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Anatomy > Pelvis and Hip > Flashcards

Pelvis and Hip Flashcards

1
Q

3 Bones in Pelvis

A

1, Ischium- most posterior

  1. Ilium- most superior
  2. Pubis- most anterior
    - these 3 bones come together at the acetabulum fossa helping move joints
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2
Q

Iliac Crest

A

top most portion of the pelvis

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3
Q

Pelvic Brim

A

Made up of arcuate lines and pectineal lines

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4
Q

False Pelvis aka Greater Pelvis

A
  • area between illiac crest and pelvic brim

- also represents inferior end of abdominal cavity

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5
Q

True Pelvis aka Lesser Pelvis

A
  • area between pelvic brim and pelvic diaphragm (pelvic floor), muscular floor
  • where pelvic viscera is located
  • where the uterus is
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6
Q

Borders of True Pelvis

A
  • Anterior: pubic symphysis
  • Superior: Pelvic Inlet
  • Posterior: sacrum and coccyx
  • Inferior: pelvic floor
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7
Q

Pelvic Inlet

A
  • imaginary but represented by arcuate and pectineal lines

- runs from pubic symphysis to the lumbosacral angle (disc between L5 and S1, aka sacral pomontory)

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8
Q

Peritoneum

A
  • roof of pelvic brim

- false pelvis is the inferior border of the abdominal cavity

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9
Q

Normal Posture

A
  • less energy expended by the body is the most optimal = screwdown mechanism
  • simple standing has few muscles contracting
  • balanced contraction of antigravity flexors and extensors to maintain erect posture using little energy
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10
Q

Transmission of Body Weight at Hip

A
  • weight is transmitted from lumbar to sacral vertebrate then thru os coxae into femoral heads and lower extremities, stable
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11
Q

Forces of Body Weight

A
  • descending forces: body weight above sacroiliac joint, weight transmitted to sacrum
  • sacroiliac joint doesn’t move and is very strong
  • body weight transmitted to sacrum -> SI joint -> os coxae -> lunate surface of acetabulum -> femur head
  • upward forces: antigravity, lower extremities pushing us up
  • balance of forces makes good amount of weight resting and balanced on hip joints
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12
Q

acetabulum

A
  • socket for the head of the femur
  • on lateral side of os coxae
  • like a cup
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13
Q

Pelvic Bones: Males vs Females

A

Males:
-adapted for bipedal locomotion (hunting and fighting)
-iliac crests are higher, pelvis looks taller
-sacrum longer
-sacral promontory more prominent
-ischial spine is more projected
-coccyx extends more down and forward
-pelvis is more heart shaped and narrower
-pubic arch is acute angle, V-shaped
Females:
-adapted for child birth
-illiac crests are shorter, pelvis looks shorter
-sacrum shorter
-pelvis is more circular and wider
-pubic arch is obtuse angle, U-shape (broader)
-smoother bones
-acetabula is smaller and farther apart -> broad hips

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14
Q

Normal vs. Anomaly

A
  • bell shaped curve for most human structures and systems
  • normal: has broad range with variations
  • anomaly: outside of normal
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15
Q

sacral promontory

A

most anterior projection of sacrum

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16
Q

sacroilliac joint/ligament

A
  • where the auricular surface of ilium meets the auricular surface of sacrum, fits together
  • at joints/ligaments have roughened surfaces to increase the surface area for attachment of ligament or muscles through ligament
  • bone modifies itself to accommodate to action of muscle
  • where transition of weight occurs from spine/sacrum to pelvis
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17
Q

iliac crest

A

-most superior portion of ilium

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18
Q

ala

A
  • wing on lateral surface of ox coxae

- bowl for false pelvis

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19
Q

anterior superior iliac spine

A
  • anterior protrusions of inferior end of iliac crest

- important for palpating

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20
Q

iliac fossa

A
  • on medial surface of os coxae

- origin of iliacus muscle (fills in cup)

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21
Q

arcuate line of ilium

A
  • where ilium and pubis meet
  • buttress that gives pelvis and pelvic brim extra structural integrity
  • also merges with pectineal line
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22
Q

iliac tuberosity

A

-site of attachment for sacroiliac ligament

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23
Q

posterior superior iliac spine

A
  • important landmark for palpation
  • create back dimples, skin attachments to PSIS
  • if uneven or in different places, the pelvis is tilted and produces shortened leg
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24
Q

Gluteal Lines

A
  1. Anterior
  2. Inferior
  3. Posterior
    - spaces between lines provide gluteal muscle attachment
    - gluteus minimus in between anterior and inferior line, adductor of hip
    - gluteus medius in between anterior and posterior line, adductor of hip
    - gluteus maximus is below posterior line, extensor of hip
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25
Q

Ischial Spine

A

-projects posteriorly on medial surface

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26
Q

Greater Sciatic Notch

A
  • becomes greater sciatic foramen

- above ischial spine

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27
Q

obturator foramen

A
  • ischial ramus and inferior pubic ramus come together to form this
  • lightens up pelvis
  • some of the muscles that externally rotate the hip have origins inside the pelvis and pass out through obturator foramen
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28
Q

ischial tuberosity

A
  • rough surface

- holds weight when sitting down

29
Q

sacroiliac synovial joint

A
  • synovial anteriorly
  • fibrous posteriorly
  • forms a boney interlocking mechanism reinforced by ligaments to absorb twisting movements
  • sacral surface has hyaline cartilage and ilial surface has fibrocartilage
30
Q

inguinal ligament

A
  • distinction between abdomen above and thigh below it

- it attaches to ASIS superior and laterally and pubic tubercle inferiorly and medially

31
Q

anterior SI ligament

A
  • injured most often because of thin structure
  • not that strong
  • attaches sacrum to ilium
32
Q

sacrospinous ligament

A

along with sacrotuberous, it opposes forward tilting of sacrum on os coxa during weight bearing, strong, turns greater sciatic notch into greater sciatic foramen

33
Q

sacrotuberous ligament

A
  • blends with posterior SI ligament
  • stabilizes against nutation of sacrum and counteracts against posterior and superior migration of sacrum during weight bearing
34
Q

posterior sacroiliac ligament

A

-very strong and tough
-nutation (anterior motion of sacrum) loosens ligament
-counternutation (posterior motion) will make ligament tight
palpated below PSIS

35
Q

interosseus sacroiliac ligament

A
  • forms major connection between sacrum and os coxa
  • strong and short ligament that is deep to posterior sacroiliac ligament
  • resists anterior and inferior movement of sacrum
  • stronger than bone
36
Q

Tests of Slight Movement

A
  • bony movements or palpations to provoke pain in same quality and location that they feel before
  • 3 or more positive provocation tests that provoke pain to diagnose correctly
37
Q

FABER

A

positive test occurs when groin pain or butt pain produced

38
Q

Compression

A
  • stresses posterior SI ligament (push together)
  • increased feeling of pressure
  • positive result replicates patients symptoms
39
Q

Thigh Thrust

A
  • produces shear force at SI, patient tries to resist

- positive test for pelvic girdle pain if axial pressure provokes pain on SI joint

40
Q

Distraction/Gapping

A
  • stresses anterior SI ligament

- pull apart, SIJ dysfunction

41
Q

Gaenslen

A
  • extends one SI and flexes othe SI; simultaneously stresses both SI joints
  • push one leg against chest and push other down on table
42
Q

acetabular fossa

A
  • deepest portion of acetabulum
  • not articular
  • not weight bearing in hip joint
43
Q

lunate surface

A
  • crescent moon shaped
  • thick, elevated, dense, bigger portion of acetabular fossa
  • articular surface
  • hyaline cartilage lays on surface
  • receives weight bearing
44
Q

acetabular rim

A

-large and sharp compared to shoulder

45
Q

acetabular notch

A
  • inferior part of acetabular fossa

- no more ridge

46
Q

labrum

A

-cartilaginous ring on acetabular ring that deepens hip socket (acetabular fossa)

47
Q

ligament of head of femur

A
  • pathway of access of blood and nerve to head of femur
  • only vascular supply to femur, scary injury
  • attaches from Fovea of the head to acetabular notch and tranverse acetabular ligament
  • limits adduction (minimally)
48
Q

hip joint

A

synovial ball and socket join between acetabulum and head of femur

49
Q

transverse acetabular ligament

A
  • layer that closes off acetabular notch

- creates acetabular foramen to allow head of femur to pass through

50
Q

femoral head

A
  • about 2/3 of sphere
  • fits into acetabular socket tightly
  • covered by hyaline cartilage, cartilage is thicker superiorly because it rubs againsts lunate cartilage
51
Q

Capsule

A
  • attaches to acetabular labrum, surrounding bone and transverse acetabular ligament
  • tough, strengthened by accessory ligaments that give stability to joint
  • capsule is attached distally to intertrochanteric line and intertrochanteric crest (elevated ridges) of femur
52
Q

Iliofemoral ligament

A
  • important support ligament of hip joint
  • anterior view of os coxa and femur
  • attaches to lateral surface of ischium and extends down on proximal surface on intertrochanteric line of femur
  • inverted shape of Y
  • spiral path of fibers from AIIS to intertrochanteric line
53
Q

pubofemoral ligament

A
  • comes from pubis and blends with interfemoral ligament

- resists/limits abduction

54
Q

ischiofemoral ligament

A
  • important support ligament of hip joint
  • comes from posterior ischial acetabulum, spirals anteriorly over femoral head and attaches to superior part of femoral neck
  • posteroinferior part of capsule is not reinforced with ligaments-weak spot, femur pushed posteriorly in injuries/car accidents
55
Q

iliofemoral ligament function

A
  • screw down mechanism: standing erect we have tightening of ligaments and squeeze head of femur deeper into acetabulum
  • hyperextension of hip screws head tightly into fossa and creates strong stability
  • tight in extension to balance forward roll on hip joint
56
Q

ischiofemoral ligament function

A
  • screw down mechanism

- tightest in hyperextension

57
Q

nutation

A
  • anterior pelvic tilt
  • nodding forward
  • interosseous sacroiliac ligament acts as axis through pelvis
  • forward moving and lowering of sacral promontory and backward/elevation of tip of coccyx
  • opens pelvic outlet and spreads pubic symphysis
58
Q

counternutation

A
  • posterior pelvic tilt
  • coccyx forward and backward/elevation of sacral promontory
  • closes pelvic outlet and increase pelvic outlet
59
Q

Anterior Tilt

A

-contract back extensors and hip flexors

60
Q

Posterior Tilt

A

-contract hamstrings posteriorly and erector abdominis anteriorally

61
Q

Muscle Balance

A

anterior and posterior tilts are balanced,

-anteior, inferior muscles are balanced with poster, superior muscles

62
Q

Muscle Balance

A
  • if abs and hamstrings are stretched out and weak and hip flexors and back extensors are strong but tight
  • See LEcture 2 slide 24
  • strong muscles pull pelvic toward it and produces pathological pelvic tilt
63
Q

leg length discrepancy

A
  • pelvic tilt occurs in lateral plane
  • tilted to one side of the body
  • produces compensatory skuliosis, curve of spine
64
Q

Center of gravity in Posture

A

-passes posterior to hip joint, increasing the tendency for pelvis to roll backwards (hyperextend), stable with no energy expedenture
- hip ligaments screw down mech forcing femoral head deeper in acetabulum
- hip, knee, and ankle are all close packed at full extension
which stabilizes lower extremity and allows weight bearing with minimal energy expense

65
Q

Unbalanced Posture: Lordosis

A
  • increased anterior lumbar curve from neutral
  • deep curve in lumbar spine
  • anterior pelvic tilt
66
Q

Unbalanced Posture: Kyphosis

A
  • increased posterior thoracic curve
  • humpback
  • head and lumbar spine is thrust forward
  • thoracic spine thrust back
  • neutral pelvis
  • knee joint hyperextended
67
Q

Unbalanced Posture: Flat Back/Sway Back

A
  • decreased anterior lumbar curve (flat back)
  • posterior pelvic tilt
  • head and neck forward
68
Q

Proper Posture

A

-rectus abdominis pull up on pubis and hamstring pull down on ilium and ischium to initiate posterior rotation (extension) for screw down mech

Anatomy (8 decks)

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