Atlas of Human Anatomy by Netter

FACTS & HINTS

Anatomic Points
page 170
page 171

Measurements of the Pelvic Inlet

Used to determine capacity of female pelvis for childbearing

True conjugate diameter

measured radiologically on a lateral x-ray

distance from superior border of pubic symphysis to sacral promontory

Transverse diameter: widest distance of pelvic inlet

Oblique diameter: distance from sacroiliac joint to contralateral iliopectineal line

Clinical Points

Fractures of the Pelvis

A large force is required to fracture the pelvis and fractures usually result from direct trauma, such as occurs in automobile accidents

The bony pelvis may fracture at any point and there may be associated damage to pelvic viscera, for example, bladder and urethral rupture

can occur with fractures involving the pubis

Pelvic fractures are classified as stable or unstable.

In a stable fracture, the pelvis remains stable and there is only one break-point in the pelvic ring with minimal hemorrhage.

In an unstable fracture, the pelvis is unstable with two or more break-points in the pelvic ring with moderate to severe hemorrhage.

Signs of a fractured pelvis include: pain in the groin, hip or lower back; difficulty walking; urethral, vaginal or rectal bleeding; scrotal

hematoma; and shock as a result of concealed hemorrhage (contained bleeding into the pelvic cavity)

A fracture can be confirmed on x-ray and is seen as a break in continuity of the pelvic ring.

Decubitus Ulcers

Also called pressure sores

Can be a partial- or full-thickness loss of skin, underlying connective tissue and can extend into muscle, bone, tendons, and joint capsules.

Two thirds of pressure sores occur in patients older than 70 years

Results from prolonged pressure on an area of skin, connective tissue and muscle from a mattress, wheelchair seat, or bed rail.

Commonly occur in those with poor mobility, bed-bound, poor nutrition, and incontinence.

Can become infected with bacteria from poor skin care, or fecal or urinary incontinence

The hip and buttock regions account for 67% of all pressure sores, with ischial tuberosity, trochanteric, and sacral locations being most

common.

In the sitting position, the ischial tuberosity bears the weight of the whole body and thus is a prime site of ulceration