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OSII Midterm > Innominates > Flashcards

Innominates Flashcards

1
Q

roles of the pelvis

A
  • body support
  • locomotion
  • maintains stability
  • at base of vertebral column but still far from ground
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2
Q

Pelvis potential for dysfunction

A

weight of the upper body directed through the spine and axial skeleton downward and the resistance to forces from below form a balance at the pelvis. injury, postural and muscle imbalances from above or below can cause somatic dysfunction

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3
Q

pelvis roles

A
  • bowl for GI system
  • supports GU system
  • contains lymphatic and vascular structure for all pelvic contents and circulatory structures below
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4
Q

significant structures influencing LE circulation and drainage

A
  • pelvic diaphragm

- inguinal area

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5
Q

Summary of pelvic functions

A
  • biomechanical function and balance (foundation for support and locomotion)
  • reproduction (genital structures)
  • elimination (GI and urologic)
  • vascular and lymphatic functions for the region
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6
Q

Innominates child vs adult

A

3 separate bones as child, completely fuse as adult

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7
Q

Acetabulum composition

A

bone from 3 different ossification centers

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8
Q

true ligaments

A

bone to bone

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9
Q

accessory ligaments

A

attach at another ligament, a tendon or other fascia

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10
Q

ligament functions

A
  • limit abnormal or excessive motion at a joint
  • permits normal motion
  • quality is slightly elastic
  • prevent excessive motion as part of a reflex response
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11
Q

sacrospinous ligament

A

sacrum to spine of the ischium, deep to sacrotuberous ligament, blends with sacrotuberous at sacrum, forms part of origin where coccygeus muscle arises

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12
Q

iliolumbar ligament

A

from ilia to 5th lumbar vertebrae, stabilizes L5, stabilizes anterior motion of lower lumbar spine, restricts anterior and rotary motion of L5, blends with the upper part of the anterior SI ligament

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13
Q

anterior sacroiliac ligament

A

covers much of sacroiliac joint, connects third sacral segment to the lateral side of the pre-auriclar sulcus, thicker than the posterior SI ligaments to prevents the sacrum form popping out anteriorly

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14
Q

inguinal ligament

A

asis to superior pubic rami, forms the floor of the inguinal canal, origin to the internal oblique and transversus abdominus muscle

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15
Q

sacrotuberous ligament

A

sacrum to ischial tuberosity, gluteus maximus attachment, connects with the fascia of the pelvis

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16
Q

posterior sacroiliac ligament

A

covers much of sacroiliac joint, from the third and fourth sacral segments, ascend to PSIS and posterior end of internal lip of liliac crest, blends with sacrotuberous ligament and thoracolumbar fascia

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17
Q

interosseous sacroiliac ligament

A

major bond between the bones, filling the irregular space posterosuperior to the joint. covered posteriorly by the posterior sacroiliac ligament

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18
Q

pubic symphysis

A

each of joints surfaces covered by fibrocartilage, linked across the midline to adjacent surfaces by fibrocartilage, surrounded by interwoven layers of collagen fibers, two ligaments associated: superior pubic ligament, inferior pubic ligament

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19
Q

forces on pubic symphysis

A
  • strong posterior ligaments of the sacrum
  • articulation of the sacroiliac joint
  • forces pushing symphysis together
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20
Q

Heel strike (right foot) innominate position

A

right innominate rotates posteriorly, left rotates anteriorly, iliopsoas and quadriceps femoris contracted to flex the LE at the hip

21
Q

toe off (right foot) innominate position

A

anterior rotation of the right innominate which is mainly a passive process; iliopsoas relaxation allows anterior rotation of the innominate with gluteus maximus and hamstring contraction

22
Q

hip flexors

A

major: iliacus, psoas
minor: rectus femoris, sartorius

23
Q

hip extensors

A

gluteus maximus, hamstrings (biceps femoris, semitendinosis, semimembranosis)

**hamstring tension may cause a posterior rotation of the innominate and affect pelvic mechanics

24
Q

hip adductors

A

major: adductor magnus, adductor brevis, adductor longus
minor: gracilis, pectineus

25
Q

hip abductors

A

gluteus medius, gluteus minimus, tensor fascia lata

26
Q

trendelenburg sign

A
  • measures hip abductor strength (glut medius) (supplied by the superior gluteal nerve L5)
27
Q

hip external rotators

A
  • piriformis
  • obturator internus and externus
  • superior and inferior gemellus
  • quadratus femoris
28
Q

piriformis

A
  • only hip rotator that connects directly to the sacrum
  • abnormal contraction may cause sciatica
  • piriformis does abduction when the hip is flexed
  • piriformis does external rotation when the hip is extended
29
Q

innominant secondary muscle attachments

A

rectus abdominis, transversus abdominis, internal and external oblique muscles, quadratus lumborum

30
Q

nerves of the pelvis

A
  • lumbar plexus
  • sacral plexus
  • coccygeal plexus
  • sacral sympathetic trunk (forms ganglion impar)
  • pelvic splanchnic perves (s2-4): left colon
  • inferior hypogastric plexus
31
Q

lumbar plexus levels

A

L1-L4

32
Q

sacral plexus levels

A

L5-S4

33
Q

coccygeal plexus

A

S5-coccygeal nerve

34
Q

dysfunction of quadratus lumborum

A

may produce symptoms similar to a groin pull or hernia by irritating the ilioinguinal and iliohypogastric nerves (L1) as the pass anterior to quadratus lumborum

35
Q

what separates the greater and lesser sciatic foramen

A

sacrospinous ligament

36
Q

gravitational line structures

A
  • auditory meatus
  • acromion process
  • greater trochanter
  • body of L3
  • anterior 1/3 of sacrum
  • lateral condyle of the knee
  • lateral malleolus
37
Q

structures used to diagnose the innominates

A

iliac crests, ASIS, pubic tubercles, medial malleoli heights (least reliable), PSIS

38
Q

when are pubic tubercles used for diagnosis

A

pubic somatic dysfunction or subluxation

39
Q

when are ischial tuberosities used for diagnosis

A

used for “small hemipelvis” AKA when one side of the pelvis is congenitally smaller than the other

40
Q

steps for pelvic somatic dysfunction Dx

A

1) lateralization test
2) palpation of landmarks
3) diagnosis

41
Q

lateralization tests

A

standing flexion, ASIS compression

42
Q

anterior innominate rotation landmarks

A

ASIS is iinferior
PSIS is superior
Iliac crest is level
medial malleolus is inferior (long)

43
Q

posterior innominante rotation landmarks

A

ASIS is superior
PSIS is inferior
Iliac crest is level
medial malleolus is superior (short)

44
Q

superior shear landmarks

A

ASIS is superior
PSIS is superior
Iliac crest is superior
Medial malleolus is superior (short)

45
Q

inferior innominate shear landmarks

A

ASIS is inferior
PSIS is inferior
Iliac crest is inferior
medial malleolus is inferior (long)

46
Q

innominate inflare Dx

A

measure from the midline (umbilicus) to each ASIS, lateralization test decides the side of dysfunction, somatic dysfunction side displays smaller distance from ASIS to midline

47
Q

innominate outflare Dx

A

measure from the midline (umbilicus) to each ASIS, lateralization test decides the side of dysfunction, somatic dysfunction side displays LARGER distance from ASIS to midline

48
Q

pubic shear Dx

A

palpate the superior aspect of the pubic ramus and decide if superior or inferior

OSII Midterm (2 decks)

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