ANATOMY (DR.

KVAVATZE OTAR)

RESEARCH PAPER

TITLE: PELVIS

AUTHOR-RAJA BASIL ADEEL (UG CODE:2103110)

INTRODUCTION

The Pelvis which is also known as the hipbone is a bowl-like structure that supports the
weight of the upper body. It is a part of the appendicular skeleton and is located below
the abdomen and above the thighs. It Is composed of the bony pelvis which contains the
hip bones, pelvic cavity, pelvic floor, and perineum. The bones of the pelvis are attached
by many ligaments and are supported by joints that help the pelvis function. The Pelvis
has many functions which include holding the body upright which allows you to run and
walk and stand also in pregnant women it helps in childbirth as women have a wider
pelvis than men.

BONES OF THE PELVIS

The bones of the Pelvis consist of the Right and Left Pelvic bones or hip bones, the
sacrum, and the coccyx.

The Pelvic bone is irregular in shape and classification of bones, and it is known as an
irregular bone. It has 2 major parts which are separated by an oblique line of the medial
surface of the pelvic bone. The pelvic bone which is located above this oblique line
represents the lateral wall of the false pelvis, which is a part of the abdominal cavity.
Conversely, the pelvic bone which Is located below or distal to this line represents the
lateral wall of the true pelvis which contains the pelvic cavity. The Linea Terminalis is the
lower two-thirds of this line, and it also contributes a little to the margin of the pelvic inlet.

The lateral surface of the bone has a large articular socket which is known as the
acetabulum which along with the head of the femur then forms the hip joint. Inferior to
this socket known as the acetabulum is a Large Obturator Foramen which is closed by a
connective tissue membrane that flat called the obturator membrane.

The Posterior margin of the bone is marked by two notches which are separated by an
ischial spine the two notches are called the greater sciatic notch and the lesser sciatic
notch. The posterior margin then terminates inferiorly as a large ischial tuberosity, and
the irregular anterior margin of the bone is marked by several things which include the
pubic tubercle, anterior inferior iliac spine, and anterior superior iliac spine.

The Pelvic bone is composed of three components, the ilium, pubis, and ischium. The
Ilium is the most superior In position and is separated into an upper and lower part by a
ridge which is on the medial surface. Anteriorly the ridge is rounded and is called the
arcuate line which forms part of the Linea terminalis and posteriorly the ridge is sharp
and is superior to the surface of the bone that articulates with the sacrum. The upper
part of the ilium expands to form a wing-shaped structure known as the ala which
provides support for the lower abdomen or false pelvis. The part of the ilium that is
inferior to the arcuate line contributes to the wall of the true pelvis. The Pubis is the
anterior and inferior part and has two rami or arms and a body. The body is flattened
dorsoventrally and has a rounded pubic crest on its superior surface that terminated
laterally as a pubic tubercle. The two rami of the pubis are the superior pubic ramus and
the inferior pubic ramus. The superior pubic ramus projects posterolateral from the body
of the pubis and then joins with the ilium and ischium at its base. The Inferior Pubic
ramus projects laterally and joins with the ramus of the ischium. The ischium is the
superior and posterior part of the bone and has a large body that projects superiorly to
join with the Superior Ramus of the Pubis and with the ilium and has a ramus of its own.
The most prominent feature of the ischium is that it has a very large tuberosity on its
posteroinferior surface known as the ischial tuberosity which serves as an attachment
site for the lower limb muscles.

The Sacrum is made by the fusion of the 5 sacral vertebrae. The apex of the sacrum
articulates the coccyx, and the base articulates with vertebra L5. The superior surface
has a wing-like transverse process on either side called the ala. The Posterior surface of
the sacrum is convex although the anterior surface is concave.

Lastly, the coccyx is formed by the fusion of 4 coccygeal vertebrae and is shaped like an
inverted triangle. The Superior surface of the coccyx has a facet, 2 cornva on each side
that thereby project upward to fuse with the cornva that projects downward.

JOINTS

There are three major joints in the pelvis, and they are the Lumbosacral Joints, the
Sacro iliac joints, and the pubic symphysis joint.

Lumbosacral Joints are formed between the sacrum and vertebra L5 and they are
consisting of two zygapophysial joints and an intervertebral disc that joins the bodies of
vertebra S1 and L5. These joints are reinforced by strong lumbosacral ligaments and
iliolumbar ligaments.

Sacro Iliac Joints are synovial joints the articular facets on the lateral surface of the
sacrum and the iliac. They transmit forces to the vertebral column from the lower limbs.
They are stabilized by 3 ligaments. The Anterior Sacro iliac ligament, the interosseus
Sacro iliac ligament and the posterior Sacro iliac ligament. The anterior Sacro iliac
ligament is a thickening of the part of the joint that has the fibrous membrane and is
located inferiorly and anteriorly to the joint. The Interosseous Sacro Iliac Ligament is the
strongest and largest of the three and is located posterosuperior to the joint. The
Posterior Sacro Iliac Ligament covers the interosseus Sacro iliac ligament.

The Pubic Symphysis Joint is covered by hyaline cartilage and is connected to the
midline of adjacent surfaces by fibrocartilage. It is surrounded by layers of collagen
fibers and 2 ligaments which are the Superior Public Ligament which is above the joint
and the Inferior Public Ligament which is below the joint.

MUSCLES, LIGAMENTS, AND APERTURES OF THE PELVIC WALL

The walls of the cavity consist of the pelvic bones, sacrum, coccyx, two muscles, and
two ligaments.

The two muscles of the pelvic wall are the obturator internus muscle and the piriformis
muscle which contribute to the lateral walls of the pelvic cavity. The Obturator internus
muscle is a flat muscle that is shaped like a fan and originates from the deep surface of
the obturator membrane and associated regions of the pelvic bone that surrounds the
obturator foramen. Its Insertion is the medial surface of the greater trochanter of the
femur. Innervation Is from the nerve to obturator internus L5 and S1 and the function of
the muscle is rotation and abduction of the hip. The Piriformis muscle is triangular and
originates from the anterior surface of the sacrum. Insertion is from the medial side and
superior border of the greater trochanter of the femur. Innervation is from branches of
S1 and S2 and the function of the muscle is to abduct the flexed hip.

The two ligaments Sacrospinous and Sacro-tuberous ligaments stabilize and support
the Sacrum and convert the lesser and greater sciatic notches of the pelvic bone into the
foramen. The Sacro Spinous Ligament is triangular and is smaller than the Sacro-
tuberous ligament. The base of it is attached to the margins of the Coccyx and sacrum
and the apex is attached to the ischial spine. The Sacro-tuberous ligament is also
triangular in shape and is superficial to the sacrospinous ligament. The base of it
extends from the posterior superior iliac spine to the dorsolateral surface of the coccyx
and the apex is attached to the margin of the ischial tuberosity.

The Lateral Pelvic wall has three Major apertures which allow the passage of structures
between the pelvic cavity and other regions. The three apertures are the Obturator
Canal, The greater sciatic foramen, and the lesser sciatic foramen. The top of the
obturator foramen is surrounded by the obturator membrane, obturator muscles, and
super pubic ramus. The Obturator nerve and vessels pass from the pelvic cavity into the
thigh through the obturator canal. The greater sciatic foramen is the major component of
communication between the pelvic cavity and the lower limb. It is formed by the greater
sciatic notch, spine of ischium, and Sacro-tuberous and sacrospinous ligaments. The
Piriformis muscle passes through it and divided it into two parts. One part is where the
Superior Gluteal nerve passes and the other is where the inferior gluteal nerve passes,
the sciatic nerve, and the pudendal nerve. The lesser sciatic foramen is formed by the
lesser sciatic notch, ischial spine, and sacrospinous and Sacro-tuberous ligaments. It
acts as communication between the gluteal and perineum region and the obturator
internus muscle passes through this.

PELVIC FLOOR

The pelvic floor is formed by the perineal membrane, deep perineal pouch, and the
pelvic diaphragm. The pelvic floor separates the pelvic cavity which is above the pelvic
floor from the perineum which is below.

The Perineal Membrane is a Fascial structure that is thick and triangular and attaches to
the pubic arch. It has a free posterior margin and is oriented in the horizontal plane.
Anterior to it is a small gap. It is above a thin space called the deep perineal pouch or
also called the deep perineal space that contains a layer of skeletal muscle and
numerous and different neurovascular elements.

The Pelvic Diaphragm is the muscular part of the pelvic floor and is shaped like a bowl.
It consists of two muscles which are the Levator ani muscles and the Coccygeus
Muscle. The Levator Ani muscle originates in a line around the pelvic wall which starts
on the posterior part of the pelvic bone and extends across the obturator internus
muscle. The anterior part is attached to the superior surface of the perineal membrane
and the posterior part is around the anal canal. Innervation is from branches of the
anterior ramus of S4 and by the rectal branch of the pudendal nerve S2-S4. The Origin
of the coccygeus muscle is the ischial spine and sacrospinous ligament. Insertion is
from the lateral margin of the coccyx and the border of the sacrum. Innervation is from
branches of the anterior rami of S3 and S4.

REFERENCES

 https://www.pregnancybirthbaby.org.au/anatomy-of-pregnancy-and-
birth-pelvis
 https://www.ncbi.nlm.nih.gov/books/NBK482258/
 Grays Anatomy for Students 3rd Edition.
 The Concise Human Body Book: An Illustrated Guide to its structure,
function, and disorders.