Selfi Handayani

ANATOMI
blok genitouropoetica

(1) pelvis
 CAKUPAN MATERI

• Pelvis
• Organa genitalia feminina:
- organ genitalia feminina externa
- organ genitalia feminina interna
- neurovascularisasi pelvis dan organ viscera
• Mammae
 PRETEST

1. sebutkan skeleton pelvis

2. sebutkan persendian di pelvis

3. sebutkan ligamenta yang menyusun pelvis

4. Sebutkan musculi yang menyusun pelvis

5. Bidang hodge

6. Ukuran pelvis
 PELVIS

• Regio di inferior dan belakang abdomen

• Membentuk dinding yang membatasi ruangan
• Dinding: bagian keras dan lunak
• Ruangan (cavitas pelvis): isi viscera pelvis
- Organ reproduksi
- Bag tractus urinarius
- Bag tractus digestivus
- N, v, a, l
 DINDING PELVIS

• Bagian keras: • Bagian lunak:

skeleton pelvis - ligamenta
- ossa coxae dexter et sinister: - musculi
os ilium, os ischium, os pubis
- fasciae
- os sacrum
- n, v, a, l
- os coccygeum
 THE PELVIC FLOOR MUSCLES-
A N EX TR A O R D IN A RY MU LTI -TA S K ER !

pelvic organ
support urinary
breathing continence

fecal
low back continence
stability

voiding
pelvic
stability
sexual
childbirth
function
SKELETON PELVIS
 ADITUS PELVIS

• Pintu dibatasi:
• Promontorium
• Sacrum
• Linea inominata
• Ramus Superior ossis Pubis
• Uper border of Symphisis pubis
 EXITUS PELVIS

Pintu dibatasi:
• Ujung bawah Sacrum
• Tulang Tuber Ischiadica
• Sacro-coccygeal
• Tepi bawah symphisis ossis pubis
 NORMAL PELVIC MEASUREMENT

Distansia
Cristarum

Distansia
Spinarum

Distansia Cristarum: 28—29 cm

Distansia Spinarum: 25—26 cm
INSIDE PELVIC MEASUREMENT

• Conjugata Diagonalis = 12,5—13cm

• Conjugata Vera = CD – (1,5—2cm)
• Conjugata Obstetrika = terpendek
 HODGE LINE

• Hodge I: imagination line drawn from promontorium to the upper border of

symphisis pubis
• Hodge II: parallel with hodge I measured from lower border of symphisis
• Hodge III: parallel with hodge II, measured from spina ischiadica
• Hodge IV: parallel with hodge III, measured from coccyx tip
GAMBAR BIDANG HODGE
 BENTUK PELVIS
BERDASARKAN ADITUS
VAGINAL TOUCHER
 LIGAMENTA DAN MUSCULI

• LIGAMENTA menghub persendian di pelvis

• Ligamentum interpubicum pada symphysis pubis

• Ligamentum sacro iliacum
• Ligamentum sacro-coccygeum
• Ligamentum sacro-tuberosum
• Ligamentum sacro spinosum
 MUSCULI

Bagian dalam skeleton pelvis dilapisi oleh beberapa otot

 Di atas aditus --- Mm. iliacus & psoas

 Dinding lateral ---- Mm. obturator internus & its fascia

 Dinding poterior ---- M. pyriformis

 Diaphragma pelvis ---- Mm. levator ani & coccygeus

 Sacral promontory

Left sacro-iliac joint

Iliopectineal line

Sacrospinous ligament

Sacrotuberous ligament

Ischial spine

Symphysis pubis

Ischial tuberosity
 PX. PELVIS

• X-Ray
• Jangka Panggul
 Distansia Cristarum
 Distansia Spinarum
 Conjugata eksterna/Bouldeloque: distance
between upper border
symphysis pubis with prosessus spinosus lumbal 5. the
normal measurement 18—20 cm
• Vaginal Touché
 VAGINAL TOUCHÉ EXAMINTION

• Promontorium touched/not
• Conjugata Vera normal/not
• Spina Ischiadica prominent/not
• Arcus pubis wide/narrow
• Sakrum curve/not

Note:
•Touched Promontory usually indicated narrow pelvic
•Height ≤145 cm also indicated narrow pelvic
Differentiation between female and male pelvic
PELVIC SHAPE
 PELVIC SHAPE

1-GYNECOID
• Typical female pelvis found in 50% of women
• Rounded—slightly oval inlet
• Straight pelvic sidewalls with roomy pelvic cavity
• Good sacral curve
• Ischial spines are not prominent
• Pubic arch is wide
 PELVIC SHAPE

2-ANDROID
• Typical male pelvis found in 1/3 white women 1/6 non-white
• Pelvic brim is heart shaped
• Pelvis funnels from above downwards (convergent sidewalls)
• Narrow pubic arch
• Prominent spines
 PELVIC SHAPE

3-ANTHROPOID
 25% white women & 50% nonwhite
 Pelvic brim APD > TD
 Long & narrow pelvic canal with long sacrum
 Straight pelvic sidewalls

4-PLATYPELLOID
 3% of women
 Pelvic brim TD >>>APD  kidney shape
 Sacral promontory pushed forwards
PELVIC SHAPE DEVIATION

A. Panggul Naegele
B. Panggul Rakhitis
C. Panggul Skoliosis
D. Panggul Kifosis
E. -”- dari Samping
F. Panggul Osteomalasia
G. Panggul Spondilolistesis
H. Panggul Robert