in this section we will talk about pelvis and lower extremity pelvis in some literature um is referred to the lumbo pelvic complex to reinforce the complexity of this region uh the primary function of pelvis is to provide a bony protection for some uh of our body organs and create a passage way for both GI and GU system in in um in this region um pelvis is also an area that offer attachment for trunk and lower extremity muscles lower extremity uh is consisted of hip joint knee joint ankle and foot joints um its main function is to carry the weight of our body and also maintain balance uh when we're in a standing position or um in sitting position um the pelvic is consist consisted of several bones so um in this in this region U there there are two elium bones and then um two isum um bones like in in the posterior area and in the front there are two pubic bones so it's uh consisted of um six bones here um plus a six sacrum bone right here and the coxis bone so and pelvis region is also um a place where actual skeleton join the uh appendicular skeleton so you can see our spine um joint the sacrum in this region so you can uh anticipate there are several joints happening in this region so we have lumbo sacr joint right here and then two Elio sacral bone uh joints right here and then one joint between the um sacrum and coxis and then another join right here for the two sides of the pubic to join together when we look at the elen bone um the easiest um Lark that we can find is the anterior superior iliac spine and then um the um anterior inferior iliac spine right here and in the back we can find the posterior uh Superior ELC spine and then the posterior uh inferior ELC spine why these four uh landmarks are important because these um spot um these landmarks offer some attachment to our uh muscles and uh one um special special structure is the three bones the elium uh the eum and then the pubic B they fusing together and form this um acetabulum and this is a part of the hip uh joint which we will talk about that later from a surface we can easily identify the Asis by using our uh finger in the front to find that bony structure um um around the waist area and then we can track through the quest and then identify the PSIs in the back when we Bend our hip to full flexion and that bony structure right there that we can find is the isual Tubity the isual uh tuberosity uh is the attachment for hemst streams muscles and adapter Magnus uh muscle and in the eum um bone right here we can see there's a a hole or forment it's called Uh opter rator fre of for Ren uh this is a um area that the obur nerve kind of passed through okay and we cannot see it from this picture but you you can see that uh the acetabulum is um can be identified right here because it's a three bones formed structure to offer the hip joint the uh pubis um it's in the anterior area um of the pelvic um region and um it has a superior pubic uh Remis and an inferior pubic Remis and um they all uh offer um attachment for different muscles and pubic uh syesis right here is U basically secured by the ingren uh ligament that you can find it right here so these are the um introduction for the Bony Li marks uh around the pelvic region so let's uh look at the joints uh in this region um the sacral ilot joint um is formed between the sacrum and ilium bone right here um there are two joints uh for SI joint and the function of uh the SI joint is to uh transfer the weight uh between the femur uh bone and the actual skeleton so basically the weight of the upper body going to distribute it um to the pelvic region to the lower extremity or uh when we um have the impact from the lower extremity we can pass it um to to this area so this is is a very important uh region um in our human movement um the pubic um symphysis um it's right here and is secure by um the ingren ligament which we will uh we talked about that earlier and the superior pubic ligament and inferior pubic ligament it's uh reinforced this region and the function of pubic uh symphysis is to increase uh the pubic Outlet when uh um woman um is giving birth to um their baby the the lumbo sacral joint is joined by the uh L5 spine and the S1 um spine right here um it is the most commonly affected joint in lumbar uh spinal disorder and you can see that um this joint is secured by a lot of ligaments so um here we have the ilio um lumbar spine connecting the um ilium and the lumbar spine we have um lumbo sacral spine sorry uh lumbo sacral ligament that um connect between the lumbo um lumbar spine and the sacral and from the anterior posterior side this joint is protected by the anterior and posterior l D no ligament so you can see that this joint is protective and in 3D um U perspective in its function is to uh join the lumbar spine and the pelvic spine sorry a pelvic bone U another joint is between the sacrum and the coxic um and it is a reinforced by anterior and posterior um sacral coidal ligaments and it's function is to increase or decrease uh the pelvic Outlet size during um labor and it is it is also a region that offer Glu teus Maximus to attach um to the pelvic region when we look at uh the movement of a pelvic uh we call it a pelvic girdle because we want to see the pelvic as a whole and then um we will talk about how the pelvic move during our um daily routines or daily activities when the pelvic girdle is at neutral position it is when um the Asis and pubic symphysis um are at are in the same frontal plane when the Asis is in front of the pubic um cices we call it anterior tilt see uh and when uh you can see that when a person is demonstrating anterior tilt um they have increased uh lumbar L uh low dois uh posterior te is when the ASI is U posterior to the pubic symphysis right here and um on the spine we can see that um the uh lumbar ankle got much more flattened so what would it affect us um so the uh the movement of pelvic uh girdle is controlled by a couple of muscle groups um um namely is for trunk and hip muscles when we are doing anterior til it is uh a combination of trunk extensor that pulling upward uh with the hip flexor that pulling downward that create this uh pelvic anterior til as we mentioned earlier when an individual um is doing pelvic anterior tilt that um at the lumbar spine we may demonstrate too much uh lumbar um Loris and it is commonly observed in uh women in their uh late stage of U pregnancy um the opposite uh condition can be found in a uh pelvic posterior tilt in this situation the trunk uh flexors are pulling upward whereas um The Hip extensors are pulling uh the pelvic downward and um a lot of time um uh in our in my uh clinical practice I can see that a lot of my client they have a very tight hip extensors and what would it cause is that uh the tight hip extensors will uh pull too much um of the lumbar spine or sorry the the pelvic into posterior tilt and as a result um they demonstrate reduced uh lumbar L dois and this type of uh posterior tilt uh or reduced or flattened uh lumbar spine can be observed in elderly adults with increased um um K kyphosis just to balance U their posture um when we uh observe uh a person at the frontal uh plant we can see uh occasionally the pelvic is demonstrating uh lateral tilt so it is um it is quite often that we see especially when a person is standing in one leg and uh when standing in one leg the gravity uh tend to pull uh the unsupported uh pelvic side downward and to counter the effect of gravity um the same side of the trunk flexor will pull upward and the Cal lateral side or the other side of the body uh the hip adapter will um um be um recruited to balance um that so um that's how our body recruit muscles uh to maintain balance and you to compensate this uh lateral tilt of pelvis um our spine May develop scoliosis so you can see um some of our um client they have this um kind of unbalanced uh spine posture uh as opposed to the pelvic posture