Sacral Review: Joy Lecture Flashcards
List the major anterior sacral anatomic landmarks
Sacral base
sacral promontory
sacral apex
List the major sacral posterior anatomic landmarks
Inferior lateral angle
coccyx
The _____ is the lowest part of the spinal column, four vertebra, some fused, some not.
coccyx
________ ______ separate adjacent sacral segments. These fuse sequentially after puberty, beginning with the lowest segments and working up.
Epiphyseal plates
What are the bony articulations of the sacrum?
The fifth lumbar vertebrae superiorly
the coccyx inferiorly
two os coxae (innominates) through the SI articulations
True/False: After puberty females have more well developed and strong SIJ ligaments
False: men do, females need them to be mobile for childbirth… yikes.
What is added to the iliac surface in the second decade of life that becomes further pronounced into the third decade, limiting mobility of the joint?
Crescent shaped ridge develops along the iliac surface that interdigitates with a depression on the sacral side
What type of joint is the SI joint?
Diarthroidal
The ______ ______ is Anteriorly smooth, Posteriorly fibrous, giving
ligaments, and has Fibrocartilage
Iliac surface
Which surface of the sacrum is being described:
generally smooth
hyaline cartilage
decreases in width interiorly and is wedged between the two ilia
Sacral surface
This ligament is made up of Inferior fibers, from the third and fourth sacral segments, ascend to the PSIS and posterior end of the internal lip of the iliac crest.
Posterior sacroiliac ligament
This ligament Connects the third sacral segment to the lateral side of the pre-auricular sulcus
anterior sacroiliac ligament
This ligament connects the PSIS to the lateral aspect of the third and fourth sacral ligaments
Long dorsal SI ligament
This ligament becomes stretched when the sacrum is rotated in a posterior manner relative to the ilium (counternutation), as in:
• The early stages of pregnancy
• Aging & degenerative changes
• Backward torsions or unilateral/bilateral sacral extensions
Long dorsal SI ligament
This ligament
Runs from lower sacral tubercles to ischial tuberosity
Gluteus maximus attachment
Tendon of the biceps femoris attachment
Connects with fascia of the pelvis
STL
This ligament
goes from ischial spine to lateral margins of the sacrum where it blends with the sacrotuberous ligament
Forms part of the origin from which coccygeus muscle arises
Sacrospinous
Which two ligaments serve to stabilize the limit of the posterior-superior rotation of the sacral apex around a transverse axis?
Sacrospinous and sacrotuberous
________ hypertonicity can cause ______. Evidence indicates that this may not be due to pressure, but to a chemical reaction that irritates peroneal fibers of the sciatic nerve. For this reason, there is referred pain down the posterior thigh.
Piriformis
sciatica
What are the posterior pelvic landmarks that are used to diagnose an SD?
PSIS AIIS ILA L5 SP and TP Sacral sulci
Differentiate between form and force closure of the self locking mechanism of the sacrum
Form closure is simply how everything articulates with each other, how the bones connect
Force closure is the effect of the muscles, and the loading forces that are present from the body
What are the posterior belt like effect muscles?
Latisimus dorsi, the thoracolumbar fascia, gluteus maximus, and the ITB.
What are the ventral SI belt like muscles?
abdominal obliques, the linea alba, and the transverse abdominals.
How are the oblique axes named in regards to the sacrum?
Named according to the side of the body toward which the superior end of the oblique axis is located.
The ____ _______ ______ is a transverse axis about which the sacrum moves during the respiratory cycle and inherently due to PRM in OCMM. It passes from side to side through the articular processes posterior to the point of attachment of the dura at S2.
Superior Transverse (REspiratory) Axis
The _____ ______ ______ axis is functional transverse axis of nutation & counternutation in the standing position, passing through the anterior aspect of S2.
Middle Transverse (Postural) axis
The _______ _______ ______ is the functional transverse axis at the level of S3 through the inferior auricular surface, and represents the axis for movement of the ilia on the sacrum.
IT (Pelvic/ilial) axis
What movements (lumbar and sacral) are being described here?
As the posterior structures of the lumbar spine move anteriorly, the sacral base moves posteriorly (apex anteriorly).
Lumbar flexion and sacral extension
What movements (lumbar and sacral) are being described here?
As the posterior structures of the lumbar spine move posteriorly, the sacral base moves anteriorly (apex posteriorly).
Lumbar extension and sacral flexion
In sacral extension, the base tips _____ and the apex moves _____
posteriorly
anteriorly
Describe sacral flexion
Base Tips Anteriorly
Apex Moves Posteriorly
All of the movements of the sacrum on the ilium are ______ movements.
gliding
Rotation applied through the lumbar spine causes the sacrum to rotate towards the _______ side and sidebends towards the _______side.
ipsilateral
contralateral
Sidebending applied through the lumbar spine causes the sacrum to sidebend towards the ______side…rotation direction during sidebending may be inconsistent.
ipsilateral
The ilium always moves in the _____ direction of the sacrum
SAME
________ is A transitional segment in which the first sacral segment becomes like an additional lumbar vertebra articulating with the second sacral segment.
lumbarization
_______ is an Incomplete separation and differentiation of the fifth lumbar vertebra (L5) such that it takes on characteristics of a sacral vertebra.
sacralization
