1. ANATOMY OF FEMALE PELVIC
By: Tiyas K
Airlangga
University
Department of Child-Maternity Nursing
Nursing Faculty 2010

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

3. A. PELVIC BONE 2 Innominate bone : Os illium Os ischium Os pubic
Sacrum
Coccyx

4. PELVIC BONE

5. PELVIC BONE

6. PELVIC BONE

7. Sacrum
PELVIC BONE

8. Tulang Coccygis
PELVIC BONE

9. Ischium Function
Support body weight (tuber ischiadica)

10. Fungsi os Coccygis
In labor this bone extent to posterior in order to wider the pelvic outlet

11. Pelvic Inlet/Pelvic brim
Area bordered by:
Promontorium
Sacrum
Linea inominata
Ramus Superior ossis Pubis
Uper border of Symphisis pubis

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

13. Normal pelvic measurement
Distansia Cristarum
Distansia Spinarum
Distansia Cristarum: 28—29 cm
Distansia Spinarum: 25—26 cm

14. Inside Pelvic measurement
Conjugata Diagonalis = 12,5—13cm
Conjugata Vera = CD – (1,5—2cm)
Conjugata Obstetrika = terpendek

15. 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

16. H I
H II
H III
H IV

17. 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

18. 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

19. PELVIC MUSCLE

20. Conjugata Vera

21. Sacral promontory Left sacro-iliac joint Iliopectineal line
Sacrospinous ligament L4
Symphysis pubis
Left sacro-iliac joint
Sacrotuberous ligament
Ischial spine
Sacral promontory
Ischial tuberosity 48
Sacral promontory
Left sacro-iliac joint
Iliopectineal line
Sacrospinous ligament
Sacrotuberous ligament
Ischial spine
Symphysis pubis
Ischial tuberosity

22. 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 18—20 cm
Vaginal Touché

23. Vaginal Touché 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

24. Differentiation between female and male pelvic

25. Pelvic Shape

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

27. 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

28. 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

29. Pelvic Shape Deviation
Panggul Naegele
Panggul Rakhitis
Panggul Skoliosis
Panggul Kifosis
-”- dari Samping
Panggul Osteomalasia
Panggul Spondilolistesis
Panggul Robert

30. Causes of pelvic deviation
Congenital:
Narrow palvic
Simple flat
Funnel (narrow outlet)
Assimilation
Disease :
Rachitic
Osteomalasia
TBC
Lordosis
Skoliosis
Kifosis
Spondilosis

31. Deviation impact Prolonged labor CPD (Chepalo Pelvic Disproportion)
Breech presentation
Infertility

32. 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?

33. 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

34. THANK YOU
“PLEASE WORK HARD IN THIS NEW SEMESTER”