ANATOMY OF FEMALE PELVIC

By: Tiyas K
Airlangga University Department of Child-Maternity Nursing Nursing Faculty 2010

PELVIC
A. Solid part
B. Soft part muscle

: Pelvic bone
: Pelvic ligament &

A. PELVIC BONE

2 Innominate bone : Os illium Os ischium Os pubic Sacrum Coccyx

PELVIC BONE

PELVIC BONE

PELVIC BONE

PELVIC BONE

Sacrum

PELVIC BONE

Tulang Coccygis

Ischium Function

Support body weight (tuber ischiadica)

Fungsi os Coccygis

In labor this bone extent to posterior in order to wider the pelvic outlet

Pelvic Inlet/Pelvic brim

Area bordered by:

Promontorium Sacrum Linea

inominata Ramus Superior ossis Pubis Uper border of Symphisis pubis

Pelvic outlet
Area bordered by: Ujung bawah Sacrum Tulang Tuber Ischiadica Sacro-coccygeal Lower border of symphisis pubis

Normal pelvic measurement

Distansia Cristarum

Distansia Spinarum

Distansia Cristarum: 2829 cm Distansia Spinarum: 2526 cm

Inside Pelvic measurement

Conjugata Diagonalis = 12,513cm
Conjugata Vera = CD (1,52cm) Conjugata Obstetrika = terpendek

Hodge line

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

B. PELVIC LIGAMENT & MUSCLE

LIGAMENT connect the pelvic joint

Ligament interpubic pada symphysis pubis Ligament sacro iliaca Ligament sacro-coccygeal Ligament sacro-tuberous Ligament sacro spinosus

PELVIC MUSCLE
The 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 ---- lavator ani & coccygeus

PELVIC MUSCLE

Conjugata Vera

Sacral promontory

Left sacro-iliac joint

Iliopectineal line

Sacrospinous ligament

Sacrotuberous ligament Ischial spine Symphysis pubis

Ischial tuberosity

PELVIC EXAMINATION

X-Ray Jangka Panggul Distansia Cristarum Distansia Spinarum Conjugata eksterna/Bouldeloque: distance
between upper border symphysis pubis with prosessus spinosus lumbal 5. the normal measurement 1820 cm

Vaginal Touch

Vaginal Touch Examintion

Promontorium touched/not Conjugata Vera normal/not Spina Ischiadica prominent/not Arkus pubis wide/narrow Sakrum curve/not

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

Differentiation between female and male pelvic

Pelvic Shape

PELVIC SHAPE
1-GYNECOID Typical female pelvis found in 50% of women Roundedslightly oval inlet Straight pelvic sidewalls with roomy pelvic cavity Good sacral curve Ischial spines are not prominent Pubic arch is wide

PELVIC SHAPE
2-ANDROID Typical male pelvis found in 1/3 white women 1/6 non-white Pelvic brim is heart shaped Pelvis funnels from above downwards (convergent sidewalls) Narrow pubic arch Prominent spines

PELVIC SHAPE
3-ANTHROPOID 25% white women & 50% nonwhite Pelvic brim APD > TD Long & narrow pelvic canal with long sacrum Straight pelvic sidewalls 4-PLATYPELLOID 3% of women Pelvic brim TD >>>APD kidney shape Sacral promontory pushed forwards

Pelvic Shape Deviation

A. Panggul Naegele B. Panggul Rakhitis C. Panggul Skoliosis D. Panggul Kifosis E. -- dari Samping

F. Panggul Osteomalasia
G. Panggul Spondilolistesis H. Panggul Robert

Causes of pelvic deviation

-

Congenital: Narrow palvic Simple flat Funnel (narrow outlet) Assimilation Disease : Rachitic Osteomalasia TBC Lordosis Skoliosis Kifosis Spondilosis

Deviation impact

Prolonged labor CPD (Chepalo Pelvic Disproportion) Breech presentation Infertility

POST TEST

Pelvic anatomy contains of what kind of part? What can you mention about Pelvic bone? What can you mention about Pelvic ligament? What can you mention about pelvic muscle? What do you know about pelvic shape? What would happen if the pelvic is not normal in measurement?

Daftar pustaka

Wyknyosastro , S., (2002) Ilmu Kebidanan. Jakarta: Yayasan Bina Pustaka Sarwono Prawiroharjo Cunningham, H. et. al., (2005) Williams Obstetrics. 22nd. New York: McGRAW-HILL Bobak, LM. & Jensen, MD., (2005) Maternity & Gynecology Care: The Nurse and The Family. 5th Ed. St. Louis: Mosby company

THANK YOU
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