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OS II Exam 1 > Innominate > Flashcards

Innominate Flashcards

1
Q

The result of what 2 forces keep the pubic symphysis together?

A

Strong posterior ligaments

Articulation at SI joint

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2
Q

What are the 2 major significant pelvic structures influencing lower extremity circulation and drainage?

A

Pelvic diaphragm

Inguinal area

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3
Q

The ______ is the area of the pelvis composed of bone from 3 different ossification centers

A

Acetabulum

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4
Q

Anterior pelvic landmarks

A 
Iliac crest
ASIS
AIIS
Ischial tuberosity
Pubic symphysis
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5
Q

Posterior pelvic landmarks

A

PSIS
PIIS
Inferior lateral angle (ILA)

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6
Q

Major joints of the pelvis

A

SI joint
Acetabulum
Pubic symphysis

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7
Q

What is the difference between true ligaments and accessory ligaments?

A

True ligaments go from bone to bone

Accessory ligaments attach at another ligament, a tendon, or other fascia

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8
Q

Major functions of ligaments

A

Limit abnormal or excessive movements at a joint

Permit normal motion

Quality is slightly elastic

Prevent excessive movement as part of reflex response

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9
Q

Major anterior pelvic ligaments

A

Sacrospinous ligament

Iliolumbar ligament

Anterior sacroiliac ligament

Inguinal ligament

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10
Q

Major posterior pelvic ligaments

A

Sacrotuberous ligament

Posterior sacroiliac ligament

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11
Q

Which ligament connects the ASIS to the superior pubic rami?

A

Inguinal ligament

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12
Q

Which ligament goes from ilia to L5?

A

Iliolumbar

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13
Q

Which ligaments cover much of the sacroiliac joints?

A

Anterior and posterior sacroiliac ligaments

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14
Q

Which ligament goes from sacrum to spine of ischium?

A

Sacrospinous ligament

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15
Q

Which ligament goes from sacrum to ischial tuberosity?

A

Sacrotuberous

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16
Q

The sacrospinous ligament goes from the ischial spine to lateral margins of sacrum where it blends with the ______ ligament. It forms part of the origin from which the _____ muscle arises

A

Sacrotuberous; coccygeus

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17
Q

The sacrotuberous ligament runs from lower sacral tubercles to the ischial tuberosity and acts as an attachment for the _____ ____ m. as well as the tendon of the ____ ______. It connects with the fascia of the pelvis.

A

Gluteus maximus

Biceps femoris

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18
Q

Primary functions of iliolumbar ligament

A

Stabilizes anterior motion of lower lumbar spine

Restricts anterior and rotary motion of L5

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19
Q

The iliolumbar ligament blends with the upper part of what ligament?

A

Anterior SI ligament

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20
Q

The inguinal ligament gives origin to what 2 muscles?

A

Internal oblique m

Transversus abdominis m

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21
Q

Which thick pelvic ligament prevents the sacrum from “popping” out anteriorly?

A

Anterior SI ligament

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22
Q

The posterior SI ligament blends with the ________ligament and ______ fascia

A

Sacrotuberous; thoracolumbar

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23
Q

What pelvic ligament forms the major bond between the pelvic bones, filling the irregular space posterosuperior to the joint and is covered posteriorly by the posterior SI ligament?

A

Interosseous sacroiliac ligament

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24
Q

The pubic symphysis lies anteriorly between adjacent surfaces of pubic bones. Each joint surface is covered by _____ cartilage and is linked across midline to adjacent surfaces by _______.

The joint is surrounded by interwoven layers of _____ fibers

A

Hyaline; fibrocartilage

Collagen

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25
Q

What are the 2 major ligaments associated with the pubic symphysis?

A

Superior pubic ligament

Inferior pubic ligament

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26
Q

During right heel strike, the right leg glides forward and is aided by the right innominate rotating ________

The contralateral innominate rotates ________

A

Posteriorly

Anteriorly

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27
Q

During heel strike, the ______ and ______ contract to flex the lower extremity at the hip.

_______ contraction and motion of the swing phase both act upon the innominate to cause posterior rotation on the respective side of the heel strike

A

Iliopsoas; quadriceps femoris

Iliopsoas

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28
Q

During right sided toe-off, the body does a controlled fall forward with the left leg gliding forward and ______ rotation of the innominate is mainly a passive process

Contralateral innominate rotates ______, mainly an active process

A

Anterior

Posterior

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29
Q

During toe-off, the ______ elongates, allowing anterior rotation of the innominate with _______ and _______ contraction to extend the lower extremity at the hip

Ipsilateral ______ and ______ contraction aid anterior innominate rotation

A

Iliopsoas; gluteus maximus; hamstring

Erector spinae; quadratus lumborum

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30
Q

4 hip flexors (2 major, 2 minor)

A

Major = iliacus, psoas

Minor = rectus femoris, sartorius

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31
Q

2 major hip extensors

A

Gluteus maximus

Hamstrings (biceps femoris+semitendinosus+semimembranosus)

32
Q

Dysfunction of the rectus femoris, the iliacus, or the ipsilateral adductor group may cause ______ rotation of the innominate and/or ______ shear at the pubis

A

Anterior; inferior

33
Q

Hamstring tension may cause a ______ rotation of the innominate and affect pelvic mechanics

34
Q

5 hip adductors (3 major, 2 minor)

A

Major = adductor magnus, adductor brevis, adductor longus

Minor = gracilis, pectineus

35
Q

3 hip abductors

A

Gluteus medius
Gluteus minimus
Tensor fascia lata

36
Q

Major hip external rotator

A

Piriformis

37
Q

Abnormal gait caused by weakness of the abductor muscles of the lower limb, gluteus medius, and gluteus minimus, which are supplied by superior gluteal n.

A

Trendelenburg gait

38
Q

Positive trendelenburg’s sign

A

Drop of pelvis when lifting leg opposite to weak gluteus medius

39
Q

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

A

Piriformis

40
Q

Contraction of the piriformis may compress a certain nerve causing what condition?

41
Q

3 major plexus associated with innominate

A

Lumbar plexus (L1-4)

Sacral plexus (L5-S4)

Coccygeal plexus (S5-coccygeal n.)

42
Q

Major ganglia associated with innominate function

A

Inferior mesenteric ganglion

Superior hypogastric ganglion

43
Q

Dysfunction of the ________ muscle may produce symptoms similar to a groin pull or hernia, by irritating the ilioinguinal and iliohypogastric nerves (L1) as they pass just anterior to it

A

Quadratus lumborum

44
Q

The sacrospinous ligament divides what 2 pelvic foramina?

A

Greater sciatic foramen

Lesser sciatic foramen

45
Q

What are the anatomical landmarks used to assess posture using the gravitational line?

A 
Auditory meatus
Acromion process
Greater trochanter
Lateral condyle of knee
Lateral malleolus
46
Q

Potential problems/SD’s that occur at pelvis

A

Rotation

Shear

Flare

Pubic bone dysfunction

47
Q

Anterior palpatory landmarks used for innominate SD

A

Iliac crests
ASIS
Pubic tubercles
Medial malleoli heights

48
Q

The pubic tubercles are used specifically to diagnose what type of pelvis SD?

A

Pubic subluxation

49
Q

Ischial tuberosity’s are used in diagnosis of what specific type of pelvic SD?

A

“Small hemipelvis”

50
Q

Posterior palpatory landmarks used for innominate SD

A

PSIS

Ischial tuberosity’s

51
Q

Lateralization tests used for innominate SD’s

A

ASIS compression test (indicates SI joint dysfunction on the side of restricted motion)

Standing flexion test (indicates SI joint dysfunction on the side that elevates first)

52
Q

What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate is anteriorly rotated?

A

ASIS inferior

PSIS superior

Iliac crest level

Medial malleolus inferior (long)

53
Q

What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate is posteriorly rotated?

A

ASIS superior

PSIS inferior

Iliac crest level

Medial malleolus is superior (short)

54
Q

What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate has superior shear?

A

ASIS superior

PSIS superior

Iliac crest superior

Medial malleolus superior (short)

55
Q

What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate has inferior shear?

A

ASIS inferior

PSIS inferior

Iliac crest inferior

Medial malleolus inferior (long)

56
Q

How do you assess for innominate inflare or outflare? How do you know which side is affected?

A

Measure for inflare/outflare from midline to each ASIS

Lateralization test defines side with SD (SD side displays smaller distance from ASIS to midline for inflare, the opposite for outflare)

57
Q

How do you assess for pubic shear? How do you know which side is affected?

A

Measured by palpating the superior aspect of pubic ramus

Lateralization test defines side with SD

58
Q

Describe a positive trendelenburg test

A

Pelvis on unsupported side drops

Indicates gluteus medius weakness on the side of the stance leg

59
Q

Describe a positive thomas test

A

Inability to fully extend at hip

Indicates psoas (hip flexor) tightness/contracture

60
Q

Describe a positive ober test

A

Leg will not fully adduct, OR cannot easily press down on the leg

Indicates IT band contracture

61
Q

Osteopathic evaluation of innominate - steps

A

Standing flexion test OR ASIS compression test to determine side of dysfunction

Evaluate for rotations and/or shears: PSIS height, ASIS height, Iliac crest height, medial malleoli height

Evaluate for inflares/outflares: ASIS to midline

Evaluate for pubic dysfunction: pubic tubercles

62
Q

Positive standing flexion test

A

One PSIS moves further superiorly

Indicates SI joint dysfunction on the side that elevates first

63
Q

Positive ASIS compression test

A

Hard end feel or restriction of motion on one side

Indicates SI joint dysfunction on the side of restricted motion

64
Q

What must you always do prior to supine evaluation of the innominate?

A

“Reset” hips

65
Q

Diagnose:

Standing flexion positive on side of dysfunction

PSIS heights: superior on side of dysfunction

ASIS heights: inferior on side of dysfunction

Malleoli: inferior (long) on side of dysfunction

Iliac crest heights: even

A

Anterior innominate rotation

66
Q

Diagnose:

Standing flexion positive on side of dysfunction

PSIS heights: inferior on side of dysfunction

ASIS heights: superior on side of dysfunction

Malleoli: superior (short) on side of dysfunction

Iliac crest heights: even

A

Posterior innominate rotation

67
Q

Diagnose:

Standing flexion positive on side of dysfunction

PSIS heights: superior on side of dysfunction

ASIS heights: superior on side of dysfunction

Malleoli: superior on side of dysfunction

Iliac crest heights: superior on side of dysfunction

A

Superior innominate shear

68
Q

Diagnose:

Standing flexion positive on side of dysfunction

PSIS heights: inferior in side of dysfunction

ASIS heights: inferior in side of dysfunction

Malleoli: inferior on side of dysfunction

Iliac crest heights: inferior on side of dysfunction

A

Inferior innominate shear

69
Q

Diagnose:

Standing flexion + on side of dysfunction

ASIS to midline longer on side of dysfunction

A

Outflare of innominate

70
Q

Diagnose:

Standing flexion + on side of dysfunction

ASIS to midline shorter on side of dysfunction

A

Inflare of innominate

71
Q

Which of the following often presents as tenderness over the pubic rami and pubic symphysis?

A. Superior pubic shear
B. Inferior pubic shear
C. Pubic compression
D. Pubic subluxation

A

C. Pubic compression

72
Q

Which of the following often occurs after childbirth, pelvic fracture, or trauma to the pelvis and is very painful?

A. Superior pubic shear
B. Inferior pubic shear
C. Pubic compression
D. Pubic subluxation

A

D. Pubic subluxation

73
Q

What is the restrictive barrier engaged by anterior innominate SD MET?

A

Hip flexion

74
Q

What is the restrictive barrier engaged by posterior innominate SD MET?

A

Hip extension

75
Q

What is the common step in the setup for inferior or superior innominate shear MET?

A

Internally rotate and abduct the leg

OS II Exam 1 (4 decks)

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