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PELVIC (GIRDLE) BONE HIP BONE FEMUR 04/07/2016 BAAB @2016 1. Sacrum, Hip bone: 2. Ilium, 3. Ischium, 4. Pelvis 5. Pubic symphisis 6. Acetabulum 7. Obtulator foramen The pelvis (plural pelvises) is either the lower part of the trunk of the human body between the abdomen and the thighs (sometimes also called pelvic region of the trunk) or the skeleton embedded in it (sometimes also called bony pelvis, or pelvic skeleton or the pelvic girdle). The pelvic region of the trunk includes the bony pelvis, the pelvic cavity (the space enclosed by the bony pelvis), the pelvic floor, below the pelvic cavity, and the perineum, below the pelvic floor. The pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and mainly consists of the reproductive organs (sex organs) and the rectum. This gap is also called the pelvic inlet superiorly and pelvic outlet inferiorly. Structure The pelvic skeleton includes several structures: ◦ posteriorly (in the area of the back), by the sacrum and the coccyx. ◦ laterally and anteriorly (forward and to the sides), by a pair of hip bones. Each hip bone consists of 3 sections, ilium, ischium and pubis. ◦ In childhood, these sections of hip bone are separate bones, joined by the triradiate cartilage. During puberty, they fuse together in the acetabulum to form a single bone. Fig. The lateral view of the hip bone to show the acetabular location The two hip bones are joined anteriorly at the pubic symphysis by a fibrous cartilage covered by a hyaline cartilage, the interpubic disk, within which a nonsynovial cavity might be present. ◦ Two ligaments, the superior and inferior pubic ligaments, reinforce the symphysis. Posteriorly, the hip bones form sacroiliac joints, formed between the auricular surfaces of the sacrum and the two hip bones. ◦ These are amphiarthroses, almost immobile joints enclosed by very taut joint capsules reinforced by ventral interosseous, and dorsal sacroiliac ligaments. Pelvic cavity: typically defined as a small part of the space enclosed by the bony pelvis, delimited by the pelvic brim above and the pelvic floor below; alternatively, the pelvic cavity is sometimes also defined as the whole space enclosed by the pelvic skeleton, subdivided into ◦ the greater (or false) pelvis, above the pelvic brim ◦ the lesser (or true) pelvis, below the pelvic brim the pelvic floor (or pelvic diaphragm), below the pelvic cavity (soft tissue) the perineum, below the pelvic floor Joints: Sacroiliac joint is formed between the auricular surfaces of the sacrum and the hip bone. The most important accessory ligaments of the sacroiliac joint are the sacrospinous and sacrotuberous ligaments which stabilize the hip bone on the sacrum and prevent the promontory (prominent or protuberant part between the 5th lumbar and sacrum) from tilting forward. Additionally, these two ligaments transform the greater and lesser sciatic notches into the greater and lesser foramina, a pair of important pelvic openings The iliolumbar ligament is said to be the lower border of the thoracolumbar fascia, the lateral lumbosacral ligament is partly continuous with the iliolumbar ligament. The sacrococcygeal symphysis is the joint between the sacrum and the coccyx. It is facilitated by a series of ligaments as ALL (Anterior Longitudinal Ligaments) and PLL (Posterior L. L.) Hip joint, between the acetabular fossa of the hip bone and hemispherical head of the femur. ◦ It is reinforced by the extracapsular iliofemoral, ischiofemoral and pubofemoral ligaments. Functions: The skeleton of the pelvis is a basin-shaped ring of bones connecting the vertebral column to the femur. Its primary functions are to bear the weight of the upper body when sitting and standing transferring that weight from the axial skeleton to the lower appendicular skeleton when standing and walking Compared to the shoulder girdle, the pelvic girdle is thus strong and rigid, hence it provides attachments for and withstanding the forces of the powerful muscles of locomotion and posture. Its secondary functions are to contain and protect the pelvic and abdominopelvic viscera (inferior parts of the urinary tracts, internal reproductive organs). providing attachment for external reproductive organs and associated muscles and membranes. ◦ The pelvic inclination angle is the single most important element of the human body posture and is adjusted at the hips. measured by the assessment of the posture. In later stages of pregnancy the fetus's head aligns inside the pelvis, and joints of bones soften due to the effect of pregnancy hormones, letting the pelvis outlet widen somewhat to allow the fetus passage through the maternal pelvic opening. Measurement of the pelvis measurements were made on pregnant women to determine whether a natural birth would be possible, The following common variations were found ◦ The gynaecoid pelvis is the so-called normal female pelvis. Found in about 50 per cent of specimens. Its inlet is either slightly oval, with a greater transverse diameter, or round. The interior walls are straight, the subpubic arch wide, the sacrum shows an average to backward inclination, and the greater sciatic notch is well rounded. Because this type is spacious and well proportioned there is little or no difficulty in the birth process. The platypelloid pelvis found Less than 3 per cent of women. has a transversally wide, flattened shape, is wide anteriorly, greater sciatic notches of male type, and has a short sacrum that curves inwards reducing the diameters of the lower pelvis. Giving birth with this type of pelvis is associated with problems, such as transverse arrest. The android pelvis is found in one third of white women and in one sixth of non-white women. It is a female pelvis with masculine features, including a wedge or heart shaped inlet caused by a prominent sacrum and a triangular anterior segment. The reduced pelvis outlet often causes problems during child birth. The anthropoid pelvis type found in ¼ of white women and almost ½ of non-white women characterized by an oval shape with a greater anteroposterior diameter. It has straight walls, a small subpubic arch, and large sacrosciatic notches. The sciatic spines are placed widely apart and the sacrum is usually straight resulting in deep nonobstructed pelvis. Sexual dimorphism Body locomotion efficiency and wide birth canal are two conflicting demands confronting the natural selection. These contrasting features resulting into a conflict referred to as the "obstetrical dilemma". The female pelvis, or gynecoid pelvis,has evolved to its maximum width for childbirth — a wider pelvis would make women unable to walk. In contrast, human male pelvises are not constrained by the need to give birth and therefore are more optimized for bipedal locomotion. Male pelvis Female pelvis.. The principal differences between male and female true and false pelvis include: ◦ The female pelvis is larger and broader than the male pelvis which is taller, narrower, and more compact. ◦ The female inlet is larger and oval in shape, while the male sacral promontory projects further (i.e. the male inlet is more heart-shaped). ◦ The sides of the male pelvis converge from the inlet to the outlet, whereas the sides of the female pelvis are wider apart. ◦ The angle between the inferior pubic rami is acute (70 degrees) in men, but obtuse (90-100 degrees) in women. Accordingly, the angle is called subpubic angle in men and pubic arch in women. Additionally, the bones forming the angle/arch are more concave in females but straight in males. The distance between the ischial bones is small in males, making the outlet narrow, but large in females, who have a relatively large outlet. The ischial spines and tuberosities are heavier and project farther into the pelvic cavity in males. The greater sciatic notch is wider in females. The iliac crests are higher and more pronounced in males, making the male false pelvis deeper and more narrow than in females. The male sacrum is long, narrow, more straight, and has a pronounced sacral promontory. The female sacrum is shorter, wider, more curved posteriorly, and has a less pronounced promontory. The acetabula are wider apart in females than in males. In males, the acetabulum faces more laterally, while it faces more anteriorly in females. Consequently, when men walk the leg can move forwards and backwards in a single plane. In women, the leg must swing forward and inward, from where the pivoting head of the femur moves the leg back in another plane. This change in the angle of the femoral head gives the female gait its characteristic (i.e. swinging of hips). The femur is the only bone located within the human thigh. It is both the longest and the strongest bone in the human body, extending from the hip to the knee. Its length on average is 26.74% of a person's height, a ratio found in both men and women and most ethnic groups with only restricted variation It is a bone of the lower limb but its proximal part associate closely to the pelvis through a strong hip joint. Important features of this bone include the head, medial and lateral condyles, patellar surface, medial and lateral epicondyles, and greater and lesser trochanters. The head is where the bone forms the hip joint with the hip bone (innominate bone). The condyles are the points of articulation (connection) with the tibia, which is a leg bone. The patellar surface is the groove where the bone articulates with the patella, or kneecap. articulation with the tibia and kneecap form the knee joint. The epicondyles and trochanters are all important attachment sites for various strong muscles. Structure The femur is the only bone in the thigh. The two femurs converge medially toward the knees, where they articulate with the proximal ends of the tibiae. The angle of convergence of the femora is a major factor in determining the femoral-tibial angle. In females the femora converge more than in males because the pelvic bone is wider in females. In the condition genu valgum (knock knee) the femurs converge so much that the knees touch one another. The opposite extreme is genu varum (bowleggedness). In the general population of people without either genu valgum or genu varum, the femoral-tibial angle is about 175 degrees. The femur is categorised as a long bone and comprises a diaphysis (shaft or body) and two epiphyses (extremities) that articulate with adjacent bones in the hip and knee. Fig: The upper extremity of right femur viewed from behind and above, showing head, neck, and the greater and lesser trochanter. This forms a proximal articulation of the femur. The head of the femur, which articulates with the acetabulum of the pelvic bone, composes 2/3 of a sphere. It has a small groove, or fovea, connected through the round ligament (ligamentum teres capitis femoris) to the sides of the acetabular notch, also is connected to the shaft through the neck or collum. The neck is 4–5 cm. long which forms an angle with the shaft in about 130 degrees. This angle is highly variant. In the infant it is about 150 degrees and in old age reduced to 120 degrees on average ◦ coxa valga - abnormal increase in the angle ◦ coxa vara - abnormal reduction in the angle two trochanters, greater and lesser trochanter are two prominences found in the area of transition between the H/N and the shaft of the femur. greater trochanter is almost box-shaped and is the most lateral prominent of the femur, its prominence is variant mostly in females located higher than the collum and reaches the midpoint of the hip joint. About the junction of the upper one-third and lower two-thirds on the intertrochanteric crest is the quadrate tubercle located In a small anatomical study it was shown that the epiphysial line passes directly through the quadrate tubercle The femur develops from the limb buds as a result of interactions between the ectoderm and the underlying mesoderm, formation occurs roughly around the fourth week of development. Function: 1. Attachment of strong muscles divided into three compartment of the thigh. 2. Body force distribution from the trunk down to the ground.