FEMALE PELVIS. Midwifery and obstetrical nursing.pptx

functions of female pelvis
It allows movement of body (walking & running).
It allows to sit & kneel.
It is adapted for child bearing because of its increased width & rounded brim.
It transmits the weight of trunk to the legs, acting as a bridge between femurs.
It bears the weight of sitting body on the ischial tuberosities.
It provides protection to the pelvic organs.
The sacrum transmits the cauda equina & distributes the nerves to various parts of the pelvis.
landmarks of pelvis Sacral promontary
Sacral ala
Sacroiliac joint
Iliopectineal line
Iliopectineal eminence
Pectineal line
Pectineal eminence
Pubic crest/pubic tubercle
Symphysis pubis

pelvic ligaments Interpubic ligament: present at symphysis pubis
Sacroilliac ligaments
Sacrococcygeal ligaments
Sacrotuberous ligament: from sacrum to ischial tuberosity
Sacrospinous ligament: from sacrum to ischial spine

1. FEMALE PELVIS

2. FUNCTION OF FEMALE PELVIS: It allows movement of body (walking & running). It allows to sit & kneel. It is adapted for child bearing because of its increased width & rounded brim. It transmits the weight of trunk to the legs, acting as a bridge between femurs. It bears the weight of sitting body on the ischial tuberosities. It provides protection to the pelvic organs. The sacrum transmits the cauda equina & distributes the nerves to various parts of the pelvis.

3. PELVIC BONES: It is composed of: 2 innominate bones or hip bones 1 sacrum 1 coccyx

4. 1. INNOMINATE BONE: Each innominate bone is composed of 3 parts: ILLIUM ISCHIUM PUBIC BONE

5. ILLIUM Illiac crest Anterior superior spine Anterior inferior spine Posterior superior spine Posterior inferior spine Illiac fossa

6. ISCHIUM It is thick lower part Ischial tuberosity Ischial spine

7. PUBIC BONE It forms the anterior part Ramus-superior & inferior Symphysis pubis Pubic arch Obturator foramen

8. ACETABULUM The innominate bones contains a deep cup to receive the head of femur. This is termed the acetabulum. Contribution: 2/5 th ilium, 2/5 th ischium & 1/5 th pubic bone.

9. GREATER SCIATIC NOTCH It extends from posterior inferior illiac spine to ischial spine LESSER SCIATIC NOTCH It extends from ischial spine to the ischial tuberosity.

10. 2. SACRUM It is wedge shaped bone made up of 5 fused vertebrae. Sacral promontory. Hollow of sacrum Sacral ala or sacral wings It has 4 pairs of foraminas or holes Rough posterior surface

11. 3. COCCYX It is a vestigial tail. It consists of 4 fused vetebras. It forms a small triangular bone.

12. LANDMARKS OF PELVIS Sacral promontary Sacral ala Sacroiliac joint Iliopectineal line Iliopectineal eminence Pectineal line Pectineal eminence Pubic crest/pubic tubercle Symphysis pubis 1 2 3 4 5 6 7 8 9

13. PELVIC JOINTS SYMPHYSIS PUBIS (1): between 2 pubic bones SACRO-ILLIAC JOINT(2 ) : between sacrum & illium SACROCOCCYGEAL JOINT (1): between sacrum & coccyx. Sacro-coccygeal joint

14. PELVIC LIGAMENTS Interpubic ligament : present at symphysis pubis Sacroilliac ligaments Sacrococcygeal ligaments Sacrotuberous ligament : from sacrum to ischial tuberosity Sacrospinous ligament : from sacrum to ischial spine

15. Sacroiliac ligament Sacrococcygeal ligament Sacrotuberous ligament Sacrospinous ligament

16. Pelvis can be divided as: True pelvis: it is the bony canal through which the fetus must pass during birth. It has a brim (inlet), a cavity & an outlet. False pelvis: It is formed laterally by flared out part of illium, posteriorly by lumbar vertebrae & anteriorly by abdominal wall

17. DIAMETERS OF TRUE PELVIS: BRIM CAVITY OUTLET Oblique diameter Transverse diameter Antero-posterior diameter

18. 1. BRIM (INLET): ANTERO-POSTERIOR DIAMETER Anatomical conjugate: 11 cms Obstetrical conjugate: 10 cms Diagonal conjugate: 12 cms OBLIQUE DIAMETER: 12 cm, from one sacroiliac joint to opposite iliopectineal eminence. TRANSVERSE DIAMETER: 13cms, it is the distance between 2 farthest point on the ileopectineal lines.

19. II.CAVITY ANTERO-POSTERIOR DIAMETER : 12 cms, midpoint of posterior surface of symphysis pubis to the junction of 2 nd & 3 rd sacral vertebrae. OBLIQUE DIAMETER : 12cms , cannot be measured. TRANSVERSE DIAMETER :12 cms, cannot be measure.

20. III. OUTLET ANTERO-POSTERIOR DIAMETER : 13 cm, from lower border of symphysis pubis to sacro-coccygeal joint. OBLIQUE DIAMETER : 12cm, distance between sacro-spinous ligament & obturator foramen. TRANSVERSE DIAMETER : bi-spinous diameter: 10.5/11 cm, distance between 2 ischial spine.

21. TYPES OF PELVIS: Pelvis are of four categories according to the shape of the brim. Gynaecoid pelvis Android pelvis Anthropoid pelvis Platypelloid pelvis

22. 1. Gynaecoid pelvis It is the normal female type. Inlet is slight transverse oval & spacious forepelvis Sacrum is wide with average concavity. Side walls are straight with blunt ischial spines. Sacro-sciatic notch is wide. Subpubic angle is wide ,90-100°.

23. 2. Android pelvis It is a male type. Inlet is heart-shaped & narrow forepelvis Sacrum is straight Side walls are converging (funnel pelvis) Projecting ischial spines & Sciatic notch is narrow. Subpubic angle is narrow <90°

24. 3. Anthropoid pelvis It is ape-like type. All anteroposterior diameters are long & all transverse diameters are short.(long oval brim) Sacrum is long and deeply concave. Sciatic notch is very wide & ischial spines are not prominent Subpubic angle is narrow (<90° )

25. 4. Platypelloid pelvis It is a flat female type. Brim is kidney shaped in which all anteroposterior diameters are short & all transverse diameters are long. Sacrum is flat & ischial spines are blunt. Sciatic notch is narrow & Subpubic angle is wide