Pelvis

The pelvis consists of the bony pelvic girdle, the muscular and ligamentous pelvic floor, and the pelvic cavity, which contains viscera, vessels, and multiple nerves and muscles. The pelvic girdle, composed of 2 “hip” bones and the sacrum, is a ring-like bony structure of the axial skeleton that links the vertebral column Vertebral column The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column with the lower extremities. The pelvic ring joints include the pubic symphysis anteriorly and the sacroiliac joints posteriorly. The hip bones are made up of 3 fused bones: the pubis, ischium, and ilium. The pelvic cavity houses various GI, urinary, and reproductive structures, which are supported by the muscles and connective tissue Connective tissue Connective tissues originate from embryonic mesenchyme and are present throughout the body except inside the brain and spinal cord. The main function of connective tissues is to provide structural support to organs. Connective tissues consist of cells and an extracellular matrix. Connective Tissue of the pelvic floor. The female pelvis, making accommodations for childbirth, is generally wider and larger than the male pelvis.

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Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Table of Contents

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Structure of the Bony Pelvis

Bones

The pelvis is a ring-like structure that surrounds and protects the pelvic cavity.  The pelvis is composed of the following bones:

  • 2 “hip bones,” which consist of 3 bones each; these 3 bones are separated at birth, joined by hyaline cartilage Cartilage Cartilage is a type of connective tissue derived from embryonic mesenchyme that is responsible for structural support, resilience, and the smoothness of physical actions. Perichondrium (connective tissue membrane surrounding cartilage) compensates for the absence of vasculature in cartilage by providing nutrition and support. Cartilage, and fuse completely in late adolescence:
    • Ilium:
      • Largest of the 3 bones 
      • Makes up the superior part of the acetabulum
      • The anterior superior iliac spine, anterior inferior iliac spine, iliac crest, and posterior superior iliac spine are anatomical physical examination landmarks.
    • Ischium:
      • Inferior aspect of the pelvis and posteroinferior aspect of the acetabulum
      • The inferior bony projection is the ischial tuberosity, which is the location of insertion of the proximal hamstrings.
    • Pubis:
      • Anteromedial portion of the pelvis
      • Joins as the pubic symphysis in the anteromedial direction
    • Acetabulum:
      • Formed from parts of the ilium, ischium, and pubis
      • Cup-shaped socket for the hip
  • Sacrum:
    • Butterfly-shaped bone Bone Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy. Structure of Bones formed by the fusion of the 5 sacral vertebrae
    • Articulates with the 2 hip bones posteriorly
    • Each side articulates with the ilium via the sacroiliac joints.
  • Coccyx:
    • Terminal end of the spine
    • Inferior to the sacrum
    • An attachment for various muscles, tendons, and ligaments of the pelvis

Joints

There are 4 primary joints within the pelvis:

  • Sacroiliac:
    • Synovial joint
    • Composed of the articular surfaces of the sacrum and ilium
    • Transmits weight from the vertebral spine to the hip bones and lower limbs
  • Sacrococcygeal:
    • Cartilaginous joint
    • Composed of the base of the coccyx and oval surface at the apex of the sacrum
  • Pubic symphysis:
    • Cartilaginous joint
    • Composed of the left and right superior rami of the pubic bones
  • Lumbosacral joint:
    • Located between lumbar spine (L5) and sacrum
    • Stabilized by the iliolumbar ligaments
Superior view of the pelvic girdle, 4 primary joints of the pelvis

Superior view of the pelvic girdle, featuring the 4 primary joints of the pelvis

Image by BioDigital, edited by Lecturio.

Ligaments

The bony pelvis is primarily stabilized by the following ligaments:

  • Anterior and posterior sacroiliac ligament: supports the sacroiliac joint
  • Sacrotuberous ligament:
    • Runs from sacrum to ischial tuberosity
    • Forms the lesser sciatic foramen
  • Sacrospinous ligament:
    • Runs from sacrum to ischial spine
    • Creates the greater sciatic foramen
  • Ligaments of the hip joint Hip joint The hip joint is a ball-and-socket joint formed by the head of the femur and the acetabulum of the pelvis. The hip joint is the most stable joint in the body and is supported by a very strong capsule and several ligaments, allowing the joint to sustain forces that can be multiple times the total body weight. Hip Joint
Anterior view of the pelvis

Anterior view of the pelvis, featuring the supporting ligaments of the joints of the pelvic girdle

Image by BioDigital, edited by Lecturio.

Pelvic Cavity

The pelvic cavity is bound by the bones of the pelvic girdle and primarily contains reproductive organs, urinary organs, and the rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal. As the peritoneal cavity rests in the pelvic cavity, spaces from this region are also considered to be part of the space of the pelvic cavity. By using bony landmarks and ligaments, the pelvis can be divided into various openings, foramina, and spaces.

Openings of the pelvis

  • Pelvic inlet: 
    • Superior aperture of the pelvis
    • Boundary between the pelvic and abdominal cavities
  • Pelvic outlet: 
    • Inferior aperture of the pelvis 
    • Lower circumference of the lesser pelvis
Table: Openings of the pelvis
Location Boundaries Contents
Pelvic inlet Superior pelvic aperture
  • Anterior: pectineal line, pubic crest, and superior margin of the pubic symphysis
  • Posterior: sacral promontory, anterior border of sacral wing
  • Lateral: arcuate line
  • Ureter
  • Spermatic cord
  • Round ligament of the uterus
  • Suspensory ligament of the ovary
  • Middle sacral vessels
  • Gonadal vessels
  • Iliolumbar vessels
  • Lumbosacral trunk
  • Sympathetic trunk
  • Obturator nerve
Pelvic outlet Inferior pelvic aperture
  • Anterior: pubic symphysis, ischiopubic ramus, and arcuate pubic ligament
  • Posterior: sacrum and coccyx
  • Lateral: ischial tuberosities and sacrotuberous ligaments
  • Inferior: pelvic and urogenital diaphragms
Terminal parts of the excretory, reproductive, and digestive systems

Foramina of the pelvis

  • Greater sciatic foramen:
    • Connects the pelvis to the gluteal region Gluteal region The gluteal region is located posterior to the pelvic girdle and extends distally into the upper leg as the posterior thigh. The gluteal region consists of the gluteal muscles and several clinically important arteries, veins, and nerves. The muscles of the gluteal region help to move the hip joint during walking, running, standing, and sitting. Gluteal Region
    • Separated from lesser sciatic foramen by the sacrospinous ligament
  • Lesser sciatic foramen: connects the pelvis to the posterior thigh Thigh The thigh is the region of the lower limb found between the hip and the knee joint. There is a single bone in the thigh called the femur, which is surrounded by large muscles grouped into 3 fascial compartments. Thigh
  • Obturator foramen:
    • Connects the pelvis to the thigh Thigh The thigh is the region of the lower limb found between the hip and the knee joint. There is a single bone in the thigh called the femur, which is surrounded by large muscles grouped into 3 fascial compartments. Thigh
    • Almost completely covered by the obturator membrane 
Table: Foramina of the pelvis
Structure Boundaries Contents
Greater sciatic foramen Formed by:
  • Sacrospinous ligament (extends from lateral edge of sacrum and coccyx to ischial spine)
  • Sacrotuberous ligament (extends from the lateral edge of sacrum and coccyx to the ischial tuberosity)
  • Inferior: sacrospinous ligament and the ischial spine
  • Superior: anterior sacroiliac ligament
  • Anterolateral: greater sciatic notch of the ilium
  • Posteromedial: sacrotuberous ligament
  • Piriformis muscle
  • Suprapiriform foramen: superior gluteal vessels and nerve
  • Infrapiriform foramen:
    • Pudendal nerve
    • Internal pudendal vessels
    • Sciatic nerve
    • Inferior gluteal vessels and nerve
    • Nerve to the obturator internus muscle
    • Nerve to the quadratus femoris muscle
    • Posterior femoral cutaneous nerve
Lesser sciatic foramen
  • Superior: sacrospinous ligament and ischial spine
  • Anterior: ischial tuberosity
  • Posterior: sacrotuberous ligament
  • Pudendal nerve
  • Internal pudendal vessels
  • Tendon and nerve of obturator internus muscle
Obturator foramen
  • Formed by the ischium and pubis bones
  • Bound by a thin margin (obturator groove) to which the obturator membrane is attached, creating the obturator canal
  • Anterior obturator tubercle (pubis)
  • Posterior obturator tubercle (ischium)
  • Obturator artery
  • Obturator vein
  • Obturator nerve

Peritoneal spaces of the pelvis

The pelvis has multiple spaces related to the caudal end of the peritoneal cavity and the peritoneal folds found within the viscera:

  • Rectovesical pouch:
    • Exists only in males
    • Located between the upper posterior part of the urinary bladder and the upper middle part of the rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal
  • Rectouterine pouch of Douglas:
    • Exists only in females
    • Located between the upper posterior part of the uterus and the upper middle part of the rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal
  • Pararectal fossa:
    • Connects at both sides with the rectovesical/rectouterine pouch
    • Located on both sides of the intraperitoneal rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal
    • Lateral boundaries: uterosacral/sacrogenital folds (females/males)
  • Vesicouterine pouch:
    • Exists only in females
    • Located between the posterior surface of the urinary bladder and the anterior surface of the uterus
  • Rectovesical space:
    • Exists only in males
    • Located posterior to the lower portion of the bladder and the prostate Prostate The prostate is a gland in the male reproductive system. The gland surrounds the bladder neck and a portion of the urethra. The prostate is an exocrine gland that produces a weakly acidic secretion, which accounts for roughly 20% of the seminal fluid. Prostate and other Male Reproductive Glands gland, inferior to the rectovesical pouch
  • Ischiorectal fossa: triangular-shaped, on both sides of the lower rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal and the anus
  • Retropubic space of Retzius: located between the posterior surface of the pubis and the anterior surface of the bladder/ prostate Prostate The prostate is a gland in the male reproductive system. The gland surrounds the bladder neck and a portion of the urethra. The prostate is an exocrine gland that produces a weakly acidic secretion, which accounts for roughly 20% of the seminal fluid. Prostate and other Male Reproductive Glands in males

Anatomical variations of the bony pelvis

There are anatomical variations between the female (gynecoid) and male (android) pelvis.

  • Gynecoid: 
    • Considered the “classic female pelvis shape”
    • Generally wider than its male counterpart, with less prominent ischial spines, as an adaptation for childbirth
  • Android: considered the “classic male pelvis shape”
The gynecoid pelvis versus the android pelvis

The gynecoid pelvis versus the android pelvis

Image by Lecturio.

Pelvic Floor

Overview

The pelvic floor, also referred to as the pelvic diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm, is a group of muscles that supports the abdominal and pelvic viscera. The pelvic floor has 3 layers:

  • Superficial layer:
    • Also referred to as the perineum or the superficial perineal layer
    • Diamond-shaped region between coccyx and pubic symphysis
  • Intermediate layer:
    • Pelvic diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm
    • Separates perineum from pelvic cavity
  • Deep layer:
    • Urogenital diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm
    • Separates upper pelvis from deep perineal sac
Table: Structures of the pelvic floor
Superficial layer: perineum Intermediate layer: pelvic diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm Deep layer: urogenital diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm
Characteristics Diamond-shaped surface region between coccyx and pubic symphysis Separates the perineum from the pelvic cavity Separates the upper pelvis from the deep perineal sac
Components
  • Ischiocavernosus
  • Bulbocavernosus/bulbospongiosus (females/males)
  • Superficial transverse perineal muscle
  • External anal sphincter
  • Levator ani
  • Coccygeus
  • Piriformis
  • Obturator internus
  • Deep transverse perineal muscle
  • Urethral sphincter
  • Perineal membrane
  • Compressor urethrae muscle
Innervation Pudendal nerve Sacral nerve roots (S3–S5) Pudendal nerve
Function Support and raise the pelvic floor

Muscles of the pelvic floor

The muscles of the pelvic floor have several important functions:  

  • Provide physical support to the pelvic viscera and prevent pelvic organ prolapse
  • Maintain both urinary and fecal continence
  • Assist in childbirth
Table: Muscles of the pelvic floor
Layer Muscle Origin Insertion
Perineum Ischiocavernosus Ischial tuberosity Crus penis Penis The penis is the male organ of copulation and micturition. The organ is composed of a root, body, and glans. The root is attached to the pubic bone by the crura penis. The body consists of the 2 parallel corpora cavernosa and the corpus spongiosum. The glans is ensheathed by the prepuce or foreskin. Penis
Bulbocavernosus/bulbospongiosus (females/males) Central tendinous median raphe of the perineum Superficial perineal membrane and dorsal penile/clitoral aponeurosis
Superficial transverse perineal Ischial tuberosity Transverse perineal muscle of the contralateral side
External anal sphincter 2 flattened muscular planes encircle the anus and meet in front to insert into the perineal body.
Pelvic diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm Levator ani group: puborectalis, pubococcygeus, and iliococcygeus Puborectalis: body of the pubis (passes around the lower rectum Rectum The rectum and anal canal are the most terminal parts of the lower GI tract/large intestine that form a functional unit and control defecation. Fecal continence is maintained by several important anatomic structures including rectal folds, anal valves, the sling-like puborectalis muscle, and internal and external anal sphincters. Rectum and Anal Canal) Puborectalis: meets its counterpart muscle at midline
Pubococcygeus: body of the pubis and anterior tendinous arch Pubococcygeus: coccyx and anococcygeal ligaments
Iliococcygeus: ischial spines and posterior tendinous arch Iliococcygeus: coccyx and anococcygeal ligaments
Coccygeus Ischial spine and sacrospinous ligament Lower sacrum and coccyx
Piriformis Anterior sacrum and superior margin of greater sciatic notch Greater trochanter
Obturator internus Ischiopubic rami and obturator membrane Medial aspect of the greater trochanter
Urogenital diaphragm Diaphragm The diaphragm is a large, dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The diaphragm consists of muscle fibers and a large central tendon, which is divided into right and left parts. As the primary muscle of inspiration, the diaphragm contributes 75% of the total inspiratory muscle force. Diaphragm Deep transverse perineal Inferior ischial rami Contralateral counterpart
Urethral sphincter Internal urethral sphincter: inferior bladder to the proximal urethra (extension of detrusor muscle)
External urethral sphincter: ischiopubic ramus towards the median plane, where it attaches with its counterpart muscle
Compressor urethrae muscle Originates from inferior pubic ramus and wraps anteriorly around the urethra to merge with its counterpart

Vessels and Innervation of the Pelvis

Arterial supply

Blood to the pelvis is supplied by:

  • Abdominal aorta: bifurcates into the left and right common iliac arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries
  • Common iliac artery: bifurcates at the sacroiliac joint into the internal and external iliac arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries
  • Internal iliac artery: divides into an anterior (supplies pelvic viscera) and a posterior ( gluteal region Gluteal region The gluteal region is located posterior to the pelvic girdle and extends distally into the upper leg as the posterior thigh. The gluteal region consists of the gluteal muscles and several clinically important arteries, veins, and nerves. The muscles of the gluteal region help to move the hip joint during walking, running, standing, and sitting. Gluteal Region) trunk
  • External iliac: 
    • Gives off the inferior epigastric and deep circumflex iliac arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries
    • Becomes the femoral artery after passing the inguinal ligament

Venous drainage

The 3 main veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins of the pelvis follow the course of the arteries Arteries Arteries are tubular collections of cells that transport oxygenated blood and nutrients from the heart to the tissues of the body. The blood passes through the arteries in order of decreasing luminal diameter, starting in the largest artery (the aorta) and ending in the small arterioles. Arteries are classified into 3 types: large elastic arteries, medium muscular arteries, and small arteries and arterioles. Arteries and are named accordingly:

  • Common iliac vein:
    • Union of the external and internal iliac veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins 
    • Joins with the corresponding common iliac vein to become the inferior vena cava
  • Internal iliac vein: responsible for the majority of pelvic venous drainage
  • External iliac vein: 
    • Continuation proximally of the femoral vein
    • Primarily drains lower extremities
Arteries and veins of the pelvis

Arteries and veins Veins Veins are tubular collections of cells, which transport deoxygenated blood and waste from the capillary beds back to the heart. Veins are classified into 3 types: small veins/venules, medium veins, and large veins. Each type contains 3 primary layers: tunica intima, tunica media, and tunica adventitia. Veins of the pelvis

Image by BioDigital, edited by Lecturio

Innervation

The innervation of the pelvis is provided by branches from the sacral plexus, including the pudendal nerve, which is formed from the sacral plexus, S2–S4. The pelvis receives both somatic and autonomic innervation.

  • Motor supply to: 
    • External urethral and anal sphincters
    • Levator ani
    • Bulbospongiosus
    • Ischiocavernosus
  • Sensory innervation to: 
    • Perineum
    • Penis/clitoris
    • Posterior scrotum/labia
    • Anal canal
  • Reflex erection: 
    • Afferent pudendal nerve → activates reflex arc 
    • Parasympathetic fibers in S2–S4 roots
  • Sympathetic: penis Penis The penis is the male organ of copulation and micturition. The organ is composed of a root, body, and glans. The root is attached to the pubic bone by the crura penis. The body consists of the 2 parallel corpora cavernosa and the corpus spongiosum. The glans is ensheathed by the prepuce or foreskin. Penis/clitoris (male ejaculation)
Nerves of the pelvis

Nerves of the pelvis

Image by BioDigital, edited by Lecturio

Clinical Relevance

  • Pelvic fractures Pelvic Fractures Pelvic fractures are a disruption in the cortex of a pelvic bone involving iliac wing fractures, acetabular fractures, or those causing loss of integrity of the pelvic ring (the sacrum and the 2 innominate bones). Patients often present with a history of trauma or a fall, limb length discrepancy, intense pain on palpation, and mechanical instability. Pelvic Fractures: most often occur in patients involved in high-energy impact injuries such as car accidents or falls. Because of the high-energy nature of this trauma, pelvic fractures are often considered unstable fractures, and individuals may present with vascular compromise and concomitant injuries to the genitourinary system. Older individuals with osteoporosis Osteoporosis Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications. Osteoporosis may present with pelvic fractures after low-impact injuries. 
  • Obturator hernia: herniation of pelvic or abdominal contents through the obturator foramen. Obturator hernia more often occurs on the right side, as the sigmoid colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix blocks the obturator canal on the left. This hernia often presents with bowel obstruction or lancinating pain Pain Pain has accompanied humans since they first existed, first lamented as the curse of existence and later understood as an adaptive mechanism that ensures survival. Pain is the most common symptomatic complaint and the main reason why people seek medical care. Physiology of Pain in the medial thigh Thigh The thigh is the region of the lower limb found between the hip and the knee joint. There is a single bone in the thigh called the femur, which is surrounded by large muscles grouped into 3 fascial compartments. Thigh, extending to the knee, due to compression of the obturator nerve.
  • Pelvic floor insufficiency or dysfunction: The pelvic floor supports the abdominal and pelvic viscera. This structure separates the perineum from the pelvic cavity and assists in controlling the sphincter function of the rectal, urinary, and genital tracts. Weakening of connective tissue Connective tissue Connective tissues originate from embryonic mesenchyme and are present throughout the body except inside the brain and spinal cord. The main function of connective tissues is to provide structural support to organs. Connective tissues consist of cells and an extracellular matrix. Connective Tissue and/or muscles can lead to pelvic floor insufficiency, contributing to pelvic floor disorders. Pelvic floor dysfunction includes pelvic organ prolapse (e.g., prolapse of the uterus), urinary incontinence Urinary incontinence Urinary incontinence (UI) is involuntary loss of bladder control or unintentional voiding, which represents a hygienic or social problem to the patient. Urinary incontinence is a symptom, a sign, and a disorder. The 5 types of UI include stress, urge, mixed, overflow, and functional. Urinary Incontinence, and fecal incontinence.
  • Childbirth: Childbirth begins with contractions that lead to progressive cervical dilation and effacement, resulting in the birth of the infant and expulsion of the placenta Placenta The placenta consists of a fetal side and a maternal side, and it provides a vascular communication between the mother and the fetus. This communication allows the mother to provide nutrients to the fetus and allows for removal of waste products from fetal blood. Placenta, Umbilical Cord, and Amniotic Cavity through the birth canal of the pelvis. Vaginal childbirth is possible because of the anatomical differences between the bony pelvis in men and women.

References

  1. Bordoni, B., Sugumar, K., Leslie, S.W. (2021). Anatomy, abdomen and pelvis, pelvic floor. StatPearls. Retrieved November 9, 2021, from https://pubmed.ncbi.nlm.nih.gov/29489277/
  2. Chaudhry, S.R., Nahian, A., Chaudhry, K. (2021). Anatomy, abdomen and pelvis, pelvis. StatPearls. Retrieved November 9, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK482258/
  3. Drake, R.L., Vogl, A.W., Mitchell, A.W.M. (2014). Gray’s Anatomy for Students, 3rd ed. Churchill Livingstone.

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