Bony Framework of Pelvis

L2
Transverse processes of lumbar vertebrae
Inner lip Sacral
promontory L3 Iliac tuberosity
Intermediate
Iliac zone
crest Iliac crest
L4
Outer lip
Wing (ala) of ilium
Tuberculum
L5
Greater
sciatic
notch

Arcuate line

Anterior superior
Ischial spine
iliac spine
Sacrum Lesser
Anterior inferior
iliac spine sciatic notch

Iliopubic Greater trochanter

eminence Coccyx of femur

Superior Pecten pubis

pubic ramus (pectineal line)

Obturator
Pubic symphysis
foramen

Pubic tubercle Ischial tuberosity

Inferior Lesser trochanter

pubic ramus Pubic arch of femur
Inferior pubic ligament

Plate 330 Bones and Ligaments

 Radiographs of Male and Female Pelvis
See also Plates 243, 475
5

Female Pelvis
Sacrum

Sacro-iliac joint

Sacral foramina

Ilium

Acetabulum Pelvic inlet (dashed line)

Head of femur Ischial spine

Greater trochanter
Superior pubic ramus
Obturator foramen
Pubic symphysis
Ischium
Lesser trochanter
Femur

Male Pelvis

Ilium
L5

Ala of sacrum

Sacro-iliac joint
Sacrum

Acetabulum

Pubis
Pubic symphysis

Ischium Obturator foramen

Femur
Subpubic angle

Bones and Ligaments Plate 331

 Sex Differences of Pelvis: Measurements
See also Plate 243

Female pelvis/female pelvic

inlet: anterior view
Sacro-iliac joint
Sacral promontory
Diagonal conjugate (~12 cm)
Diameters of
Transverse (~13 cm)
the pelvis
Oblique (~12.5 cm)
Ischial spine
Iliopubic eminence
Pubic symphysis
Ischial tuberosity

Pubic arch

Male pelvis/male pelvic

inlet: anterior view

Diagonal All measurements slightly shorter in

conjugate relation to body size than in female
is only Pelvic inlet oriented more antero-
diameter of posteriorly than in female, where
pelvic it tends to be transversely oval
inlet that Pubic symphysis deeper (taller)
can be Pubic arch (subpubic angle) narrower
measured Ischial tuberosities less far apart
clinically Iliac wings less flared

Pubic
Transverse symphysis
diameter of pelvic
outlet (~11 cm)

True conjugate
Sacral is ~1.5 cm
promontory shorter than
diagonal
conjugate
t
inle
lvic

True conjugate
f pe

diameter
eo

of pelvic inlet
(~11 cm)
Plan

Ischial
tuberosity
le t
Anteroposterior Ischial spine ic out
diameter of pelv
Diagonal e of
pelvic outlet Plan
(varies 9.5–11.5 cm conjugate Anteroposterior
because of mobility diameter of
Tip of coccyx Pubic pelvic outlet
of coccyx) symphysis (9.5–11.5 cm)
Transverse diameter is the widest distance of pelvic inlet
Female pelvis/female pelvic outlet:
inferior view Female: sagittal section

Plate 332 Bones and Ligaments

 Bones and Ligaments of Pelvis
See also Plate 473
5
Iliolumbar ligament
Iliac crest
Supraspinous ligament
Posterior superior iliac spine
Posterior sacro-iliac ligaments
Iliac tubercle
Posterior sacral foramina
Greater sciatic foramen

Anterior superior iliac spine

Sacrospinous ligament
Sacrotuberous ligament
Lesser sciatic foramen
Acetabular margin
Ischial tuberosity
Tendon of long head of Anterior
biceps femoris muscle longitudinal
ligament
Iliolumbar
ligament

Deep Posterior Iliac

sacrococcygeal fossa
Superficial ligaments

Lateral sacrococcygeal Anterior sacro-iliac ligament

ligament
Sacral promontory
Posterior view
Greater sciatic foramen
Anterior superior iliac spine

Sacrotuberous ligament
Sacrospinous ligament

Anterior inferior iliac spine

Anterior
Ischial spine sacral
Lesser sciatic foramen foramina
Coccyx
Anterior
Iliopubic eminence sacrococcygeal
ligaments
Superior pubic ramus
Ischiopubic ramus
Pubic tubercle Pubic
Anterior view
symphysis

Bones and Ligaments Plate 333

 Bones and Ligaments of Pelvis (continued)
See also Plate 158

Median (sagittal) section

Body of L5 vertebra
Iliac Intermediate zone False pelvis
crest Inner lip
Lumbosacral (L5–S1) intervertebral disc
Iliac fossa Sacral promontory
Anterior superior Greater sciatic foramen
iliac spine
True pelvis
Arcuate line
Ischial spine
Anterior inferior
iliac spine Sacrospinous ligament
Iliopubic eminence Lesser sciatic foramen
Obturator canal Sacrotuberous ligament
Superior pubic ramus Coccyx
Pecten pubis Ischial tuberosity
(pectineal line)

Pubic tubercle

Symphyseal
surface

Obturator membrane Body of L4 vertebra

Intermediate zone
Lateral view Supraspinous ligament Outer lip Iliac crest
Iliac tubercle
Posterior, anterior, and
inferior gluteal lines Wing (ala) of ilium
(gluteal surface)
Posterior superior iliac spine Body of ilium
Anterior superior
Median sacral crest iliac spine
Posterior inferior iliac spine Anterior inferior
iliac spine
Posterior sacro-iliac ligament Acetabulum
Greater sciatic foramen Acetabular labrum

Sacrospinous ligament Acetabular margin

Posterior and lateral Lunate (articular) surface

sacrococcygeal ligaments Acetabular notch

Sacrotuberous ligament Transverse acetabular

ligament
Ischial spine Superior pubic ramus
Pubic tubercle
Lesser sciatic foramen
Obturator crest
Ischial tuberosity
Obturator canal
Obturator membrane Ischiopubic ramus

Plate 334 Bones and Ligaments

 Pelvic Diaphragm: Female
See also Plates 348, 350, 370
5

Piriformis
muscle

Ischial
Medial view spine
Arcuate line
Obturator internus muscle
and obturator fascia (cut)
Tendinous arch of levator ani muscle
Obturator canal
Iliococcygeus muscle
(part of levator ani muscle)
Rectum Coccygeus
Urethra (ischiococcygeus)
muscle
Pubococcygeus muscle
(part of levator ani muscle) Left levator ani
muscle (cut)
Vagina
Sphincter urethrae muscle External anal
sphincter muscle
Left puborectalis muscle and
perineal membrane
Compressor urethrae and urethrovaginal Superficial and deep
sphincter (portions of sphincter urethrae muscle) transverse perineal muscles

Piriformis muscle
Lateral view Greater sciatic foramen

Sacrotuberous ligament (cut) Ischial spine

Iliococcygeus muscle
(part of levator ani muscle)
Median sacral crest Tendinous arch of levator ani muscle
Pubococcygeus muscle
(part of levator ani muscle)
Puborectalis muscle
Coccygeus (ischiococcygeus) muscle (part of levator ani muscle)

Sacrospinous ligament (cut)

Pubic bone
(cut surface)
Coccyx
Deep dorsal vein
of clitoris
Urethra
Rectum Vagina

Pelvic Floor and Contents Plate 335

 Pelvic Diaphragm: Female (continued)
For urogenital diaphragm see Plate 356

Medial view Pubic bone (cut surface)

Obturator internus muscle

and obturator fascia (cut)
Obturator canal
Urethra Arcuate line of ilium
Vagina
Pubococcygeus muscle
(part of levator ani muscle)
Tendinous arch of
levator ani muscle Ischial
spine
Rectum
Iliococcygeus muscle Piriformis
muscle

Coccygeus
Coccyx

Superior view Inferior (arcuate) pubic ligament

Pubic symphysis Deep dorsal vein of clitoris
Transverse perineal ligament
Inguinal ligament Fascia of deep perineal muscles
(Poupart’s)
Urethra
Vagina
Obturator canal
Obturator fascia
(over obturator
internus muscle)
Pubococcygeus muscle
(part of levator ani
muscle)

Tendinous arch of
levator ani muscle
Rectum
Iliococcygeus muscle
(part of levator ani muscle)
Ischial spine
Levator plate (median raphe)
of levator ani muscle
Coccygeus (ischiococcygeus)
muscle
Piriformis muscle
Coccyx

Anterior sacro-
coccygeal ligament

Sacral promontory

Plate 336 Pelvic Floor and Contents

 Pelvic Diaphragm: Female (continued) 5
Pubic symphysis
Urethra
Vagina

Puborectalis

Pubococcygeus Levator
ani muscle
Iliococcygeus

Anus
Anococcygeal body (ligament)
Inferior view
Musculofascial extensions to urethra
Pubic symphysis Musculofascial extensions to vagina
Inferior (arcuate) Interdigitating fibers of perineum
pubic ligament
Puborectalis muscle
Deep dorsal (part of levator ani muscle)
vein of clitoris
Pubococcygeus muscle
Inferior pubic ramus (part of levator ani muscle)

Urethra Tendinous arch of levator ani muscle

Vagina Obturator internus muscle

Iliococcygeus muscle
Rectum (part of levator ani muscle)
Ischial tuberosity
Ischial spine
Obturator internus
tendon
Sacrospinous ligament
Sacrotuberous ligament
Piriformis muscle

Ischial spine Median raphe

Coccygeus of levator ani muscle
(ischiococcygeus) Anococcygeal body (ligament)
muscle (attachment of external anal sphincter muscle)
Piriformis muscle (cut)
Sacrospinous ligament (cut) Tip of coccyx
Sacrotuberous ligament (cut)
Sacrum

Pelvic Floor and Contents Plate 337

 Pelvic Diaphragm: Male
See also Plates 258, 261
Superior view
(viscera removed)
Pubic tubercle
Pecten pubis
Inferior (arcuate) pubic ligament
Pubic symphysis
Hiatus for deep dorsal vein of penis
Pubic crest
Transverse perineal ligament
(anterior thickening of
Perineal membrane)

Superior ramus of pubis Hiatus for urethra

Muscle fibers from levator ani to
conjoined longitudinal muscle of anal canal
Obturator canal
Puborectalis
Obturator fascia Pubococcygeus Levator ani
Iliococcygeus muscle
Iliopubic eminence
Tendinous arch of
Acetabular margin levator ani muscle

Anterior inferior Obturator

iliac spine internus muscle

Wing (ala)
of ilium

Arcuate line
Coccygeus (ischiococcygeus)
Ischial spine muscle
Piriformis muscle

Sacro-iliac joint Anterior sacral (pelvic) foramina

Anterior sacrococcygeal ligament
Sacrum
Sacral canal Anorectal hiatus

Plate 338 Pelvic Floor and Contents

 Pelvic Diaphragm: Male (continued)
For urogenital diaphragm see Plate 361
5
Inferior view
Deep dorsal veins of penis Pubic symphysis
Fat in retropubic (prevesical) space Inferior pubic (arcuate) ligament
Perineal body
Sphincter urethrae muscle ascending Fibromuscular extensions of levator
anterior aspect of prostate ani muscle to prostate
Urethra Pubic tubercle
Recto-urethralis superior muscle
Rectoprostatic (Denonvilliers’) fascia
Prerectal muscle fibers (of Luschka)
Medial border (pillar) from levator ani muscle
of levator ani muscle
Muscle fibers from levator
Perineal membrane (cut away) ani to conjoined longitudinal
muscle of anal canal
Ischiopubic
ramus

Obturator
internus
tendon

Ischial tuberosity

Sacrotuberous ligament (cut)

Gluteus maximus
Sacrospinous ligament (cut) muscle
Obturator internus muscle
Coccygeus (ischiococcygeus) muscle Tendinous arch of
levator ani muscle
Sacrospinous ligament (cut)
Iliococcygeus
Pubococcygeus Levator ani muscle
Sacrotuberous ligament (cut)
Puborectalis
Tip of coccyx
Circular muscle layer of anorectal junction
Conjoined longitudinal muscle

Pelvic Floor and Contents Plate 339