Pelvis I

Question 1

What are the bony landmarks of the Sacrum?

Answer 1

Ischial tuberosities
Ischial spines
Pubic tubercle
Iliac Crests
ASIS
AIIS

Question 2

What are the gender differences between male and females in terms of false pelvis, pelvic inlet, inlet to toutlet, pelvic outlet, ischial tubes, sacrum, innominates and pubic symphysis?

Answer 2

false pelvis: Deeper (m); Shallow (f)
pelvic inletL Heart-shaped (m); oval (f)
inlet to outlet: longer (m); shorter (f)
pelvic outlet: smaller (m): larger (f)
ischial tubes: inverted (m); everted (f)
sacrum: narow, long (m); wider, shorter (f)
innominates: narrow (m); wide (f)
pubic symphysis: higher/cranial (m); lower/caudal (f)

Question 3

What is the most common female type of pelvis and male type of pelvis?

Answer 3

Gynecoid = Most common female pelvis (AP = transverse)

Android = most common male type (heart shaped)

Question 4

What are the intrinsic and extrinsic joints of the pelvis? What type of joint is it?

Answer 4

Intrinsic joints:

• pubic symphysis fibrocartilaginous joint
• sacroiliac joints = synovial joint

Extrinsic joints:

• lumbosacral junction = intervertebral articulation
• hip joints/Acetabulum = synovial ball-and-socket

Question 5

What ligaments attach to the pelvis (true pelvis ligaments, accessory pelvis ligaments, etc..)?

Answer 5

True pelvis ligaments
–Anterior sacroiliac
–Posterior sacroiliac
–Interosseus sacroiliac

Accessory pelvis ligaments
–Iliolumbar
–Sacrotuberous
–Sacrospinous

Inguinal ligament

Question 6

What is the function of the iliolumbar ligament?

Answer 6

Stabilizes the anterior motion of L5 and limits rotation (connects L5 to ilia)

Question 7

What is the function of the sacrospinous ligament?

Answer 7

stabilizes the sacrum to prevent Anterior rotation of the sacrum around a transverse axis

Question 8

What is the function of the sacrotuberous ligament?

Answer 8

stabilizes the sacrum to prevent Anterior rotation of the sacrum around a transverse axis.

Question 9

True/False: There are muscles specific for movement of the sacroiliac joints.

Answer 9

False: There are NO muscles specific for movement of the sacroiliac joints; as motion there results from actions of muscles that function to move the back or legs.

Question 10

What are the extrinsic pelvic muscles?

Answer 10

Abdominals (rectus abdominis)
Erector spinae
quadratus lumborum
gluteal muscles
Hip flexors, extensors, abductors, adductors (influence pelvic motion)

Question 11

What is the major hip flexor?

Answer 11

Iliopsoas muscle (comprised of iliacus and psoas)

Question 12

What muscles are hip extensors? Which one is the strongest extensor?

Answer 12

Hamstrings (semimembranosus & semitendonosus & Biceps femoris).

Gluteus maximus

Question 13

What muscles are hip adductors? Where do they attach?

Answer 13

Adductor Magnus
Adductor Brevis
Adductor Longus
Gracilis & Pectineus

All attach to the pubic ramus and the medial and/or posterior femur

Question 14

What are major hip abductors? What is special of the abductors?

Answer 14

gluteus medius and gluteus minimus muscles.

Both have a few anterior fibers that depending on the position of the leg can internally and externally rotate the thigh.

Question 15

What is the major hip external rotator? Are there any other muscles that externally rotate the hip?

Answer 15

Piriformis and also gluteus maximus (also a hip extensor)

Question 16

What does the pelvis exam include when the patient is standing?

Answer 16

Observation (Static vs. gait)
ASIA
Iliac crest and PSIS
Trochanteric heights
Flexion tests (seated, standing, ilisacral vs. sacroiliac)?

Question 17

What is examinable from the supine position?

Answer 17

ASIS
Iliac crests
medial mallleoli
pubic one

Question 18

What is examinable from the prone position?

Answer 18

PSIS
Ischial tuberosity
Iliac Crests

Question 19

What is the purpose and procedure for a standing flexion test?

Answer 19

Purpose: lateralize dysfunctions to a side. (+) tells us there is a somatic dysfuntions at the SI joint on the side that moves the most..

Procedure: Place thumbs under PSIS and tell the standing patient to touch their toes.

Question 20

What are the possible somatic dysfunctions that could be diagnosed with a standing flexion test?

Answer 20

innominate, pubic, hip muscle imbalance dysfunction

Question 21

What is the purpose and procedure for a AP compression test?

Answer 21

Purpose: lateralize dysfunction of the innominates. (+) tells us there is a somatic dysfunction the side with the most resistance when adding compression.

Procedure: Apply equal compression on ASIS and rotate right and the left to find side of most resistance.