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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
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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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