Dr. Dougherty Innominates PRE CLASS Lecture (Test 1) Flashcards
Anatomy/ Biomechanics
1) Medial, Posterior, and Superior
- Load via the SACROILIAC JOINT
- Transmits Weight from the AXIAL SPINE
2) Medial, Anterior, and Inferior
- The PUBIC SYMPHYSIS point of Stabilization
- Does so for BOTH Hips
3) These point of attachment can Affect the ANGLE and ROTATION of the ACETABULAR FOSSA
Right in the Middle, the Pelvis
- Forces from Above and Below, Including Gravity
- Foundation for Body Support and LOCOMOTION
- Base of the Vertebral Column, yet still a Long Way from the Ground
- Helps to distribute the Forces evenly
- Holds most of the GI Contents
- Holds most of the GU System and Reproductive
Why Important?
- Body is a Unit
- Structure and Function are INTERRELATED
- The Body Possess Self-Regulatory Mechanisms
- The Body has the Inherent Capacity to Defend and Repair itself
Parts of the Pelvis
Ilium:
- Superior and Largest
Ischium:
- Inferior and Posterior
Pubis:
- Inferior and Anterior
Anatomic Landmarks
- Iliac Crest
- ASIS
- AIIS
- Pubic Tubercle
- PSIS
- PIIS
Clinical Assessment
Palpatory Landmarks- Anterior
- ASIS
- Pubic Tubercle
- Iliac Crest
- Greater Trochanter
- Medial Malleoli Heights
Placatory Landmarks- Posterior
- PSIS
- Sacral Sulci
- Ischial Tuberosity
Ligaments
- Ligament: From Latin “To Bind, To Tie” as in a Bandage
- Ligament go from BONE to BONE
- Tendons from MUSCLE to BONE
- “True” Ligament does from BONE to BONE
- “Accessory” Ligament attaches at another Ligament, a TENDON or other FASCIA
Function of Ligaments
- Ligaments are designed to LIMIT ABNORMAL or EXCESSIVE Movements at a Joint
- Ligaments do permit Normal Motion
- Ligament are Slightly Elastic
- Ligament are part of a Reflex response to Excessive Movement
Major Pelvic Ligaments
1) ILIOLUMBAR
- From Ilia to 5th Lumbar Vertebrae
2) SACROSPINOUS
- Scrum to Spine of the Ischium
3) SACROTUBEROUS
- Sacrum to Ischial Tuberosity
3) SACROILIAC Ligament
- Covers much of the Sacroiliac Joint, Anterior and Posterior
Iliolumbar Ligament
- Restrict ANTERIOR Motion of L5
- May restrict ROTATORY Movement of L5
- Upper part of the Sacroiliac (Lumbosacral) Ligament also attaches to L5 but blends in with Iliolumbar Ligament. Also stabilizes ANTERIOR Motion of the Lower Lumbar Spine
Sacrospinous Ligament
- From Ischial Spine to Lateral Margins of the Sacrum where it blends (Anteriorly) with the Sacrotuberous Ligament
- Divides space Above and Below into a Greater and Lesser Sciatic Foramen!!!!!!!!!!!!!!!!
- Ligament is part of the Coccygues Muscle
Sacrotuberous Ligament
- Runs from Lower Sacral Tubercles to Ischial Tuberosity
- Along with Sacrospinous Ligament, Restrains ANTERIOR Movement of Sacrum
- Gluteus Maximus attachments
- Long head of Biceps Femurs Tendon attaches
- Piriformis Attachments
- Connects with Fascia of the Pelvis
Sacroiliac Ligament
ANTERIRO (Ventral) SACROILIAC:
- Form 3rd Sacral Segment to Auricular Surface of Ilium and Lateral Preauricular Sulcus
INTEROSSEOUS SACROILIAC:
- Massive bond between the Upper parts of the Joint (Connect Tuberosities of Sacrum and Ilium)
- Lies DEEP to Posterior SI Ligament
POSTERIOR (Dorsal) SACROILIAC
- Partly covers the Interosseous, from Lateral Sacral Crest to PSIS and Internal Iliac Crest
Pubic Symphysis
Secondary Cartilaginous Joint
- Surfaces of the articulating bones are covered with HYALINE CARTILAGE and the bones are united by Strong Fibrous Connective Tissue and/or Fibrocartilage
- Strong, Slight Moveable Joint
- FIBROCARTILAGENOUS Joint!!!!!!!
- Has a Disc, the “INTERPUBIC DISC”
Muscles acting at the Hip
FLEXORS:
- Pull Pelvis ANTERIORLY
EXTENSORS:
- Pull Pelvis POSTERIORLY
ADDUCTORS:
- Stabilize and “Pull” MEDIALLY
EXTERNAL ROTATORS:
- EXTERNALLY Rotate
Hip Flexors
MAJOR HIP FLEXORS
1) ILIACUS
- From Ala to the Ilia (Iliac Fossa) to the Lesser Trochanter of the Femur
2) PSOAS
- From the 5 Lumbar Vertebrae to the Lesser Trochanter of the Femur
3) RECTUS FEMORIS
- ASIS to Patella
4) SARTORIUS
- ASIS to Medial Tibia
Anatomy/ Biomechanics
FLEXION
- Primarily ILIOPSOAS
Contributors:
- Adductor (Longus and Brevis)
- Rectus Femoris
- Pectinous
- Sartorius
- Gracilis
Extensor Group
MEDIAL HAMSTRING GROUP
a) Semimembranosus
b) Semitendinosus
(Both attach at the Ischial Tuberosity and Medial Proximal Tibia)
c) Gracilis
d) Sartorius
LATERAL HAMSTRING GROUP
a) Biceps Femoris (Attaches to Sacrotuberous Ligament/ Ischial Tuberosity and Lateral Aspect of Fibualr Head/ Lateral Condyle of Tibia)
b) Gluteus Maximus (Posterior aspect of Medius)
c) Adductor Magnus
Hamstrings
- Major Function: HIP EXTENSION
Also aid in:
- Knee Flexion
- Some affect MEDIAL Rotation of the Thigh
- Some affect LATERAL Rotation of the Thigh
Gluteus Maximus = Classic HIP EXTENSOR***
Adductors
- Adductor Magnus
- Adductor Brevis
- Adductor Longus (Gracilis and Pectinous)
- Function: HIP ADDUCTION!!!!
Anatomy/ Biomechanics
Adduction
Medially:
- Adductor Longus
- Adductor Brevis
- Adductor Magnus
- Pectinius
- Gracilis
Adductor Group
- All attach to the PUBIC RAMUS and the Medial and/or Posterior Femur
- Function of all is ADDUCTION!!!
Abductors
1) Gluteus Medius
- Attaches to the Ilium and Greater Trochanter of Femur
2) Gluteus Minimus
- Attaches to Ilium and Greater Trochanter of Femur
3) Tensor Fascia Lata
External Rotators
- Piriformis
- Obturator Internus
- Obturator Externus
- Gemellus Superior
- Gemellus Inferior
- Quadrates Femoris
Piriformis
- 10 to 12% of the Population
- Sciatic Nerve pierces the Piriformis
- Contraction of the Piriformis may cause SCIATICA
- Function depends on position of the HIP!!!
- ABDUCTOR when the HIP is FLEXED
- An EXTERNAL ROTATOR when the HIP is EXTENDED!!!
- The only Rotator that Connects DIRECTLY to the SACRUM!!!!!!!!!!!!!!!!
Innominate Motion
1) ROTATION
- Anterior
- Posterior
2) TRANSLATION
- Anterior
- Posterior
- Inferior
- Superior
3) Caliper (Scapation)
