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What is the inferoposterior portion of the abdomen that serves as a transition from trunk to lower limb?
What is the function of the bony pelvis?
protects distal digestive and urinary tracts and internal reproductive organs, serves as attachment site for spine above and limbs below
Where is the perineum?
between thighs and extends from tip of coccyx to pubis
What does the perineum include in men? women?
anus, penis scrotum
anus and vulva
What are the boundaries of the greater pelvis?
from iliac crests inferiorly to pelvic brim
What are the boundaries of the lesser pelvis?
from pelvic brim to pelvic diaphragm
Describe the location of the pelvic brim or inlet?
marked by sacral promontory, arcuate line and pectineal line and upper edge of pubic symphysis
How many bones form the bony pelvis? What are they?
2 os coxi (hip bones), sacrum and coccyx
What forms the hip bones (os coxi)? When does fusion of these bones occur?
fusion of three bones-ilium, ischium, pubis
age 15-20
How many fused vertebrae make up the sacrum?
What is the sacral promontory? What covers it?
anterosuperior most portion of the sacrum just below the juntion of the sacrum w/ the 5th lumbar vertebrae
covered w/ broad anterior longitudinal spinal ligament
What is the clinical significance of the sacral promontory?
protrudes into the pelvic inlet and is the most limiting dimension of the pelvic inlet (anteroposterior direction)
What makes up the coccyx?
fusion of 4 rudimentary vertebrae
What are 3 ways of measuring the dimensions of the pelvic inlet? What is the common measuring spot in all 3? What varies?
anatomical, true (obstetric), and diagonal conjugate
-sacral promontory
-different spots on pubic symphysis
What part of the pubic symphysis do you measure from when measuring the anatomical conjugate diameter? true (obstetrical)? diagonal?
-superior surface
-inner surface
-inferior surface
What is an estimate of the true obstetric conjugate?
diagonal conjugate
What is a way to estimate the diagonal conjugate?
trans-vaginal palpation
What is the anteroposterior diameter of the pelvic outlet?
inferior surface of pubic symphysis and tip of coccyx
is about 9.5cm
What is the transverse diameter of the pelvic inlet?
Where is the sacral hiatus? What marks it on each side?
on posterior surface at the end of the sacral canal
inferior sacral cornu are on each side
What covers the sacral hiatus?
posterior sacrococcygeal ligament
What is the sacral hiatus used for clinically?
to gain access to caudal epidural space for injuection
What level does the dural sac terminate? spinal cord?
What does the body of the ilium help form?
acetabulum for the femur head
What originates at the ASIS?
inguinal ligament
What does the ilium articulate with?
Where is the ischium located with regard to the pelvis?
posterior inferior, what you sit on
What part of the ischium helps create the obturator foramen?
What are the parts of the ischium?
ramus, ischial tuberosities (2), body, ischial spines
What parts of the pelvis help form the acetabulum?
body of ischium and body of ilium and superior ramus of the pubis
What attaches to the ischial spines?
sacrospinous ligament
What is superior to the ischial spine? inferior?
s-greater sciatic notch
i-inferior sciatic notch
Where is the pubis located?
inferior and anterior
What are the parts of the pubis?
superior and inferior ramus, body, pubic crest, pubic tubercle
What helps create the obturator foramen?
ramus of ischium, and superior and inferior rami of pubis
What 2 things does the superior ramus of the pubis help create?
obturator foramen and acetabulum
Where is the pubic tubercle located? What is it an attachment for?
lateral edge of pubic crest
attachemnt for inguinal ligament
What is the subpubic angle? What is the average for men? women?
angle below the pubic symphysis to the ischial tuberosities
men-60 degrees' women-90 deg
What are the boundaries of the pelvic outlet?
anterior-inferior margin of pubic symphysis
anterolaterally-inferior ramus of pubis and ischial tuberosities
posterolaterally-sacrotuberous ligaments
posteriorly-tip of coccyx
In the anatomical position which two parts of the pelvis are vertical?
ASIS and pubic symphysis
Describe the difference between the greater pelvis in males vs females. true pelvis?
men-deeper and narrow
women-shallower and wider
Describe the shape of the pelvic brim (inlet) in females and males.
females-oval and rounded
Is the pelivc outlet lareger in females or males?
Describe the shape of the sacrum in females and males.
males-more concave anteriorly
Define gynecoid.
typical female shaped pelvis
Define android.
typical male shaped pelvis
Define anthropoid.
pelvis w/ elongated anterior to posterior dimension, similar to man's ancestors
Define platypelloid.
broad pelvis w/ a subpubic angle greater than 90 degrees
What commonly occurs in pelvic fractures?
displacement of pubic symphysis posteriorly
Name the 2 pelvic joints.
lubosacral and sacrococcygeal
What are the two portions of the lubosacral joint? Name the facet joint.
intervertebral disc between L5 and sacrum and two posterior zygapophyseal (facet joints)
What type of a joint is the sacrococcygeal joint?
What helps to strengthen the sacrococcygeal joint?
the anterior and posterior sacrococcygeal ligaments
What type of a joint is the sacroiliac joint?
both fibrous and synovial
What does the sacroiliac joint do?
transfers weight of the vertebral column to the pelvis
What stabilizes the sacroiliac joint?
interosseous ligaments and posterior and anterior sacroiliac ligaments
What type of a joint is the pubic symphysis?
What helps stabilize the pubic symphysis?
superior and inferior pubic ligaments
During pregnancy what hormones are released that help degrade the collagen fibers of the pelvis? What joint is particularly affected?
progesterone and relaxin
pubic symphysis
From where does the pelvic inlet (or brim) extend? Which conjugae diameter does this correspond with? What is the average length?
internal superior portion of pubic symphysis, posteriorly to sacral promontory
anatomical conjugate
From where does the pelvic outlet extend? What is the average length?
anteriorly from the internal inferior portion of the pubic symphysis, posteriorly tot he tip of the coccyx
What is the average distance of the transverse pelvic inlet in women?
13-14 cm
What makes up the anterior portion of the pelvic wall?
body and ramus of pubic bone and pubic symphysis
What is located laterally in the pelvic wall?
greater pelvis ala of ilium w/ iliacus muscle; true pelvis-obturator internus muscle
Where does the obturator internus muscle exit the pelvis? What does it attach to? What is its action?
lesser sciatic foramen
greater trochanter of femur
laterally rotates leg
What is located in the posterior portion of the pelvic wall?
sacrum, coccyx, part of ilia, sacroiliac joints and ligaments, piriformis muscle
Where does the piriformis muscle exit the pelivs? What does it attach to? What is its action?
greater sciatic foramen
anterior surface of sacrum and greater trochanter of femus
lateral rotation of leg
What forms the pelvic diaphragm?
levator ani and coccygeus muscle
The pelvic diaphragm stretches from the _____ anteriorly to the _____ posteriorly and is laterally attached to ________.
a-pubic symphysis
l-obturator internus muscle
What are the three parts of the levator ani?
pubococcygeus, puborectalis, iliococcygeus
What is the largest part of the levator ani? What does it attach to?
pubococcygeus, attached from body of pubis to coccyx (bone to bone)
What is the puborectalis attached to?
medial body of pubis, forms a U-shaped muscular sling around the anorectal junction
What is the slimmest portion of the levator ani? What does it attach to?
from tendinous arch of fascia on top of obturator internus and ischial spine to the coccyx
What does the coccygeus muscle attach to? What is it innervated by?
from ischial spine to distal sacrum and coccyx
S4 (some S3 or 5)
What is the function of the pelvic diaphragm?
maintains proper positioning of pelvic organs, essential for maintaining abdominal and thoracic pressure during micturation, defecation, parturition, and heavy lifting
What muscle aids in maintaining fecal continence?
What muscle is contracted during Kegal exercises?
Which muscle can be torn while giving birth? Compromised functions of this muscle can lead to what?
urinary stress incontinence, can contribute to uterine prolapse

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