ANATOMY OF FEMALE PELVIC

By: khodijah, SSTAkbid budi mulia Palembang

PELVIC Solid part: Pelvic bone Soft part: Pelvic ligament & muscle

A. PELVIC BONE2 Innominate bone : Os illiumOs ischiumOs pubic

Sacrum Coccyx

PELVIC BONE

PELVIC BONE

PELVIC BONE

Sacrum PELVIC BONE

Tulang CoccygisPELVIC BONE

Ischium Function Support body weight (tuber ischiadica)

Fungsi os CoccygisIn labor this bone extent to posterior in order to wider the pelvic outlet

Pelvic 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

Normal pelvic measurement Distansia SpinarumDistansia CristarumDistansia Cristarum: 2829 cmDistansia Spinarum: 2526 cm

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

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

B. PELVIC LIGAMENT & MUSCLELIGAMENT connect the pelvic joint

Ligament interpubic pada symphysis pubisLigament sacro iliacaLigament sacro-coccygealLigament sacro-tuberousLigament 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

L4

Ischial spine

Ischial tuberosity

48

Sacral promontory

Left sacro-iliac joint

Iliopectineal line

Sacrospinous ligament

Sacrotuberous ligament

Symphysis pubisSacral promontory Left sacro-iliac joint Iliopectineal line Sacrospinous ligament Sacrotuberous ligament Symphysis pubis Ischial tuberosity Ischial spine

PELVIC EXAMINATIONX-RayJangka PanggulDistansia CristarumDistansia SpinarumConjugata eksterna/Bouldeloque: distance between upper border symphysis pubis with prosessus spinosus lumbal 5. the normal measurement 1820 cmVaginal Touch

Vaginal Touch ExamintionPromontorium 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 pelvic

Pelvic 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

PELVIC 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

PELVIC 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 forwards

Pelvic Shape DeviationPanggul NaegelePanggul RakhitisPanggul SkoliosisPanggul Kifosis-- dari SampingPanggul OsteomalasiaPanggul SpondilolistesisPanggul Robert

Causes of pelvic deviationCongenital:Narrow palvicSimple flatFunnel (narrow outlet)AssimilationDisease :RachiticOsteomalasiaTBCLordosisSkoliosisKifosisSpondilosis

Deviation impact Prolonged laborCPD (Chepalo Pelvic Disproportion)Breech presentationInfertility

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

THANK YOUPLEASE WORK HARD IN THIS NEW SEMESTER

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