Innominate Flashcards
What does the pelvis play a critical role in (4)?
- foundation for body support and movement
- reproduction (genital structures)
- elimination (GI and GU)
- vascular and lymphathic functions
What are the 3 bones of the innominate?
ilium, pubis, and ischium
What is the acetabulum?
where the 3 bones of the innominate (ilium, pubis, and ischium) fuse together
Name 4 anterior landmarks of the innominate
iliac crest, ASIS, AIIS, and pubic symphysis
Name 3 posterior landmarks of the innominate
PSIS, PIIS, ischial tuberosity
True ligaments vs accessory ligaments
- true ligaments: go from bone to bone
- accessory ligaments: attache to another ligament, tendon, or fascia
Sacrospinous L attachment
sacrum to spine of ischium
Iliolumbar L attachment
from ilia to 5th lumbar vertebrae
Anterior Sacroiliac L attachment
covers much of the sacroiliac joint
Inguinal L attachement
ASIS to superior pubic rami
Sacrotuberous L (STL) attachement
sacrum to ischial tuberosity
Posterior Sacroiliac L attachement
covers much of the sacroiliac joint
What are the 3 joints of the pelvis?
- sacroiliac joint
- acetabulum (hip joint)
- pubic symphysis
Interosseous Sacroiliac L location. What covers it as well?
- major bond between bones and fills irregular space posterosuperior to the joint
- covered posteriorly by posterior sacroiliac L.
What are the 2 major ligaments associated w/ the pubic symphysis?
superior and inferior pubic Ls. - located above and below the joint
Which direction does innominate move when you step forward (heel strike)? What does the contralateral innominate do?
Innominate moves posteriorly; contralateral inanimate moves anteriorly
What 2 muscles are involved in flexing the LE at the hip?
iliopsoas M. and Quadratus femoris M.
What 2 muscles are involved in extending the LE at the hip?
gluteus maximus M. and hamstring M.
Name 2 major and 2 minor hip flexors and where they act at
- iliacus M. (major - hip)
- psoas M. (major - hip)
- rectus femoris M. (minor - knee)
- sartorius M. (minor - knee)
Name 4 hip extensors
- gluteus maximus M.
- Biceps femoris M. (hamstring)
- Semitendinosis M. (hamstring)
- Semimembranosis M. (hamstring)
Name 3 major and 2 minor hip adductors
- Adductor magnus M. (major)
- Adductor brevis M. (major)
- Adductor longus M. (major)
- Gracilis M. (minor)
- Pectineus M. (minor)
Name 3 hip abductors
- Gluteus medius M.
- Gluteus minimus M.
- Tensor fascia lata M.
What is trendelenburg sign testing? What does a positive test look like?
- testing the strength of a pt’s hip abductors (mainly gluteus medius M.)
- Positive test: pelvis drops when pt’s lifts foot off ground -> opposite gluteus medius M. is weak
Name 6 hip external rotators
- piriformis M.
- Obturator externus M.
- Obturator internus M.
- Superior gemelli M.
- Inferior gemelli M.
- Quadratus femoris M.
What may an abnormally contract piriformis M. cause?
sciatica - may impinge sciatic N.
Where does the piriformis directly connect to? What 2 functions can it possibly have?
- connects directly to sacrum (only rotator that does)
- abductor: when hip is flexed
- external rotator: when hip is extended
Name 5 secondary muscles w/ partial attachment to the innominate
- rectus abdominis M.
- transversus abdominis M.
- Internal oblique M.
- External oblique M.
- Quadratus lumborum M.
What levels make the the following plexuses: lumbar, sacral, and coccygeal?
- lumbar plexus: L1-L4
- Sacral plexus: L5-S4
- Coccygeal plexus: S5-coccygeal N.
What can quadratus lumborum SD cause?
sxs similar to a groin pull or hernia due to irritation of the ilioinguinal and iliohypogastric Ns. (L1) as they pass anterior to it
What L forms the greater sciatic foramen?
Sacrospinous L.
Name the 10 structures that exit out of the greater sciatic foramen
- superior/inferior gluteal Ns and As
- Piriformis M.
- Sciatic N.
- Posterior femoral cutaneous N.
- PIN structures ( pudendal N., internal pudendal A, and Nerve to obturator internus/superior gemellus Ms.)
What L forms the lesser sciatic foramen?
Sacrotuberous L.
Name the 3 structures that enter the foramen and the 1 that exits it
- PIN structures ( pudendal N., internal pudendal A, and Nerve to obturator internus/superior gemellus Ms.) - enters
- Obturator internus M. (exits)
What 7 structures make up the gravitational line?
- auditory meatus
- acromion process
- greater trochanter
- body of L3
- anterior 1/3 of sacrum
- lateral condyle of knee
- lateral malleolus
What 2 tests do you use to determine the side of pelvic dysfunction?
- lateralization tests: standing flexion and ASIS compression
What landmarks should you palpate to determine pelvic dysfunction?
- iliac crest
- ASIS
- pubic tubercles
- PSIS
- medial malleoli
How would you perform a standing flexion test?
- pt stands w/ you behind them at the level of the PSIS
- contact inferior aspect of PSIS bilaterally and ask pt to bend forward
- Positive if one PSIS moves farther up (that is the dysfunctional side - SI joint dysfunction)
How would you perform an ASIS compression test?
- pt supine
- contact ASIS bilaterally and push toward the table (posterior and medial) alternating between sides
- Positive if there is restriction of motion or a hard end feel on one side
Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ an anterior innominate rotation
- ASIS inferior
- PSIS superior
- iliac crest is level
- medial malleolus inferior (leg longer)
Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a posterior innominate rotation
- ASIS superior
- PSIS inferior
- iliac crest is level
- medial malleolus superior (leg shorter)
Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a superior innominate shear
- ASIS superior
- PSIS superior
- iliac crest superior
- medial malleolus superior (shorter leg)
Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a inferior innominate shear
- ASIS inferior
- PSIS inferior
- iliac crest inferior
- medial malleolus inferior (longer leg)
Where do you measure for an inflare/outflare of the pelvis?
measure from the midline (umbilicus) to each ASIS
How do you determine the side of the dysfunction w/ an inflare/outflare?
- lateralization tests define side of SD
- Inflare: SD side displays a smaller distance from ASIS to midline
- Outflare: SD side displays larger distance from ASIS to midline
What should you palpate to look for pubic shears?
palpate the superior aspect of the pubic ramus (pubic tubercles)
