The Pelvis

Lectured by Bien Eli Nillos, MD

1. No. of bones composing the bony pelvis
2. What divides the true pelvis from false
pelvis
3 – 5. What comprises the answer to No. 2?
(anterior, lateral and posterior)
6. What is the floor of the pelvis?
7 – 8. What comprises answer to No. 8
For no. 9 – 10, answer whether it is a male of female
pelvis being described.
9. Pelvic inlet is heart shaped
10. False pelvis is shallower.
 The Pelvis
 Theregion of the trunk that lies
below the abdomen. The abdominal
and pelvic cavities are continuous.
 Surface Landmarks
 IliacCrest
 Anterior Superior Iliac Spine – upper
lateral end of the fold of the groin
 Posterior Superior Iliac Spine –
posterior end of the iliac crest, lies at
the bottom of a small skin dimple
and on a level with the second sacral
spine.
 Pubic Tubercle – upper border of the
pubis
 Symphysis Pubis – cartilaginous joint
that lies in the midline between the
bodies of the pubic bones.
 Pubic Crest – ridge of bone on the
superior surface of the pubic bone,
medial to the pubic tubercle
 Spinous Process of the Sacrum –
fused in the midline to form the
median sacral crest
 Sacral Hiatus – posterior aspect of
the lower end of the sacrum
 Coccyx – inferior surface and tip can
be palpated in the natal cleft about 1
inch behind the anus
 Pelvis
 Composed of four bones: 2
innominate bones, sacrum and
coccyx

 Pelvic
brim: sacral promontory
behind, iliopectineal lines laterally,
symphysis pubis anteriorly.
 Above the brim is the FALSE PELVIS
(greater pelvis).
 Below the brim is the TRUE PELVIS
(lesser pelvis)
 The Lesser or True Pelvis (pelvis minor).
—The lesser pelvis is that part of the
pelvic cavity which is situated below and
behind the pelvic brim. Its bony walls are
more complete than those of the greater
pelvis. For convenience of description, it
is divided into an inlet bounded by the
superior circumference, and outlet
bounded by the inferior circumference,
and a cavity.
 The Superior Circumference.—The
superior circumference forms the brim of
the pelvis, the included space being called
the superior aperture or inlet
 The superior aperture is somewhat heart-
shaped, obtusely pointed in front,
diverging on either side, and encroached
upon behind by the projection forward of
the promontory of the sacrum.
 Ithas three principal diameters:
antero-posterior, transverse, and
oblique.
 The anteroposterior or conjugate
diameter extends from the
sacrovertebral angle to the symphysis
pubis; its average measurement is
about 110 mm. in the female.
 The transverse diameter extends
across the greatest width of the
superior aperture, from the middle of
the brim on one side to the same
point on the opposite; its average
measurement is about 135 mm. in
the female.
 The oblique diameter extends from
the iliopectineal eminence of one
side to the sacroiliac articulation of
the opposite side; its average
measurement is about 125 mm. in
the female.
 The Lower Circumference—The
lower circumference of the pelvis is
very irregular; the space enclosed by
it is named the inferior aperture or
outlet, is bounded behind by the
point of the coccyx, and laterally by
the ischial tuberosities.
 The diameters of the outlet of the
pelvis are two: antero-posterior
and transverse.
 The antero-posterior diameter
extends from the tip of the coccyx to
the lower part of the pubic
symphysis; its measurement is from
90 to 115 mm. in the female.
 Thetransverse diameter,
measured between the posterior
parts of the ischial tuberosities, is
about 115 mm. in the female.
 Inthe erect posture, the pelvis is
placed obliquely with regard to the
trunk: the plane of the superior
aperture forms an angle of from 50°
to 60°, and that of the inferior
aperture one of about 15° with the
horizontal plane.
 The pelvic surface of the symphysis
pubis looks upward and backward, the
concavity of the sacrum and coccyx
downward and forward.
 The position of the pelvis in the erect
posture may be indicated by holding
it so that the anterior superior iliac
spines and the front of the top of the
symphysis pubis are in the same
vertical plane.
 Muscles of the Pelvis
 Piriformis
– Origin: front of
sacrum
– Insertion: greater
trochanter of femur
– Action: lateral
rotator of femur at
hip joint
 Obturator Internus:
– Origin: obturator
membrane and
adjoining part of hip
bone
– Insertion: greater
trochanter of femur
– Action: lateral
rotator of femur at
hip joint
 Levator ani:
– Origin: body of pubis, fascia of obturator
internus, spine of ischium
– Insertion: perinela body, anococcygeal
body, walls of prostate, vagina, rectum
and anal canal
– Action: supports pelvic organs
 Anterior fibers – levator
prostatae/sphincter vaginae
 Intermediate fibers – puborectalis,
pubococcygeus, anococcygeal body
 Posterior fibers - iliococcygeus
 Coccygeus:
– Origin: spine of ischium
– Insertion: lower end of sacrum; coccyx
– Action: assists levator ani to support
pelvic organs
Male and Female Pelvis
 Urinary Bladder
 Receptacle for storage of urine
 Ureter
 Crosses the pelvic inlet in front of the bifurcation of
the common iliac artery
 Vas Deferens
 Conveys mature sperm from epididymis to the
ejaculatory duct and the urethra
 Prostate
 Inverted
pyramid, fibromuscular
glandular organ.
 Ovary
 Almond-shaped organ
 Uterine (Fallopian) Tubes
4 inches long, four parts: infundibulum, ampulla,
isthmus, intramural
Uterus
Cervix
Vagina