Pelvic walls, vessels, and nerves

Dr. Firas Mohammed Ghazi

The pelvis

Cavity for Pelvic viscera

Continuous with abdominal cavity

Inlet, outlet, walls, and floor

The pelvic bonesHip

Sacrum

Coccyx

AP

True Vs Falls pelvis

• Pelvis is divided into true and falls by _______ which

is formed by______________

Cavity of the true pelvis

Between Inlet & Outlet

Bounded by

1. Ant., post., & lat. walls

2. Floor

Pelvic inlet

• Transversely oval

• Bounded by Vessels

• Many structures pass

through it

Posterior wall1. Anterior sacral foramina

2. Piriformis

3. Sacral plexus (sciatic N.)

Lateral wall 1. Sacrotuberous & sacrospinous ligaments

2. Greater and lesser sciatic foramina

3. Obturator foramen, membrane and canal

4. Obturator internus

The Pelvic outlet

(Diamond shaped)

Formed by

1. ____________ anteriorly

2. ____________ posteriorly

Pelvic Floor

(Pelvic diaphragm)

Formed by 2 Muscles

Gutter-shaped

Separates pelvic cavity from ____

Openings: urethra ±vagina, rectum

Perineal body??

Pelvic viscera

Male Female

Female pelvis is adapted to childbirth

1. Roomier

2. Inlet: Oval in women/ heart-shaped in men

3. Cavity: wider and shorter in women

4. Outlet: larger in women

5. Sub-pubic angle: Wider in women

Linings of the pelvis

Pelvic fascia and peritoneum

Parietal and visceral

Reflections on viscera?

Pelvic nerves &vessels lie outside

Peritoneal reflections and spaces

Rectovesical pouch Recto uterine pouch

Female pelvis and labor

Curved axis

Fetal head rotates 2 times while descending

Explain rotation of the fetal head !!!

Major vessels of the pelvis

Internal iliac artery and vein (± ovarian rtery)

Run on the walls of the pelvis

Pelvic fractures can lead to sever internal bleeding

Obturator nerve and pelvic appendix

• Run on the lateral pelvic wall covered by pelvic

fascia and peritoneum