iv year bsc nursing obg

1. THE FEMALE PELVIS
Prepared By :Mrs Bemina JA
Assistant Professor
ESIC College of Nursing
Kalaburagi

2. INTRODUCTION
 The female pelvis because of its characteristics ,aids in
childbirth.
 It is a skeletal ring formed by two innominate or hip
bone, the sacrum and the coccyx.
 The pelvis is the lower part of the torso.
 It’s located between the abdomen and the legs.
 This area provides support for the intestines and also
contains the bladder and reproductive organs.

3.  The bony pelvis is made up of four bones:
 Sacrum.
 Coccyx.
 Two innominate bone.

5.  Two Innominate bones(hip bone)
 Each hip bone consists of 3 sections,
 Ilium,
 Ischium,
 Pubis.
 PARTS OF PELVIS
 •The ilium,
 the ischium pubis
 • Iliac fossa.
 • Iliac crest
 • Anterior superior iliac spine
 • Anterior inferior iliac spine.
 • Posterior superior iliac spine
 • Posterior inferior iliac spines.
 •Acetabulum
 • Ischial tuberosity.
 • Ischial spine.
 • Superior ramus
 • Inferior ramus
 • Obturator foramen

8.  JOINTS
 There are four joints in the pelvis
 1 Sacrococcygeal joint
 2 Sacro-iliac joints
 1 Symphysis Pubis
 The weight of the body is transmitted through the
ischial tuberosities in sitting.

9.  Levator ani muscles
 The levator ani muscles are the largest group of muscles in the
pelvis. They have several functions, including helping to
support the pelvic organs.
 The levator ani muscles consist of three separate muscles:
 Puborectalis. This muscle is responsible for holding in urine
and feces. It relaxes when you urinate or have a bowel
movement.
 Pubococcygeus. This muscle makes up most of the levator ani
muscles. It originates at the pubis bone and connects to the
coccyx.
 Iliococcygeus. The iliococcygeus has thinner fibers and serves to
lift the pelvic floor as well as the anal canal.
 Coccygeus
 This small pelvic floor muscle originates at the ischium and
connects to the sacrum and coccyx.

10.  Uterus
 The uterus is a thick-walled, hollow organ where a baby develops during pregnancy.
 During the reproductive years, the lining of the uterus sheds every month during menstruation if you
don’t become pregnant.
 Ovaries
 There are two ovaries located on either side of the uterus. The ovaries produce eggs and also release
hormones, such estrogen and progesterone.
 Fallopian tubes
 The fallopian tubes connect each ovary to the uterus. Specialized cells in the fallopian tubes use
hair-like structures called cilia to help direct eggs from the ovaries toward the uterus.
 Cervix
 The cervix connects the uterus to the vagina. It’s able to widen, allowing sperm to pass into the
uterus.
 In addition, thick mucus produced in the cervix can help to prevent bacteria from reaching the
uterus.
 Vagina
 The vagina connects the cervix to the exterior female genitalia. It’s also called the birth canal, as the
baby passes through the vagina during delivery.
 Rectum
 The rectum is the lowest part of the large intestine. Feces collects here until exiting through the anus.
 Bladder
 The bladder is the organ that collects and stores urine until it’s released. Urine reaches the bladder
through tubes called ureters that connect to the kidneys.
 Urethra
 The urethra is the tube that urine travels through to exit the body from the bladder.

11.  1.Sacroiliac ligament
 2.Pubic ligament
 3.Sacrotuberous ligament
 4.Sacrospinous ligament
 5.Sacrococcygeal ligament

12.  LANDMARKS OF THE BRIM :
 A bony fixed point where fetus comes in contact with
maternal pelvis at time of engagement.
 • From anterior to posterior way in numerical sequence-
 1. Symphysis pubis
 2. Pubic crest
 3. Pubic tubercle
 4. Pectineal line
 5. Ilio-pectineal eminance
 6. ilio=-pectineal line
 7. Sacroiliac joint
 8. Anterior border of sacral ala
 9. Sacral promontary.

16.  It is a segment, the boundaries of which are:
 * the roof is the plane of pelvic brim,
 * the floor is the plane of least pelvic dimension,
 * anteriorly the shorter symphysis pubis,
 * posteriorly the longer sacrum.

17.  Anatomical outlet
 It is lozenge-shaped bounded by;
 * the lower border of symphysis pubis,
 * pubic arch,
 * ischial tuberosities,
 *sacrotuberous and sacrospinous ligaments and,
 * tip of the coccyx.

18.  It is a segment, the boundaries of which are:
 * the roof is the plane of least pelvic dimension,
 * the floor is the anatomical outlet,
 * anteriorly the lower border of symphysis pubis,
 * posteriorly the coccyx.
 * laterally the ischial spines.

19.  Anteroposterior diameter : It is a line from the sacral
promontory to the upper broder of the symphysis
pubis. Its 11 cm.
 Oblique diameter : It is a line from one sacroiliac
joint to the iliopectineal eminence. Its 12 cm.
 Transverse diameter: It is line between ilio-pectineal
lines .Its 13 cm.

20.  a. Anatomical antero-posterior diameter (true conjugate)
= 11cm(from the tip of the sacral promontory to the
upper border of the symphysis pubis.)
 b. Obstetric conjugate = 10.5 cm(from the tip of the
sacral promontory to the most bulging point on the
back of symphysis pubis which is about 1 cm below its
upper border. It is the shortest antero-posterior diameter.)
 c.Diagonal conjugate = 12.5 cm(i.e. 1.5 cm longer than
the true conjugate. From the tip of sacral promontory to
the lower border of symphysis pubis)

21.  a. Anatomical transverse diameter =13cm between
the farthest two points on the iliopectineal lines.
 It lies 4 cm anterior to the promontory and 7 cm
behind the symphysis.
 It is the largest diameter in the pelvis.
 b.Obstetric transverse diameter: It bisects the true
conjugate and is slightly shorter than the anatomical
transverse diameter.

22.  Right oblique diameter =12 cm from the right
sacroiliac joint to the left iliopectineal eminence.
 Left oblique diameter = 12 cm from the left sacroiliac
joint to the right iliopectineal eminence.

23.  Anatomical antero-posterior diameter=11cm from the
tip of the coccyx to the lower border of symphysis
pubis
 Obstetric antero-posterior diameter = 13 cm from the
tip of the sacrum to the lower border of symphysis
pubis as the coccyx moves backwards during the
second stage of labour
Transverse diameters:
Bituberous diameter = 11 cm(between the inner aspects
of the ischial tuberosities.)
Bispinous diameter = 10.5 cm ( between the tips of
ischial spines)

24.  These are imaginary planes lie as follow:
 Plane of pelvic inlet:passing with the boundaries of pelvic brim
and making an angle of 55 with the horizon (angle of pelvic
inclination).
 Plane of mid cavity (plane of greatest pelvic dimensions)pass
between the middle of the posterior surface of the symphysis
pubis and the junction between 2nd and 3rd sacral vertebrae.
 Laterally, it passes to the centre of the acetabulum and the upper
part of the greater sciatic notch. It is a round plane with diameter
of 12.5 cm.
 Internal rotation of the head occurs when the biparietal
diameter occupies this wide pelvic plane while the occiput is
on the pelvic floor i.e. at the plane of the least pelvic dimensions

25.  Plane of obstetric outlet (plane of least pelvic dimensions)
passes from the lower border of the symphysis pubis
anteriorly, to the ischial spines laterally, to the tip of the
sacrum posteriorly
 Plane of anatomical outlet passes with the boundaries of
anatomical outlet and consists of 2 triangular planes with
one base which is the bituberous diameter
 * Anterior sagittal plane: its apex at the lower border of
the symphysis pubis.
 *Anterior sagittal diameter: 6-7 cm: from the lower border
of the symphysis pubis to the centre of the bituberous
diameter.
 * Posterior sagittal plane: its apex at the tip of the coccyx.
 * Posterior sagittal diameter: 7.5-10 cm: from the tip of the
sacrum to the centre of the bituberous diameter

26. Anatomical axis (curve of Carus)
 * It is an imaginary line joining the centre points of
the planes of the inlet, cavity and outlet.
 * It is C shaped with the concavity directed forwards.
 * It has no obstetric importance
Obstetric axis
• It is an imaginary line represents the way passed by
the head during labour.
• * It is J shaped passes downwards and backwards
along the axis of the inlet till the ischial spines where it
passes downwards and forwards along the axis of the
pelvic outlet

27.  Gynaecoid pelvis(50%)
 Anthropoid pelvis (25%)
 Android pelvis (20%)
 Platypelloid pelvis (5%)

30.  GYNAECOID PELVIS
 It is the normal female type.
 Inlet is slightly transverse oval.
 Sacrum is wide with average concavity and inclination.
 Side walls are straight with blunt ischial spines.
 Sacro-sciatic notch is wide.
 Subpubic angle is 90-100
 Anthropoid pelvis: (25%)
 It favors a posterior position of the fetus.
 Oval in shape
 Transverse diameter is shorter
 Seen in tall women with narrow shoulders

31.  Android pelvis: (20%)
 It is commonly known as male pelvis because it occurs
more frequently in men.
 Heart shaped brim
 Anterior posterior diameter is shorter
 Transverse diameter is wider
 Childbirth is difficult

32.  Platypelloid (flat) pelvis: (5%)
 This type of pelvis is rare.
 Kidney shaped brim
 Anterior posterior diameter is smaller
 Transverse diameter is wider
 Not conductive to vaginal delivery

33. FALSE PELVIS
 It is formed by the upper flared out portion of the ilium.
 Laterally- iliac fossae,
 Posterior- fifth lumbar vertebrae,
 Anteriorly – the abdominal wall and inguinal ligament
 It protects the abdominal organs.
 It has no obstetrical importance except that it provides
certain landmarks for external pelvimetry.

34.  TRUE PELVIS
 The true pelvis is the bony canal through which the fetus
passes during birth.
 It has three parts-
 BRIM
 CAVITY
 OUTLET
 THE PELVIC BRIM OR INLET
 It is formed by the sacrum posteriorly, the iliac bones
laterally and the pubic bones anterior.
 Shape: it is almost rounded with anterio posterior diameter
being the shortest.
 Its boundaries are the sacral promontory and wings of the
sacrum behind the iliac bones on the sides and the pubic
bones in front.

35.  DEFORMITIES OF PELVIS
 Contracted pelvis
 Rachitic pelvis [A rachitic pelvis is contracted and twisted
as a result of softening of the bones early on in life due the
rickets.]
 Asymmetrical pelvis
 Roberts pelvis [A pelvis that is narrowed transversely due
to the almost entire absence of the alae of the sacrum.]
 Nageles pelvis [An obliquely contracted pelvis in which
the conjugate diameter assumes an oblique direction.]
 Osteomalacis / maacosteon pelvis [Osteomalacia results
from a defect in the bone-maturing process]
 Assimilation pelvis
 Others- Kyphosis, scoliosis, spondylosisthesis

36.  Pelvic Disorders, Such As
 Pelvic Floor Dysfunction,
 Pelvic Inflammatory Disease (PID) And
 pelvic organ prolapse, are conditions that affect the
pelvis, the basin-shaped structure that supports the
spinal column and protects the abdominal organs.