The following presentation will go over some normal pelvic anatomy. We'll be looking at pelvic radiographs and pelvic CT scans. And this will be a review of general pelvic anatomy. There will be additional presentation specific to male and female pelvic anatomy. Here are the following objectives. At the end of this presentation, you will be able to identify the following osseous structures. You'll be able to identify muscles had listed below. And finally, you will be able to identify the stated vasculature. The following is a pelvic radiograph obtained in the mantra posterior direction. The first bones I'd like to draw your attention to are the iliac bones which are the large bones you can see on either side, both the right and left side. In between the iliac bones in the midline, you have the sacrum outlined here. And at the junction of the iliac bones and the sacrum, you have the sacroiliac joints. In this case, we've highlighted it on the left side. Additional bony structures that we can see include the right superior pubic ramus. Over here is the left superior pubic ramus. We can also see the right inferior pubic ramus over here. The left inferior pubic ramus is over here. We also have the ischial tuberosity on the right side, on the left side. And the pubic rami are joining the midline by the pubic symphysis, which is this lucent structure you can see in the midline over here. Additional structures that are important to know about include the obturator foramen, highlighted in blue on the left side. We also have the iliopectineal line, which goes along this orange curvilinear line that I've drawn over here. And it's important to make sure that this is intact in the setting of trauma. This is disrupted. It indicates that there is a pelvic fracture. Similarly, we look at the ilioischial line. We also want to make sure that's intact in the setting of pelvic trauma. And finally, we can look at the femur. We can see nicely here, the left femoral head, the left femoral neck, and the greater trochanter, the left femur, and the lesser trochanter seen more in fairly. The following is a CT scan of the pelvis, and I've put it in bone windows that you can better see some of the osseous structures. On the left is a axial CT image. Well, on the right is a Kurono 3D rendered image made from the actual imaging data. As we scroll through the actual data set, you can see an orange line that will scroll down words to indicate where you are on the Kuronos. And you'll appreciate some of the anatomy on the axles with respect to how it would look like on a Kurono CT scan, which looks very similar to what a pelvic radiograph would look like. So as we scroll downwards, the first bones in the pelvis that will notice are the iliac bones. You can see the right iliac bone over here, where the left iliac bone is over here. I just throw more inferiorly. You can see portions of the right sacroiliac joint and the left sacroiliac joint, and you can also see the sacrum is a midline osseous structure. As we go even more inferiorly, we're going to start to notice both the right and left super pubic rami and to really see the pubic symphysis. And more inferiorly, we start to see the inferior pubic rami. Further posterior from the inferior pubic rami, you can see the ischial tuberocity on the right and on the left. Strong back upwards, you can see both femoral heads on the right and left side, the femoral neck, slightly more inferiorly. At that level, you can also see the greater trochanter of the femurs both on the right and left side. And further inferiorly, the lesser trochanter of the femurs. The obturator foramen, is perhaps difficult to appreciate on the axial imaging that if you follow the orange line of the Kurono imaging, we're just above it at this level. As you go downwards, you can see that there is a small opening through which the obturator artery, vein and nerve, will travel. We'll now move on to reviewing some of the muscles that we find in the pelvis. So just above the pelvic inlet, we're seeing the psoas muscles. We also see on this image the rectus abdominis muscles anteriorly as well as additional muscles, laterally from outermost layer, the innermost layer. These are the external oblique, the internal oblique, and the transversus abdominis muscles. Further down, we can see additional muscles within the pelvis. Firstly, you can see the iliacus muscles which are associated the iliac bone. Posterior to the iliac bone, you can see three gluteal muscles. From inner to outer, we can see the gluteus minimus, gluteus medius, and the gluteus maximus. More inferiorly here, we can see the piriformis muscles on the right and left. And then the following image, we can see several additional muscles. These include the sartorius, the tensor fascia lata, the rectus femoris and the iliopsoas muscles. We can also see the puborectalis muscle, which forms a portion of elevator and I musculature. We will now move on to evaluating the vasculature of the pelvis. On this image, you can see the aorta and the IVC. As you scroll more inferiorly, we will start to see the aortic bifurcation, and the aorta will bifurcate into the right and left common iliac arteries. At the same level, you can see the right and left common iliac veins. Each of these common iliac vessels will further divide into the external and internal iliac artery and vein, respectively. On this level, you can see the bifurcation and more inferiorly you can see discreetly both the external iliac vasculature. As we follow the external iliac vasculature more inferiorly passing on a ligament which is approximately a takeoff of the inferior epigastric arteries, which we can see over here. That vessel becomes the common femoral artery and vein, respectively. This extends down into the thigh, has the femoral artery and vein, respectively. We'll talk about a few additional organs of the pelvis to conclude. On this level, you can see the anus. Superior to that, you'll see the rectum. The rectum eventually joins to form the sigmoid colon. And the sigmoid colon, in turn, will form the descending colon. You can see multiple loops of small bowel that also extended the pelvis as well as the bladder, which is the fluid filled structure seen in the midline. In summary, the following video reviewed pelvic anatomy seen on conventional radiography as well as the CT imaging. We went through identifying the whole number of osseous structures as listed here. We followed that by identifying a variety of muscles that are seen within the pelvis. And finally, we went over some of the vasculature as listed over here. [MUSIC]
