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The pelvis (: pelves or pelvises) is the lower part of an
anatomical Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
trunk, between the
abdomen The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...
and the thighs (sometimes also called pelvic region), together with its embedded skeleton (sometimes also called bony pelvis or pelvic skeleton). The pelvic region of the trunk includes the bony pelvis, the
pelvic cavity The pelvic cavity is a body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet (the superior opening of the pelvis). Its lower boundary is the pelvic floor. The pelvic cavity primarily contains the reproduc ...
(the space enclosed by the bony pelvis), the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
, below the pelvic cavity, and the
perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...
, below the pelvic floor. The pelvic skeleton is formed in the area of the back, by the sacrum and the
coccyx The coccyx (: coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horse anatomy, horses. In tailless primates (e.g. hum ...
and anteriorly and to the left and right sides, by a pair of
hip bone The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the Ilium (bone) ...
s. The two hip bones connect the spine with the lower limbs. They are attached to the sacrum posteriorly, connected to each other anteriorly, and joined with the two femurs at the
hip joint In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) (: ''coxae'') in medical terminology, refers to either an anatomical region or a joint o ...
s. The gap enclosed by the bony pelvis, called the pelvic cavity, is the section of the body underneath the abdomen and mainly consists of the reproductive organs and the
rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
, while the pelvic floor at the base of the cavity assists in supporting the organs of the abdomen. In mammals, the bony pelvis has a gap in the middle, significantly larger in females than in males. Their
offspring In biology, offspring are the young creation of living organisms, produced either by sexual reproduction, sexual or asexual reproduction. Collective offspring may be known as a brood or progeny. This can refer to a set of simultaneous offspring ...
pass through this gap when they are born.


Structure

The pelvic region of the trunk is the lower part of the trunk, between the
abdomen The abdomen (colloquially called the gut, belly, tummy, midriff, tucky, or stomach) is the front part of the torso between the thorax (chest) and pelvis in humans and in other vertebrates. The area occupied by the abdomen is called the abdominal ...
and the thighs. It includes several structures: the bony pelvis, the pelvic cavity, the pelvic floor, and the perineum. The bony pelvis (pelvic skeleton) is the part of the skeleton embedded in the pelvic region of the trunk. It is subdivided into the pelvic girdle and the pelvic spine. The pelvic girdle is composed of the appendicular
hip bone The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the Ilium (bone) ...
s ( ilium,
ischium The ischium (; : is ...
, and pubis) oriented in a ring, and connects the pelvic region of the spine to the lower limbs. The pelvic spine consists of the sacrum and
coccyx The coccyx (: coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horse anatomy, horses. In tailless primates (e.g. hum ...
. * the
pelvic cavity The pelvic cavity is a body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet (the superior opening of the pelvis). Its lower boundary is the pelvic floor. The pelvic cavity primarily contains the reproduc ...
, typically defined as a small part of the space enclosed by the bony pelvis, delimited by the
pelvic brim The pelvic brim is the edge of the pelvic inlet. It is an approximately butterfly-shaped line passing through the prominence of the sacrum, the arcuate and pectineal lines, and the upper margin of the pubic symphysis. Structure The pelvic ...
above and the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
below; alternatively, the pelvic cavity is sometimes also defined as the whole space enclosed by the pelvic skeleton, subdivided into: ** the greater (or false) pelvis, above the
pelvic brim The pelvic brim is the edge of the pelvic inlet. It is an approximately butterfly-shaped line passing through the prominence of the sacrum, the arcuate and pectineal lines, and the upper margin of the pubic symphysis. Structure The pelvic ...
** the lesser (or true) pelvis, below the pelvic brim * the
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
(or pelvic diaphragm), below the pelvic cavity * the
perineum The perineum (: perineums or perinea) in placentalia, placental mammals is the space between the anus and the genitals. The human perineum is between the anus and scrotum in the male or between the anus and vulva in the female. The perineum is ...
, below the pelvic floor


Pelvic bone

The pelvic skeleton is formed posteriorly (in the area of the back), by the sacrum and the
coccyx The coccyx (: coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horse anatomy, horses. In tailless primates (e.g. hum ...
and laterally and anteriorly (forward and to the sides), by a pair of
hip bone The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the Ilium (bone) ...
s. Each hip bone consists of three sections: ilium,
ischium The ischium (; : is ...
, and pubis. During childhood, these sections are separate bones, joined by the
triradiate cartilage The triradiate cartilage (in Latin cartilago ypsiloformis) is the Y-shaped epiphyseal plate between the ilium, ischium and pubis to form the acetabulum of the os coxae. Human development In children, the triradiate cartilage closes at an appr ...
. During puberty, they fuse together to form a single bone.


Pelvic cavity

The pelvic cavity is a
body cavity A body cavity is any space or compartment, or potential space, in an animal body. Cavities accommodate organs and other structures; cavities as potential spaces contain fluid. The two largest human body cavities are the ventral body cavity, a ...
that is bounded by the bones of the pelvis and which primarily contains reproductive organs and the
rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
. A distinction is made between the lesser or true pelvis inferior to the terminal line, and the greater or false pelvis above it. The
pelvic inlet The pelvic inlet or superior aperture of the pelvis is a planar surface which defines the boundary between the pelvic cavity and the abdominal cavity (or, according to some authors, between two parts of the pelvic cavity, called lesser pelvis an ...
or superior pelvic aperture, which leads into the lesser pelvis, is bordered by the
promontory A promontory is a raised mass of land that projects into a lowland or a body of water (in which case it is a peninsula). Most promontories either are formed from a hard ridge of rock that has resisted the erosive forces that have removed the s ...
, the arcuate line of ilium, the iliopubic eminence, the pecten of the pubis, and the upper part of the pubic symphysis. The pelvic outlet or inferior pelvic aperture is the region between the
subpubic angle The pubic arch, also referred to as the ischiopubic arch, is part of the pelvis. It is formed by the convergence of the inferior ramus of the ischium, inferior rami of the ischium and pubis (bone), pubis on either side, below the pubic symphysis. ...
or pubic arch, the ischial tuberosities and the
coccyx The coccyx (: coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horse anatomy, horses. In tailless primates (e.g. hum ...
. * Ligaments: obturator membrane,
inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may ...
( lacunar ligament, iliopectineal arch) Alternatively, the pelvis is divided into three planes: the inlet, midplane, and outlet.


Pelvic floor

The
pelvic floor The pelvic floor or pelvic diaphragm is an anatomical location in the human body which has an important role in urinary and anal continence, sexual function, and support of the pelvic organs. The pelvic floor includes muscles, both skeletal and ...
has two inherently conflicting functions: One is to close the pelvic and abdominal cavities and bear the load of the visceral organs; the other is to control the openings of the
rectum The rectum (: rectums or recta) is the final straight portion of the large intestine in humans and some other mammals, and the gut in others. Before expulsion through the anus or cloaca, the rectum stores the feces temporarily. The adult ...
and
urogenital The genitourinary system, or urogenital system, are the sex organs of the reproductive system and the organ (biology), organs of the urinary system. These are grouped together because of their proximity to each other, Development of the urinary a ...
organs that pierce the pelvic floor and make it weaker. To achieve both these tasks, the pelvic floor is composed of several overlapping sheets of muscles and connective tissues.''Thieme Atlas of Anatomy'' (2006), p. 137 The pelvic diaphragm is composed of the
levator ani The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the ...
and the
coccygeus muscle The coccygeus muscle or ischiococcygeus is a muscle of the pelvic floor located posterior to levator ani and anterior to the sacrospinous ligament. Structure The coccygeus muscle is posterior to levator ani and anterior to the sacrospinous liga ...
. These arise between the symphysis and the ischial spine and converge on the coccyx and the anococcygeal ligament which spans between the tip of the
coccyx The coccyx (: coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horse anatomy, horses. In tailless primates (e.g. hum ...
and the
anal hiatus Anal may refer to: Related to the anus *Related to the anus of animals: ** Anal fin, in fish anatomy ** Anal vein, in insect anatomy ** Anal scale, in reptile anatomy *Related to the human anus: ** Anal sex, a type of sexual activity involving s ...
. This leaves a slit for the anal and urogenital openings. Because of the width of the genital aperture, which is wider in females, a second closing mechanism is required. The
urogenital diaphragm Older texts have asserted the existence of a urogenital diaphragm, also called the triangular ligament, which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of ...
consists mainly of the deep transverse perineal which arises from the inferior ischial and pubic rami and extends to the urogenital hiatus. The urogenital diaphragm is reinforced posteriorly by the superficial transverse perineal.Platzer (2004), p. 106 The external anal and
urethral sphincter The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the external sphincter muscle of male urethra, male or external sphincter muscle of female urethra, fe ...
s close the anus and the urethra. The former is surrounded by the bulbospongiosus which narrows the vaginal introitus in females and surrounds the corpus spongiosum in males.
Ischiocavernosus The ischiocavernosus muscle (erectores penis ''or'' erector clitoridis in older texts) is a muscle just below the surface of the perineum, present in both men and women. Structure It arises by tendinous and fleshy fibers from the inner surface of ...
squeezes blood into the
corpora cavernosa penis A corpus cavernosum penis (singular) (from Latin, characterised by "cavities/ hollows" of the penis, : corpora cavernosa) is one of a pair of sponge-like regions of erectile tissue, which contain most of the blood in the penis of several animals ...
and clitoridis.''Thieme Atlas of Anatomy'' (2006), p. 136


Variation

Modern humans are to a large extent characterized by bipedal locomotion and large brains. Because the pelvis is vital to both locomotion and childbirth,
natural selection Natural selection is the differential survival and reproduction of individuals due to differences in phenotype. It is a key mechanism of evolution, the change in the Heredity, heritable traits characteristic of a population over generation ...
has been confronted by two conflicting demands: a wide birth canal and locomotion efficiency, a conflict referred to as the "
obstetrical dilemma The obstetrical dilemma is a hypothesis to explain why humans often require assistance from other humans during childbirth to avoid Complications of pregnancy, complications, whereas most non-human primates give birth unassisted with relatively lit ...
". The female pelvis, or gynecoid pelvis, has evolved to its maximum width for childbirth—a wider pelvis would make human females unable to walk. In contrast, human male pelvises are not constrained by the need to give birth and therefore are more optimized for bipedal locomotion. The principal differences between male and female true and false pelvis include: * The female pelvis is larger and broader than the male pelvis which is taller, narrower, and more compact.''Thieme Atlas of Anatomy'', (2006), p. 113 The female pelvis is lighter and thinner than the male pelvis. * The female inlet is larger and oval in shape, while the male
sacral promontory The sacrum (: sacra or sacrums), in human anatomy, is a triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30. The sacrum situates at the upper, back part of the pelvic cavit ...
projects further (i.e. the male inlet is more heart-shaped). * The sides of the male pelvis converge from the inlet to the outlet, whereas the sides of the female pelvis are wider apart. * The angle between the inferior pubic rami is acute (70 degrees) in males, but obtuse (90–100 degrees) in females. Accordingly, the angle is called
subpubic angle The pubic arch, also referred to as the ischiopubic arch, is part of the pelvis. It is formed by the convergence of the inferior ramus of the ischium, inferior rami of the ischium and pubis (bone), pubis on either side, below the pubic symphysis. ...
in males and pubic arch in females. Additionally, the bones forming the angle/arch are more concave in females but straight in males. * The distance between the ischia bones is small in males, making the outlet narrow, but large in females, who have a relatively large outlet. The ischial spines and tuberosities are heavier and project farther into the pelvic cavity in males. The greater sciatic notch is wider in females. * The iliac crests are higher and more pronounced in males, making the male false pelvis deeper and more narrow than in females. * The male sacrum is long, narrow, more straight, and has a pronounced sacral promontory. The female sacrum is shorter, wider, more curved posteriorly, and has a less pronounced promontory. * The acetabula are wider apart in females than in males. In males, the acetabulum faces more laterally, while it faces more anteriorly in females. Consequently, when males walk the leg can move forwards and backwards in a single plane. In females, the leg must swing forward and inward, from where the pivoting head of the femur moves the leg back in another plane. This change in the angle of the femoral head gives the female gait its characteristic (i.e. swinging of hips).


Development

Each side of the pelvis is formed as cartilage, which ossifies as three main bones which stay separate through childhood: ilium,
ischium The ischium (; : is ...
, pubis. At birth the whole of the hip joint (the acetabulum area and the top of the femur) is still made of cartilage (but there may be a small piece of bone in the great trochanter of the femur); this makes it difficult to detect congenital hip dislocation by
X-ray An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
ing. There is preliminary evidence that the pelvis continues to widen over the course of a lifetime.


Functions

The skeleton of the pelvis is a basin-shaped ring of bones connecting the vertebral column to the femora. It is then connected to two hip bones. Its primary functions are to bear the weight of the upper body when sitting and standing, transferring that weight from the axial skeleton to the lower appendicular skeleton when standing and walking, and providing attachments for and withstanding the forces of the powerful muscles of locomotion and posture. Compared to the shoulder girdle, the pelvic girdle is thus strong and rigid. Its secondary functions are to contain and protect the pelvic and abdominopelvic viscera (inferior parts of the urinary tracts, internal reproductive organs), providing attachment for external reproductive organs and associated muscles and membranes.


As a mechanical structure

The pelvic girdle consists of the two hip bones. The hip bones are connected to each other anteriorly at the pubic symphysis, and posteriorly to the sacrum at the sacroiliac joints to form the pelvic ring. The ring is very stable and allows very little mobility, a prerequisite for transmitting loads from the trunk to the lower limbs.''Thieme Atlas of Anatomy'' (2006), p. 112 As a mechanical structure the pelvis may be thought of as four roughly triangular and twisted rings. Each superior ring is formed by the iliac bone; the anterior side stretches from the acetabulum up to the anterior superior iliac spine; the posterior side reaches from the top of the acetabulum to the sacroiliac joint; and the third side is formed by the palpable
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterio ...
. The lower ring, formed by the rami of the pubic and ischial bones, supports the acetabulum and is twisted 80–90 degrees in relation to the superior ring.Holm (1980), pp. 425–6 An alternative approach is to consider the pelvis part of an integrated mechanical system based on the tensegrity
icosahedron In geometry, an icosahedron ( or ) is a polyhedron with 20 faces. The name comes . The plural can be either "icosahedra" () or "icosahedrons". There are infinitely many non- similar shapes of icosahedra, some of them being more symmetrical tha ...
as an infinite element. Such a system is able to withstand omnidirectional forces—ranging from weight-bearing to childbearing—and, as a low energy requiring system, is favoured by
natural selection Natural selection is the differential survival and reproduction of individuals due to differences in phenotype. It is a key mechanism of evolution, the change in the Heredity, heritable traits characteristic of a population over generation ...
.Levin (2003), ''A Different Approach to the Mechanics of the Human Pelvis: Tensegrity'' (See conclusions.) The pelvic inclination angle is the single most important element of the human body posture and is adjusted at the hips. It is also one of the rare things that can be measured at the assessment of the posture. A simple method of measurement was described by the British orthopedist Philip Willes and is performed by using an
inclinometer An inclinometer or clinometer is an measuring instrument, instrument used for measuring angles of slope, elevation, or depression (geology), depression of an object with respect to gravity's direction. It is also known as a ''tilt indicator'', ' ...
.


As an anchor for muscles

The lumbosacral joint, between the sacrum and the last lumbar vertebra, has, like all vertebral joints, an
intervertebral disc An intervertebral disc (British English), also spelled intervertebral disk (American English), lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the ver ...
,
anterior Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
and posterior ligaments, ligamenta flava, interspinous and supraspinous ligaments, and synovial joints between the articular processes of the two bones. In addition to these ligaments the joint is strengthened by the iliolumbar and lateral lumbosacral ligaments. The iliolumbar ligament passes between the tip of the transverse process of the fifth lumbar vertebra and the posterior part of the iliac crest. The lateral lumbosacral ligament, partly continuous with the iliolumbar ligament, passes down from the lower border of the transverse process of the fifth vertebra to the ala of the sacrum. The movements possible in the lumbosacral joint are flexion and extension, a small amount of lateral flexion (from 7 degrees in childhood to 1 degree in adults), but no axial rotation. Between ages 2–13 the joint is responsible for as much as 75% (about 18 degrees) of flexion and extension in the lumbar spine. From age 35 the ligaments considerably limit the range of motions. Palastanga (2006), pp. 331–2 The three extracapsular ligaments of the
hip joint In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) (: ''coxae'') in medical terminology, refers to either an anatomical region or a joint o ...
—the iliofemoral, ischiofemoral, and pubofemoral ligaments—form a twisting mechanism encircling the neck of the
femur The femur (; : femurs or femora ), or thigh bone is the only long bone, bone in the thigh — the region of the lower limb between the hip and the knee. In many quadrupeds, four-legged animals the femur is the upper bone of the hindleg. The Femo ...
. When sitting, with the hip joint flexed, these ligaments become lax permitting a high degree of mobility in the joint. When standing, with the hip joint extended, the ligaments get twisted around the femoral neck, pushing the head of the femur firmly into the
acetabulum The acetabulum (; : acetabula), also called the cotyloid cavity, is a wikt:concave, concave surface of the pelvis. The femur head, head of the femur meets with the pelvis at the acetabulum, forming the Hip#Articulation, hip joint. Structure The ...
, thus stabilizing the joint.''Thieme Atlas of Anatomy'' (2006), p. 381 The
zona orbicularis The zona orbicularis or annular ligament is a ligament on the neck of the femur formed by the circular fibers of the articular capsule of the hip joint In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hi ...
assists in maintaining the contact in the joint by acting like a buttonhole on the femoral head.Platzer (2004), p. 198 The intracapsular ligament, the ligamentum teres, transmits blood vessels that nourish the femoral head.''Thieme Atlas of Anatomy'' (2006), p. 383


Junctions

The two hip bones are joined anteriorly at the pubic symphysis by a fibrous cartilage covered by a hyaline cartilage, the interpubic disk, within which a non-synovial cavity might be present. Two ligaments, the superior and inferior pubic ligaments, reinforce the symphysis.Platzer (2004), p. 188 Both sacroiliac joints, formed between the auricular surfaces of the sacrum and the two hip bones. are amphiarthroses, almost immobile joints enclosed by very taut joint capsules. This capsule is strengthened by the
ventral Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
, interosseous, and dorsal sacroiliac ligaments. The most important accessory ligaments of the sacroiliac joint are the sacrospinous and sacrotuberous ligaments which stabilize the hip bone on the sacrum and prevent the promonotory from tilting forward. Additionally, these two ligaments transform the greater and lesser sciatic notches into the greater and lesser foramina, a pair of important pelvic openings.Palastanga (2006), pp. 326–7 The iliolumbar ligament is a strong ligament which connects the tip of the transverse process of the fifth lumbar vertebra to the posterior part of the inner lip of the iliac crest. It can be thought of as the lower border of the thoracolumbar fascia and is occasionally accompanied by a smaller ligamentous band passing between the fourth lumbar vertebra and the iliac crest. The lateral lumbosacral ligament is partly continuous with the iliolumbar ligament. It passes between the transverse process of the fifth vertebra to the ala of the sacrum where it intermingle with the anterior sacroiliac ligament.Palastanga (2006), pp. 332–3 The joint between the sacrum and the coccyx, the sacrococcygeal symphysis, is strengthened by a series of ligaments. The anterior sacrococcygeal ligament is an extension of the anterior longitudinal ligament (ALL) that run down the anterior side of the vertebral bodies. Its irregular fibers blend with the
periosteum The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. (At the joints of long bones the bone's outer surface is lined with "articular cartila ...
. The posterior sacrococcygeal ligament has a deep and a superficial part, the former is a flat band corresponding to the posterior longitudinal ligament (PLL) and the latter corresponds to the ligamenta flava. Several other ligaments complete the
foramen In anatomy and osteology, a foramen (; : foramina, or foramens ; ) is an opening or enclosed gap within the dense connective tissue (bones and deep fasciae) of extant and extinct amniote animals, typically to allow passage of nerves, artery, ...
of the last sacral nerve.Morris (2005), p. 59


Shoulder and intrinsic back

The inferior parts of
latissimus dorsi The latissimus dorsi () is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi (plural: ''latissimi dorsi'') comes from L ...
, one of the muscles of the upper limb, arises from the posterior third of the iliac crest.Platzer (2004), p. 140 Its action on the shoulder joint are internal rotation, adduction, and retroversion. It also contributes to respiration (i.e. coughing).''Thieme Atlas of Anatomy'' (2006), p. 266 When the arm is adducted, latissimus dorsi can pull it backward and medially until the back of the hand covers the buttocks. In a longitudinal osteofibrous canal on either side of the spine there is a group of muscles called the erector spinae which is subdivided into a lateral superficial and a medial deep tract. In the lateral tract, the
iliocostalis Iliocostalis muscle is the muscle immediately lateral to the longissimus that is the nearest to the furrow that separates the epaxial muscles from the hypaxial. It lies very deep to the fleshy portion of the serratus posterior muscle. It late ...
lumborum and longissimus thoracis originates on the back of the sacrum and the posterior part of the iliac crest. Contracting these muscles bilaterally extends the spine and unilaterally contraction bends the spine to the same side. The medial tract has a "straight" ( interspinales, intertransversarii, and spinalis) and an "oblique" ( multifidus and semispinalis) component, both of which stretch between vertebral processes; the former acts similar to the muscles of the lateral tract, while the latter function unilaterally as spine extensors and bilaterally as spine rotators. In the medial tract, the multifidi originates on the sacrum.Platzer (2004), pp. 72, 74


Abdomen

The muscles of the
abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the vi ...
are subdivided into a superficial and a deep group. The superficial group is subdivided into a lateral and a medial group. In the medial superficial group, on both sides of the centre of the abdominal wall (the ''linea alba''), the
rectus abdominis The rectus abdominis muscle, () also known as the "abdominal muscle" or simply better known as the "abs", is a pair of segmented skeletal muscle on the ventral aspect of a person, person's abdomen. The paired muscle is separated at the midline b ...
stretches from the cartilages of ribs V-VII and the
sternum The sternum (: sternums or sterna) or breastbone is a long flat bone located in the central part of the chest. It connects to the ribs via cartilage and forms the front of the rib cage, thus helping to protect the heart, lungs, and major bl ...
down to the
pubic crest Medial to the pubic tubercle is the pubic crest, which extends from this process to the medial end of the pubis (bone), pubic bone. It gives attachment to the conjoint tendon, the rectus abdominis, the abdominal external oblique muscle, and the ...
. At the lower end of the rectus abdominis, the pyramidalis tenses the ''linea alba''. The lateral superficial muscles, the transversus and external and internal oblique muscles, originate on the rib cage and on the pelvis (iliac crest and
inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may ...
) and are attached to the anterior and posterior layers of the sheath of the rectus.Platzer (2004), pp. 84–91 Flexing the trunk (bending forward) is essentially a movement of the rectus muscles, while lateral flexion (bending sideways) is achieved by contracting the obliques together with the quadratus lumborum and intrinsic back muscles. Lateral rotation (rotating either the trunk or the pelvis sideways) is achieved by contracting the internal oblique on one side and the external oblique on the other. The transversus' main function is to produce abdominal pressure in order to constrict the abdominal cavity and pull the diaphragm upward. There are two muscles in the deep or posterior group. Quadratus lumborum arises from the posterior part of the iliac crest and extends to the rib XII and lumbar vertebrae I–IV. It unilaterally bends the trunk to the side and bilaterally pulls the 12th rib down and assists in expiration. The iliopsoas consists of psoas major (and occasionally psoas minor) and iliacus, muscles with separate origins but a common insertion on the
lesser trochanter In human anatomy, the lesser trochanter is a conical, posteromedial, bony projection from the shaft of the femur. It serves as the principal insertion site of the iliopsoas muscle. Structure The lesser trochanter is a conical posteromedial p ...
of the femur. Of these, only iliacus is attached to the pelvis (the
iliac fossa The iliac fossa is a large, smooth, concave surface on the internal surface of the Ilium (bone), ilium (part of the three fused bones making the hip bone). Structure The iliac fossa is bounded above by the iliac crest, and below by the Arcuate ...
). However, psoas passes through the pelvis and because it acts on two joints, it is topographically classified as a posterior abdominal muscle but functionally as a hip muscle. Iliopsoas flexes and externally rotates the hip joints, while unilateral contraction bends the trunk laterally and bilateral contraction raises the trunk from the
supine position The supine position () means lying horizontally, with the face and torso facing up, as opposed to the prone position, which is face down. When used in surgical procedures, it grants access to the peritoneal, thoracic, and pericardium, pericardial ...
.''Thieme Atlas of Anatomy'' (2006), p. 128


Hip and thigh

The muscles of the hip are divided into a dorsal and a ventral group. The dorsal hip muscles are either inserted into the region of the
lesser trochanter In human anatomy, the lesser trochanter is a conical, posteromedial, bony projection from the shaft of the femur. It serves as the principal insertion site of the iliopsoas muscle. Structure The lesser trochanter is a conical posteromedial p ...
(anterior or inner group) or the greater trochanter (posterior or outer group). Anteriorly, the psoas major (and occasionally psoas minor) originates along the spine between the rib cage and pelvis. The iliacus originates on the
iliac fossa The iliac fossa is a large, smooth, concave surface on the internal surface of the Ilium (bone), ilium (part of the three fused bones making the hip bone). Structure The iliac fossa is bounded above by the iliac crest, and below by the Arcuate ...
to join psoas at the iliopubic eminence to form the iliopsoas which is inserted into the lesser trochanter.Platzer (2004), p. 234 The iliopsoas is the most powerful hip flexor.''Thieme Atlas of Anatomy'' (2006), p. 422. The posterior group includes the gluteus maximus, gluteus medius, and gluteus minimus. Maximus has a wide origin stretching from the posterior part of the iliac crest and along the sacrum and coccyx, and has two separate insertions: a proximal which radiates into the iliotibial tract and a distal which inserts into the gluteal tuberosity on the posterior side of the femoral shaft. It is primarily an extensor and lateral rotator of the hip joint, but, because of its bipartite insertion, it can both adduct and abduct the hip. Medius and minimus arise on the external surface of the ilium and are both inserted into the greater trochanter. Their anterior fibers are medial rotators and flexors while the posterior fibers are lateral rotators and extensors. The piriformis has its origin on the ventral side of the sacrum and is inserted on the greater trochanter. It abducts and laterally rotates the hip in the upright posture and assists in extension of the thigh. The tensor fasciae latae arises on the anterior superior iliac spine and inserts into the iliotibial tract.''Thieme Atlas of Anatomy'' (2006), p. 424 It presses the head of the femur into the
acetabulum The acetabulum (; : acetabula), also called the cotyloid cavity, is a wikt:concave, concave surface of the pelvis. The femur head, head of the femur meets with the pelvis at the acetabulum, forming the Hip#Articulation, hip joint. Structure The ...
and flexes, medially rotates, and abducts the hip. The ventral hip muscles are important in the control of the body's balance. The internal and external obturator muscles together with the quadratus femoris are lateral rotators of the hip. Together they are stronger than the medial rotators and therefore the feet point outward in the normal position to achieve a better support. The obturators have their origins on either sides of the
obturator foramen The obturator foramen is the large, Bilateral symmetry, bilaterally paired opening of the bony pelvis. It is formed by the pubis and ischium. It is mostly closed by the obturator membrane except for a small opening, the obturator canal, through wh ...
and are inserted into the trochanteric fossa on the femur. Quadratus arises on the ischial tuberosity and is inserted into the intertrochanteric crest. The superior and inferior gemelli, arising from the ischial spine and ischial tuberosity respectively, can be thought of as marginal heads of the obturator internus, and their main function is to assist this muscle. The muscles of the thigh can be subdivided into adductors (medial group), extensors (anterior group), and flexors (posterior group). The extensors and flexors act on the knee joint, while the adductors mainly act on the hip joint. The thigh adductors have their origins on the inferior ramus of the pubic bone and are, with the exception of gracilis, inserted along the femoral shaft. Together with sartorius and semitendinosus, gracilis reaches beyond the knee to their common insertion on the
tibia The tibia (; : tibiae or tibias), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two Leg bones, bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outsi ...
.Platzer (2004), pp. 240–3 The anterior thigh muscles form the
quadriceps The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
which is inserted on the patella with a common tendon. Three of the four muscles have their origins on the femur, while rectus femoris arises from the anterior inferior iliac spine and is thus the only of the four acting on two joints.Platzer (2004), p. 248 The posterior thigh muscles have their origins on the inferior ischial ramus, with the exception of the short head of the biceps femoris. The semitendinosus and semimembranosus are inserted on the tibia on the medial side of the knee, while biceps femoris is inserted on the fibula, on the knee's lateral side.Platzer (2004), p. 250


In pregnancy and childbirth

In later stages of
pregnancy Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
the
fetus A fetus or foetus (; : fetuses, foetuses, rarely feti or foeti) is the unborn offspring of a viviparous animal that develops from an embryo. Following the embryonic development, embryonic stage, the fetal stage of development takes place. Pren ...
's head aligns inside the pelvis. Also joints of bones soften due to the effect of pregnancy hormones. These factors may cause ''pelvic joint pain'' ( symphysis pubis dysfunction or SPD). As the end of pregnancy approaches, the ligaments of the sacroiliac joint loosen, letting the pelvis outlet widen somewhat; this is easily noticeable in the cow. During
childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
(unless by Cesarean section) the fetus passes through the maternal ''pelvic opening''.


Clinical significance

Hip fracture A hip fracture is a break that occurs in the upper part of the femur (thigh bone), at the femoral neck or (rarely) the femoral head. Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. Usually ...
s often affect the elderly and occur more often in females; this is frequently due to
osteoporosis Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to more porous bone, and consequent increase in Bone fracture, fracture risk. It is the most common reason f ...
. There are also different types of pelvic fracture, often resulting from traffic accidents.
Pelvic pain Pelvic pain is pain in the area of the pelvis. Acute (medicine), Acute pain is more common than chronic pain. If the pain lasts for more than six months, it is deemed to be chronic pelvic pain. It can affect both the male and female pelvis. Common ...
can affect anybody and has a variety of causes, including bowel adhesions,
irritable bowel syndrome Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by a group of symptoms that commonly include abdominal pain, abdominal bloating, and changes in the consistency of bowel movements. These symptoms may ...
,
interstitial cystitis Interstitial cystitis (IC), a type of bladder pain syndrome (BPS), is chronic pain in the Urinary bladder, bladder and pelvic floor of unknown cause. Symptoms include urinary urgency, feeling the need to urinate right away, urinary frequency, ...
, and
endometriosis Endometriosis is a disease in which Tissue (biology), tissue similar to the endometrium, the lining of the uterus, grows in other places in the body, outside the uterus. It occurs in women and a limited number of other female mammals. Endomet ...
in women. There are many anatomical variations of the pelvis. In the female the pelvis can be of a much larger size than normal, known as a giant pelvis or pelvis justo major, or it can be much smaller, known as a reduced pelvis or pelvis justo minor. Other variations include an android pelvis, a pelvis of the normal male shape in a female, which can prove problematic in
childbirth Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy, where one or more Fetus, fetuses exits the Womb, internal environment of the mother via vaginal delivery or caesarean section and becomes a newborn to ...
.


History


Caldwell–Moloy classification

Throughout the 20th century pelvimetric measurements were made on pregnant women to determine whether a natural birth would be possible, a practice today limited to cases where a specific problem is suspected or following a caesarean delivery. William Edgar Caldwell and Howard Carmen Moloy studied collections of skeletal pelves and thousands of stereoscopic radiograms and finally recognized three types of female pelves plus the masculine type. In 1933 and 1934 they published their typology, including the Greek names since then frequently quoted in various handbooks: Gynaecoid (''gyne'', woman), anthropoid (''anthropos'', human being), platypelloid (''platys'', flat), and android (''aner'', man). * The gynaecoid pelvis is the so-called normal female pelvis. Its inlet is either slightly oval, with a greater transverse diameter, or round. The interior walls are straight, the subpubic arch wide, the sacrum shows an average to backward inclination, and the greater sciatic notch is well rounded. Because this type is spacious and well proportioned there is little or no difficulty in the birth process. Caldwell and his co-workers found gynaecoid pelves in about 50 per cent of specimens. This gives a round shape to the gluteus region, circle shape to hip region, and circle shape side way profile https://www.ncbi.nlm.nih.gov/books/NBK519068/# * The platypelloid pelvis has a transversally wide, flattened shape, is wide anteriorly, greater sciatic notches of male type, and has a short sacrum that curves inwards reducing the diameters of the lower pelvis. This is similar to the rachitic pelvis where the softened bones widen laterally because of the weight from the upper body resulting in a reduced anteroposterior diameter. Giving birth with this type of pelvis is associated with problems, such as transverse arrest. Less than 3 per cent of women have this pelvis type. This gives an inverted triangle shape to the gluteus region, hip region and straight sideway profile https://www.ncbi.nlm.nih.gov/books/NBK519068/# * The android pelvis is a female pelvis with masculine features, including a wedge or heart shaped inlet caused by a prominent sacrum and a triangular anterior segment. The reduced pelvis outlet often causes problems during child birth. In 1939 Caldwell found this type in one-third of white women and in one-sixth of non-white women. The android pelvis is found in the vast majority of subsaharan african women . The android pelvis gives the human skeleton a triangle shape looking at it from the front and a android shape looking at it from the back these features result in giving steatopygia the basis of its unique specific shape with added relation to the femur. also gives a trapezoidal shape to the gluteus region, hip region, and side way profile https://www.ncbi.nlm.nih.gov/books/NBK519068/# This trapezoidal shape is what gives the genetic characteristic steatopygia its specific shape. * The anthropoid pelvis is characterized by an oval shape with a greater anteroposterior diameter. It has straight walls, a small subpubic arch, and large sacrosciatic notches. The sciatic spines are placed widely apart and the sacrum is usually straight resulting in deep non-obstructed pelvis. Caldwell found this type in one-quarter of white women and almost half of non-white women. This gives a square shape to the gluteus region, also hip region and side way profile https://www.ncbi.nlm.nih.gov/books/NBK519068/# However, Caldwell and Moloy then complicated this simple fourfold scheme by dividing the pelvic inlet into posterior and anterior segments. They named a pelvis according to the anterior segment and affixed another type according to the character of the posterior segment (i.e. anthropoid-android) and ended up with no less than 14 morphologies. Notwithstanding the popularity of this simple classification, the pelvis is much more complicated than this as the pelvis can have different dimensions at various levels of the birth canal. Caldwell and Moloy also classified the physique of women according to their types of pelves: the gynaecoid type has small shoulders, a small waist and wide hips; the android type looks square-shaped from behind; and the anthropoid type has wide shoulders and narrow hips. Lastly, in their article they described all non-gynaecoid or "mixed" types of pelves as "abnormal", a word which has stuck in the medical world even though at least 50 per cent of women have these "abnormal" pelves. The classification of Caldwell and Moloy was influenced by earlier classifications attempting to define the ideal female pelvis, treating any deviations from this ideal as dysfunctions and the cause of obstructed labour. In the 19th century anthropologists and others saw an evolutionary scheme in these pelvic typologies, a scheme since then refuted by archaeology. Since the 1950s
malnutrition Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is a deficiency, excess, or imbalance of energy, protein and other nutrients which adversely affects the body's tissues a ...
is thought to be one of the chief factors affecting pelvic shape in the
Third World The term Third World arose during the Cold War to define countries that remained non-aligned with either NATO or the Warsaw Pact. The United States, Canada, Taiwan, Japan, South Korea, the Southern Cone, NATO, Western European countries and oth ...
even though there are at least some genetic component to variation in pelvic morphology. Nowadays obstetric suitability of the female pelvis is assessed by
ultrasound Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...
. The dimensions of the head of the fetus and of the birth canal are accurately measured and compared, and the feasibility of labor can be predicted.


Other animals

The pelvic girdle was present in early
vertebrate Vertebrates () are animals with a vertebral column (backbone or spine), and a cranium, or skull. The vertebral column surrounds and protects the spinal cord, while the cranium protects the brain. The vertebrates make up the subphylum Vertebra ...
s, and can be tracked back to the paired fins of fish that were some of the earliest chordates. The shape of the pelvis, most notably the orientation of the iliac crests and shape and depth of the acetabula, reflects the style of locomotion and body mass of an animal. In bipedal mammals, the iliac crests are parallel to the vertically oriented sacroiliac joints, where in quadrupedal mammals they are parallel to the horizontally oriented sacroiliac joints. In heavy mammals, especially in quadrupeds, the pelvis tend to be more vertically oriented because this allows the pelvis to support greater weight without dislocating the sacroiliac joints or adding torsion to the vertebral column. In ambulatory mammals, the acetabula are shallow and open to allow a wider range of hip movements, including significant abduction, than in cursorial mammals. The lengths of the ilium and ischium and their angles relative to the acetabulum are functionally important as they determine the moment arms for the hip extensor muscles that provide momentum during locomotion.Hall (2007), pp. 254–5 In addition to this, the relatively wide shape (front to back) of the pelvis provides greater leverage for the gluteus medius and minimus. These muscles are responsible for hip abduction which plays an integral role in upright balance.


Primates

In
primate Primates is an order (biology), order of mammals, which is further divided into the Strepsirrhini, strepsirrhines, which include lemurs, galagos, and Lorisidae, lorisids; and the Haplorhini, haplorhines, which include Tarsiiformes, tarsiers a ...
s, the pelvis consists of four parts - the left and the right
hip bone The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the Ilium (bone) ...
s which meet in the mid-line ventrally and are fixed to the sacrum dorsally and the coccyx. Each hip bone consists of three components, the ilium, the
ischium The ischium (; : is ...
, and the pubis, and at the time of sexual maturity these bones become fused together, though there is never any movement between them. In
human Humans (''Homo sapiens'') or modern humans are the most common and widespread species of primate, and the last surviving species of the genus ''Homo''. They are Hominidae, great apes characterized by their Prehistory of nakedness and clothing ...
s, the ventral joint of the pubic bones is closed. Larger apes, such as '' Pongo'' (
orangutan Orangutans are great apes native to the rainforests of Indonesia and Malaysia. They are now found only in parts of Borneo and Sumatra, but during the Pleistocene they ranged throughout Southeast Asia and South China. Classified in the genus ...
s), ''
Gorilla Gorillas are primarily herbivorous, terrestrial great apes that inhabit the tropical forests of equatorial Africa. The genus ''Gorilla'' is divided into two species: the eastern gorilla and the western gorilla, and either four or five su ...
'' (
gorilla Gorillas are primarily herbivorous, terrestrial great apes that inhabit the tropical forests of equatorial Africa. The genus ''Gorilla'' is divided into two species: the eastern gorilla and the western gorilla, and either four or five su ...
s), ''
Australopithecus afarensis ''Australopithecus afarensis'' is an extinct species of australopithecine which lived from about 3.9–2.9 million years ago (mya) in the Pliocene of East Africa. The first fossils were discovered in the 1930s, but major fossil finds would not ta ...
'', and '' Pan troglodytes'' (
chimpanzee The chimpanzee (; ''Pan troglodytes''), also simply known as the chimp, is a species of Hominidae, great ape native to the forests and savannahs of tropical Africa. It has four confirmed subspecies and a fifth proposed one. When its close rel ...
s), have longer three-pelvic planes with a maximum diameter in the sagittal plane.


Evolution

The present-day morphology of the pelvis is inherited from the pelvis of our quadrupedal ancestors. The most striking feature of evolution of the pelvis in primates is the widening and the shortening of the blade called the ilium. Because of the stresses involved in bipedal locomotion, the muscles of the thigh move the thigh forward and backward, providing the power for bi-pedal and quadrupedal locomotion. The drying of the environment of East Africa in the period since the creation of the Red Sea and the African Rift Valley saw open woodlands replace the previous closed canopy forest. The apes in this environment were compelled to travel from one clump of trees to another across open country. This led to a number of complementary changes to the human pelvis. It is suggested that bipedalism was the result.


Additional images

File:Slide1ADAA.JPG, Diameters of
pelvic inlet The pelvic inlet or superior aperture of the pelvis is a planar surface which defines the boundary between the pelvic cavity and the abdominal cavity (or, according to some authors, between two parts of the pelvic cavity, called lesser pelvis an ...
File:Gray235.png, Right hip bone. External surface. File:Pelvic Girdle Anatomy by Jason Christian.webm, Pelvic girdle anatomy


See also

* * * * * *


Notes


References

* * * * * * * * * * *


External links

{{DEFAULTSORT:Pelvis, human Flat bones