Lecture: Sacroiliac Joint Flashcards
the SI joint is a point of __ bw the __ and the __ __ joints.
it is the __ understood joint and one of the most __ and interesting areas of the spine
- intersection
- spine
- lower extremity
- least
- controversial
the __, __ & __ fuse at the acetabulum to form each innominate
- ilium
- ischium
- pubic bone
the __ is a strong and triangular bone located bw the two __.
- sacrum
- innominates
sacrum provides __ to this area and transmits the __ of the body from the mobile __ column to the __ region.
- stability
- weight
- vertebral
- pelvic
the iliac joint surfaces are formed from:
-fibrocartilage
the sacral surfaces are formed from:
-hyaline cartilage
hyaline cartilage is __X thicker than __.
- 3-5
- fibrocartilage
SI joint is reinforced by __, some the of __ & __ of the body.
- ligaments
- strongest
- toughest
the Anterior Sacral Ligament (ASL) is an __-__ thickening of the fibrous capsule.
relatively __ compared to the rest of the SI ligs, extends bw the __ & __ borders of the iliac auricular surface and the __ border of the __ auricular surface.
- anterior-inferior
- weak
- anterior & inferior
- anterior
- sacral
interosseous ligament is a __ lig. located __ to the dorsal SI lig.
- short
- deep
dorsal SI ligament (long) connects the __ with the lateral crest of the __+__.
- PSIS
- S3 + S4
the sacrospinous lig.= __ large __ bands, broadly attached by its base to the __, lateral __ and partly blended with the __ SI lig., deep to the __ lig.
- 3
- fibrous
- PIIS
- sacrum
- dorsal
- sacrotuberous
sacrospinous lig. stabilizes against __ (forward __) of the __.
and counteracts against the dorsal and cranial migration of the sacral __ during __ __.
- nutation
- rotation
- sacrum
- apex
- weight-bearing
sacrotuberous lig. extends from the __ tuberosity to the lateral margins of the __, __ & __.
lower borders of lig. are continuous with the __ __ tendon.
& counteracts against __ of the sacrum.
- ischial
- ilium, sacrum & coccyx
- biceps femoris
- nutation
the pubic symphysis is classified as a __, as it has NO __ tissue or __. and contains a __ disc.
- symphysis
- synovial
- fluid
- fibrocartilaginous
the bone surfaces of the pubic symphysis joint are covered in __ cartilage, but are kept apart by the presence of the __.
- hyaline
- disc
__ muscles attach directly to the sacrum and/or innominate.
these M.’s fxn primarily to __ the SI joint rather than to __ it.
- 35
- stabilize
- move
the __ muscle is innervated by S1-2.
it primarily fxns to produce external rotation & __ of the femur.
hip flexed @90deg. helps fxn as an abductor & __ __ of the hip.
capable of restricting __ joint motion.
- piriformis
- abduction
- internal rotator
- SI
“pelvic floor muscles”: (3)
which muscle group?
they join the __ muscles to complete the pelvic floor.
- pubococcygeus
- puborectalis
- iliococcygeus
- levator ani
- coccygeus
the pelvic floor muscles work in a coordinated manner to ^increase:
- intra-abdominal pressure
- provide rectal support during defecation
- inhibit bladder activity
- help to support the pelvic organs
- assist in lumbopelvic stability
the anterior portion of the sacroiliac joint likely receives innervation from?
-the posterior rami of the L2-S2 roots
the pelvic area must fxn to absorb the majority of the lower extremity __ which still permitting __ to occur.
- rotation
- motion
osteopathic model:
of pelvic complex biomechanics
- sacrum rotates around 2 oblique axes
- the innominate are capable of rotating anteriorly and posterior
chiropractic model:
of pelvic complex biomechanics
- as one innominate flexes, the ipsilateral sacral base moves anterior and inferior
- and as the other innominate extends, the sacral base on that side moves posterior and superior
biomechanical model:
of pelvic complex biomechanics
- when the sacrum nutates (<=moves ant.), relative to the innominate, a linear glide occurs b/w the 2 L-shaped articular surfaces of the sacroiliac joint
- the shorter of the 2 lengths, level w/ S1, lies in a vertical plane
- the longer length, spanning S2-4, lies in an A-P plane.
Hx of SIJ dysfxn:
pt will have __ pain awakening them from sleep/__ in bed.
also pain with:
(+ with SLR)
- sharp
- turning
- walking
- ascending/descending stairs
- standing from sitting position
- hopping
- or standing on the involved leg
given the # of visceral organs in the vicinity of the SIJ, a thorough systems review is needed to __ __ a __ source for the symptoms.
- rule out
- visceral
SIJ stress tests:
- Gaenslen’s/Lewin-G. (stressed into ext.)
- Hibb (pain in buttock/pelvic=lesion)
- Fabere/Laguerre
acute phase goals:
- regain soft tissue extensibility
- & neuromuscular control
fxnal phase goals:
-restoration of gait, pelvic & lower quadrant strength & neuromuscular control
