Ppt on pelvis

ASSIGNMENT ON
THE PELVIS
BY
MANISHA MEHRA

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.COCCYX
 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

Ppt on pelvis

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