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Los Angeles Academy of Figurative Art Kaan Yücel M.D., Ph.D. 10.January.2014 Friday inferoposterior to the abdomen transition between the trunk and the lower limbs L. Basin Right hip bone Sacrum Coccyx Left hip bone A ring of 3 bones connects the vertebral column to the two femora Right and left hip bones coxal bones; pelvic bones Sacru m Bear the weight of the upper body Transfer that weight lower appendicular skeleton Provide attachment for muscles of locomotion,posture & abdominal wall strong and rigid Contain and protect the pelvic viscera Provide support for the abdominopelvic viscera and gravid (pregnant) uterus Provide attachment for the erectile bodies of the external genitalia. Provide attachment for the muscles and membranes Superior, fan-shaped part of the hip bone Ala, or wing, of the ilium spread of the fan Body of the ilium, the handle of the fan. On its external aspect, the body participates in formation of the acetabulum. Gluteal surface down the iliac crest from the lateral margin of the iliac crest arches inferiorly across the ilium vertically from the iliac crest to a position near the posterior inferior iliac spine originates superior to the AIIS and ends near the posterior margin of the acetabulum. an angulated bone Superior ramus helps form the acetabulum Inferior ramus helps form the obturator foramen. Pubic crest thickening on the anterior part of the body Pubic tubercle Pubic crest ends laterally as a prominent swelling Pecten pubis Oblique ridge@ lateral part of superior pubic ramus Distinct features of the pelvic bone acetabulum obturator foramen/canal greater sciatic notch lesser sciatic notch Greater (false) pelvis Lesser (true) pelvis by the oblique plane of the pelvic inlet (superior pelvic aperture). The bony edge (rim) surrounding and defining the pelvic inlet Formed by: Promontory and ala of the sacrum A right and left linea terminalis (terminal line) formed by ischiopubic rami inferior rami of the pubis + ischium of the 2 sides. Meet @ pubic symphysis its inferior border -subpubic angle The width of the subpubic angle is determined by the distance between the right and the left ischial tuberosities, which can be measured with the gloved fingers in the vagina during a pelvic examination. Pelvic outlet (inferior pelvic aperture) bounded by: pubic arch anteriorly ischial tuberosities laterally sacrotuberous and sacrospinous ligaments posterolaterally tip of the coccyx posteriorly iliopubic eminence (iliopectineal eminence) a raised area below he anterior inferior iliac spine marks the point of union of the ilium and pubis. constitutes a lateral border of the pelvic inlet. Circular opening between abdominal cavity & pelvic cavity Formed Anteriorly by pubic symphysis Posteriorly by sacrum (promontory in the middle) Laterally by iliopectineal line Part of the pelvis superior to the pelvic inlet bounded by iliac alae posterolaterally anterosuperior aspect of the S1 posteriorly Occupied by abdominal viscera ileum and sigmoid colon. between pelvic inlet & pelvic outlet bounded by pelvic surfaces of the hip bones, sacrum, and coccyx. includes true pelvic cavity & deep parts of the perineum. Major obstetrical and gynecological significance. The blue line in this 3-D volume rendered CT image (above) represents the linea terminales that separates the false pelvis, which is above it from the true pelvis below it. The false pelvis consists of the iliac wings and has no anterior wall. The pubis bones, sacrum and coccyx, and both ischium bones delimit the false pelvis. Linea terminalis arcuate line + pecten pubis+ pubic crest Arcuate line of the ilium smooth rounded border on the internal surface of the ilium. immediately inferior to the iliac fossa. Forms part of the border of the pelvic inlet. Joints and Ligaments of Pelvic Girdle The primary joints Sacroiliac joints & pubic symphysis Sacroiliac joints link axial skeleton & inferior appendicular skeleton. Lumbosacral & sacrococcygeal joints, although joints of the axial skeleton, are directly related to the pelvic girdle. Strong ligaments support and strengthen these joints. Strong, weight-bearing compound joints An anterior synovial joint between the earshaped auricular surfaces of the sacrum & ilium A posterior syndesmosis between the tuberosities of the same bones Differ from most synovial joints limited mobility is allowed, a consequenceof theirrole in transmittingthe weightof mostof the body to the hip bones. Weight from the axial skeleton: Sacroiliac ligaments ilia Femurs –during standingIschial tuberosities –during sitting- Sacrum is actually suspended between the iliac bones Firmly attached to iliac bones by posterior and interosseous sacroiliac ligaments. Anterior sacroiliac ligaments Anterior part of the fibrous capsule of the synovial part of the joint. Interosseous sacroiliac ligaments Lie deep between the tuberosities of the sacrum and ilium. Primary structures involved in transferring the weight. Posterior sacroiliac ligaments Posterior external continuation of the same mass of fibrous tissue. Formed by posterior sacroiliac ligaments Passes from posterior ilium, lateral sacrum & coccyx to ischial tuberosity Transforms the sciatic notch of the hip bone into a large sciatic foramen. Sacrospinous ligament from lateral sacrum & coccyx to ischial spine subdivides sciatic foramen into greater and lesser sciatic foramina. Most of the time, movement at the sacroiliac joint is limited by interlocking of the articulating bones and the sacroiliac ligaments. By allowing only slight upward movement of the inferior end of the sacrum relative to the hip bones, resilience is provided to the sacroiliac region when the vertebral column sustains sudden increases in force or weight. Secondary cartilaginous joint A fibrocartilaginous interpubic disc & surrounding ligaments uniting the bodies of the pubic bones in the median plane. Interpubic disc wider in women. Superior & inferior pubic ligaments superior & inferior margins of the symphysis Superior pubic ligament connects the superior aspects of the pubic bodies and interpubic disc. Inferior (arcuate) pubic ligament connect the inferior aspects of the joint components round off the subpubic angle as it forms the apex of the pubic arch. L5 & S1 articulate Anterior intervertebral (IV) joint formed by L5/S1 IV disc between their bodies & 2 posterior zygapophysial joints (facet joints) between the articular processes of these vertebrae Fan-like iliolumbar ligaments radiate from the transverse processes of the L5 vertebra to the ilia. Secondary cartilaginous joint with an intervertebral disc. Fibrocartilage & ligaments join apex of the sacrum base of coccyx. Anterior & posterior sacrococcygeal ligaments long strands that reinforce the joint.