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

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Presentation on theme: "ANATOMY OF FEMALE PELVIC By: Tiyas K Airlangga University Department of Child-Maternity Nursing Nursing Faculty 2010."— Presentation transcript:

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

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

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

4 PELVIC BONE

5

6

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

13 Normal pelvic measurement Distansia Spinarum Distansia Cristarum 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 L4 Ischial spineIschial tuberosity 48 Sacral promontoryLeft sacro-iliac jointIliopectineal lineSacrospinous ligamentSacrotuberous ligamentSymphysis pubis Sacral promontory Left sacro-iliac joint Iliopectineal line Sacrospinous ligament Sacrotuberous ligament Symphysis pubis Ischial tuberosity Ischial spine

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 A.Panggul Naegele B.Panggul Rakhitis C.Panggul Skoliosis D.Panggul Kifosis E.-”- dari Samping F.Panggul Osteomalasia G.Panggul Spondilolistesis H.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. 22 nd. New York: McGRAW-HILL  Bobak, LM. & Jensen, MD., (2005) Maternity & Gynecology Care: The Nurse and The Family. 5 th Ed. St. Louis: Mosby company

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


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