
The pelvis (plural pelves or pelvises) is the lower part of the
trunk, between the
abdomen
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...
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 bone
The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the ilium, isc ...
s.
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 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 ...
s. 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
A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female ...
(sex 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
young 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
The abdomen (colloquially called the belly, tummy, midriff, tucky or stomach) is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the to ...
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 bone
The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the ilium, isc ...
s (
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
The pelvic brim is the edge of the pelvic inlet. It is an approximately Mickey Mouse head-shaped line passing through the prominence of the sacrum, the arcuate and pectineal lines, and the upper margin of the pubic symphysis.
Structure
The p ...
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
greater (or false) pelvis, above the
pelvic brim
The pelvic brim is the edge of the pelvic inlet. It is an approximately Mickey Mouse head-shaped line passing through the prominence of the sacrum, the arcuate and pectineal lines, and the upper margin of the pubic symphysis.
Structure
The p ...
** the
lesser (or true) pelvis, below the pelvic brim
* 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 bone
The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the ilium, isc ...
s.
Each hip bone consists of 3 sections,
ilium,
ischium, and
pubis. During childhood, these sections are separate bones, joined by the
triradiate cartilage
The triradiate cartilage (in Latin cartilago ypsiloformis) is the 'Y'-shaped epiphyseal plate between the ilium, ischium and pubis to form the acetabulum of the os coxae.
Human development
In children, the triradiate cartilage closes at an app ...
. 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
A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female ...
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 arcuate line of the ilium is a smooth rounded border on the internal surface of the ilium. It is immediately inferior to the iliac fossa and Iliacus muscle.
It forms part of the border of the pelvic inlet.
In combination with the pectineal ...
, the
iliopubic eminence, the
pecten of the pubis, and the upper part of the
pubic symphysis
The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubi ...
. The
pelvic outlet
The lower circumference of the lesser pelvis is very irregular; the space enclosed by it is named the inferior aperture or pelvic outlet. It is an important component of pelvimetry.
Boundaries
It has the following boundaries:
* anteriorly: the pub ...
or inferior pelvic aperture is the region between the
subpubic angle or
pubic arch, the
ischial tuberosities and the
coccyx.
* Ligaments:
obturator membrane,
inguinal ligament
The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may ...
(
lacunar ligament,
iliopectineal arch)
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
The genitourinary system, or urogenital system, are the organs of the reproductive system and the urinary system. These are grouped together because of their proximity to each other, their common embryological origin and the use of common pathw ...
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.
[''Thieme Atlas of Anatomy'' (2006), p. 137]
The pelvic diaphragm is composed of the
levator ani and the
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 lig ...
. 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
Older texts have asserted the existence of a urogenital diaphragm, also called the triangular ligament, which was described as a layer of the pelvis that separates the deep perineal sac from the upper pelvis, lying between the inferior fascia of ...
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.
[Platzer (2004), p. 106]
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 mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hy ...
in females and surrounds the
corpus spongiosum in males.
Ischiocavernosus squeezes blood into the
corpus cavernosum penis and
clitoridis.
[''Thieme Atlas of Anatomy'' (2006), p. 136]
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,
natural selection
Natural selection is the differential survival and reproduction of individuals due to differences in phenotype. It is a key mechanism of evolution, the change in the heritable traits characteristic of a population over generations. Char ...
has been confronted 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 women 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 pelvis include:
* The female pelvis is larger and broader than the male pelvis which is taller, narrower, and more compact.
[''Thieme Atlas of Anatomy'', (2006), p. 113]
* 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 men, but obtuse (90–100 degrees) in women. Accordingly, the angle is called
subpubic angle in men and
pubic arch in women.
Additionally, the bones forming the angle/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 more narrow than in females.
* The male sacrum is long, narrow, more straight, and has a pronounced sacral promontory. The female sacrum is shorter, wider, more curved posteriorly, and has a less pronounced promontory.
* The
acetabula are wider 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).
Development
Each side of the pelvis is formed as cartilage, which ossifies as three main bones which stay separate through childhood:
ilium,
ischium,
pubis. At birth the whole of the hip joint (the acetabulum area and the top of the femur) is still made of cartilage (but there may be a small piece of bone in the
great trochanter of the femur); this makes it difficult to detect
congenital hip dislocation by
X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&n ...
ing.
There is preliminary evidence that the pelvis continues to widen over the course of a lifetime.
Functions
The skeleton of the pelvis is a basin-shaped ring of bones connecting the vertebral column to the femora. It is then connected to two hip bones.
Its primary functions are to bear the weight of the upper body when sitting and standing, transferring that weight from the axial skeleton to the lower appendicular skeleton when standing and walking, and providing attachments for and withstanding the forces of the powerful muscles of locomotion and posture. Compared to the shoulder girdle, the pelvic girdle is thus strong and rigid.
Its secondary functions are to contain and protect the pelvic and abdominopelvic viscera (inferior parts of the urinary tracts, internal reproductive organs), providing attachment for external reproductive organs and associated muscles and membranes.
As a mechanical structure

The
pelvic girdle consists of the two hip bones. The hip bones are connected to each other anteriorly at the
pubic symphysis
The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubi ...
, and posteriorly to the
sacrum at the
sacroiliac joints to form the pelvic ring. The ring is very stable and allows very little mobility, a prerequisite for transmitting loads from the trunk to the lower limbs.
[''Thieme Atlas of Anatomy'' (2006), p. 112]
As a mechanical structure the pelvis may be thought of as four roughly triangular and twisted rings. Each superior ring is formed by the iliac bone; the anterior side stretches from the acetabulum up to the
anterior superior iliac spine
The anterior superior iliac spine (abbreviated: ASIS) is a bony projection of the iliac bone, and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis. It provides attachment for the in ...
; the posterior side reaches from the top of the acetabulum to the
sacroiliac joint; and the third side is formed by the
palpable
Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determin ...
iliac crest
The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis.
Structure
The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterio ...
. The lower ring, formed by the rami of the
pubic and
ischial bones, supports the acetabulum and is twisted 80–90 degrees in relation to the superior ring.
[Holm (1980), pp. 425–6]
An alternative approach is to consider the pelvis part of an integrated mechanical system based on the
tensegrity
Tensegrity, tensional integrity or floating compression is a structural principle based on a system of isolated components under compression inside a network of continuous tension, and arranged in such a way that the compressed members (usuall ...
icosahedron as an infinite element. Such a system is able to withstand omnidirectional forces—ranging from weight-bearing to childbearing—and, as a low energy requiring system, is favoured by
natural selection
Natural selection is the differential survival and reproduction of individuals due to differences in phenotype. It is a key mechanism of evolution, the change in the heritable traits characteristic of a population over generations. Char ...
.
[Levin (2003), ''A Different Approach to the Mechanics of the Human Pelvis: Tensegrity'' (See conclusions.)]
The pelvic inclination angle is the single most important element of the human body posture and is adjusted at the hips. It is also one of the rare things that can be measured at the assessment of the posture. A simple method of measurement was described by the British orthopedist
Philip Willes and is performed by using an
inclinometer
An inclinometer or clinometer is an instrument used for measuring angles of slope, elevation, or depression of an object with respect to gravity's direction. It is also known as a ''tilt indicator'', ''tilt sensor'', ''tilt meter'', ''slop ...
.
As an anchor for muscles
The
lumbosacral joint, between the sacrum and the last
lumbar vertebra, has, like all vertebral joints, an
intervertebral disc
An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the vertebrae, to act as a ligament to ho ...
,
anterior and
posterior ligaments,
ligamenta flava
The ligamenta flava (singular, ''ligamentum flavum'', Latin for ''yellow ligament'') are a series of ligaments that connect the ventral parts of the laminae of adjacent vertebrae. They help to preserve upright posture, preventing hyperflexion, and ...
,
interspinous and
supraspinous ligaments, and synovial joints between the articular processes of the two bones. In addition to these ligaments the joint is strengthened by the
iliolumbar and lateral lumbosacral ligaments. The iliolumbar ligament passes between the tip of the transverse process of the fifth lumbar vertebra and the posterior part of the iliac crest. The lateral lumbosacral ligament, partly continuous with the iliolumbar ligament, passes down from the lower border of the transverse process of the fifth vertebra to the ala of the sacrum. The movements possible in the lumbosacral joint are flexion and extension, a small amount of lateral flexion (from 7 degrees in childhood to 1 degree in adults), but no axial rotation. Between ages 2–13 the joint is responsible for as much as 75% (about 18 degrees) of flexion and extension in the lumbar spine. From age 35 the ligaments considerably limit the range of motions.
[Palastanga (2006), pp. 331–2]
The three extracapsular ligaments of the
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 ...
—the
iliofemoral,
ischiofemoral, and
pubofemoral ligament
The pubofemoral ligament (pubocapsular ligament) is a ligament on the inferior side of the hip joint.
This ligament is attached, above, to the obturator crest and the superior ramus of the pubis; below, it blends with the capsule and with the d ...
s—form a twisting mechanism encircling the neck of the
femur. When sitting, with the hip joint flexed, these ligaments become lax permitting a high degree of mobility in the joint. When standing, with the hip joint extended, the ligaments get twisted around the femoral neck, pushing the head of the femur firmly into the
Acetabulum, thus stabilizing the joint.
[''Thieme Atlas of Anatomy'' (2006), p. 381] The
zona orbicularis assists in maintaining the contact in the joint by acting like a buttonhole on the femoral head.
[Platzer (2004), p. 198] The intracapsular ligament, the
ligamentum teres, transmits blood vessels that nourish the femoral head.
[''Thieme Atlas of Anatomy'' (2006), p. 383]
Junctions

The two hip bones are joined anteriorly at the
pubic symphysis
The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubi ...
by a
fibrous cartilage covered by a
hyaline cartilage, the interpubic disk, within which a non-synovial cavity might be present. Two ligaments, the
superior and
inferior pubic ligaments, reinforce the symphysis.
[Platzer (2004), p. 188]
Both
sacroiliac joints, formed between the auricular surfaces of the sacrum and the two hip bones. are
amphiarthroses, almost immobile joints enclosed by very taut joint capsules. This capsule is strengthened by the
ventral
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pr ...
,
interosseous, and
dorsal sacroiliac ligaments.
The most important accessory ligaments of the sacroiliac joint are the
sacrospinous and
sacrotuberous ligaments which stabilize the hip bone on the sacrum and prevent the promonotory from tilting forward. Additionally, these two ligaments transform the
greater and
lesser sciatic notches into the
greater and
lesser foramina, a pair of important pelvic openings.
[Palastanga (2006), pp. 326–7] The
iliolumbar ligament is a strong ligament which connects the tip of the transverse process of the fifth lumbar vertebra to the posterior part of the inner lip of the iliac crest. It can be thought of as the lower border of the
thoracolumbar fascia and is occasionally accompanied by a smaller ligamentous band passing between the fourth lumbar vertebra and the iliac crest. The
lateral lumbosacral ligament is partly continuous with the iliolumbar ligament. It passes between the transverse process of the fifth vertebra to the
ala of the sacrum where it intermingle with the anterior sacroiliac ligament.
[Palastanga (2006), pp. 332–3]
The joint between the sacrum and the coccyx, the
sacrococcygeal symphysis
The sacrococcygeal symphysis (sacrococcygeal articulation, articulation of the sacrum and coccyx) is an amphiarthrodial joint, formed between the oval surface at the apex of the sacrum, and the base of the coccyx.
It is a slightly moveable jointM ...
, is strengthened by a series of ligaments. The
anterior sacrococcygeal ligament
The anterior sacrococcygeal ligament or ventral sacrococcygeal ligament consists of a few irregular fibers, which descend from the anterior surface of the sacrum to the front of the coccyx, blending with the periosteum.Morris (2005), p 59
This sho ...
is an extension of the
anterior longitudinal ligament
The anterior longitudinal ligament is a ligament that runs down the anterior surface of the spine. It traverses all of the vertebral bodies and intervertebral discs on their ventral side. It may be partially cut to treat certain abnormal curvatu ...
(ALL) that run down the anterior side of the
vertebral bodies. Its irregular fibers blend with the
periosteum
The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. Endosteum lines the inner surface of the medullary cavity of all long bones.
Struc ...
. The
posterior sacrococcygeal ligament has a deep and a superficial part, the former is a flat band corresponding to the
posterior longitudinal ligament
The posterior longitudinal ligament is a ligament connecting the posterior surfaces of the vertebral bodies of all of the vertebrae. It weakly prevents hyperflexion of the vertebral column. It also prevents posterior spinal disc herniation, altho ...
(PLL) and the latter corresponds to the
ligamenta flava
The ligamenta flava (singular, ''ligamentum flavum'', Latin for ''yellow ligament'') are a series of ligaments that connect the ventral parts of the laminae of adjacent vertebrae. They help to preserve upright posture, preventing hyperflexion, and ...
. Several other ligaments complete the
foramen of the
last sacral nerve.
[Morris (2005), p. 59]
Shoulder and intrinsic back

The inferior parts of
latissimus dorsi
The latissimus dorsi () is a large, flat muscle on the back that stretches to the sides, behind the arm, and is partly covered by the trapezius on the back near the midline. The word latissimus dorsi (plural: ''latissimi dorsorum'') comes from ...
, one of the muscles of the upper limb, arises from the posterior third of the iliac crest.
[Platzer (2004), p. 140] Its action on the shoulder joint are internal rotation, adduction, and retroversion. It also contributes to respiration (i.e. coughing).
[''Thieme Atlas of Anatomy'' (2006), p. 266] When the arm is adducted, latissimus dorsi can pull it backward and medially until the back of the hand covers the buttocks.
In a longitudinal osteofibrous canal on either side of the spine there is a group of muscles called the
erector spinae
The erector spinae ( ) or spinal erectors is a set of muscles that straighten and rotate the back. The spinal erectors work together with the glutes (gluteus maximus, gluteus medius and gluteus minimus) to maintain stable posture standing or sitt ...
which is subdivided into a lateral superficial and a medial deep tract. In the lateral tract, the
iliocostalis lumborum and
longissimus thoracis originates on the back of the sacrum and the posterior part of the iliac crest. Contracting these muscles bilaterally extends the spine and unilaterally contraction bends the spine to the same side. The medial tract has a "straight" (
interspinales,
intertransversarii
The intertransversarii are small muscles placed between the transverse processes of the vertebrae.
Structure Cervical
In the cervical region they are best developed, consisting of rounded muscular and tendinous fasciculi, and are placed in pairs ...
, and
spinalis) and an "oblique" (
multifidus
The multifidus (multifidus spinae : ''pl. multifidi'' ) muscle consists of a number of fleshy and tendinous fasciculi, which fill up the groove on either side of the spinous processes of the vertebrae, from the sacrum to the axis. While very th ...
and
semispinalis) component, both of which stretch between vertebral processes; the former acts similar to the muscles of the lateral tract, while the latter function unilaterally as spine extensors and bilaterally as spine rotators. In the medial tract, the multifidi originates on the
sacrum.
[Platzer (2004), pp. 72, 74]
Abdomen
The muscles of the
abdominal wall are subdivided into a superficial and a deep group.
The superficial group is subdivided into a lateral and a medial group. In the medial superficial group, on both sides of the centre of the abdominal wall (the
''linea alba''), the
rectus abdominis
The rectus abdominis muscle, ( la, straight abdominal) also known as the "abdominal muscle" or simply the "abs", is a paired straight muscle. It is a paired muscle, separated by a midline band of connective tissue called the linea alba. It ex ...
stretches from the cartilages of ribs V-VII and the
sternum down to the
pubic crest
Medial to the pubic tubercle is the pubic crest, which extends from this process to the medial end of the pubic bone.
It gives attachment to the conjoint tendon, the rectus abdominis, the abdominal external oblique muscle, and the pyramidalis ...
. At the lower end of the rectus abdominis, the
pyramidalis tenses the ''linea alba''. The lateral superficial muscles, the
transversus and
external and
internal oblique muscles, originate on the rib cage and on the pelvis (iliac crest and
inguinal ligament
The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may ...
) and are attached to the anterior and posterior layers of the
sheath of the rectus.
[Platzer (2004), pp. 84–91]
Flexing the trunk (bending forward) is essentially a movement of the rectus muscles, while lateral flexion (bending sideways) is achieved by contracting the obliques together with the quadratus lumborum and intrinsic back muscles. Lateral rotation (rotating either the trunk or the pelvis sideways) is achieved by contracting the internal oblique on one side and the external oblique on the other. The transversus' main function is to produce abdominal pressure in order to constrict the abdominal cavity and pull the diaphragm upward.
There are two muscles in the deep or posterior group.
Quadratus lumborum
The quadratus lumborum muscle, informally called the ''QL'', is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each is irregular and quadrilateral in sh ...
arises from the posterior part of the iliac crest and extends to the rib XII and lumbar vertebrae I–IV. It unilaterally bends the trunk to the side and bilaterally pulls the 12th rib down and assists in expiration. The
iliopsoas
The iliopsoas muscle (; from lat, ile, lit=groin and grc, ψόᾱ, psóā, muscles of the loins) refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usua ...
consists of
psoas major (and occasionally
psoas minor) and
iliacus, muscles with separate origins but a common insertion on the
lesser trochanter of the femur. Of these, only iliacus is attached to the pelvis (the
iliac fossa). However, psoas passes through the pelvis and because it acts on two joints, it is topographically classified as a posterior abdominal muscle but functionally as a hip muscle. Iliopsoas flexes and externally rotates the hip joints, while unilateral contraction bends the trunk laterally and bilateral contraction raises the trunk from the
supine position.
[''Thieme Atlas of Anatomy'' (2006), p. 128]
Hip and thigh
The muscles of the
hip are divided into a dorsal and a ventral group.
The dorsal hip muscles are either inserted into the region of the
lesser trochanter (anterior or inner group) or the
greater trochanter (posterior or outer group). Anteriorly, the
psoas major (and occasionally
psoas minor) originates along the spine between the rib cage and pelvis. The
iliacus originates on the
iliac fossa to join psoas at the
iliopubic eminence to form the
iliopsoas
The iliopsoas muscle (; from lat, ile, lit=groin and grc, ψόᾱ, psóā, muscles of the loins) refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usua ...
which is inserted into the lesser trochanter.
[Platzer (2004), p. 234] The iliopsoas is the most powerful hip flexor.
[''Thieme Atlas of Anatomy'' (2006), p. 422.]
The posterior group includes the
gluteus maximus
The gluteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human ...
,
gluteus medius, and
gluteus minimus. Maximus has a wide origin stretching from the posterior part of the iliac crest and along the sacrum and coccyx, and has two separate insertions: a proximal which radiates into the
iliotibial tract
The iliotibial tract or iliotibial band (ITB; also known as Maissiat's band or the IT band) is a longitudinal fibrous reinforcement of the fascia lata. The action of the muscles associated with the ITB (tensor fasciae latae and some fibers of glu ...
and a distal which inserts into the
gluteal tuberosity on the posterior side of the femoral shaft. It is primarily an extensor and lateral rotator of the hip joint, but, because of its bipartite insertion, it can both adduct and abduct the hip. Medius and minimus arise on the external surface of the ilium and are both inserted into the greater trochanter. Their anterior fibers are medial rotators and flexors while the posterior fibers are lateral rotators and extensors. The
piriformis
The piriformis muscle () is a flat, pyramidally-shaped muscle in the gluteal region of the lower limbs. It is one of the six muscles in the lateral rotator group.
The piriformis muscle has its origin upon the front surface of the sacrum, and ...
has its origin on the ventral side of the sacrum and is inserted on the greater trochanter. It abducts and laterally rotates the hip in the upright posture and assists in extension of the thigh.
The
tensor fasciae latae arises on the anterior superior iliac spine and inserts into the iliotibial tract.
[''Thieme Atlas of Anatomy'' (2006), p. 424] It presses the
head of the femur into the
acetabulum and flexes, medially rotates, and abducts the hip.
The ventral hip muscles are important in the control of the body's balance. The
internal and
external obturator muscles together with the
quadratus femoris are lateral rotators of the hip. Together they are stronger than the medial rotators and therefore the feet point outward in the normal position to achieve a better support. The obturators have their origins on either sides of the
obturator foramen and are inserted into the
trochanteric fossa on the femur. Quadratus arises on the
ischial tuberosity and is inserted into the
intertrochanteric crest. The
superior and
inferior gemelli, arising from the ischial spine and ischial tuberosity respectively, can be thought of as marginal heads of the obturator internus, and their main function is to assist this muscle.
The muscles of the
thigh can be subdivided into adductors (medial group), extensors (anterior group), and flexors (posterior group). The extensors and flexors act on the knee joint, while the adductors mainly act on the hip joint.
The thigh adductors have their origins on the
inferior ramus of the pubic bone and are, with the exception of
gracilis, inserted along the femoral shaft. Together with
sartorius and
semitendinosus, gracilis reaches beyond the knee to their common insertion on the
tibia.
[Platzer (2004), pp. 240–3]
The anterior thigh muscles form the
quadriceps which is inserted on the
patella with a common tendon. Three of the four muscles have their origins on the femur, while
rectus femoris arises from the anterior inferior iliac spine and is thus the only of the four acting on two joints.
[Platzer (2004), p. 248]
The posterior thigh muscles have their origins on the
inferior ischial ramus, with the exception of the short head of the
biceps femoris. The
semitendinosus and
semimembranosus are inserted on the tibia on the medial side of the knee, while biceps femoris is inserted on the
fibula, on the knee's lateral side.
[Platzer (2004), p. 250]
In pregnancy and childbirth
In later stages of
pregnancy the
fetus's head aligns inside the pelvis. Also joints of bones soften due to the effect of pregnancy hormones. These factors may cause ''pelvic joint pain'' (
symphysis pubis dysfunction or SPD). As the end of pregnancy approaches, the ligaments of the sacroiliac joint loosen, letting the pelvis outlet widen somewhat; this is easily noticeable in the
cow.
During
childbirth (unless by
Cesarean section
Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or m ...
) the fetus passes through the maternal ''pelvic opening''.
Clinical significance
Hip fracture
A hip fracture is a break that occurs in the upper part of the femur (thigh bone). Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. Usually the person cannot walk.
They most often occur as a re ...
s often affect the elderly and occur more often in females, and this is frequently due to
osteoporosis. There are also different types of
pelvic fracture often resulting from traffic accidents.
Pelvic pain generally, can affect anybody and has a variety of causes;
bowel adhesions,
irritable bowel syndrome
Irritable bowel syndrome (IBS) is a "disorder of gut-brain interaction" characterized by a group of symptoms that commonly include abdominal pain and or abdominal bloating and changes in the consistency of bowel movements. These symptoms may ...
,
interstitial cystitis,
endometriosis
Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, fa ...
in women.
There are many
anatomical variations of the pelvis. In the female the pelvis can be of a much larger size than normal, known as a ''giant pelvis'' or
pelvis justo major, or it can be much smaller, known as a ''reduced pelvis'' or ''pelvis justo minor''.
Other variations include an ''android pelvis'' the normal shape of the male pelvis, in women this shape can prove problematic in
childbirth.
History
Caldwell–Moloy classification
Throughout the 20th century
pelvimetric measurements were made on pregnant women to determine whether a natural birth would be possible, a practice today limited to cases where a specific problem is suspected or following a caesarean delivery.
William Edgar Caldwell and
Howard Carmen Moloy studied collections of skeletal pelves and thousands of stereoscopic radiograms and finally recognized three types of female pelves plus the masculine type. In 1933 and 1934 they published their typology, including the Greek names since then frequently quoted in various handbooks: Gynaecoid (''gyne'', woman), anthropoid (''anthropos'', human being), platypelloid (''platys'', flat), and android (''aner'', man).
* The gynaecoid pelvis is the so-called normal female pelvis. Its inlet is either slightly oval, with a greater transverse diameter, or round. The interior walls are straight, the subpubic arch wide, the sacrum shows an average to backward inclination, and the greater sciatic notch is well rounded. Because this type is spacious and well proportioned there is little or no difficulty in the birth process. Caldwell and his co-workers found gynaecoid pelves in about 50 per cent of specimens.
* The platypelloid pelvis has a transversally wide, flattened shape, is wide anteriorly, greater sciatic notches of male type, and has a short sacrum that curves inwards reducing the diameters of the lower pelvis. This is similar to the
rachitic pelvis where the softened bones widen laterally because of the weight from the upper body resulting in a reduced anteroposterior diameter. Giving birth with this type of pelvis is associated with problems, such as transverse arrest. Less than 3 per cent of women have this pelvis type.
* The android pelvis is a female pelvis with masculine features, including a wedge or heart shaped inlet caused by a prominent sacrum and a triangular anterior segment. The reduced pelvis outlet often causes problems during child birth. In 1939 Caldwell found this type in one third of white women and in one sixth of non-white women.
* The anthropoid pelvis is characterized by an oval shape with a greater anteroposterior diameter. It has straight walls, a small subpubic arch, and large sacrosciatic notches. The sciatic spines are placed widely apart and the sacrum is usually straight resulting in deep non-obstructed pelvis. Caldwell found this type in one quarter of white women and almost half of non-white women.
However, Caldwell and Moloy then complicated this simple fourfold scheme by dividing the pelvic inlet into posterior and anterior segments. They named a pelvis according to the anterior segment and affixed another type according to the character of the posterior segment (i.e. anthropoid-android) and ended up with no less than 14 morphologies. Notwithstanding the popularity of this simple classification, the pelvis is much more complicated than this as the pelvis can have different dimensions at various levels of the birth canal.
Caldwell and Moloy also classified the
physique of women according to their types of pelves: the gynaecoid type has small shoulders, a small waist and wide hips; the android type looks square-shaped from behind; and the anthropoid type has wide shoulders and narrow hips. Lastly, in their article they described all non-gynaecoid or "mixed" types of pelves as "abnormal", a word which has stuck in the medical world even though at least 50 per cent of women have these "abnormal" pelves.
The classification of Caldwell and Moloy was influenced by earlier classifications attempting to define the ideal female pelvis, treating any deviations from this ideal as dysfunctions and the cause of obstructed labour. In the 19th century anthropologists and others saw an evolutionary scheme in these pelvic typologies, a scheme since then refuted by archaeology. Since the 1950s
malnutrition is thought to be one of the chief factors affecting pelvic shape in the
Third World
The term "Third World" arose during the Cold War to define countries that remained non-aligned with either NATO or the Warsaw Pact. The United States, Canada, Japan, South Korea, Western European nations and their allies represented the ...
even though there are at least some genetic component to variation in pelvic morphology.
Nowadays obstetric suitability of the female pelvis is assessed by
ultrasound
Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies ...
. The dimensions of the head of the fetus and of the birth canal are accurately measured and compared, and the feasibility of labor can be predicted.
Other animals

The pelvic girdle was present in early
vertebrates, and can be tracked back to the paired fins of fish that were some of the earliest
chordate
A chordate () is an animal of the phylum Chordata (). All chordates possess, at some point during their larval or adult stages, five synapomorphies, or primary physical characteristics, that distinguish them from all the other taxa. These fi ...
s.
The shape of the pelvis, most notably the orientation of the iliac crests and shape and depth of the
acetabula, reflects the style of locomotion and body mass of an animal. In bipedal mammals, the iliac crests are parallel to the vertically oriented sacroiliac joints, where in quadrupedal mammals they are parallel to the horizontally oriented sacroiliac joints. In heavy mammals, especially in quadrupeds, the pelvis tend to be more vertically oriented because this allows the pelvis to support greater weight without dislocating the sacroiliac joints or adding torsion to the vertebral column.
In ambulatory mammals the acetabula are shallow and open to allow a wider range of hip movements, including significant abduction, than in cursorial mammals. The lengths of the ilium and ischium and their angles relative to the acetabulum are functionally important as they determine the moment arms for the hip extensor muscles that provide momentum during locomotion.
[Hall (2007), pp. 254–5]
In addition to this, the relatively wide shape (front to back) of the pelvis provides greater leverage for the gluteus medius and minimus. These muscles are responsible for hip abduction which plays an integral role in upright balance.
Primates
In
primates, the pelvis consists of four parts - the left and the right
hip bone
The hip bone (os coxae, innominate bone, pelvic bone or coxal bone) is a large flat bone, constricted in the center and expanded above and below. In some vertebrates (including humans before puberty) it is composed of three parts: the ilium, isc ...
s which meet in the mid-line ventrally and are fixed to the sacrum dorsally and the coccyx. Each hip bone consists of three components, the ilium, the
ischium, and the pubis, and at the time of sexual maturity these bones become fused together, though there is never any movement between them. In
human
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
s, the ventral joint of the pubic bones is closed.
Larger
ape
Apes (collectively Hominoidea ) are a clade of Old World simians native to sub-Saharan Africa and Southeast Asia (though they were more widespread in Africa, most of Asia, and as well as Europe in prehistory), which together with its sister ...
s, such as ''Pongo'' (
orangutan
Orangutans are great apes native to the rainforests of Indonesia and Malaysia. They are now found only in parts of Borneo and Sumatra, but during the Pleistocene they ranged throughout Southeast Asia and South China. Classified in the ...
s), ''Gorillas'' (
gorillas), ''Australopithecus afarensis'', and ''Pan troglodytes'' (
chimpanzee
The chimpanzee (''Pan troglodytes''), also known as simply the chimp, is a species of great ape native to the forest and savannah of tropical Africa. It has four confirmed subspecies and a fifth proposed subspecies. When its close relative th ...
s), have longer three-pelvic planes with a maximum diameter in the sagittal plane.
Evolution
The present-day morphology of the pelvis is inherited from the pelvis of our quadrupedal ancestors. The most striking feature of evolution of the pelvis in primates is the widening and the shortening of the blade called the ilium. Because of the stresses involved in bipedal locomotion, the muscles of the thigh move the thigh forward and backward, providing the power for bi-pedal and quadrupedal locomotion.
The drying of the environment of East Africa in the period since the creation of the Red Sea and the African Rift Valley saw open woodlands replace the previous closed canopy forest. The apes in this environment were compelled to travel from one clump of trees to another across open country. This led to a number of complementary changes to the human pelvis. It is suggested that bipedalism was the result.
Additional images
File:Slide1ADAA.JPG, Diameters of pelvic inlet.
File:Gray235.png, Right hip bone. External surface.
File:Pelvic Girdle Anatomy by Jason Christian.webm, Pelvic Girdle Anatomy
See also
*
Coccygeal plexus
The coccygeal plexus is a nerve plexus near the coccyx bone.
Structure
This plexus is formed by the ventral rami of the fourth and fifth sacral nerves, S4 & S5, and the ventral ramus of the coccygeal nerve, Co. The relative contributions of S4 an ...
*
Coccyx (tailbone)
*
Pelvimetry
* ''
Pelvis justo major''
*
Pubic symphysis
The pubic symphysis is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attaches to the pubi ...
*
Sacroiliac joint
Notes
References
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External links
{{DEFAULTSORT:Pelvis, human
Flat bones