Lecture 1: Innominate Lecture

Question 1

What 2 forces hold the pubic symphysis together?

Answer 1

Extermely strong posterior ligaments and articulation at the sacroiliac joint

Question 2

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

Answer 2

• Pelvic diaphragm
• Inguinal area

Question 3

What part of the innominate is composed of bone from 3 different ossification centers?

Answer 3

Acetabulum

Question 4

True ligaments vs. accessory ligaments?

Answer 4

True: from bone to bone

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

Question 5

What are the major Anterior Pelvic ligaments and what are their connections?

Answer 5

Sacrospinous: sacrum to spine of the ischium

Iliolumbar: from ilia to 5th lumbar vertebae

Anterior Sacroiliac: covers much of sacroiliac joint

Inguinal: ASIS to superior pubic rami

Question 6

What are the major Posterior Pelvic ligaments and what are their connections?

Answer 6

Sacrotuberous: sacrum to ischial tuberosity

Posterior Sacroiliac: covers much of the sacraliliac joint

Question 7

Which innominate ligament has a gluteus maximus attachment, tendon of the bicepts femoris attachment, and runs from the lower sacral tubercles to ischial tuberosity?

Answer 7

Sacrotuberous ligament (STL)

Question 8

Function of the Iliolumbar ligament; which ligament does it blend with?

Answer 8

• Stabilization of L5
• Stabilizes anterior motion of lumbar spine
• Restricts anterior and rotary motio of L5
• Blends with the upper part of the anteror SI ligament

Question 9

What type of joint is the Pubic Symphysis; what are the characteristics?

Answer 9

• Secondary cartilaginous joint
• Surfaces of the articulating bones are covered w/ hyaline cartilage and the bones are united by strong fibrous CT and/or fibrocartilage

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Question 10

What pelvic ligament forms the major bond between the bone, filling irregular space posterosuperior to the joint?

Answer 10

Interosseous Sacroiliac Ligament

Question 11

During heel strike which way is the innominate rotated on the leg/foot making contact; how about the contralateral leg (toeing off); which of these processes is active and which is passive?

Answer 11

• Posterior innominate rotation (active process)
• Contralateral = anteiror innominate rotation (passive process)

Question 12

Which muscles contract to flex the LE at the hip and which causes posterior innominate rotation?

Answer 12

• Iliopsoas and quadriceps femoris were contracted to flex LE at the hip
• Iliopsoas contraction and motion of the swing phase both act upon the innominate to cause posterior rotation

Question 13

What occurs to the innomincate during the toe off phase of walking?

Answer 13

Anterior rotation of the innominate, which is mainly a passive process

Question 14

Which muscles are involved in anterior innominate rotation during the gait cycle; which are the main and which aid in the process?

Answer 14

• Iliopsoas elongates allowing anterior rotation of the innominate
• Gluteus maximus and hamstrings contract to extend the LE at the hip
• Erector spinae and Quadratus Lumborum contraction aids anterior innominate rotation

Question 15

What are the Major and Minor hip flexors?

Answer 15

Major:

1) Iliacus
2) Psoas

Minor:

1) Rectus femoris
2) Sartorius

Question 16

What are the Hip Extensors?

Answer 16

• Gluteus Maximus

Hamstrings

1) Biceps femoris
2) Semitendonosis
3) Semimembranosis

Question 17

Dysfunction of which muscles may cause an anterior rotation of the innominate and/or inferior shear at the pubes?

Answer 17

• Rectus femoris
• Iliacus
• Ipsilateral adductor group

Question 18

Tension in which muscle may lead to posterior rotation of the innominate and affect pelvic mechanics?

Answer 18

Hamstrings

Question 19

What are the major hip abductor muscles?

Answer 19

• Gluteus medius
• Gluteus Minimus
• Tensor Fascia Lata

Question 20

What are the 3 major hip ADductors and 2 minor?

Answer 20

Major:

1) Adductor Magnus
2) Adductor Brevis
3) Adductor Longus

Minor:

1) Sartorius
2) Pectineus

Question 21

ADductors limit which motion of the pelvis?

Answer 21

Lateral movement

Question 22

Which rotator is the ONLY one that connects directly to the hip; contraction of this muscle may cause?

Answer 22

• Piriformis
• May cause sciatica

Question 23

What is the function of piriformis during hip flexion and hip extension?

Answer 23

• ABductor (some int. rot) when the hip is flexed
• An external rotator when the hip is extended

Question 24

Trendelenburg gait pattern is caused by weakness of which muscles; supplied by which nerve?

Answer 24

• ABductor muscles: gluteus medius and gluteus minimus
• Superior gluteal n.

Question 25

Which muscles act as external rotators of the hip?

Answer 25

• Piriformis (when hip extended)
• Superior and inferior Gemelli
• Obturator internus and externus
• Quadratus Femoris

Question 26

Dysfunction of which muscle may produce symptoms similar to a groin pull or hernia, by irritating which nerves?

Answer 26

• Quadratus lumborum
• Irritating the ilioinguinal and iliohypogastric nerves (L1)

Question 27

What is the landmark for determining pubic shears?

Answer 27

Palpating the superior aspect of the pubic ramus