pelvimetry.
  • 22. TRUE PELVIS  The true pelvis is the bony canal through which the fetus passes during birth.  It has three parts- BRIM CAVITY OUTLET
  • 23. THE PELVIC BRIM OR INLET  It is formed by the sacrum posteriorly, the iliac bones laterally and the pubic bones anterior.  Shape: it is almost rounded with anterio posterior diameter being the shortest.  Its boundaries are the sacral promontory and wings of the sacrum behind the iliac bones on the sides and the pubic bones in front.
  • 24.
  • 25. LANDMARKS OF THE BRIM  Sacral promontory  Sacral ala or sacral wing  Sacroiliac joint  Iliopectineal line  Iliopubic eminence  Pectineal line  Pubic tubercle  Pubic Crest  Symphysis pubis
  • 26. DIAMETERS OF THE BRIM  Anterio posterior  Transverse  Oblique
  • 27. ANTERIO POSTERIOR (11CM)  it is a line from the sacral promontory to the upper border of symphysis pubis. This diameter is of three types-  Diagonal conjugate- distance between lower border of symphysis pubis to mid point on sacral promontory it is 12 cm.  Obstetrical conjugate- it is distance between midpoint of sacral promontory to prominent bony projection in mid line of symphysis pubis. it measures 10 cm  True conjugate - it extends from the sacral promontory to the top of the symphysis pubis. Its normal measurement is 11 cm or more.
  • 28. Transverse (13cm) – it is the distance between the two farthest points on the pelvic brim over the Iliopectineal lines. Oblique (12cm) – it starts from the sacroiliac joint to the opposite iliopubic eminence.
  • 29.
  • 30. THE PELVIC CAVITY  The cavity extends from the brim above to the outlet below.  Shape: its shape is almost rounded. It consist of -  Anterior border: Symphysis pubis  Posterior border: Sacral hollow  Lateral border: Soft tissues  All diameters- measure 12cms.
  • 31. THE PELVIC OUTLET ANATOMICAL OUTLET:  It consists of the lower border of all bones and Sacro tuberous ligament.  It consists of lower border of symphysis pubis, Sacro coccygeal joint and Sacro ischial spine.  Shape: it is antero – posteriorly oval.
  • 32. OBSTETRICAL OUTLET:  This outlet has greater practical significance, because it includes the narrow pelvic strait through which the fetus must pass.  It is otherwise known as bony outlet.  Shape: it is diamond shaped.
  • 33. DIAMETERS OF OUTLET:  Antero-posterior diameter (13cm): it Extend from lower border of symphysis pubis to the tip of coccyx.  Oblique diameter (12): it extend from Rt. & Lt. Sacro spinous ligament to Obturator foramen  Transverse diameter (11cm): between the ischial spines.
  • 34. TYPES OF PELVIS GYNAECOID ANTHROPOID ANDROID PLATYPELLOID
  • 35. 1.Gynaecoid pelvis: (50%)  It is commonly known as the female pelvis because that type occurs most frequently in women.  Most suitable for childbirth.  Wider brim.  Ischial spines are blunt  Sub pubic angle is 90º
  • 36. 2.Anthropoid pelvis: (25%)  It favors a posterior position of the fetus.  Oval in shape  Transverse diameter is shorter  Seen in tall women with narrow shoulders
  • 37. 3.Android pelvis: (20%)  It is commonly known as male pelvis because it occurs more frequently in men.  Heart shaped brim  Anterior posterior diameter is shorter  Transverse diameter is wider  Childbirth is difficult
  • 38. 4.Platypelloid (flat) pelvis: (5%)  This type of pelvis is rare.  Kidney shaped brim  Anterior posterior diameter is smaller  Transverse diameter is wider  Not conductive to vaginal delivery
  • 39. DEFORMITIES OF PELVIS  Contracted pelvis  Rachitic pelvis  Asymmetrical pelvis  Roberts pelvis  Nageles pelvis  Osteomalacis / maacosteon pelvis  Assimilation pelvis  Others- Kyphosis, scoliosis, spondylosisthesis