5. Innominate/SD

Question 1

The pelvis maintains a critical role in…

Answer 1

1. biomechanical function and balance
2. Reproduction
3. Elimination
4. Vascular and Lymphatics

Question 2

When do the three bones of the pelvis completely fuse?

Answer 2

late teens

Question 3

What are true ligaments? accessory?

Answer 3

1. bone to bone

2. attach at another ligament, tendon, or other fascia

Question 4

Where do the following anterior ligaments attach?

1. Sacrospinous
2. Iliolumbar
3. Anterior Sacroiliac Ligament
4. Inguinal Ligament

Answer 4

1. sacrum to spine of the ischium
2. from ilia to 5th lumbar vertebrae
3. covers much of the sacroiliac joint
4. ASIS to superior pubic rami

Question 5

Where do the following posterior ligaments attach?

1. Sacrotuberous
2. Posterior Sacroiliac Ligament

Answer 5

1. sacrum to ischial tuberosity

2. covers much of sacroiliac joint

Question 6

What is the role of the pubic symphysis?

Answer 6

• lies anteriorly between surfaces of the pubic bones
• each joint’s surfaces is covered with hyaline cartilage, and is linked by fibrocartilage
• suprior public L. lies above the joint, and inferior public L. lies below

Question 7

If you have dysfunction in a hip flexor, what kind of rotation/shear of the innominate/pubes occurs?

Answer 7

anterior rotation, inferior shear

Question 8

What type of rotation does increased hamstring tension cause?

Answer 8

posterior rotation of the innominate

Question 9

What does the Trendelenburg Sign test for?

Answer 9

whether the patient has adequate hip abductor strength (specifically gluteus medius)

Question 10

What can abnormal contraction of the piriformis cause?

Answer 10

sciatic

Question 11

Symptoms of groin pull/hernia can be caused by dysfunction in what back muscle?

Answer 11

quadrates lumborum - it irritates ilioinguinal and iliohypogastric nerves

Question 12

What is the only hip rotator that connects directly to the sacrum?

Answer 12

Piriformis

Question 13

What makes up the gravitational line?

Answer 13

• auditory meatus
• acromion process
• greater trochanter
• body of L3
• anterior 1/3 of sacrum
• lateral condyle and the knee
• lateral malleolus

Question 14

What does it mean when an innominate is “shear”?

Answer 14

one innominate can move superior or inferior relative to the sacrum or other innominate

Question 15

What does it mean when an innominate is “flare”?

Answer 15

an innominate can out-flare or in-flare as measured by the position of the ASIS relative to midline

Question 16

What are the steps for Pelvis SD Dx?

Answer 16

Lateralization test (which side has the SD) –> palpation of landmarks –> dx

Question 17

What structures are used to diagnose the innominate?

Answer 17

PSIS, ASIS, Iliac crests, Pubic tubercles, Medial malleoli heights

*Medial malleoli heights are the least reliable

Question 18

What structures are used to diagnose pubic SD or subluxation?

Answer 18

pubic tubercles

Question 19

What can ischial tuberosity’s be used to diagnose?

Answer 19

small hemipelvis (one side of the pelvis is congenitally smaller)