Innominate SD Flashcards
What are 2 significant structures influencing LE circulation?
Pelvic diaphragm
Inguinal area
What do “true” ligaments attach?
Bone to bone
What do “accessory” ligaments attach?
Attachment at another ligament, tendon, or fascia
During R heel strike, what innominate is rotating posteriorly? What hip muscles are being contracted?
R innominate
Iliopsoas and quadriceps femoris
During R toe off, which innominate is being rotated anteriorly? Which muscles are being contracted?
L innominate rotating forward
Contraction of gluteus maximus M. and Hamstrings
What is the attachment of the sacrospinous L.?
Sacrum to spine of the ischium
What is the attachment of the Iliolumbar L?
Ilium to the 5th Lumbar vertebrae?
What are the anterior pelvic ligaments?
Sacrospinous L.
Iliolumbar L.
Anterior Sacroiliac L.
Inguinal L.
What is the attachment of the anterior sacroiliac L.?
Most of the sacroiliac joint
What is the attachment of the Inguinal L.?
ASIS to the superior pubic rami/pubic tubercle
What are the major posterior pelvic ligaments?
Sacrotuberous L.
Posterior Sacroiliac L.
What is the attachment of the sacrotuberous L.?
Sacrum to ischial tuberosity
What is the attachment of the posterior sacroiliac L.?
Most of the sacroiliac joint
What is the action of the iliolumbar L.?
Stabilize the L5
Restrict anterior and rotation of L5
What are the major hip flexor muscles?
Iliacus + Psoas = Iliopsoas M.
What are the minor hip flexor muscles?
Rectus Femoris M.
Sartorius M.
What is the origin and insertion of the Iliacus M.?
Iliac fossa to the lesser trochanter of the femur
What is the origin and insertion of the Psoas Major and Psoas Minor Ms.?
L5 to lesser trochanter of the femur
What is the origin and insertion of the Rectus Femoris M.?
AIIS to patella
What is the origin and insertion of the Rectus Femoris M.?
ASIS to medial tibia
What muscles comprise the hip extensors?
Gluteus maximus m.
Hamstrings - biceps femoris, semitendonosis
What is the origin and insertion of the gluteus maximus m.?
Posterior iliac fossa to posterosuperior aspect of greater trochanter of femur
What is the origin and insertion of the semimembranosus m.?
Ischial tuberosity to medial tibia
What is the origin and insertion of the semitendonosus m.?
Ischial tuberosity to medial tibia
What is the origin and insertion of the biceps femoris m.?
Ischial tuberosity and sacrotuberous L. to lateral fibula and tibial plateau
Hamstring tension may cause what to happen to the innominate?
Posterior rotation
Tension of the hip flexors may cause what to happen to the innominate?
Anterior rotation
Tension of the hip flexors may cause what to happen to the pubic bones?
Inferior shear
What are the major hip adductor muscles?
Adductor Magnus M.
Adductor Brevis M.
Adductor Longus M.
What are the minor hip adductor ms.?
Gracilis M.
Pectineus M.
What is the origin and insertion of the pectineus M.?
Pectineal Line on pubic bone to the pectineal line of the femur
What is the origin and insertion of the gracilis M.?
The inferior ramus of the pubis to the medial aspect of the proximal femur and tibial plateau
What is the origin and insertion of the adductor brevis?
Body and inferior ramus of the pubis to the pectineal line and proximal linea aspera of the femur
What is the origin and insertion of the adductor magnus m.?
Body and inferior ramus of the pubis to the pectineal line and proximal linea aspera of the femur
What is the origin and insertion of the adductor longus m.?
Body and inferior ramus of the pubis to the superomedial surface of the distal femur
What muscles comprise the hip abductors?
Gluteus medius m.
Gluteus minimus m.
Tensor Fascia Lata
What is the origin and insertion of the Gluteus Medius M.?
Posterior ischial fossa to superior greater trochanter
What is the origin and insertion of the Gluteus minimus M.?
Posterior ischial fossa to superior greater trochanter
What is the origin and insertion of the tensor fascia lata?
Anterior part of the external lip of iliac crest/lateral surface of ASIS to the iliotibial band which eventually inserts onto lateral condyle of the tibia
If a patient has positive Trendelenburg sign, what muscle group has failed to contract?
Hip Abductors of the side opposite to the hip drop
What muscles comprise the hip external rotators?
Piriformis M.
Obturator (internus/externus)
Gemelli (Superior/inferior)
Quadratus femoris
What is the origin and insertion of the piriformis m.?
Anterior sacrum to superior greater trochanter
What is the origin and insertion of the superior and inferior gemelli ms.?
Ischial spine to greater trochanter
What is the origin and insertion of the obturator internus and externus ms.?
Obturator membrane to the greater trochanter
What is the origin and insertion of the quadratus femoris m.?
Ischial tuberosity to greater trochanter
What muscle is the only hip rotator that connects directly to the sacrum?
Piriformis M.
What muscle is responsible for sciatic pain?
Piriformis M.
In what hip position will the piriformis m. act as an abductor?
Hip flexed
In what hip position will the piriformis m. act as an external rotator?
Hip extended
What are the levels of the lumbar plexus?
L1-L4
What are the levels of the sacral plexus?
L5-S4 (This is different from the levels in Dr. Olinger’s lecture which say L4-S4)
What nerves is the coccygeal plexus comprised of?
Anterior rami of S5 and coccygeal N.
What nerves will be irritated by dysfunction of the Quadratus Lumborum M.? What sx will arise as a result?
Ilioinguinal and iliohypogastric Ns. (L1)
Sx similar to groin pull or hernia
What vessels travel through the greater sciatic foramen?
Superior gluteal N. and A.
Inferior Gluteal N. and A.
What vessels travel through the lesser sciatic foramen?
Pudendal N.
Internal pudendal A.
N. to obturator internus m.
What are the landmarks of the gravitational line?
Auditory meatus
Acromion process
Greater trochanter of the femur
Body of L3
Anterior 1/3 of sacrum
Lateral condyle of the knee
Lateral malleolus
What structures of the pelvis are used to diagnose the innominate?
Iliac Crests SIS Pubic tubercles Medial malleoli heights PSIS
When would ischial tuberosities be used to diagnose the pelvis?
For small hemipelvis - when one side of the pelvis is congenitally smaller than the other
What are the three steps to pelvic SD diagnosis?
Lateralization test
Palpation of landmarks
Diagnosis
What ligament inserts onto the iliac crest with the posterior sacroiliac ligament?
Sacrotuberous Ligament