Innominate

Question 1

What does the pelvis play a critical role in (4)?

Answer 1

• foundation for body support and movement
• reproduction (genital structures)
• elimination (GI and GU)
• vascular and lymphathic functions

Question 2

What are the 3 bones of the innominate?

Answer 2

ilium, pubis, and ischium

Question 3

What is the acetabulum?

Answer 3

where the 3 bones of the innominate (ilium, pubis, and ischium) fuse together

Question 4

Name 4 anterior landmarks of the innominate

Answer 4

iliac crest, ASIS, AIIS, and pubic symphysis

Question 5

Name 3 posterior landmarks of the innominate

Answer 5

PSIS, PIIS, ischial tuberosity

Question 6

True ligaments vs accessory ligaments

Answer 6

• true ligaments: go from bone to bone

- accessory ligaments: attache to another ligament, tendon, or fascia

Question 7

Sacrospinous L attachment

Answer 7

sacrum to spine of ischium

Question 8

Iliolumbar L attachment

Answer 8

from ilia to 5th lumbar vertebrae

Question 9

Anterior Sacroiliac L attachment

Answer 9

covers much of the sacroiliac joint

Question 10

Inguinal L attachement

Answer 10

ASIS to superior pubic rami

Question 11

Sacrotuberous L (STL) attachement

Answer 11

sacrum to ischial tuberosity

Question 12

Posterior Sacroiliac L attachement

Answer 12

covers much of the sacroiliac joint

Question 13

What are the 3 joints of the pelvis?

Answer 13

• sacroiliac joint
• acetabulum (hip joint)
• pubic symphysis

Question 14

Interosseous Sacroiliac L location. What covers it as well?

Answer 14

• major bond between bones and fills irregular space posterosuperior to the joint
• covered posteriorly by posterior sacroiliac L.

Question 15

What are the 2 major ligaments associated w/ the pubic symphysis?

Answer 15

superior and inferior pubic Ls. - located above and below the joint

Question 16

Which direction does innominate move when you step forward (heel strike)? What does the contralateral innominate do?

Answer 16

Innominate moves posteriorly; contralateral inanimate moves anteriorly

Question 17

What 2 muscles are involved in flexing the LE at the hip?

Answer 17

iliopsoas M. and Quadratus femoris M.

Question 18

What 2 muscles are involved in extending the LE at the hip?

Answer 18

gluteus maximus M. and hamstring M.

Question 19

Name 2 major and 2 minor hip flexors and where they act at

Answer 19

• iliacus M. (major - hip)
• psoas M. (major - hip)
• rectus femoris M. (minor - knee)
• sartorius M. (minor - knee)

Question 20

Name 4 hip extensors

Answer 20

• gluteus maximus M.
• Biceps femoris M. (hamstring)
• Semitendinosis M. (hamstring)
• Semimembranosis M. (hamstring)

Question 21

Name 3 major and 2 minor hip adductors

Answer 21

• Adductor magnus M. (major)
• Adductor brevis M. (major)
• Adductor longus M. (major)
• Gracilis M. (minor)
• Pectineus M. (minor)

Question 22

Name 3 hip abductors

Answer 22

• Gluteus medius M.
• Gluteus minimus M.
• Tensor fascia lata M.

Question 23

What is trendelenburg sign testing? What does a positive test look like?

Answer 23

• testing the strength of a pt’s hip abductors (mainly gluteus medius M.)
• Positive test: pelvis drops when pt’s lifts foot off ground -> opposite gluteus medius M. is weak

Question 24

Name 6 hip external rotators

Answer 24

• piriformis M.
• Obturator externus M.
• Obturator internus M.
• Superior gemelli M.
• Inferior gemelli M.
• Quadratus femoris M.

Question 25

What may an abnormally contract piriformis M. cause?

Answer 25

sciatica - may impinge sciatic N.

Question 26

Where does the piriformis directly connect to? What 2 functions can it possibly have?

Answer 26

- connects directly to sacrum (only rotator that does) - abductor: when hip is flexed - external rotator: when hip is extended

Question 27

Name 5 secondary muscles w/ partial attachment to the innominate

Answer 27

- rectus abdominis M. - transversus abdominis M. - Internal oblique M. - External oblique M. - Quadratus lumborum M.

Question 28

What levels make the the following plexuses: lumbar, sacral, and coccygeal?

Answer 28

- lumbar plexus: L1-L4 - Sacral plexus: L5-S4 - Coccygeal plexus: S5-coccygeal N.

Question 29

What can quadratus lumborum SD cause?

Answer 29

sxs similar to a groin pull or hernia due to irritation of the ilioinguinal and iliohypogastric Ns. (L1) as they pass anterior to it

Question 30

What L forms the greater sciatic foramen?

Answer 30

Sacrospinous L.

Question 31

Name the 10 structures that exit out of the greater sciatic foramen

Answer 31

- superior/inferior gluteal Ns and As - Piriformis M. - Sciatic N. - Posterior femoral cutaneous N. - PIN structures ( pudendal N., internal pudendal A, and Nerve to obturator internus/superior gemellus Ms.)

Question 32

What L forms the lesser sciatic foramen?

Answer 32

Sacrotuberous L.

Question 33

Name the 3 structures that enter the foramen and the 1 that exits it

Answer 33

- PIN structures ( pudendal N., internal pudendal A, and Nerve to obturator internus/superior gemellus Ms.) - enters - Obturator internus M. (exits)

Question 34

What 7 structures make up the gravitational line?

Answer 34

- auditory meatus - acromion process - greater trochanter - body of L3 - anterior 1/3 of sacrum - lateral condyle of knee - lateral malleolus

Question 35

What 2 tests do you use to determine the side of pelvic dysfunction?

Answer 35

- lateralization tests: standing flexion and ASIS compression

Question 36

What landmarks should you palpate to determine pelvic dysfunction?

Answer 36

- iliac crest - ASIS - pubic tubercles - PSIS - medial malleoli

Question 37

How would you perform a standing flexion test?

Answer 37

- pt stands w/ you behind them at the level of the PSIS - contact inferior aspect of PSIS bilaterally and ask pt to bend forward - Positive if one PSIS moves farther up (that is the dysfunctional side - SI joint dysfunction)

Question 38

How would you perform an ASIS compression test?

Answer 38

- pt supine - contact ASIS bilaterally and push toward the table (posterior and medial) alternating between sides - Positive if there is restriction of motion or a hard end feel on one side

Question 39

Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ an anterior innominate rotation

Answer 39

- ASIS inferior - PSIS superior - iliac crest is level - medial malleolus inferior (leg longer)

Question 40

Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a posterior innominate rotation

Answer 40

- ASIS superior - PSIS inferior - iliac crest is level - medial malleolus superior (leg shorter)

Question 41

Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a superior innominate shear

Answer 41

- ASIS superior - PSIS superior - iliac crest superior - medial malleolus superior (shorter leg)

Question 42

Describe location of ASIS, PSIS, iliac crest, and medial malleolus w/ a inferior innominate shear

Answer 42

- ASIS inferior - PSIS inferior - iliac crest inferior - medial malleolus inferior (longer leg)

Question 43

Where do you measure for an inflare/outflare of the pelvis?

Answer 43

measure from the midline (umbilicus) to each ASIS

Question 44

How do you determine the side of the dysfunction w/ an inflare/outflare?

Answer 44

- lateralization tests define side of SD - Inflare: SD side displays a smaller distance from ASIS to midline - Outflare: SD side displays larger distance from ASIS to midline

Question 45

What should you palpate to look for pubic shears?

Answer 45

palpate the superior aspect of the pubic ramus (pubic tubercles)