Download Kaan Yücel MD, Ph.D.

Los Angeles Academy of Figurative Art
Kaan Yücel M.D., Ph.D.
17.February.2014 Monday
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.
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 the 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.
Sexual differences are related mainly
1. Heavier build and larger muscles of most men
2. Adaptation of the pelvis (particularly the lesser pelvis)
in women for parturition (childbearing).
The difference
between the male
and female pelvis
Difference
Between Male
& Female
Pelvis
male or funnel-shaped pelvis with a
contracted outlet
41% of women
long, narrow, and oval shaped
wide pelvis 2% of women
 In forensic medicine (the application of medical and anatomical
knowledge for the purposes of law), identification of human
skeletal remains usually involves the diagnosis of sex.
 A prime focus of attention is the pelvic girdle because sexual
differences usually are clearly visible.
 Even fragments of the pelvic girdle are useful in determining
sex.
Feature
General
Structure
Male pelvis
Female pelvis
Thick & Heavy
Thin & Light
Greater
pelvis
Deep
Shallow
Lesser
pelvis
Narrow and deep,
tapering
Wide and shallow,
cylindirical
Heart-shaped, narrow
Oval and rounded, wide
Comparatively small
Comparatively large
Project further medially
into the pelvic cavity
Do not project as far medially
into the pelvic cavity & smooth
Pelvic inlet
Pelvic outlet
Ischial
spines
Feature
Male pelvis
Obturator
foramen
Round
Oval
Acetabulum
Large
Small
Narrow, inverted V
(approximately 70
degrees)
Almost 90 degrees
Smaller
(50-60 degrees)
Larger
(80-85 degrees)
Prominent
Not prominent
Greater
schiatic
notch
Subpubic
angle
Sacral
promontory
Female pelvis
PELVIC DIAMETERS (CONJUGATES)
Size of the lesser pelvis important in obstetrics
Because it is the bony canal through which the fetus passes
during a vaginal birth.
To determine the capacity of the female pelvis for childbearing,
diameters of the lesser pelvis are noted radiographically or
manually during a pelvic examination.
PELVIC DIAMETERS (CONJUGATES)
Diameters of pelvic outlet
Antero - posterior diameters
Anatomical antero-posterior diameter 11cm
from tip of the coccyx to lower border of symphysis pubis
Obstetric antero-posterior diameter 13 cm
from tip of the sacrum to lower border of symphysis pubis
as the coccyx moves backwards during the second stage of labour.
Diameters of pelvic outlet
Bituberous diameter 11 cm
between inner aspects of ischial tuberosities
Bispinous diameter 10.5 cm
between tips of ischial spines
Transverse diameters
Diameters of pelvic inlet
Antero - posterior diameters
Anatomical antero-posterior diameter True conjugate 11cm
from tip of sacral promontory to upper border of symphysis pubis
Diameters of pelvic inlet
Antero - posterior diameters
Obstetric conjugate 10.5 cm
from tip of sacral promontory to
the most bulging point on back of symphysis pubis ,about 1 cm below its upper
border.
shortest antero-posterior diameter
Diameters of pelvic inlet
Antero - posterior diameters
Diagonal conjugate 12.5 cm
1.5 cm longer than the true conjugate
From tip of sacral promontory to lower border of symphysis pubis
Minimum anteroposterior (AP) diameter of the lesser pelvis
True (obstetrical) conjugate
Narrowest distance through which the baby's head
must pass in a vaginal delivery.
This distance, however, cannot be measured directly during a pelvic
examination because of the presence of the bladder.
Diagonal conjugate (from inferior pubic lig. to promontory)
Measured by palpating sacral promontory with the tip of the middle
finger, using the other hand to mark the level of the inferior margin of
the pubic symphysis on the examining hand.
After the examining hand is withdrawn, the distance between the tip of the
index finger (1.5 cm shorter than the middle finger) and the marked level of the
pubic symphysis is measured to estimate the true conjugate, which should be
11.0 cm or greater.
Transverse diameter is the greatest distance between the linea
terminalis on either side of the pelvis.