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Ischial Spine
The ischial spine is part of the posterior border of the body of the ischium bone of the pelvis. It is a thin and pointed triangular eminence, more or less elongated in different subjects. Structure The pudendal nerve travels close to the ischial spine. Clinical significance The ischial spine can serve as a landmark in pudendal anesthesia, as the pudendal nerve The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or fem ... lies close to the ischial spine. Additional images File:Sciatic notches.png, Right hip bone, external surface, showing the greater and lesser sciatic notches, separated by the ischial spine. File:Gray319.png, Articulations of pelvis. Anterior view. File:Slide3ADA.JPG, PELVIS. ANTERIOR VIEW. References External links * - "The Female Perineum: Osteology" * - "Th ...
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Hip-joint
In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint. The hip region is located lateral and anterior to the gluteal region, inferior to the iliac crest, and overlying the greater trochanter of the femur, or "thigh bone". In adults, three of the bones of the pelvis have fused into the hip bone or acetabulum which forms part of the hip region. The hip joint, scientifically referred to as the acetabulofemoral joint (''art. coxae''), is the joint between the head of the femur and acetabulum of the pelvis and its primary function is to support the weight of the body in both static (e.g., standing) and dynamic (e.g., walking or running) postures. The hip joints have very important roles in retaining balance, and for maintaining the pelvic inclination angle. Pain of the hip may be the result of numerous causes, ...
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Ischium
The ischium () forms the lower and back region of the (''os coxae''). Situated below the ilium and behind the pubis, it is one of three regions whose fusion creates the . The superior portion of this region forms approximately one-third of the acetabulum.


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Pelvis
The pelvis (plural pelves or pelvises) is the lower part of the trunk, between the abdomen 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 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 (sex organs) and the rectum, while the pelvic f ...
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Gemelli Muscles
The gemelli muscles are the inferior gemellus muscle and the superior gemellus muscle, two small accessory fasciculi to the tendon of the internal obturator muscle. The gemelli muscles belong to the lateral rotator group of six muscles of the hip that rotate the femur in the hip joint. Superior gemellus muscle The gemelli muscles are two small muscular fasciculi, accessories to the tendon of the internal obturator muscle which is received into a groove between them. The superior gemellus muscle is the higher placed gemellus muscle that arises from the outer (gluteal) surface of the ischial spine, and blends with the upper part of the tendon of the internal obturator. It is smaller than the inferior gemellus. In some people, the fibres of the gemellus superior extend further than average, and are prolonged onto the medial surface of the greater trochanter of the femur. The superior and inferior gemelli are supplied by the inferior gluteal artery. Nerve supply to the superior geme ...
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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 ligament in the pelvic floor. It is a triangular plane of muscular and tendinous fibers. It arises by its apex from the spine of the ischium and sacrospinous ligament. It is inserted by its base into the margin of the coccyx and into the side of the lowest piece of the sacrum. In combination with the levator ani, it forms the pelvic diaphragm. The pudendal nerve runs between the coccygeus muscle and the piriformis muscle, superficial to the coccygeus muscle. Nerve supply The coccygeus muscle is innervated by the pudendal nerve, which runs between it and the piriformis muscle. Function The coccygeus muscle assists the levator ani and piriformis muscle in closing in the back part of the outlet of the pelvis. This helps to support the ...
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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 lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and painfully contracts during vaginismus. It also contracts rhythmically during orgasm. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx and a ...
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Pelvic Fascia
The pelvic fasciae are the fascia of the pelvis and can be divided into: * (a) the fascial sheaths of ** the Obturator internus muscle ( Fascia of the Obturator internus) ** the Piriformis muscle ( Fascia of the Piriformis) ** the pelvic floor * (b) fascia associated with the organs of the pelvis. Structure Fascia of pelvic organs Pelvic fascia extends to cover the organs within the pelvis. It is attached to the fascia that runs along the pelvic floor along the tendinous arch. The fascia which covers pelvic organs can be divided according to the organs that are covered: * The front is known as the "vesical layer". It forms the anterior and lateral ligaments of the bladder. * In males, its middle lamina crosses the floor of the pelvis between the rectum and vesiculæ seminales as the ''rectovesical septum''; in the female this is perforated by the cervix and is named the transverse cervical ligament. * At the back, the fascia passes to the side of the rectum; it forms a loose s ...
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Sacrospinous Ligament
The sacrospinous ligament (small or anterior sacrosciatic ligament) is a thin, triangular ligament in the human pelvis. The base of the ligament is attached to the outer edge of the sacrum and coccyx, and the tip of the ligament attaches to the spine of the ischium, a bony protuberance on the human pelvis. Its fibres are intermingled with the sacrotuberous ligament. Structure The sacrotuberous ligament passes behind the sacrospinous ligament. In its entire length, the sacrospinous ligament covers the equally triangular coccygeus muscle, to which its closely connected.Gray's Anatomy 1918 Function The presence of the ligament in the greater sciatic notch creates an opening (foramen), the greater sciatic foramen, and also converts the lesser sciatic notch into the lesser sciatic foramen.Platzer (2004), p 188 The greater sciatic foramen lies above the ligament, and the lesser sciatic foramen lies below it. The pudendal vessels and nerve pass behind the sacrospinous ligament directl ...
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Pudendal Nerve
The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If damaged, most commonly by childbirth, lesions may cause sensory loss or fecal incontinence. The nerve may be temporarily blocked as part of an anaesthetic procedure. The pudendal canal that carries the pudendal nerve is also known by the eponymous term "Alcock's canal", after Benjamin Alcock, an Irish anatomist who documented the canal in 1836. Structure The pudendal nerve is paired, meaning there are two nerves, one on the left and one on the right side of the body. Each is formed as three roots immediately converge above the upper border of the sacrotuberous ligament and the coccygeus muscle. The three roots become two cords when the middle and lower root join to fo ...
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Pudendal Anesthesia
Pudendal anesthesia, also known as a pudendal block, or saddle block, is a form of local anesthesia commonly used in the practice of obstetrics to relieve pain during the delivery of baby by forceps. The pudendal nerve block prevents fainting during forceps delivery which was common before pudendal nerve block use was available. The anesthesia is produced by blocking the pudendal nerves near the ischial spine of the pelvis. The ischial spine separates the greater and lesser sciatic foramina at the exit of the bony pelvis. The pudendal block gets its name because a local anesthetic, such as lidocaine or chloroprocaine, is injected into the pudendal canal where the pudendal nerve is located. This allows quick pain relief to the perineum, vulva, and vagina. A pudendal block is usually given in the second stage of labor just before delivery of the baby. It relieves pain around the vagina and rectum as the baby comes down the birth canal. It is also helpful just before an episiotomy ...
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Bones Of The Pelvis
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, and enable mobility. Bones come in a variety of shapes and sizes and have complex internal and external structures. They are lightweight yet strong and hard and serve multiple functions. Bone tissue (osseous tissue), which is also called bone in the uncountable sense of that word, is hard tissue, a type of specialized connective tissue. It has a honeycomb-like matrix internally, which helps to give the bone rigidity. Bone tissue is made up of different types of bone cells. Osteoblasts and osteocytes are involved in the formation and mineralization of bone; osteoclasts are involved in the resorption of bone tissue. Modified (flattened) osteoblasts become the lining cells that form a protective layer on the bone surface. The mineralized matri ...
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