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Through Anatomy, Abdomen and Birth

The pelvic region of the trunk includes the bony pelvis, the pelvic cavity (the space enclosed by the bony pelvis), the pelvic floor, below the pelvic cavity, and the perineum, below the pelvic floor. The pelvic skeleton is formed in the area of the back, by the sacrum and the coccyx and anteriorly and to the left and right sides, by a pair of hip bones.

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 joints. 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, 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 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 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 bones (ilium, ischium, 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 pelvic cavity, typically defined as a small part of the space enclosed by the bony pelvis, delimited by the pelvic brim above and the pelvic floor below; alternatively, the pelvic cavity is sometimes also defined as the whole space enclosed by the pelvic skeleton, subdivided into:
  • the pelvic floor (or pelvic diaphragm), below the pelvic cavity
  • the perineum, below the pelvic floor

Pelvic bone

The pelvic skeleton is formed posteriorly (in the area of the back) by the sacrum and the coccyx, and laterally and anteriorly (forward and to the sides) by a pair of hip bones. Each hip bone consists of three sections: ilium, ischium, and pubis. During childhood, these sections are separate bones, joined by the triradiate cartilage. During puberty, they fuse together to form a single bone.

Pelvic cavity

The pelvic cavity is a body cavity that is bounded by the bones of the pelvis and which primarily contains reproductive organs and the rectum.

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, or superior pelvic aperture, which leads into the lesser pelvis, is bordered by the promontory, 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, or pubic arch, the ischial tuberosities, and the coccyx.

Alternatively, the pelvis is divided into three planes: the inlet, midplane, and outlet.

Pelvic floor

The pelvic floor 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 and urogenital 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.

The pelvic diaphragm is composed of the levator ani and the coccygeus muscle. 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 and the anal hiatus. 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 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.

The external anal and urethral sphincters 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. The ischiocavernosus muscle squeezes blood into the corpora cavernosa penis and clitoridis.

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, the process of natural selection is constrained by two conflicting demands: a wide birth canal and locomotion efficiency, a conflict referred to as the "obstetrical dilemma". 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 pelves include:

  • The female pelvis is larger and broader than the male pelvis, which is taller, narrower, and more compact. 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 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 the subpubic angle in males and the pubic arch in females. Additionally, the bones forming the 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 narrower than in females.
  • The male sacrum is longer, narrower, and straighter, and has a pronounced sacral promontory. The female sacrum is shorter, wider, and more curved posteriorly, and has a less pronounced promontory.
  • The acetabula are farther 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).

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