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OMM > Pelvis Anatomy > Flashcards

Pelvis Anatomy Flashcards

1
Q

What type of joint is the pubic symphysis?

A
  • Amphiarthrodial joint (allows for slight mvmt)
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2
Q

Iliolumbar ligament

A
  • Spans b/w transverse processes of L4 and L5 to inner lip of the iliac crest
  • Lower border of the thoracolumbar fascia
  • Stabalizes the lumbar spine at the L/S jxn
    • preventing anterior displacement
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3
Q

Iliolumbar ligament pain radiation areas

A
  • Inguinal area
  • Inner thigh
  • Lateral upper thigh
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4
Q

4 Types of Pelvises

A
  • Gynecoid
  • Android
  • Anthropoid
  • Platypelloid
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5
Q

Gynecoid pelvis

A
  • 1 of 4 types of pelvises
  • More classically a female pelvis
  • Ideal for birth
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6
Q

Android pelvis

A
  • 1 of 4 types of pelvises
  • More classically a male pelvis
  • Most birthing difficulty
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7
Q

Anthropoid pelvis

A
  • 1 of 4 types of pelvises
  • Ape pelvis
  • Problematic w/ certain positions of fetal head engagement
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8
Q

Platypelloid pelvis

A
  • 1 of 4 types of pelvises

- Head engages later, but usually ok after that

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9
Q

Female pelvis

A
  • Larger, oval pelvic inlet
  • Greater distance b/w ischial spines-larger outlet
  • Wider greater sciatic notch
  • Shorter, wider sacrum curved posteriorly
  • Moreso anteriorly-facing acetabula, placed wider apart
    • forward and inward leg swing in diff. planes (swinging hips)
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10
Q

Male pelvis

A
  • Heart shaped inlet
    • sacral promontory projects further posteriorly
  • Sides converge from inlet to outlet
    • ischial spines close together-small outlet
  • Larger ischial spines and tuberosities
  • Higher iliac crests
    • deep greater/false pelvis
  • Moreso laterally-facing acetabula
    • leg swing is anterior-posterior in a single plane
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11
Q

Ideal standing posture effects on pelvis

A
  • Pelvis level and the hips neutral
  • ASIS and pubic symphysis are in the same plane
  • PSIS and ASIS are in the same plane
  • Center of gravity is posterior to femoral head
  • Posterior weight is counteracted by:
    • ligamentous structures
    • close-packing of hip joint in extension
    • hip flexors (sometimes)
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12
Q

Exaggerated kyphosis/lordosis standing effects on pelvis

A
  • Classic upper and lower cross imbalance
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13
Q

Flat back standing effects on pelvis

A
  • Hamstrings maintain upright posture by pulling pelvis posterior
  • Bad posture, tight hamstrings
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14
Q

Swayback standing effects on pelvis

A
  • Gravitational line is further posterior to hips
  • Requires no increased muscle activity
  • Ligamentous structures take the weight, may become stretched
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15
Q

Patterns seen with poor posturing

A
  • Tight: upper traps and levator scap, pecs, erector spinae, iliopsoas
  • Weak: deep neck flexors, rhomboids and serratus anterior, abdominals, glutes
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16
Q

Pelvic activities during gait cycle

A

2 activites during gait

  • Pelvic rotation
    • occurs in the transverse plane (on vertical axis)
    • approx. 8 degrees
    • increased leg reach
    • decreases work by decreasing hip extension and flexion
  • Pelvic tilt
    • lateral lowering (sidebending) of the pelvis in stance phase
    • decreases vertical motion of the rest of the body
17
Q

Pelvic floor responsibility

A
  • Maintains structural integrity of pelvic viscera and lower abdomen
  • Helps in controlling urination and defecation
    • urethral meatus and rectal sphincter
  • Mechanism of sexual function
18
Q

Pelvic floor layers

A

Cephalad to caudad

  • Endopelvic fascia
    • connect the pelvic organs to pelvic walls
  • Pelvic diaphragm
    • levator ani muscles
    • coccygeus muscle
    • arcus tendineus
    • levator plate
  • Urogenital diaphragm
    • deep transverse perinei
    • perineal membrane
    • perineal body
19
Q

Levator Ani muscles

A

Located caudad to endopelvic fascia

  • Iliococcygeus
  • Pubococcygeus
  • Puborectalis
20
Q

Levator Ani muscles function

A
  • Keep urogenital hiatus closed by compressing the urethra, vagina and rectum against the pubic bone, pulling the pelvic floor and organs in a cephalic direction
    • coccygeus also aids in this
21
Q

Pelvic diaphragm

A
  • Levator ani and assoc. fascia together
22
Q

Urogenital hiatus

A
  • Opening b/w the levator ani muscles thru which the urethra, vagina and rectum pass
  • Orifice thru which prolapse occurs, esp in females
  • Supported anteriorly by the pubic bones and the levator ani muscles, and posteriorly by the perineal body and external anal sphincter
23
Q

Pelvic floor/ diaphragm function

A
  • Maintains pelvic organ support
  • Maintains urinary and fecal continence
    • via urethral and anal sphincter control, urinary
24
Q

Pelvic floor/ diaphragm dysfunctional effects

A
  • Incontinence
  • Prolapse
  • Rectal/vaginal/pelvic floor pain
    • can have large neg. impact on QOL (often clinical assoc. w/ Interstitial Cystitis (IC) aka Painful Bladder Syndrome (PBS))
    • intense dyspareunia or pain w/ any penetration
    • inability to sit or stand for long periods; can lead to employment disability
25
Q

High tone pelvic floor dysfunction OMT

A
  • Not recognized in males
  • OMT directed at the external pelvis/sacrum, as well as internal
  • OMT is very helpful in this condition (direct inhibition via intra-rectal or intra-vaginal route)
26
Q

Pathology of pelvic floor prolapse

A
  • Vaginal childbirth, advancing age, increased BMI
    • most consistent risk factors
  • ~50% of parous women have prolapse
    • not all prolapses are problematic, but 10-20% of affected women seek help b/c of symptoms
  • # of urethral striated muscle fibers declines w/ age (the longer we live the weaker or pelvic floor becomes)
27
Q

Symptoms of prolapse

A
  • Heaviness or dragging sensation in vagina
  • Uncomfortable bulge or a lump protruding from the vagina
  • LBP; dull
  • Dyspareunia; uterine prolapse, which can be compounded by vaginal dryness in postmenopausal women
  • Bladder and bowel problems often co-exist
    • urinary hesitancy
    • slow urinary flow rate and incomplete emptying
    • urinary urgency and frequency when a cystocele is present
    • constipation may be a symptom of rectocele
    • incomplete fecal emptying or the need to manually assist defecation (direct extraction or “splinting”)
28
Q

Most common type of pelvic floor dysfunction

A
  • Stress urinary incontinence

* involuntary leakage w/ increased abdominal pressure (effort, exertion, sneezing, coughing, laughing)

29
Q

Post partum effects on the pelvic floor

A
  • Pubococcygeus is most susceptible to stretch injury during vaginal birth
  • Pudendal nerve provides innervation to external genitalia, sphincters of bladder and rectum
30
Q

Pelvic floor trigger points

A
  • Levator ani and coccygeus

- Obturator internus

31
Q

T10-T11 Autonomics-Sympathetics

A
  • Kidneys, gonads, upper ureter, adrenals
32
Q

T12-L2 Autonomics-Sympathetics

A
  • Lower ureters, uterus, vagina, clitoris, vas deferens, prostate, bladder, urethra, fallopian tubes, seminal vesicles, sphincter, trigone
33
Q

Vagus Autonomics-Parasympathetics

A
  • Kidney, upper ureter, ovaries, testes
34
Q

S2-4 Autonomics-Parasympathetics

A
  • Lower ureter, bladder, prostate

OMM (6 decks)

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