ANATOMY OF FEMALE PELVIC

ANATOMY OF FEMALE PELVICDr. Heny Anggraeny Lenap

PELVIC BONEA. PELVIC BONE2 Innominate bone : Os illiumOs ischiumOs pubic

Sacrum Coccyx

PELVIC BONE

PELVIC BONEPelvic Inlet/Pelvic brimArea bordered by: PromontoriumSacrumLinea inominataRamus Superior ossis PubisUper border of Symphisis pubis

Pelvic outletArea bordered by:Ujung bawah SacrumTulang Tuber IschiadicaSacro-coccygealLower border of symphisis pubis

Hodge lineHodge I: imagination line drawn from promontorium to the upper border of symphisis pubis Hodge II: parallel with hodge I measured from lower border of symphisisHodge III: parallel with hodge II, measured from spina ischiadicaHodge IV: parallel with hodge III, measured from coccyx tip

H IH IIH IIIH IVB. PELVIC LIGAMENT & MUSCLELIGAMENT connect the pelvic joint

Ligament interpubic pada symphysis pubisLigament sacro iliacaLigament sacro-coccygealLigament sacro-tuberousLigament sacro spinosusPELVIC MUSCLEThe inner aspect of the bony pelvis is covered with muscles: Above the brim --- iliacus & psoas

Sidewalls ---- obturator internus & its fascia

Post wall ---- pyriformis

Pelvic floor ---- levator ani & coccygeus

12PELVIC MUSCLE

Conjugata VeraL4

Ischial spine

Ischial tuberosity

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Sacral promontory

Left sacro-iliac joint

Iliopectineal line

Sacrospinous ligament

Sacrotuberous ligament

Symphysis pubis

Sacral promontory Left sacro-iliac joint Iliopectineal line Sacrospinous ligament Sacrotuberous ligament Symphysis pubis Ischial tuberosity Ischial spine PELVIC EXAMINATIONPelvic inlet examinationPelvic outlet examination EngagementJangka PanggulDistansia CristarumDistansia SpinarumConjugata eksterna/Bouldeloque: distance between upper border symphysis pubis with prosessus spinosus lumbal 5. the normal measurement 1820 cmVaginal TouchPelvic outlet examinationbiischial diameter, intertuberous diameter, and transverse diameter of the outlet. A measurement of more than 8 cm is considered normalNormal pelvic measurement

Distansia SpinarumDistansia CristarumDistansia Cristarum: 2829 cmDistansia Spinarum: 2526 cmInside Pelvic measurement

Conjugata Diagonalis = 12,513cm Conjugata Vera = CD (1,52cm) Conjugata Obstetrika = terpendekVaginal Touch ExaminationPromontorium touched/notConjugata Vera normal/notSpina Ischiadica prominent/notArkus pubis wide/narrowSakrum curve/not

Note: Touched Promontory usually indicated narrow pelvicHeight 145 cm also indicated narrow pelvic

Differentiation between female and male pelvicPelvic Shape

PELVIC SHAPE 1-GYNECOIDTypical female pelvis found in 50% of womenRoundedslightly oval inlet Straight pelvic sidewalls with roomy pelvic cavityGood sacral curve Ischial spines are not prominentPubic arch is wide 23PELVIC SHAPE2-ANDROIDTypical male pelvis found in 1/3 white women 1/6 non-whitePelvic brim is heart shapedPelvis funnels from above downwards (convergent sidewalls)Narrow pubic archProminent spines

24PELVIC SHAPE3-ANTHROPOID25% white women & 50% nonwhitePelvic brim APD > TDLong & narrow pelvic canal with long sacrumStraight pelvic sidewalls

4-PLATYPELLOID3% of womenPelvic brim TD >>>APD kidney shapeSacral promontory pushed forwards25Thank you