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OS II (Spring 2020) > Introduction to the Sacrum > Flashcards

Introduction to the Sacrum Flashcards

1
Q

At what level of the sacrum is the inferior lateral angle?

A

at S4 & S5

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2
Q

Name some sacral anterior anatomic landmars

A

Sacral base
Sacral Promontory
Sacral Apex

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3
Q

What is the coccyx?

A

the lowest part of the spinal column

consists of 4 vertebra

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4
Q

What separates adjacent sacral segments?

A

epiphyseal plates that fuse after puberty

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5
Q

Bony articulations of the sacrum

A

articulates w/ 5th lumbar vertebra superiorly

articulates w/ coccyx inferiorly

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6
Q

Sacral Joints

A

Right SI joint
Left SI joint
L5-S1 intervertebral disc
Sacrococcygeal joint

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7
Q

Considerations for SI joint after puberty

A

in males, SIJ ligaments are well-developed & strong

in females, SIJ ligaments are less developed

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8
Q

Considerations for SI joint in 2nd decade of life

A

ridge develops along iliac surface that interdigitates w/ depression on sacral side to add stability & limits mobility

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9
Q

Considerations for SI joint in 3rd decade of life

A

crescent shape ridge is more pronounced & decreases ROM

some degenerative changes occur on iliac side in males

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10
Q

Considerations for SI joint in 4th & 5th decades of life

A

in males, degenerative changes begin on sacral side

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11
Q

SI joint characteristics

A

L or C shaped with shorter upper arm & longer lower arm

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12
Q

Which direction does the apex point?

A

points anteriorly

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13
Q

What type of joint is the SI joint?

A

diarthrodial joint b/c contains synovial fluid & matching articular surfaces

1 side is hyaline cartilage & other side is fibrocartilage

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14
Q

Sacral surface of SI joint

A

smooth, hyaline cartilage, decreases in width inferiorly & wedged between 2 ilia

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15
Q

Iliac surface of SI joint

A

smooth anteriorly, is fibrous on posterior side (gives rise to interosseous ligaments), fibrocartilage

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16
Q

Posterior Sacroiliac Ligament

A

from 3rd & 4th sacral segments & ascents to PSIS & posterior end of iliac crest

thicker

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17
Q

Anterior Sacroiliac Ligament

A

connects 3rd sacral segment to lateral side of pre-auricular surface

blends w/ iliolumbar ligaments

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18
Q

Interosseous Sacroiliac Ligament

A

major bond between the bones, filling irregular space

covered posteriorly by posterior sacroiliac ligament

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19
Q

Long Dorsal SI ligament

A

connects PSIS to lateral aspect of 3rd & 4th sacral segments

close relationship w/ erector spinae muscles, posterior layer of thoracolumbar fascia & sacrotuberous ligament

20
Q

Sacrospinous Ligament

A

from ischial spine to lateral margins of sacrum

forms part of origin from which coccygeus ms arise

21
Q

Sacrotuberous ligament

A

runs from lower sacral tubercles to ischial tuberosity

where gluteus maximus attaches & tendon of biceps femoris attaches

22
Q

What is the role of the sacrospinous & sacrotuberous ligaments?

A

stabilize to limit posterior-superior rotation of sacral apex around transverse axis

23
Q

Piriformis m

A

from ant surface of 2-4 lateral masses of sacrum & sacrotuberous ligament to superior border of greater trochanter of femur

externally rotates thigh when hip joint is extended & abducts thigh when hip joint is flexed

24
Q

What can cause sciatica?

A

piriformis hypertonicity due to chemical reaction that irritates peroneal fibers of the sciatic nerve

causes referred pain down posterior thigh

25
Q

Nervous system of the sacrum

A 
Lumbar Plexus (L1-L4)
Sacral Plexus (L5-S4)
Coccygeal plexus (S5-coccygeal nerve)
26
Q

What ganglion are found in sacrum?

A

inferior mesenteric ganglion
superior hypogastric ganglion
ganglion impar

27
Q

What are some posterior landmarks used to identify sacral SD?

A

PSIS
AIIS
inferior lateral angle
L5 spinous process

28
Q

Self-locking mechanism of the sacrum

A

critical for resistance against shear due to form closure and force closure

29
Q

Force closure

A

compression produced by body weight, muscle action, and ligament force

30
Q

What is sacral dysfunction related to?

A

common cause of low back pain & produces many possible viscerosomatic & somatovisceral reflexes

31
Q

What are important to the stability of the SI joint?

A

postural muscles

32
Q

What are important anterior muscles to the SI joint?

A

activity of oblique abdominal muscles in both standing & sitting (especially internal obliques)

33
Q

Describe physiological sacral motion

A

2 oblique axes of sacral motion

named according to side of body toward which the superior end of oblique axis is located

34
Q

ST axis

A

transverse axis about which sacrum moves during respiratory cycle

passes from side to side through articular processes posterior to point of attachment of dura @ S2

35
Q

MT axis

A

functional transverse axis of nutation & counternutation in standing position, passing thru anterior aspect of S2

36
Q

IT axis

A

functional transverse axis @ level of S3 through inferior auricular surface & represents axis for movement of ilia on sacrum

37
Q

Describe the reciprocal relationship of lumbar spine & sacral base

A

lumbar flexion with sacral extension

lumbar extension w/ sacral flexion

38
Q

Sacral extension counternutation

A

base tips posterior & apex moves anteriorly

39
Q

Sacral flexion nutation

A

base tips anteriorly & apex moves posteriorly

40
Q

Principles of sacral motion

A

all of the movements of the sacrum on ilium are gliding movements

41
Q

How does rotation in lumbar spine affect sacral motion?

A

causes sacrum to rotate towards the same side & sidebends toward contralateral side

42
Q

How does sidebending in lumbar spine affect sacral motion?

A

causes sacrum to sidebend towards same side

43
Q

What way does the ilium move?

A

ilium always moves in same direction as sacrum

44
Q

Lumbarization

A

transitional segment in which 1st sacral segment becomes like an additional lumbar vertebra articulating w/ 2nd sacral segment

45
Q

Sacrilization

A

incomplete separation & differentiation of L5 so takes on characteristics of sacral vertebra

also caused by TP of L5 being atypically large

46
Q

What does form closure of sacrum require?

A

proper size, shape & attitude of articulating surfaces

OS II (Spring 2020) (6 decks)

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