Female pelvis.pptx

Female Pelvis ppt..
Introduction
Function
Bones
Joints
Ligaments
Landmarks
True and False pelvis
Diameter

1. Prepared by: Rashmi Goswami F.Y MSc Nursing Female pelvis

2. introduction The female pelvis is basin shape like structured, connects the spine to the lower limbs, because of its characteristics its aids in childbirth. The bony pelvis in normal standing posture transmits the body weight of head, trunk and the upper extremities. In female it is adapted for child bearing.

3. Functions of pelvis Female pelvis is skeletal ring, because of it,s characteristics, aids in childbirth. Obstetrical Function: 1. Adapted for childbearing in comparison to male pelvis, brim is rounder and wider. 2. It support gravid uterus. 3. It gives passage way to fetus. General Function: 1. Primary function to allow movement to body. 2. Helps in walking, sitting, running. 3. Pelvis contain and protect reproductive organs along with bladder and rectum. 4. Sitting weight of body is taken up by the ischial tuberosity. 5. Helps in transmitting weight of body to legs.

4. Bones of pelvis There are 4 bones: - Two Hip bones (Innominate or nameless) - One Sacrum - One Coccyx

5. ilium It is the largest flarred out part present on the superior aspect of female pelvis. Its superior border on which our hand is rest is known as Iliac crest. It has two bony projections anteriorly and posteriorly. The bony projection felt at the front of iliac crest known as anterior superior iliac spine, just below it there is anterior inferior iliac spine. At opposite end of iliac crest similar prominence are present which are named as Posterior superior and posterior inferior iliac spine. The concave anterior surface of the ilium is the Iliac Fossa.

6. ischium The ischium is the thick lower part of the hip bone. Ischial tuberosity the largest bony prominence. In sitting position body rest on Ischial tuberosity. Behind and a little above the tuberosity is an inward projection, the Ischial Spine. - In labor, station of fetal head estimated in relation to ischial spine. - Internal rotation of fetal head occur here. Greater sciatic notch – extends from sacroiliac joint to ischial spine Lesser sciatic notch – extends from ischial spine to ischial tuberosity.

7. Pubic bone The two pubic bone form the anterior part of the hip bone. It has body and two oar like projection known as Superior ramus & Inferior Ramus. The two pubic bone meet at S ymphysis Pubis. Two inferior rami form pubic arch. Space enclosed by body of the pubic bone, ramus, and ischium is called as Obturator foramen. The innominate has a deep cup to receive the head of femur, termed as Acetabulum.

8. Sacrum The sacrum is a wedge shaped bone consisting of five fused vertebrae. The prominent upper boarder of the first sacral vertebra is known as Sacral Promontory. The anterior surface of the sacrum is concave and is referred to as the hollow of sacrum Laterally the sacrum extends into a wing or ala The posterior surface is roughened to receive attachments of muscles.

9. coccyx The coccyx is a vestigial tail. It consist of four fused vertebra forming a small triangular bone. During labor it moves backward, to enlarge the pelvic outlet allowing more space for passage of fetus called Nodding.

10. Pelvic joints Four pelvic joints- Sacroiliac joints (2)- - Slightly movable joint. - Formed where ilium join first 2 sacral vertebrae on either side. - Strongest joint of body. 2. Symphysis Pubis (1)- - Cartilagenous fibrous joint between 2 pubic bones. 3 . Sacro -coccygeal (1)- - Hinge join between sacrum and coccyx. During pregnancy due to softening of ligament, provide more space for fetal head to pass through pelvis.

11. Pelvic ligaments Each of the pelvic joints is held together by ligaments. Interpubic ligaments at the Symphysis pubis. Sacro -iliac ligaments Sacro -coccygeal ligaments There are two other ligaments important midwifery The sacro-tuberous ligament The sacro-spinous ligament

12. Structure of pelvis The pelvis is broadly divided into true and false pelvis. False pelvis: It is formed by the upper flared out portion of the ilium. It protects the abdominal organs. It has no obstetrical importance except that it provides certain landmarks for external pelvimetry . True pelvis : The true pelvis constitutes the bony passage through which the fetus must pass through to be born vaginally. Therefore, its construction planes and diameters are of utmost interest in obstetrics. It has three parts: - Brim - Cavity - Outlet

13. False pelvis true pelvis

14. Landmarks of pelvic inlet/brim Symphysis pubis Pubic crest Pubic tubercle Pectineal line Ilio-pectineal eminence Ileopectineal line Sacroiliac joint Anterior border of ala of sacrum Sacral promontory

15. Diameters of pelvic brim Anterior-posterior diameter of Inlet- Anatomical conjugate(11cm)- Distance between midpoint of sacral promontory to inner margin of upper border of symphysis pubis. It measures about 11cm. Obstetric conjugate(10cm)- D istance between midpoint of sacral promontory to midline of inner surface of symphysis pubis. Shortest diameter of inlet, measures about 10cm. Diagonal conjugate(12cm)- Distance between lower border of symphysis pubis to midpoint of sacral promontory. Measures by bimanual examination. It measures about 12cm.

16. 2. Transverse diameter of inlet: Distance between two farthest point on pelvic brim over Iliopectineal lines. Measures about 13cm 3. Oblique diameter of inlet: There are two oblique diameter right & left. Each extends from one sacro-iliac joint to opposite iliopectineal eminence. Measures about 12cm.

17. The pelvic cavity The cavity extends from the brim above to the outlet below. Shape: its shape is almost rounded. It consist of - Anterior border – Symphysis pubis - Posterior border – Sacral hollow - Lateral border – Soft tissues All diameters measures 12cm

18. The pelvic outlet Describes as anatomical and obstetrical outlet. Obstetrical outlet has practical value, through which fetus has to pass outlet only. The oblique diameter cannot be measured exacly due to presence of soft tissues, roughly measured about 12cm. Anatomical outlet- - Anterio-Posterio diameter extends from lower border of symphysis pubis to tip of coccyx, measures about 13cm. - Transverse diameter is inter tuberous diameter, is the distance between inner border of 2 ischial tuberosity, measures about 11cm. Obstetrical outlet- - N arrow through which fetus has to pass. - Anterio-Posterio diameter extends from inferior border of symphysis pubis to tip of the sacrum, measures about 11cm. - Transverse diameter is bispinous diameter. It is distance between tip of two ischial spine, measures about 10.5cm.