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OS II Midterm > Intro to Sacrum DSA > Flashcards

Intro to Sacrum DSA Flashcards

1
Q

What is the coccyx?

A

lowest part of the spinal column, four vertebra (some fused, some not)

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2
Q

How is the sacrum formed?

A

union of 5 modified vertebrae

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3
Q

When does the bony vertebral arch fuse with its adjacent costal part?

A

between years 2 and 5

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4
Q

When do the epiphyseal plates fuse?

A

after puberty, beginning with lowest segments and working up

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5
Q

Where does the dura attach?

A

level of the second sacral segment

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6
Q

What does the sacrum articulate with?

A

5th lumbar vertebra superiorly
coccyx inferiorly
two os coxae through SI articulation

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7
Q

What difference occurs after puberty in males vs females with the SI joint?

A

males SI joint ligaments are well developed and strong, while women’s SI joint ligaments are less developed for child birth

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8
Q

What occurs to the SI joint during the second decade of life?

A

cresent shaped ridge develops along iliac surface that interdigiates with a depression on the sacral side, adding stability and limits mobility

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9
Q

What occurs to the SI joint during the 3rd decade of life?

A

cresent shaped ridge becomes more pronounced, decreasing ROM

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10
Q

What occurs to the SI joint during the 4th and 5th decades of life?

A

males: degenerative changes begin on sacral side

fibrous ankylosis may further limit joint motion

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11
Q

Why is the SI joint described as L or C shaped?

A

contoured with a shorter upper arm and longer lower arm with the junction occurring at S2

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12
Q

Which way does the apex point?

A

anteriorly

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13
Q

What kind of joint is the SI?

A

diarthrodial; contains synovial fluid and matching articular surfaces

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14
Q

How is the SI joint different than any other joint in the body?

A

one side is hyaline cartilage and the other is fibrocartilage

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15
Q

How is the sacral surface described?

A

smooth, hyaline cartilage, decreases in width inferiorly, wedged between the two ilia

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16
Q

How is the iliac surface described?

A

anteriorly smooth, posteriorly fibrous giving rise to interosseous ligaments, fibrocartilage

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17
Q

Describe the posterior sacroiliac ligament

A

inferior fibers from the 3rd and 4th sacral segments
ascends to the PSIS and posterior end of the internal lip of the iliac crest
thicker than anterior SI ligaments

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18
Q

Describe the anterior sacroiliac ligament

A

connects the third sacral segment to the lateral side of the pre-auricular sulcus
iliolumbar ligaments blends

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19
Q

Describe the interosseous sacroiliac ligament

A

major bond between the bones

covered posteriorly by the posterior sacroiliac ligament

20
Q

Long dorsal SI ligament

A

connects PSIS to lateral aspect of the 3rd and 4th sacral segments

21
Q

What is the long dorsal SI ligament in close anatomic relationship with?

A
  • erector spinae muscle group
  • posterior layer of the thoracolumbar fascia
  • sacrotuberous ligament
22
Q

What happens to the long dorsal SI ligament when it is rotated in a posterior manner relative to the ilium?

A
  • becomes stretched

- occurs during early stages of pregnancy, aging and degenerative changes, backward torsions or sacral extensions

23
Q

Anatomy of the sacrospinous ligament

A
  • 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
24
Q

Anatomy of sacrotuberous ligament

A
  • runs from lower sacral tubercles to ischial tuberosity
  • gluteus maximus attachment
  • tendon of the biceps femoris attachment
  • connects with fascia of the pelvis
25
Q

What do the sacrospinous and sacrotuberous do?

A

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

26
Q

Action of the piriformis muscle

A

externally rotate the thigh when the hip joint is extended and abducts the thigh when the hip joint is flexed; assists in holding the femoral head in the acetabulum

27
Q

What is sciatica?

A

irritation of the peroneal fibers of the sciatic nerve which lies in close proximity to the piriformis

28
Q

Define form closure

A

specific properties of the articular surfaces of the SIJ; requires proper size, shape, and attitude of the articulating surfaces

29
Q

Define force closure

A

compression produced by body weight, muscle action, and ligament force

30
Q

What is form closure due to?

A

how the joint fits together

31
Q

What is force closure due to?

A

gravity and loading forces; muscles, fascia, ligaments

32
Q

How are the 2 oblique axes named?

A

according to the side of the body toward which the superior end of the oblique axis is located

33
Q

What happens as the posterior structures of the lumbar spine move anteriorly?

A

the sacral base moves posteriorly, apex anteriorly
Lumbar Flexion
Sacral Extension

34
Q

What happens as the posterior structures of the lumbar spine move posteriorly?

A

the sacral base moves anteriorly, apex posteriorly
Lumbar Extension
Sacral Flexion

35
Q

What are the 4 points to evaluate the sacrum?

A

2 ILAs

2 sacral sulci

36
Q

How do you record motion testing?

A 
N = normal
I = increased motion
R = restricted motion
P = poor motion
37
Q

Where do you direct your force for the load and spring of the sacral sulcus?

A

towards the ipsilateral greater trochanter

38
Q

Where do you direct your force for the load and spring of the ILA?

A

towards the ipsilateral ASIS

39
Q

What kind of movements are all of the movements of the sacrum on the ilium?

A

gliding

40
Q

What does rotation applied through the lumbar spine induce?

A

sacrum to rotate towards the ipsilateral side and sidebend away

41
Q

What does sidebending through the lumbar spine induce?

A

sacrum to sidebend towards ipsilateral side

42
Q

Which has greater ROM, flexion/extension and up/down glide or rotation and sidebending

A

flexion/extension

up/down glide

43
Q

How does the ilium move in relation to the sacrum?

A

same direction, lesser degree

44
Q

When may intraosseous strains originate?

A

during the time the neural arch, costal elements, and body centers are fusing

45
Q

What is a restricted inferior occipital condylar part related to?

A

lowered sacral base on that side

46
Q

Lumbarization

A

a transitional segment becomes like an additional lumbar vertebra articulating with the second sacral segment

47
Q

Sacralization

A

incomplete separation and differentiation of L5 such that it takes on characteristics of a sacral vertebra

OS II Midterm (14 decks)

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