Anatomy of the pelvis, understand the clinical relevance and key landmarks,parts and function,blood and nerve supply and disorders associated with the pelvis.

1. THE PELVIS
PREPARED BY: WAHABU IMORO.
RESIDENT ORTHOPAEDIC NURSING, MEMBERSHIP. KUMASI SITE.

2. OUTLINE OF PRESENTATION
i. Describe the pelvis
ii. Structure of the pelvis
iii.Parts of the pelvis
iv.Types of pelvis
v. Functions of the pelvis
vi.Common conditions affecting the pelvis
vii.References

3. DESCRIPTION OF THE PELVIS
• The pelvis is made up of two hipbones connected anteriorly at the pubic
symphysis and posteriorly to the sacrum and the coccyx, each is made up of
3 bones-the blade shaped ILIUM-on each side- the ISCHIUM posterior and
inferior on which the weight falls when sitting and the PUBIS anteriorly.
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4. STRUCTURE OF THE PELVIS
• Anterior view of the pelvis
Anterior view of the pelvic girdle. Adapted from [Van de Graaff, 2001, Ch. 7]

5. STRUCTURE OF THE PELVIS cont…
• Posterior view

6. PARTS OF THE PELVIS AND THEIR
FUNCTIONS
• Base of the sacrum: It is a large oval articular surface, the
upper surface of the body of the first sacral vertebra which
is connected with the under surface of the last lumbar
vertebra by an intervertebral fibrocartilage( intervertebral
disc)
• The pelvic surface of the sacrum: It is concave from top
and curved slightly from side to the side.
• Iliac crest: The top border of the ilium.

7. Cont…
• Ilium: It is the widest and largest of the three parts of the hip bones
• Sacroiliac articulation: it connects the hip bones to the sacrum and
the coccyx. It serves as a shock absorber between the upper body and
the legs.
• Anterior sacral foramina: They are four in number and their size
diminishes from top to bottom, they give exit to the anterior sacral
nerves and entrance to the lateral sacral arteries.
• Spine of ischium: it is a thin pointed triangular eminence at the
posterior border of the ischium bone, it supports and resist intra-
abdominal pressure that is exerted from above.

8. Cont…
• Acetabulum: The cup-shaped socket that forms the hip
joint with the head of the femur.
• Obturator foramen: it the largest foramen in the body, it
allows passage of the obturator artery, vein and nerve, it is
situated between the ischium and the pubis.
• Superior and inferior rami: they are what we refer to as the
pubic bones.
• Pubic tubercle: It serve as a point of attachment for the
inguinal ligament, it is clinically used to locate the rings of
the inguinal canal.

9. Cont….
• Symphysis pubis: It is a cartilaginous joint between the two
pubic bones, it keeps the two pelvic bones together and
steady during activities, it absorb shock and allow delivery
of a baby.
• Acetabular notch: it is an anterioinferior depression of the
margin of the acetabulum, the margins serves as attachment
of ligaments of the head of the femur.
• Coccyx: triangular bony structure located at the end of the
vertebral column, also known as tailbone, its made up of 3-
5 bones fused together.

10. Cont……
iliac spine: Serves as attachment for ligaments and muscle,
it is an important landmark for measurement of the true
length of the leg.
Iliac fossa: it is a large, smooth, concave area on the
internal surface of the ilium.
Sacral canal: Is a continuation of the spinal canal and runs
throughout the greater part of the sacrum. The canal lodges
the sacral nerves via the anterior and posterior sacral
foramina.
Sacral hiatus: Located at the distal part of the sacrum, it's
the area in which epidural medication are administered.

11. TYPES OF PELVIS
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12. TYPES OF PELVIS
• Gynecoid. This is the most common type of pelvis in females and is
generally considered to be the typical female pelvis. Its overall shape
is round, shallow, and open.
• Android. This type of pelvis bears more resemblance to the male
pelvis. It’s narrower than the gynecoid pelvis and is shaped more like
a heart or a wedge.
• Anthropoid. An anthropoid pelvis is narrow and deep. Its shape is
similar to an upright egg or oval.
• Platypelloid. The platypelloid pelvis is also called a flat pelvis. This
is the least common type. It’s wide but shallow, and it resembles an
egg or oval lying on its side.

13. FUNCTIONS OF THE PELVIS
• For locomotion: The body weight is transmitted through
the pelvis to the lower limbs.
• Childbirth: The birth canal lies within the pelvic girdle, it
serves as a passage for the neonate.
• Support: It supports the organs of the pelvic cavity.

14. BLOOD PASSAGE

15. BLOOD SUPPLY

16. Cont…

17. LIGAMENTS OF THE PELVIS
1. ILIOLUMBAR LIGAMENT
2.SACROILIAC LIGAMENT
3.SACROSPNOUS LIGAMENT
4.SACROTUBEROUS LIGAMENT
5.INGUINAL LIGAMENT

18. Iliolumbar Ligament
• It spans between the tip of the 4 and 5th transverse process of
the spine to the waist bone (iliac crest). It functions to restrain
movement in the lumbosacral and sacroiliac joints. In doing
so, the iliolumbar ligament is a major stabilizer of the low
back and sacroiliac joint

19. ILIOLUMBAR LIGAMENT

20. Sacroiliac (SI) Joint Ligaments:
• These are the massive ligaments at the back of the sacroiliac
joints (the joints between the tailbone and back of the
pelvis/hip). Women have more issues here than men, and
these can be stretched during childbirth, falls onto the butt,
and trauma. The pain is often in this area at the back of the
hip and can refer down the leg.

21. Sacroiliac Ligament

22. Sacrospinous Ligament
• It is a thin triangular ligament that stretches between the
sacrum and boney outcropping on the ischium. It functions
to prevent posterior rotation of the ilium. Stress to this
ligament occurs most often when leaning forward or getting
out of a chair

23. Sacrospinous Ligament

24. Sacrotuberous Ligament
• It stretches between the sacrum and the Sitz bone (ischial
spine). It functions to prevent rotation of the ilium. The
sacrotuberous ligament also contributes to the strength of the
pelvis, prevents rotation of the ilium, and provides an
attachment point for buttock and thigh muscles.

25. Sacrotuberous Ligament

26. INGUINAL LIGAMENT

27. CONT..
• The inguinal ligament (also ligamentum inguinale,
arcus inguinalis or Pouparts’s ligament) is a band of
connective tissue that extends from the anterior
superior iliac spine of the ilium to the pubic
tubercle on the pubic bone

28. Muscle Attachment
Anterior view

29. Cont..
• Posterior view

30. Cont..

31. NERVE PASSAGE

32. NERVE SUPPLY

33. Cont..

34. Cont..

35. Cont..

36. COMMON DISORDERS OF THE
PELVIS
• Osteitis pubis: Inflammation of the pubis symphysis, characterized
by pain in the groin and tenderness over the front of the pelvis.
Common with footballers due to repeated kicking.
• Fractures: Common with motorcycle users, acetabulum and
sacroiliac dislocation, open book and vertical shears,
• Contracted pelvis: due to developmental and severe nutritional
deficiencies. e.g. Naegeles pelvis, Roberts pelvis, Osteomalacic
pelvis etc.
• Osteoarthritis of the hip

37. Osteitis pubis

38. Acetabular Fractures

39. Classification of Acetabular fractures

40. Vertical Shears

41. Open Book Fracture

42. Cont..

43. Cont.…

44. Non-Operative Management

45. Cont..
• Osteoarthritis of the hip joint

46. Cont..

47. References
• Clinical Application of Neuromuscular Techniques, Volume
2(second edition)2011.
• https/www.physio-pedia.com
• https://www.britanica.com>science
• https://radiopedia.org>articles
• https://teachmeanatomy.info

48. END