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PELVIS/PELVIC GIRDLE ANATOMY

 STRUCTURE OF PELVIC GIRDLE

BONY PELVIS

Four bones make up the pelvic girdle;

  • the sacrum
  • the coccyx
  • the two hip bones
  •   ilium
  •   ischium
  •   pubis

FUNCTION OF PELVIS

  • Supports the weight of the body through vertebral column.
  • Transmit force on to the hip bones.
  • Receives the ground forces generated when the foot contracts the ground and transmits them upward toward the vertebral column.
  • It supports and protects pelvic viscera.
  • It also makes up the bony portion of the birth canal in females.
  • Pelvic girdle provides locomotion and rotation during walking to create smooth rhythmic pelvic swing of both trunk and lower extremity.
  • Supporting and transferring the weight of the HAT (head, arm, and trunk complex) to the femurs in standing or to the ischial tuberosities in sitting.
  • Providing a broad area for muscular attachment.
  • Absorb vertical forces to and from both HAT superiorly and the lower extremities inferiorly.
  • The pelvic girdle offers a highly prescribed degree of mobility so that it works in concert with the lumbar spine, sacrum, and hip to move the body efficiently and effectively.
  • The pelvis facilitates movement of the femur by rotating so that the acetabulum is positioned toward the direction of impending femoral movement
  • the pelvis is a single non-jointed structure, but it can rotate in all three planes of movement

ARTICULATION OF PELVIC GIRDLE

The joints or articulations in the pelvic girdle include;

  • the right and left sacroiliac joints (postero-laterally)
  • the symphysis pubis (anteriorly)
  • the lumbosacral joint (superiorly)

TRUE PELVIS

  • Lesser pelvis or minor pelvis
  • Space enclosed by the pelvic girdle
  • Lies between pelvic inlet and pelvic outlet
  • Makes pelvic cavity
  • Separates the pelvic cavity. above. from the perineum, below

FALSE PELVIS

  • Greater or major pelvis
  • Space enclosed by pelvic girdle and pelvic brim
  • Bony area between iliac crest and pelvic inlet
  • Considered part of abdominal cavity; also referred as abdominopelvic cavity

PELVIC INLET

  • It is the circular opening between the abdominal cavity and the pelvic cavity through which structures transverse between abdomen and pelvic cavity.
  • Completely surrounded by bones

MARGINS

  • Posteriorly; promontory of sacrum
  • Laterally; iliopectineal lines
  • Anteriorly; symphysis pubis

PELVIC OUTLET

It is diamond shaped

MARGINS

  • Anteriorly; muscles
  • Posteriorly; ligaments

BOUNDARY

  • Anteriorly; pubic symphysis, pubic arch
  • Laterally and posteriorly; inferior border of the body of pubis, inferior ramus of the pubis, ramus of ischium, ischial tuberosity
  • Posteriorly and medially; coccyx, sacrotuberous ligament
  • Enclosed by; pelvic outlet and perineum below

PELVIC WALLS

The walls of the pelvis are formed by bones and ligaments partly lined by muscles covered in fascia and parietal peritoneum

ANTERIOR PELVIC WALL

It is a shallow wall formed by

  • Body of pubic bones (right and left)
  • Pubic rami
  • Symphysis pubis

POSTERIOR PELVIC WALL

It is an extensive wall formed by;

  • Sacrum
  • Coccyx
  • Piriformis muscle
  • Parietal pelvic fascia

LATERAL PELVIC WALL

The lateral pelvic wall is formed by;

  • Hip bone
  • Pelvic inlet
  • Obturator membrane
  • Sacrotuberous ligament
  • Sacrospinous ligament
  • Obturator internus muscle

INFERIOR PELVIC WALL

  • Also referred as Pelvic floor
  • It supports the pelvic viscera
  • It is formed by pelvic diaphragm
  • It divides the pelvis into Main pelvic cavity and Perineum

Muscles of pelvic wall;

  • Piriformis
  • Obturator internus
  • Levator ani
  • coccygeus

APEERTURES IN THE PELVIC WALL

Each pelvic wall has three major apertures

  • The obturator canal
  • The greater sciatic foramen
  • The lesser sciatic foramen

PELVIC DIAPHRAGM

It is a gutter shaped sheet of muscle formed by;

  • Levator ani muscles
  • Coccygeus muscle

It contains passage for urethra in males and the urethra and vagina in females

MUSCLES OF THE PELVIC WALL

  • Obturator internus
  • Piriformis

PELVIC FASCIA

It is formed by connective tissue continuous with fascia lining of abdominal wall and perineum

DIVISION OF PELVIC FASCIA

Parietal fascia; the parietal pelvic fascia becomes continuous through the opening with the fascia covering the inferior surface of the pelvic diaphragm, in the perineum. It covers the sphincter urethrae muscle and the perineal membrane and forms the superior fascial layer of the urogenital diaphragm.

Visceral fascia; The visceral layer of pelvic fascia covers and supports all the pelvic viscera. It is condensed to form the pubo-cervical, transverse cervical, and sacrocervical ligaments of the uterus

NERVES OF THE PELVIS

LUMBO-SACRAL PLEXUS

  • Superior gluteal nerve
  • Inferior gluteal nerve
  • Nerve to piriformis
  • Nerve to obturator internus
  • Nerve to quadratus femoris
  • Perforating cutaneous nerve
  • Posterior cutaneous nerve of thigh
  • Common peroneal nerve
  • Sciatic nerve
  • Pudendal nerve
  • Obturator nerve (branch of lumbar plexus)

AUTONOMIC NERVES

The pelvic part of the sympathetic trunk is continuous above, behind the common iliac vessels, with the abdominal part

  • Pelvic splanchnic nerve
  • Superior hypogastric plexus
  • Inferior hypogastric plexus

ARTERIES OF THE PELVIS

Common iliac artery

  • External iliac artery
  • Inferior epigastric artery
  • Deep circumflex artery
  • Femoral artery
  • Internal iliac artery
  • Anterior division of internal iliac artery
  • Umbilical artery
  • Superior vesical artery
  • Artery to vas deferens(males)
  • Obturator artery
  • Inferior vesical artery
  • Middle rectal artery
  • Internal pudendal artery
  • Inferior gluteal artery
  • In females;
  • Uterine artery
  • Vaginal artery
  • Posterior division
  • Iliolumbar artery
  • Lateral sacral artery
  • Superior gluteal artery

VEINS OF THE PELVIS

  • External iliac vein
  • Internal iliac vein
  • Median iliac vein

LYMPHATICS OF PELVIS

  • External iliac nodes
  • Internal iliac nodes
  • Common iliac nodes

LIGAMENTS

  • Anterior sacroiliac ligament
  • Interosseous sacroiliac ligament
  • Short posterior sacroiliac ligament
  • Long posterior sacroiliac ligament
  • Sacrotuberous ligament
  • Sacrospinous ligament
  • Iliolumbar ligament
  • Superior pubic ligament
  • Inferior pubic ligament
  • Lumbosacral ligament

MOVEMENTS OF PELVIC GIRDLE

  • Anterior pelvic rotation
  • Posterior pelvic rotation
  • Left lateral pelvic rotation
  • Right lateral pelvic rotation
  • Left transverse pelvic rotation
  • Right transverse pelvic rotation

PELVIC GIRDLE MUSCLES

Muscles of hip and pelvic girdle work in conjunction

  • Iliopsoas
  • Pectineus
  • Rectus femoris
  • Sartorius
  • Gluteus medius
  • Gluteus minimus
  • External rotators
  • Tensor fascia latae
  • Biceps femoris
  • Semitendinosus
  • Semimembranosus
  • External rotators
  • Adductor brevis
  • Adductor longus
  • Adductor brevis
  • Gracilis

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