anatomy

1. ANATOMY OF FEMALE
PELVIC
By: Tiyas K
Airlangga
University
Department of Child-Maternity Nursing
Nursing Faculty 2010

2. PELVIC
A. Solid part : Pelvic bone
B. Soft part : Pelvic ligament &
muscle

3. A. PELVIC BONE
 2 Innominate bone :
- Os illium
- Os ischium
- Os pubic
 Sacrum
 Coccyx

4. PELVIC BONE

5. PELVIC BONE

6. PELVIC BONE

7. Sacrum
PELVIC BONE

8. Tulang Coccygis
PELVIC BONE

9. Ischium Function
 Support body weight (tuber
ischiadica)

10. Fungsi os Coccygis
 In labor this bone extent to posterior
in order to wider the pelvic outlet

11. Pelvic Inlet/Pelvic brim
 Area bordered by:
 Promontorium
 Sacrum
 Linea inominata
 Ramus Superior
ossis Pubis
 Uper border of
Symphisis pubis

12. Pelvic outlet
Area bordered by:
 Ujung bawah
Sacrum
 Tulang Tuber
Ischiadica
 Sacro-coccygeal
 Lower border of
symphisis pubis

13. Normal pelvic measurement
Distansia
Spinarum
Distansia
Cristarum
Distansia Cristarum: 28—29 cm
Distansia Spinarum: 25—26 cm

14. Inside Pelvic measurement
• Conjugata Diagonalis = 12,5—13cm
• Conjugata Vera = CD – (1,5—2cm)
• Conjugata Obstetrika = terpendek

15. Hodge line
 Hodge I: imagination line drawn from
promontorium to the upper border of
symphisis pubis
 Hodge II: parallel with hodge I measured from
lower border of symphisis
 Hodge III: parallel with hodge II, measured
from spina ischiadica
 Hodge IV: parallel with hodge III, measured
from coccyx tip

16. H
IH
II
H
III
H
IV

17. B. PELVIC LIGAMENT &
MUSCLE
 LIGAMENT connect the pelvic joint
 Ligament interpubic pada symphysis pubis
 Ligament sacro iliaca
 Ligament sacro-coccygeal
 Ligament sacro-tuberous
 Ligament sacro spinosus

18. PELVIC MUSCLE
The inner aspect of the bony pelvis is covered with
muscles:
 Above the brim --- iliacus & psoas
 Sidewalls ---- obturator internus & its fascia
 Post wall ---- pyriformis
 Pelvic floor ---- lavator ani & coccygeus

19. PELVIC MUSCLE

20. Conjugata Vera

21. Sacral promontory
Left sacro-iliac joint
Iliopectineal line
Sacrospinous ligament
Sacrotuberous ligament
Symphysis pubis
Ischial tuberosity
Ischial spine

22. PELVIC EXAMINATION
• X-Ray
• Jangka Panggul
• Distansia Cristarum
• Distansia Spinarum
• Conjugata eksterna/Bouldeloque: distance
between upper border symphysis pubis with
prosessus spinosus lumbal 5. the normal
measurement 18—20 cm
• Vaginal Touché

23. Vaginal Touché Examintion
 Promontorium touched/not
 Conjugata Vera normal/not
 Spina Ischiadica prominent/not
 Arkus pubis wide/narrow
 Sakrum curve/not
Note:
•Touched Promontory usually indicated narrow pelvic
•Height ≤145 cm also indicated narrow pelvic

24. Differentiation between female and male pelvic

25. Pelvic Shape

26. PELVIC SHAPE
1-GYNECOID
 Typical female pelvis found in 50% of women
 Rounded—slightly oval inlet
 Straight pelvic sidewalls with roomy pelvic cavity
 Good sacral curve
 Ischial spines are not prominent
 Pubic arch is wide

27. PELVIC SHAPE
2-ANDROID
 Typical male pelvis found in 1/3 white women
1/6 non-white
 Pelvic brim is heart shaped
 Pelvis funnels from above downwards
(convergent sidewalls)
 Narrow pubic arch
 Prominent spines

28. PELVIC SHAPE
3-ANTHROPOID
 25% white women & 50% nonwhite
 Pelvic brim APD > TD
 Long & narrow pelvic canal with long sacrum
 Straight pelvic sidewalls
4-PLATYPELLOID
 3% of women
 Pelvic brim TD >>>APD  kidney shape
 Sacral promontory pushed forwards

29. Pelvic Shape Deviation
A. Panggul Naegele
B. Panggul Rakhitis
C. Panggul Skoliosis
D. Panggul Kifosis
E. -”- dari Samping
F. Panggul Osteomalasia
G. Panggul Spondilolistesis
H. Panggul Robert

30. Causes of pelvic deviation
 Congenital:
- Narrow palvic
- Simple flat
- Funnel (narrow outlet)
- Assimilation
 Disease :
- Rachitic
- Osteomalasia
- TBC
- Lordosis
- Skoliosis
- Kifosis
- Spondilosis

31. Deviation impact
 Prolonged labor
 CPD (Chepalo Pelvic Disproportion)
 Breech presentation
 Infertility

32. POST TEST
 Pelvic anatomy contains of what kind of part?
 What can you mention about Pelvic bone?
 What can you mention about Pelvic ligament?
 What can you mention about pelvic muscle?
 What do you know about pelvic shape?
 What would happen if the pelvic is not normal
in measurement?

33. Daftar pustaka
 Wyknyosastro , S., (2002) Ilm u Ke bidanan.
Jakarta: Yayasan Bina Pustaka Sarwono
Prawiroharjo
 Cunningham, H. et. al., (2005) William s
O bste trics. 22nd
. New York: McGRAW-HILL
 Bobak, LM. & Jensen, MD., (2005) Mate rnity &
Gyne co lo g y Care : The Nurse and The Fam ily.
5th
Ed. St. Louis: Mosby company

34. THANK YOU
“PLEASE WORK HARD IN
THIS NEW SEMESTER”