Muscles of the pelvis

Transcription

Muscles of the pelvis
Pelvic bones
Dr.Faghani
‫ﺍﻫﺩﺍﻑ ﺁﻣﻭﺯﺷﻲ ﺟﻠﺳﻪ‬
‫‪ ‬ﺁﺷﻧﺎﺋﻲ ﺑﺎ ﺍﺳﺗﺧﻭﺍ ﻧﻬﺎﻱ ﻛﻣﺭﺑﻧﺩ ﻟﮕﻧﻲ‬
‫‪ ‬ﺁﺷﻧﺎﺋﻲ ﺑﺎ ﻭﺿﻌﻳﺕ ﺁﻧﺎﺗﻭﻣﻳﻛﻲ ﺍﺳﺗﺧﻭﺍﻥ ﻫﻳپ‬
‫‪ ‬ﺁﺷﻧﺎﺋﻲ ﺑﺎ ﺳﻁﻭﺡ ﻭ ﻛﻧﺎﺭﻩ ﻫﺎﻱ ﺍﺳﺗﺧﻭﺍﻥ ﻫﻳپ‬
‫‪ ‬ﺁﺷﻧﺎﺋﻲ ﺑﺎ ﺩﻫﺎﻧﻪ ﻫﺎﻱ ﻓﻭﻗﺎﻧﻲ ﻭ ﺗﺣﺗﺎﻧﻲ ﺍﺳﺗﺧﻭﺍﻥ ﻫﻳپ‬
‫‪ ‬ﺁﺷﻧﺎﺋﻲ ﺑﺎ ﺍﻗﻁﺎﺭ ﺣﻔﺭﻩ ﻟﮕﻧﻲ‬
Innominate bone
(ilium, ischium, pubis, acetabulum and obturator)

Ilium
-iliac crest
-upper two-fifths of the
acetabulum
-gluteal (posterolateral)
surface
-anteromedial surface;
-iliac fossa & sacropelvic
surface
-medial border
iliac
Iliac crest
-ant. Sup. Iliac spine
-post. Sup. Iliac spine
-ventral2/3 segment
(outer & inner lips &
intermediate zone)
- dorsal1/3 segment
(longitudinal ridge)
-tubercle of the crest
5cm
-summit behind midpoint
level with L3-L4 lumbar
spine
*iliac ant. border
-ant. Inf. Iliac spine
*iliac post. Border
-post. Inf. Iliac spine
-part of greater sciatic
notch

iliac
Iliac medial border
-arcuate line
-iliopubic eminence

iliac
The gluteal surface
*three gluteal lines
-post. Gluteal line
-ant. Gluteal line
-inf. Gluteal line

iliac
Iliac fossa
 Sacropelvic surface
-iliac tuberosity
-articular surface
-pelvic surface
-preauricular surface

Pubis
(body, inferior ramus and superior ramus)
Body; three surfaces
-anterior surface
-posterior surface
-symphysial surface
-pubic crest
-pubic tubercle
*superior pubic ramus
-ant. or pectineal surface
-iliopubic eminence
-obturator crest
-pectineal (pectine pubis) line
*pelvic surface
-inferior border
*obturator surface
-obturator groove

pubis
Inferior pubic ramus
-antero-external surface
-postero-internal surface
-medial part; crus penis
or crus clitoris
-intermediate part;
internal pudendal
vessels, dorsal penile
nerve and urogenital
diaphragm
-lateral part; obturator
internus
-medial border
-lateral border

Ischium
(body and ramus)
Body; three surface
and border
*Femoral surface;
-lateral border
-anterior border
*dorsal surface
-ischial tuberosity
-transverse &
oblique lines and
vertical ridge
-posterior border
-greater sciatic notch
-ischial spine
-lesser sciatic notch

ischium
*pelvic surface
*ischial ramus
-anterior surface
-posterior surface
-upper & lower border
Acetabulum cavity
Acetabular notch
-acetabular ligament
 Acetabular fossa
 Lunate surface

Obturator foramen



Obturator membrane
Ant. Obturator
tubercle
Post. Obturator
tubercle
Sacrum



Five vertebrae, apex,
base,lumbosacral
angle
Dorsal, pelvic &
lateral surfaces
Sacral canal

Base:
first sacral vertebra,
sacral promontory,
lamina, pedicle,
spinous processes,
transvers processes

Pelvic surface:
four pairs of pelvic
sacral
foramina,transverse
ridge, costal
element,lateral part

Dorsal surface:
median sacral crest,
sacral hiatus, dorsal
sacral foramina,
intermediate sacral
crest, lateral sacral
crest

Lateral surface:
auricular surface,
inferior lateral angle.




Sacral apex
Sacral canal
Sacralization
lumbarization
coccyx


Base, first coccygeal
vertebral body,
Coccygeal cornua,
transverse process
2 to 4 coccygeal
vertebral rudementary
vertebral body
‫‪× ۱۰۰ ‬‬
‫‪ ‬ﭘﻬﻧﺎﻱ ﻗﺎﻋﺩﻩ ﺳﺎﻛﺭﻭﻡ‬
‫=ﺷﺎﺧﺹ ﺳﺎﻛﺭﻭﻡ‬
‫ﻁﻭﻝ ﺳﺎﻛﺭﻭﻡ‬
Skeletal pelvic
(true and false pelves)
Superior aperture;
1-sacral promontory
2-lineae terminalis;
-iliac arcuate line
-pectineal line
-pubic crest

‫ﺍﻫﺩﺍﻑ ﺁﻣﻭﺯﺷﯽ‬
‫‪ ‬ﺁﺷﻧﺎﻳﻲ ﺑﺎ ﭘﻠﻭﻳﻣﺗﺭﻱ ﻭ ﺭﻭﺷﻬﺎﻱ ﺁﻥ‬
‫‪ ‬ﺷﻧﺎﺧﺕ ﺗﻔﺎﻭﺗﻬﺎﻱ ﻟﮕﻥ ﺯﻥ ﻭ ﻣﺭﺩ‬
‫‪ ‬ﺁﺷﻧﺎﻳﻲ ﺑﺎ ﻻﻳﻪ ﻫﺎﻱ ﻓﺎﺳﻳﺎﻱ ﻟﮕﻧﻲ‬
‫‪ ‬ﺷﻧﺎﺧﺕ ﻋﺿﻼﺕ ﺍﻳﻧﺗﺭﻧﺳﻳﻙ ﻭ ﺍﻛﺳﺗﺭﻧﺳﻳﻙ ﻟﮕﻥ ﻭ ﻋﻣﻠﻛﺭﺩ‬
‫ﺁﻧﻬﺎ‬
Three dimention of the inlet:
1-ant. Post. Diameter or true
conjugate: promontory-upper
border symphysis pubis 112
or 100mm
2-transverse diameter:
maximum distance 131mm
or 125mm
3-oblique line: iliopubic
eminence-opposite sacroiliac
joint 125mm or 120mm

Three dimention of the
cavity:
1-ant. Post. Diameter: S3 to
post surface of symphysis
pubis 130mm or 105mm
2-transverse diameter:
maximum distance 120mm
or 125mm
3-oblique line: inf of sacroiliac
joint obturator membrane to
131mm or 110mm

Three dimention of the
outlet:
1-ant. Post. Diameter:
coccyx to inf of
symphysis pubis
125mm or 80mm
2-transverse diameter:
distance between
ischial tuberosity
118mm or 85mm
3-oblique line:
sacrotuberous lig to
ischiopubic
ramus118mm or
100mm





Diagonal or oblique Conjugate :
promontory to lower border
symphysis pubis – 1.5cm
External Conjugate: spinous process
of L5 to symphysis pubis – 8or9cm
Interspinous diameter: Distance
between ASIS= 25cm
Intercrestal diameter: Distance
between iliac crest=27 or 27.5cm
Morphological classification of pelves

Gynaecoid or mesatipllic -%41.4
Android or brachypellic -%32.5
Anthropoid or dolichopellic -%23.5

Platypelloid or platypellic -%2.6


‫ﺗﻔﺎﻭﺕ ﻫﺎی ﻟﮕﻥ ﺩﺭ ﻣﺭﺩ ﻭ ﺯﻥ‪:‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫‪‬‬
‫ﻟﮕﻥ ﻣﺭﺩ ﺳﻧﮕﻳﻥ ﺗﺭ‪ ،‬ﻣﺣﮑﻣﺗﺭ ﻭ ﺧﺷﻥ ﺗﺭ ﺍﺯ ﻟﮕﻥ ﺯﻥ ﺍﺳﺕ‪.‬‬
‫ﺯﺍﻭﻳﻪ ﺳﺎﺏ ﭘﻭﺑﻳﮏ ﺩﺭ ﻣﺭﺩ ‪ ۵۰‬ﺗﺎ ‪ ۶۰‬ﺩﺭﺟﻪ ﻭﻟﯽ ﺩﺭ ﺯﻥ ‪ ۸۰‬ﺗﺎ ‪ ۸۵‬ﺩﺭﺟﻪ‬
‫ﺍﺳﺕ‪.‬‬
‫ﺗﻭﺑﺭﻭﺯﻳﺗﻪ ﻭ ﺧﺎﺭ ﺍﻳﺳﮑﻳﺎﻝ ﺩﺭ ﻣﺭﺩ ﺑﺳﻣﺕ ﺩﺍﺧﻝ ﭼﺭﺧﻳﺩﻩ ﻭﻟﯽ ﺩﺭ ﺯﻥ ﺑﺳﻣﺕ‬
‫ﺧﺎﺭﺝ ﭼﺭﺧﻳﺩﻩ ﺍﺳﺕ‪.‬‬
‫ﺗﻧﻪ ﻭ ﺳﺗﻳﻎ ﭘﻭﺑﻳﺱ ﺩﺭ ﺯﻧﺎﻥ ﭘﻬﻧﺗﺭ ﺍﺯ ﻣﺭﺩﺍﻥ ﻣﯽ ﺑﺎﺷﻧﺩ‪.‬‬
‫ﺯﺍﻭﻳﻪ ﺑﺭﻳﺩﮔﯽ ﺳﻳﺎﺗﻳﮏ ﺩﺭ ﺯﻧﺎﻥ ‪ ۷۵‬ﺩﺭﺟﻪ ﻭﻟﯽ ﺩﺭ ﻣﺭﺩﺍﻥ ‪۵۰‬ﺩﺭﺟﻪ ﺍﺳﺕ‪.‬‬
‫ﺍﺳﺗﺎﺑﻭﻟﻭﻡ ﺩﺭ ﻣﺭﺩﺍﻥ ﺑﺯﺭﮔﺗﺭ ﺍﺳﺕ ﺑﻁﻭﺭﻳﮑﻪ ﻗﻁﺭ ﺍﻥ ﻣﻌﺎﺩﻝ ﻓﺎﺻﻠﻪ ﺍﺳﺗﺎﺑﻭﻟﻭﻡ‬
‫ﺗﺎ ﺳﻣﻔﻳﺯﻳﺱ ﭘﻭﺑﻳﺱ ﻣﯽ ﺑﺎﺷﺩ‪ ،‬ﻭﻟﯽ ﺩﺭ ﺯﻧﺎﻥ ﮐﻭﭼﮑﺗﺭ ﺍﺳﺕ‪.‬‬
‫ﮐﻠﻳﻪ ﺍﻗﻁﺎﺭ ﻟﮕﻥ ﻣﺭﺩ‪ ،‬ﺑﻭﻳژﻩ ﺍﻗﻁﺎﺭ ﺩﻫﺎﻧﻪ ﺗﺣﺗﺎﻧﯽ ﻟﮕﻥ‪ ،‬ﮐﻭﭼﮑﺗﺭ ﺍﺯ ﺍﻗﻁﺎﺭ ﻟﮕﻥ‬
‫ﺯﻥ ﻣﯽ ﺑﺎﺷﺩ‪.‬‬
‫ﺳﻭﺭﺍﺥ ﺍﻭﺑﺗﺭﺍﺗﻭﺭ ﺩﺭ ﻣﺭﺩﺍﻥ ﺑﻳﺿﻭی ﻭ ﺩﺭ ﺯﻧﺎﻥ ﻣﺛﻠﺛﯽ ﺷﮑﻝ ﺍﺳﺕ‬
Sacroiliac joint
Sacroiliac joint
-synovial joint
-ventral sacroiliac lig.
-interosseous sacroiliac
-dorsal sacroiliac lig.
 Vertebral pelvic lig.
-Iliolumbar lig.
-Lumbosacral lig.
 Sacrotuberous lig.
 Sacrospinous lig.
 Greater sciatic foramen
 Lesser sciatic foramen


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