Female Pelvis
INTRODUCTION
Females are the creatures by the god where
they are giving birth to new generation.
Through pelvis the fetus must pass down
during childbirth with several physiological
changes and adaptations to expel into new
world.
Overview
• Pelvic bones
• Pelvic ligaments
• Planes of the pelvis
• Diameters of the true pelvis
• Landmarks of the pelvis
• Variations in pelvis shape
Learning Objectives
• By the end of the class, students will be able
to,
Describe about pelvic bones and joints
Explains about the planes and diameters of the
true pelvis
Mention the variations in the pelvis shape
TERMINOLOGIES
• Pelvis
Pelvis is the hip bone which acts as the ridge
between the trunk and the lower extremities.
• Joints
Joint is an articulation where two or more bones
meet together.
• Ligaments
It is a connective tissue at the junction of the
joints.
PELVIS
• The true pelvis is the hollow bony
canal consists of innominate bone,
sacrum and the coccyx through
which the fetus must pass during
birth. It has a brim, cavity and outlet.
FUNCTIONS OF PELVIS
• Allows movements of the body like walking,
sitting etc
• Adapts during child bearing
• Acting as a bridge between the trunk and femur
• Protects the pelvic organs and lesser extent of
abdominal contents
PELVIC BONES
Pelvic bones consists of four bones
• Two innominate bones or hip bones
• One sacrum
• One coccyx
INNOMINATE BONES
Each innominate consists of three parts:
• The ilium
• The ischium
• The Pubic bone
ILIUM
• The ilium is large flared-out part. When the hand is
placed on the hip it rests on the iliac crest, which is the
upper border.
• At the front of the iliac crest can be felt a bony
prominence known as the anterior superior iliac spine.
• A short distance below it is the anterior inferior iliac
spine.
Posterior view of pelvis
Cont..,
• There are two similar points at the other end of
the iliac crest, namely the posterior superior
and the posterior inferior iliac spines.
• The concave anterior surface of the ilium is the
iliac fossa.
ISCHIUM
• The ischium is the thick lower part. It has a
large prominence known as the ischial
tuberosity, on which the body rests when
sitting.
Cont..,
• Behind and a little above the tuberosity is an
inward projection, the ischial spine.
• In labour, the station of the fetal head is
estimated in relation to the ischial spines.
PUBIC BONE
• Pubic bone forms the anterior part.
• It has a body and two oar-like projections, the
superior ramus and the inferior ramus.
• The two pubic bones meet at the Symphysis
pubis and the two inferior rami form the pubic
arch, merging into a similar ramus on the
ischium.
Cont..,
• The space enclosed by the body of the pubic bone,
the rami and the ischium is called the obturator
foramen.
• The innominate bone contains a deep cup to receive
the head of the femur. This is termed as the
acetabulum.
• All three parts of the bone contribute to the
acetabulum in the following proportions: two-fifths
ilium, two-fifths ischium and one-fifth pubic bone.
Cont..,
• On the lower border of the innominate bone are found
two curves.
• One extends from the posterior inferior iliac spine up
to the ischial spine and is called the greater sciatic
notch is wide and rounded.
• The other lies between the ischial spine and the
ischial tuberosity and is the lesser sciatic notch.
THE SACRUM
• The sacrum is a wedge- shaped bone consisting
of five fused vertebraes.
• The upper border of the first sacral vertebra just
forward and is known as the sacral promontory.
• The anterior surface of the sacrum is concave
and is referred to as the hollow of the sacrum.
Cont..,
• Laterally the sacrum extends into a wing or ala.
• Four pairs of holes or foramina pierce the sacrum
and, through these, nerves from the cauda equine
emerge to supply the pelvic organs.
• The posterior surface is roughened to receive
attachments of muscles.
THE COCCYX
• The coccyx is a vestigial tail.
• It consists of four fused vertebrae, forming a
small triangular bone.
PELVIC JOINTS
There are four pelvic joints:
• One Symphysis pubis
• Two sacro-iliac joints
• One sacro-coccygeal
joint
Cont..,
• The Symphysis pubis
The Symphysis pubis is formed at the junction of the
two pubic bones, which are united by a pad of
cartilage.
• The sacro-iliac joints
These are the strongest joints in the body. They join
the sacrum to the ilium and thus connect the spine to
the pelvis.
Cont..,
• The sacro-coccygeal joint
This joint is formed where the base of the
coccyx articulates with the tip of the sacrum.
PELVIC LIGAMENTS
Pelvic ligaments are,
• The Inter pubic ligaments at the Symphysis
• The Sacro-iliac joints
• The Sacro-coccygeal ligaments
• The sacrotuberous ligaments
• The sacrospinous ligaments
LIGAMENTS OF PELVIS
LANDMARKS OF PELVIS
• Sacral promontory
• Sacral ala or wing
• Sacro-iliac joint
• Ilio-pectineal line
• Ilio-pectineal eminence
• Superior ramus of the pubic bone
• Upper inner border of the body of the pubic bone
• Upper inner border of the Symphysis pubis
Diameters of the pelvis
BRIM
• Antero-posterior diameter
When the line is taken to the uppermost of the Symphysis
pubis, it is called the anatomical conjugate and measures
about 12cms.
When it is taken to the posterior border of the upper
surface, which is about 1.25cms lower, called as obstetrical
conjugate measures about 11cms (true conjugate).
CONT..,
The diagonal conjugate is also measured
antero-posteriorly from the lower border of the
Symphysis pubis to the sacral promontory
measures about 12-13cms.
Cont..,
• The oblique diameter
The diameter is a line from one sacroiliac joint to
the Ilio-pectineal eminence on the other side of the
pelvis measures about 12cms.
• The transverse diameter
The diameter is a line between the points furthest
apart on the Ilio-pectineal lines measures about
13cms.
THE PELVIC CAVITY
• The cavity extends from the brim above to the outlet
below. The anterior is formed by the pubic bones and the
Symphysis pubis and its depth is 4 cm.
• The posterior wall is formed by the curve of the sacrum,
which is 12cms in length.
• The cavity is circular in shape and although it is not
possible to measures its diameters exactly, they are all
considered to be 12cms.
THE OUTLET
• Anatomical outlet is formed by the lower
borders of each of the bones together with the
sacrotuberous ligaments.
• The obstetrical outlet is the space between
the narrow pelvic strait and the anatomical
outlet is diamond in shape.
• The narrow strait lies between the
sacrococcygeal joint, the two ischial spines
and the lower border of the Symphysis pubis.
Cont..,
• The antero-posterior diameter
This is a line from the lower border of the Symphysis
pubis to the sacro- coccygeal joint measures about
13cms.
• The oblique diameter
The line between the obturator foramen and the sacro-
spinous ligaments, although there is no fixed points
measures about 12cms.
• The transverse diameter
The line between the two ischial spines measures about
10-11cms
TYPES OF PELVIS
Gynaecoid Anthropoid Android Platypelloid
Shape Round AP oval Triangular Transversely
oval
Inlet Ant & Post Almost equal Both increased Post – short & Both reduced
segment and spacious with anterior ant – narrow flat
narrowing
Sacrum Sacral angle > Sacral angle > Sacral angle < Sacral angle
90` , inclined 90` , inclined 90` , inclined > 90` ,
backwards. posteriorly forwards inclined
posteriorly
Cavity Sacro- Wide and More wide Narrow Slightly
sciatic shallow and and deep narrow
notch shallow and small
Side walls Straight or Straght or Convergent Divergent
divergent divergent
Outlet Ischial Not Not Prominent Not
spines prominent prominent prominent
Pubic arch Curved Long and Long and Short and
curved straight curved
Sub pubic Wide(85`) Slightly Narrow Very wide
angle narrow (>90`)
Bituberous Normal Normal or Short wide
diameter short
Evaluation
• Define true pelvis?
• What is anatomical conjugate?
• List out the diameters of the pelvic brim
• Mention the landmarks of the pelvis
• What are the various types of the pelvis?
• Assignment:
write about pelvimetry
• Demonstrate on female pelvis and its
parts
References
• D C Dutta, “Textbook of obstetrics”, 6 th
edition(2004), published by new central book
agency (P) ltd, calcutta
• Myles, “Textbook for midwives”, 14th edition
(2006), published by churchill livingstone,
philadelphia.
• T.S.Ranganathan, “ A textbook of human
anatomy”, 1st edition jaypee brothers, New
delhi.
