Innominate Flashcards

(75 cards)

1
Q

The result of what 2 forces keep the pubic symphysis together?

A

Strong posterior ligaments

Articulation at SI joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 major significant pelvic structures influencing lower extremity circulation and drainage?

A

Pelvic diaphragm

Inguinal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The ______ is the area of the pelvis composed of bone from 3 different ossification centers

A

Acetabulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anterior pelvic landmarks

A
Iliac crest
ASIS
AIIS
Ischial tuberosity
Pubic symphysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Posterior pelvic landmarks

A

PSIS
PIIS
Inferior lateral angle (ILA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Major joints of the pelvis

A

SI joint
Acetabulum
Pubic symphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the difference between true ligaments and accessory ligaments?

A

True ligaments go from bone to bone

Accessory ligaments attach at another ligament, a tendon, or other fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Major functions of ligaments

A

Limit abnormal or excessive movements at a joint

Permit normal motion

Quality is slightly elastic

Prevent excessive movement as part of reflex response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Major anterior pelvic ligaments

A

Sacrospinous ligament

Iliolumbar ligament

Anterior sacroiliac ligament

Inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Major posterior pelvic ligaments

A

Sacrotuberous ligament

Posterior sacroiliac ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which ligament connects the ASIS to the superior pubic rami?

A

Inguinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which ligament goes from ilia to L5?

A

Iliolumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which ligaments cover much of the sacroiliac joints?

A

Anterior and posterior sacroiliac ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which ligament goes from sacrum to spine of ischium?

A

Sacrospinous ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which ligament goes from sacrum to ischial tuberosity?

A

Sacrotuberous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The sacrospinous ligament goes from the ischial spine to lateral margins of sacrum where it blends with the ______ ligament. It forms part of the origin from which the _____ muscle arises

A

Sacrotuberous; coccygeus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The sacrotuberous ligament runs from lower sacral tubercles to the ischial tuberosity and acts as an attachment for the _____ ____ m. as well as the tendon of the ____ ______. It connects with the fascia of the pelvis.

A

Gluteus maximus

Biceps femoris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Primary functions of iliolumbar ligament

A

Stabilizes anterior motion of lower lumbar spine

Restricts anterior and rotary motion of L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The iliolumbar ligament blends with the upper part of what ligament?

A

Anterior SI ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The inguinal ligament gives origin to what 2 muscles?

A

Internal oblique m

Transversus abdominis m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which thick pelvic ligament prevents the sacrum from “popping” out anteriorly?

A

Anterior SI ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The posterior SI ligament blends with the ________ligament and ______ fascia

A

Sacrotuberous; thoracolumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What pelvic ligament forms the major bond between the pelvic bones, filling the irregular space posterosuperior to the joint and is covered posteriorly by the posterior SI ligament?

A

Interosseous sacroiliac ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The pubic symphysis lies anteriorly between adjacent surfaces of pubic bones. Each joint surface is covered by _____ cartilage and is linked across midline to adjacent surfaces by _______.

The joint is surrounded by interwoven layers of _____ fibers

A

Hyaline; fibrocartilage

Collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the 2 major ligaments associated with the pubic symphysis?
Superior pubic ligament Inferior pubic ligament
26
During right heel strike, the right leg glides forward and is aided by the right innominate rotating ________ The contralateral innominate rotates ________
Posteriorly Anteriorly
27
During heel strike, the ______ and ______ contract to flex the lower extremity at the hip. _______ contraction and motion of the swing phase both act upon the innominate to cause posterior rotation on the respective side of the heel strike
Iliopsoas; quadriceps femoris Iliopsoas
28
During right sided toe-off, the body does a controlled fall forward with the left leg gliding forward and ______ rotation of the innominate is mainly a passive process Contralateral innominate rotates ______, mainly an active process
Anterior Posterior
29
During toe-off, the ______ elongates, allowing anterior rotation of the innominate with _______ and _______ contraction to extend the lower extremity at the hip Ipsilateral ______ and ______ contraction aid anterior innominate rotation
Iliopsoas; gluteus maximus; hamstring Erector spinae; quadratus lumborum
30
4 hip flexors (2 major, 2 minor)
Major = iliacus, psoas Minor = rectus femoris, sartorius
31
2 major hip extensors
Gluteus maximus | Hamstrings (biceps femoris+semitendinosus+semimembranosus)
32
Dysfunction of the rectus femoris, the iliacus, or the ipsilateral adductor group may cause ______ rotation of the innominate and/or ______ shear at the pubis
Anterior; inferior
33
Hamstring tension may cause a ______ rotation of the innominate and affect pelvic mechanics
Posterior
34
5 hip adductors (3 major, 2 minor)
Major = adductor magnus, adductor brevis, adductor longus Minor = gracilis, pectineus
35
3 hip abductors
Gluteus medius Gluteus minimus Tensor fascia lata
36
Major hip external rotator
Piriformis
37
Abnormal gait caused by weakness of the abductor muscles of the lower limb, gluteus medius, and gluteus minimus, which are supplied by superior gluteal n.
Trendelenburg gait
38
Positive trendelenburg’s sign
Drop of pelvis when lifting leg opposite to weak gluteus medius
39
What is the only hip rotator that connects directly to the sacrum?
Piriformis
40
Contraction of the piriformis may compress a certain nerve causing what condition?
Sciatica
41
3 major plexus associated with innominate
Lumbar plexus (L1-4) Sacral plexus (L5-S4) Coccygeal plexus (S5-coccygeal n.)
42
Major ganglia associated with innominate function
Inferior mesenteric ganglion Superior hypogastric ganglion
43
Dysfunction of the ________ muscle may produce symptoms similar to a groin pull or hernia, by irritating the ilioinguinal and iliohypogastric nerves (L1) as they pass just anterior to it
Quadratus lumborum
44
The sacrospinous ligament divides what 2 pelvic foramina?
Greater sciatic foramen Lesser sciatic foramen
45
What are the anatomical landmarks used to assess posture using the gravitational line?
``` Auditory meatus Acromion process Greater trochanter Lateral condyle of knee Lateral malleolus ```
46
Potential problems/SD’s that occur at pelvis
Rotation Shear Flare Pubic bone dysfunction
47
Anterior palpatory landmarks used for innominate SD
Iliac crests ASIS Pubic tubercles Medial malleoli heights
48
The pubic tubercles are used specifically to diagnose what type of pelvis SD?
Pubic subluxation
49
Ischial tuberosity’s are used in diagnosis of what specific type of pelvic SD?
“Small hemipelvis”
50
Posterior palpatory landmarks used for innominate SD
PSIS | Ischial tuberosity’s
51
Lateralization tests used for innominate SD’s
ASIS compression test (indicates SI joint dysfunction on the side of restricted motion) Standing flexion test (indicates SI joint dysfunction on the side that elevates first)
52
What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate is anteriorly rotated?
ASIS inferior PSIS superior Iliac crest level Medial malleolus inferior (long)
53
What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate is posteriorly rotated?
ASIS superior PSIS inferior Iliac crest level Medial malleolus is superior (short)
54
What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate has superior shear?
ASIS superior PSIS superior Iliac crest superior Medial malleolus superior (short)
55
What changes occur in the ASIS, PSIS, iliac crest, and medial malleolus when the innominate has inferior shear?
ASIS inferior PSIS inferior Iliac crest inferior Medial malleolus inferior (long)
56
How do you assess for innominate inflare or outflare? How do you know which side is affected?
Measure for inflare/outflare from midline to each ASIS Lateralization test defines side with SD (SD side displays smaller distance from ASIS to midline for inflare, the opposite for outflare)
57
How do you assess for pubic shear? How do you know which side is affected?
Measured by palpating the superior aspect of pubic ramus Lateralization test defines side with SD
58
Describe a positive trendelenburg test
Pelvis on unsupported side drops Indicates gluteus medius weakness on the side of the stance leg
59
Describe a positive thomas test
Inability to fully extend at hip Indicates psoas (hip flexor) tightness/contracture
60
Describe a positive ober test
Leg will not fully adduct, OR cannot easily press down on the leg Indicates IT band contracture
61
Osteopathic evaluation of innominate - steps
Standing flexion test OR ASIS compression test to determine side of dysfunction Evaluate for rotations and/or shears: PSIS height, ASIS height, Iliac crest height, medial malleoli height Evaluate for inflares/outflares: ASIS to midline Evaluate for pubic dysfunction: pubic tubercles
62
Positive standing flexion test
One PSIS moves further superiorly Indicates SI joint dysfunction on the side that elevates first
63
Positive ASIS compression test
Hard end feel or restriction of motion on one side Indicates SI joint dysfunction on the side of restricted motion
64
What must you always do prior to supine evaluation of the innominate?
“Reset” hips
65
Diagnose: Standing flexion positive on side of dysfunction PSIS heights: superior on side of dysfunction ASIS heights: inferior on side of dysfunction Malleoli: inferior (long) on side of dysfunction Iliac crest heights: even
Anterior innominate rotation
66
Diagnose: Standing flexion positive on side of dysfunction PSIS heights: inferior on side of dysfunction ASIS heights: superior on side of dysfunction Malleoli: superior (short) on side of dysfunction Iliac crest heights: even
Posterior innominate rotation
67
Diagnose: Standing flexion positive on side of dysfunction PSIS heights: superior on side of dysfunction ASIS heights: superior on side of dysfunction Malleoli: superior on side of dysfunction Iliac crest heights: superior on side of dysfunction
Superior innominate shear
68
Diagnose: Standing flexion positive on side of dysfunction PSIS heights: inferior in side of dysfunction ASIS heights: inferior in side of dysfunction Malleoli: inferior on side of dysfunction Iliac crest heights: inferior on side of dysfunction
Inferior innominate shear
69
Diagnose: Standing flexion + on side of dysfunction ASIS to midline longer on side of dysfunction
Outflare of innominate
70
Diagnose: Standing flexion + on side of dysfunction ASIS to midline shorter on side of dysfunction
Inflare of innominate
71
Which of the following often presents as tenderness over the pubic rami and pubic symphysis? A. Superior pubic shear B. Inferior pubic shear C. Pubic compression D. Pubic subluxation
C. Pubic compression
72
Which of the following often occurs after childbirth, pelvic fracture, or trauma to the pelvis and is very painful? A. Superior pubic shear B. Inferior pubic shear C. Pubic compression D. Pubic subluxation
D. Pubic subluxation
73
What is the restrictive barrier engaged by anterior innominate SD MET?
Hip flexion
74
What is the restrictive barrier engaged by posterior innominate SD MET?
Hip extension
75
What is the common step in the setup for inferior or superior innominate shear MET?
Internally rotate and abduct the leg