The Pelvis

ANHB 2212 – 2008

Avinash Bharadwaj

Bony Pelvis

• Hip bones

• Sacrum

• Joints and ligaments

Hip Bone

Ligaments

• Sacrospinous

• Sacrotuberous

• Notches Foramina

• Other ligaments

The walls

• Pelvis as a container• Muscles

– Piriformis– Obturator muscles

(Internus/externus)• Membrane

• Vessels and nerves

The Floor

• Pelvic diaphragm– Pubis sacrum

(coccyx)– Obturator fascia

The Floor• Pelvic diaphragm

– Levator ani• Puborectalis• Pubococcygeus• Iliococcygeus

– Coccygeus (ischio-)

• Perineum– Urogenital region

• …diaphragm

– Anal region

Urogenital Region

• Male urethra

• Penis– Corpus spongiosum and corpora cavernosa– Muscles

• Comparable female structures

The Pelvis – “True” and “False”

• Iliac fossae

• The pelvic brim

• Pelvic cavity

Contents

• Urinary system– Bladder and urethra

• Repoductive system– Male / female

• Digestive system– Rectum – anal canal

• Peritoneum…

Urinary Bladder

• Muscular wall

• Reservoir

• Sphincters– Internal – smooth– External – urogenital diaphragm - skeletal

• Variation in size, shape and location…

• Empty – Tetrahedral, Pelvis

• Full – ovoid, partly abdominal

Urogenital Organs - Male

• Prostate• Seminal vesicles• Ductus deferens

Female Reproductive Organs

• Uterus– Fundus, body, cervix

• Vagina• Angles• Fornix• Ovary and the tube

Female Reproductive Organs

• Uterus– Fundus, body, cervix

• Non-pregnant– Pelvic

• Pregnant– Pelvic 12 weeks– Abdominal

• 20 weeks – umbilicus• 36 weeks -

xiphisternum

Female Reproductive Organs

• Ovaries– Descent– Stops in the pelvis– Ligaments

• Round ligament

– Ovarian artery• From aorta

Female Reproductive Organs

• Uterine tubes– Parts

• Also note– Ovarian artery– Uterine artery

• Ligaments

Rectum and Anal Canal

• The junction• Developmental

correlation• Venous anastomoses• Nerves and lymphatics• Mucosa and sphincters

Internal sphincter – smooth muscleExternal sphincter - skeletal

Rectum and Anal Canal

• Lower part – Ectodermal– Systemic veins– “Modified skin”

The Pelvis – Birth Canal

• Is it adequate?

• How do we know?

• Sexual dimorphism

• Variations and types

Pelvic Dimensions

• Inlet

• Midcavity

• Outlet

• A-P

• Transverse

• Oblique

Types of Female Pelvis

• Gynaecoid

• Android

• Antrhopoid

• Platypelloid

• Abnormalities