PELVIC GIRDLE

Pamela BL(M.D, MSc Anatomy)

• The pelvis(L. basin), is the part of the trunk
inferoposterior to the abdomen.
• Anatomically, the pelvis is the part of the body
surrounded by the pelvic girdle(bony pelvis).
• The pelvic girdle is a basin shaped ring of
bones that connects the vertebral column to
the femurs.
• The pelvis is subdivided into:
Greater pelvis
Lesser pelvis
• The greater pelvis is occupied by the inferior
abdominal viscera, and it protects them in a
similar manner as the superior abdominal
viscera are protected by the inferior thoracic
cage.
• The lesser pelvis provides the skeleton
framework for both the pelvic cavity and the
perineum, compartments of the trunk
separated by the musculofascial pelvic
diaphragm.
• Externally, the pelvis is covered or overlapped
by the:
Inferior anterolateral abdominal wall
anteriorly
 Gluteal region posterolaterally
Perineum inferiorly.
 Functions of the pelvic girdle
• Bear the weight of the upper body when
sitting and standing
• Transfer the weight from the axial to the
lower appendicular skeleton for standing and
walking
• Provide attachment for muscles of locomotion
and posture and those of the abdominal wall.
• Contain and protect the pelvic viscera:
Inferior parts of the urinary tracts
Internal reproductive organs
Inferior abdominal viscera
• Provide support for the abdominopelvic
viscera, and the gravid uterus.
 Bones of the pelvic girdle
• In matured individuals, the pelvic girdle has
the following bones:
The right and left hipbones(which develops
from fusion of 3 bones, ilium ,ischium and
pubis).
Sacrum, formed by the fusion of 5, originally
separate sacral vertebrae.
• In infants and children, the hip bone consists
of three separate bones that are united by a
triradiate cartilage in the acetabulum.
• The acetabulum is a cup like depression on
the lateral surface of the hip bone which
articulates with the head of the femur.
• After puberty, the ilium, ischium and pubis
fuse to form the hip bone.
• The two hip bones are joined anteriorly at the
pubic symphysis(symphysis pubis) and
articulate posteriorly with the sacrum at the
sacroiliac joints.
• Ilium: is the superior fan shaped part of the
hip bone.
• Its ala/wing represents the spread of the fan,
and the body of ilium, the handle of the fan.
• On its external aspect, the body of ilium
participates in the formation of the
acetabulum.
• The iliac crest, the rim of the fan, has a curve
that follows the contour of the ala between
the anterior and posterior superior iliac
spines.
• The anteromedial concave surface of the ala
forms the iliac fossa.
• Ischium: has a body and ramus.
• The body of the ischium helps form the
acetabulum and the ramus of the ischium
forms part of the obturator foramen.
• The bone has a large posteroinferior
protuberance called the ischial tuberosity.
• The small pointed posteromedial projection
near the junction of the ramus and body is the
ischial spine.
• The concavity between the ischial spine and
ischial tuberosity is the lesser sciatic notch.
• The larger concavity, superior to the ischial
spine is the greater sciatic notch.
• The pubis has:
Superior ramus that helps form the
acetabulum
Inferior ramus that helps the obturator
foramen
A body of the pubis.
• There is a thickening on the anterior part of
the body of the pubis called the pubic crest
that ends laterally as a prominent swelling
called the pubic tubercle.
• The lateral part of the superior pubic ramus
has an oblique ridge, the pecten
pubis(pectineal line of pubis).
• The pubic arch is formed by the ischiopubic
rami(conjoined inferior rami of the pubis and
ischium).
• These rami meet at the symphysis pubis, their
inferior borders defining the subpubic angle.
• The width of the subpubic angle is determined
by the distance measured with fingers in the
vagina during pelvic examination.
• The pelvis is divided into greater(false) and
lesser(true) pelves by an oblique plane of the
pelvic inlet(superior pelvic aperture).
• The bony edge(rim)surrounding and defining
the pelvic inlet is the pelvic brim which has the
following boundaries:
Symphysis pubis anteriorly
Sacral promontory posteriorly
Iliopectineal lines laterally
• The pelvic outlet(inferior pelvic outlet)is
bounded by:
Pubic arch anteriorly
Ischial tuberosities laterally
Tip of coccyx posteriorly
• The greater pelvis(false pelvis) is the part of
the pelvis:
Superior to the pelvic inlet
Bounded by iliac alas posterolaterally and
anterosuperior aspect of S1 vertebrae
posteriorly.
Occupied by abdominal viscera(e.g. ileum,
sigmoid colon).
• The lesser pelvis(true pelvis|)is the part of the
pelvis:
Between the pelvic inlet and pelvic outlet
Bounded by the pelvic surfaces of the hip
bones, sacrum and coccyx
That includes the true pelvic cavity and deep
parts of the perineum(specifically the
ischioanal fossae).
 Comparison of male and female bony
pelves
Bony pelvis Male Female
General structure Thick and heavy Thin and light
Greater pelvis Deep Shallow
Lesser pelvis Narrow, deep, tapering Wide and shallow
Pelvic inlet Heart shaped, narrow Oval and rounded, wide
Pelvic outlet Comparatively small Comparatively large
Pubic arch and subpubic Narrow Wide(more than 80 deg)
angle
Obturator foramen Round Oval
Acetabulum Large Small
Greater sciatic notch Narrow(less than 70 deg) Almost 90 deg
 Clinical application
• In forensic medicine(the application of
medical and anatomical knowledge for the
law purposes), identification of human
skeletal remains usually involves the
identification of sex.
• Attention is given to the pelvic girdle because
of the visible sexual differences of the bony
pelves in males and females.
• Pelvic diameters:
• The size of the lesser pelvis is particularly
important because it is the bony canal which
the fetus passes during vaginal delivery.
• The capacity for child bearing of the female
pelvis can be determined by diameters of the
lesser pelvis noted radiographically or
manually during a pelvic examination.
• The anteroposterior(AP) diameter of the
lesser pelvis, the true(obstetrical) conjugate
from middle of the sacral promontory to the
posterosuperior margin of the pubic
symphysis.
• The AP diameter is a fixed distance through
which the baby’s head must pass in a vaginal
delivery.
• Due to presence of the urinary bladder, this
distance cannot be measured directly during a
pelvic examination.
• In all pelvic girdles, the ischial spines extend
towards each other, and the interspinous
distance between them is normally the
narrowest part of the pelvic canal.
• During a pelvic examination, if the ischial
tuberosities are far enough apart to permit 3
fingers to enter the vagina side by side, the
subpubic angle is considered sufficiently wide to
permit passage of an average fetal head at full
term.