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OS Exam II > sacrum 1 > Flashcards

sacrum 1 Flashcards

1
Q

what is the coccyx

A

lowest part of the spinal column w four vertebra, some fused, some not.

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2
Q

The sacrumisformed by the union of _____ modified vertebrae (___ossification centers)

A

5

35

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3
Q

what parts. of the ascrum develop within a cartilaginous mode,?

A

costal elements

vertebral arch

centrum

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4
Q

how does the rest of the sacrum develop

A
  1. 2-5. yo: vertebral arch fuses with adjacent costal part.
  2. 8 yo: unite with centrum
  3. After puberty, epiphyseal plates (which seperate sacral segments), fuse sequentially, behingin with the lowest and working up.
  4. Dura will attach at the 2nd sacral segment
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5
Q

how many epipseal plates does each lateral surface have?

A

2

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6
Q

What articulates with sacrum

A

Superiorly: L5

Infeirorly: coccyx

2 ox coxae via SI joints

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7
Q

what. are the sacral joints?

A
  1. Right SI joing
  2. Left SI joint
  3. L5-S1 intervertebral disc
  4. Sacrococcygeal joint
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8
Q

SI Joint Developmental Considerations

After Puberty:

Males:

Females:

A

Males: SIJ ligaments are strong

Females: SIJ ligaments are less developed,to allow for. childbirth

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9
Q

SI joint

2nd decade of life

A

Stability increases and mobility. decerases

because a ceresent. shaped ridge develops on the iliac surface

and it interacts with sacrum

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10
Q

SI joint development

3rd decalde

A

ROM decreases more

crescent shaped ridge becomes more pronounded.

In males, degeneratiion on ilium side

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11
Q

SI joint development

4th and 5th decalde

A

Males: degernation of sacral side

fibrous ankylosis form and limit joint movement.

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12
Q

Shape of SI joint

A

L or. C

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13
Q

SI joint arms

A

Upper arm- short

lower arm- longer

with a junction at S2

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14
Q

type of joint. is SI

A

Diarthroidal

contains synovial fluid + matching articular surfaces.

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15
Q

how is SI joint different. from any other joint?

A

one side is hyaline cartliage (sacral surface)

other side is fibrocartilage (iliac surface)

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16
Q

long dorsal SI L has a close anatomic relationship w/

A
  1. Erector spinae muscle group•
  2. Posterior layer of the thoracolumbar fascia
  3. Sacrotuberous ligament
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17
Q

movement of long dorsal SI L.

A

stretched when the sacrum is rotated in a posterior manner relative to the ilium (counternutation)

  • ex. early. pregnancy,
  • aging and degerative changes,
  • backward torsions or unilarteral/bilateral sacral extension
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18
Q

What stabilizes

to limit the posterior-superior rotation of the sacral apex around a transverse axis.

A

sacrospinous and sacrotuberous L

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19
Q

Sciatic nerve in relationship to the piriformis muscle

A

Sciatica. can be caused by. piriformis hypertonicity d/t chemical reaction that irrates peroneal fibers of sciatic nerve.

Thus, reffered pain down posterior though

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20
Q

___ of causes sciatic n comes out below piriformis

_____ though

A

85%

10%

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21
Q

sacrum has a _________ mechanism. why is this important

A

self-locking mechanism, which is important to prevent SHEARS

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22
Q

self-locking mexhniams of sacrum is d/t what?

A
  1. Form closure- how the joints fit together (properties of the articular surfaces)
  2. Force closure- d/t gravity and loading forces (compression), body, weight, muscles and L and fascia
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23
Q

what does form closure require

A

proper size

shape

and attitude of aritculating surfaces

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24
Q

_____ is the keyston

A

sacrum

25
Q

_________ muscles can affect SI joint stability

A

postural

26
Q

Posterioly, what. postural musles affect SI joint stabilityl

A

lat. dorsi

thoracolumbar fascia

glut max

ITB

27
Q

ventrally, waht. muscles affect SI joint stability

A

abdominal obliques

linea alba

transverse abdominals

28
Q

in STANDING and SITTING, what. muscles are signifant

A

oblique abdominal muscles (internal obliques)

29
Q

How can we help ppl w low back bain and SI syndrome

A

therapeutic excerseize

and osteopathic treatment for the core lumbar and pelvic muscles

30
Q

what. is the motion of the sacrum?

A

move around 1 or more axis

-2 oblique axis named accoriding to te side of the body the superior end is at.

31
Q

Motion about an oblique axis may actually result through motions occurring about a

A

1. vertical AP

2. Transverse sacral axis (rotation and SB combo)

32
Q

what a re the hypothetlical axis of motion of sacrum?

A

1. Superior Transverse (repiratory) axis

2. MT (postural) axis

4. IT (pelvic/iliac) axis

33
Q

What is MT (postural axis)

A

transverse axis of nutation and coutnernutation in the standinng oisution

-anterior aspect of S2

34
Q

IT (pelvic/iliac axis)

A

Transverse axis at S3 and is the axis for moveement of ilia on sacrum

35
Q

what is the relationship between lumbar spine and sacral base?

A

RECIPRICOL RELATIONSJHIP!

  1. Lumbar flexion-> sacral extension (postioer structures of lumbar spine move aneterior, sacral base moves posterior and apex moves anterior)
  2. Lumbar extension -> sacral flexion (as posterior lumbar structures move posterior, sacral base moves anterior)
36
Q

Sacral extension is also called (_________)

Base->

Apex->

A

counternutation

base-> posterior

apex -> anterior

37
Q

what is nutation?

A

sacral flexion

38
Q

what is the principal of sacral motion?

A

all movements of sacrum on ilium are GLIDING movements: flexion, extension, rotation, SB, gliding up and down.

39
Q

Downward force transmitted from the lumbar region glides the sacrum ______ and causes _______.

A

downward

nutation

40
Q

Traction applied from above the LS junction glides the sacrum ______ and causes

A

upward

counternutation

41
Q

Rotation applied through the lumbar spine causes the sacrum to rotate towards the _________ and sidebends towards the _______

A

rotate-> ipsilateral side

SB-> contralateral side

42
Q

Sidebending applied through the lumbar spine causes the sacrum to sidebend towards the ___________ side…

rotation>

A

ipsilateral side

rotation. is inconsistent.

43
Q

Flexion/Extension

gliding Upward/Downward ROM is ___________ than rotation or sidebending.

A

GRESTER

44
Q

dpes the ilium move in the same direction as the sacrum?

A

Yes, but to a lesser degree

45
Q

a restricted inferior occipital condylar part is related to a_______________

A

lowered sacral base on that side.

46
Q

lumbarization

A

first sacral segments acts like lumbar and articulates with second sacral sefment

47
Q

Sacralization

A
  1. L5 does not finish separating and differentiating -> looks liek a. sacral vertebral
  2. TP of L5 are. large -> pseudoarthrosis w sacrum and or ilim; look like a batwing if bilateral
48
Q

lumbarization of S1

A

S1 becomes a 6th lumbar vertebral

S2 acts like sacral base

49
Q

sacralization

A

L5 attaches to sacrum and acts like sacral base

50
Q

facet assumetry. of L4

A

1. Coronal plane facet

2. saggital plane facet

51
Q

partial sacrilization of L5. is called

A

bertolotti

52
Q

what is F spina bifida occula of both Ls. and S

A

L5 laminae. and S1 lamina does not completely fuse

53
Q

what can cause SD of sacrum

A

muscles that. a ttach

L strain and sprain

Strains (interrosseous) may cause structural change

54
Q

MOtion of the sacrum is imp in gait cycle

sacral SD -> LBP and viscerosomatic and somatovisceral reflexes.

A
55
Q

Nutations (flexion) causes stretch in what. L?

A

sacrospinous

sacrotuberous

56
Q

counternutation causes stretches in what?

A

long dorsal SI L

57
Q

what. makes. up pelvic diphramg

A

levator anni mus

obturator internus

pirigirms

ischiococcygeaus

58
Q

what are interrousseus strains

A

develop at time of neural arch, costal elements and body centers fuse

not limited to intervertabral segemnets

OS Exam II (7 decks)

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