59 The Pelvic Girdle
Marcos Gridi-Papp
The Pelvic Girdle9
The pelvic girdle (hip girdle) is formed by a single bone, the hip bone or coxal bone (coxal = “hip”), which serves as the attachment point for each lower limb. Each hip bone, in turn, is firmly joined to the axial skeleton via its attachment to the sacrum of the vertebral column. The right and left hip bones also converge anteriorly to attach to each other. The bony pelvis is the entire structure formed by the two hip bones, the sacrum, and, attached inferiorly to the sacrum, the coccyx (Figure).
Unlike the bones of the pectoral girdle, which are highly mobile to enhance the range of upper limb movements, the bones of the pelvis are strongly united to each other to form a largely immobile, weight-bearing structure. This is important for stability because it enables the weight of the body to be easily transferred laterally from the vertebral column, through the pelvic girdle and hip joints, and into either lower limb whenever the other limb is not bearing weight. Thus, the immobility of the pelvis provides a strong foundation for the upper body as it rests on top of the mobile lower limbs.
Pelvis
The pelvic girdle is formed by a single hip bone. The hip bone attaches the lower limb to the axial skeleton through its articulation with the sacrum. The right and left hip bones, plus the sacrum and the coccyx, together form the pelvis.
Hip Bone
The hip bone, or coxal bone, forms the pelvic girdle portion of the pelvis. The paired hip bones are the large, curved bones that form the lateral and anterior aspects of the pelvis. Each adult hip bone is formed by three separate bones that fuse together during the late teenage years. These bony components are the ilium, ischium, and pubis (Figure). These names are retained and used to define the three regions of the adult hip bone.
The Hip Bone
The ilium is the fan-like, superior region that forms the largest part of the hip bone. It is firmly united to the sacrum at the largely immobile sacroiliac joint (see Figure). The ischium forms the posteroinferior region of each hip bone. It supports the body when sitting. The pubis forms the anterior portion of the hip bone. The pubis curves medially, where it joins to the pubis of the opposite hip bone at a specialized joint called the pubic symphysis.
Ilium
When you place your hands on your waist, you can feel the arching, superior margin of the ilium along your waistline (see Figure). This curved, superior margin of the ilium is the iliac crest. The rounded, anterior termination of the iliac crest is the anterior superior iliac spine. This important bony landmark can be felt at your anterolateral hip. Inferior to the anterior superior iliac spine is a rounded protuberance called the anterior inferior iliac spine. Both of these iliac spines serve as attachment points for muscles of the thigh. Posteriorly, the iliac crest curves downward to terminate as the posterior superior iliac spine. Muscles and ligaments surround but do not cover this bony landmark, thus sometimes producing a depression seen as a “dimple” located on the lower back. More inferiorly is the posterior inferior iliac spine. This is located at the inferior end of a large, roughened area called the auricular surface of the ilium. The auricular surface articulates with the auricular surface of the sacrum to form the sacroiliac joint. Both the posterior superior and posterior inferior iliac spines serve as attachment points for the muscles and very strong ligaments that support the sacroiliac joint.
The shallow depression located on the anteromedial (internal) surface of the upper ilium is called the iliac fossa. The inferior margin of this space is formed by the arcuate line of the ilium, the ridge formed by the pronounced change in curvature between the upper and lower portions of the ilium. The large, inverted U-shaped indentation located on the posterior margin of the lower ilium is called the greater sciatic notch.
Ischium
The ischium forms the posterolateral portion of the hip bone (see Figure). The large, roughened area of the inferior ischium is the ischial tuberosity. This serves as the attachment for the posterior thigh muscles and also carries the weight of the body when sitting. You can feel the ischial tuberosity if you wiggle your pelvis against the seat of a chair. Projecting superiorly and anteriorly from the ischial tuberosity is a narrow segment of bone called the ischial ramus. The slightly curved posterior margin of the ischium above the ischial tuberosity is the lesser sciatic notch. The bony projection separating the lesser sciatic notch and greater sciatic notch is the ischial spine.
Pubis
The pubis forms the anterior portion of the hip bone (see Figure). The enlarged medial portion of the pubis is the pubic body. Located superiorly on the pubic body is a small bump called the pubic tubercle. The superior pubic ramus is the segment of bone that passes laterally from the pubic body to join the ilium. The narrow ridge running along the superior margin of the superior pubic ramus is the pectineal line of the pubis.
The pubic body is joined to the pubic body of the opposite hip bone by the pubic symphysis. Extending downward and laterally from the body is the inferior pubic ramus. The pubic arch is the bony structure formed by the pubic symphysis, and the bodies and inferior pubic rami of the adjacent pubic bones. The inferior pubic ramus extends downward to join the ischial ramus. Together, these form the single ischiopubic ramus, which extends from the pubic body to the ischial tuberosity. The inverted V-shape formed as the ischiopubic rami from both sides come together at the pubic symphysis is called the subpubic angle.
Pelvis
The pelvis consists of four bones: the right and left hip bones, the sacrum, and the coccyx (see Figure). The pelvis has several important functions. Its primary role is to support the weight of the upper body when sitting and to transfer this weight to the lower limbs when standing. It serves as an attachment point for trunk and lower limb muscles, and also protects the internal pelvic organs. When standing in the anatomical position, the pelvis is tilted anteriorly. In this position, the anterior superior iliac spines and the pubic tubercles lie in the same vertical plane, and the anterior (internal) surface of the sacrum faces forward and downward.
The three areas of each hip bone, the ilium, pubis, and ischium, converge centrally to form a deep, cup-shaped cavity called the acetabulum. This is located on the lateral side of the hip bone and is part of the hip joint. The large opening in the anteroinferior hip bone between the ischium and pubis is the obturator foramen. This space is largely filled in by a layer of connective tissue and serves for the attachment of muscles on both its internal and external surfaces.
Marcos Gridi-Papp, Human Anatomy. OpenStax CNX. Mar 1, 2018 http://cnx.org/contents/c29920ff-cf11-4c44-a140-046fb0e6e1f0@2.57
