Updated: 6/8/2021

Pelvis Anatomy

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  • Osteology
    • Pelvic ring formed from 2 innominate bones
      • articulate posteriorly with the sacrum and anteriorly through pubis symphysis
    • Each innominate bone is composed of three fused bones: ilium, ischium, and pubis
      • ilium - prominences
        • ASIS
        • AIIS
        • PSIS
        • iliopectineal eminence - region union between ilium and pubis
        • sciatic notch
      • ischium
      • pubis
    • Stability
      • no inherent stability of articulations
      • stability comes from ligament complexes
    • Ligament complexes
      • posterior complex
        • sacroiliac ligaments
          • posterior stronger than anterior
        • iliolumbar ligaments
          • transverse process of L4/L5 to posterior ilium
      • anterior complex
        • pubis syphysis
          • fibrocartilaginous disc between innominate bones
      • pelvic floor complex
        • sacrospinous ligament
          • transversely oriented
          • resists external rotation
        • sacrotuberous ligaments
          • longitudinally oriented
          • resists vertical translation
  • Blood Supply
    • Abdominal aorta
      • bifurcates at L4 into common iliac system
        • external iliac artery
          • courses along pelvic brim
          • branches into common femoral artery (distal to inguinal ligament)
        • internal iliac artery
          • divides distal and posterior near the SI joint into
          • posterior division
            • leads to superior guteal artery and other branches
          • anterior division
            • leads to obturator artery
    • Corona mortis
      • connects iliac and obturator systems
    • Posterior venous plexus
      • injury in pelvic fractures can account for majority of blood loss
  • Neurologic
    • Lumbosacral plexus
      • L1-S4 nerve roots
    • Lateral femoral cutanous nerve
      • L2-L3 nerve roots
      • deep to inguinal ligament near ASIS
    • Obturator nerve
    • Femoral nerve
    • Sciatic nerve
    • AP pelvis
      • standard radiograph for all trauma patients
    • Inlet view
      • beam perpendicular to the S1 end plate (caudal tilt)
    • Outlet view
      • cranial tilt
      • demonstrates cranial-caudal displacemnt of the pelvic ring and sacral morphology
    • CT
      • provides excellent detail of bony anatomy and can confirm pelvic ring / acetabular fractures that are not always visible on plain radigraphs.
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