L6.2 Bones & joints of pelvis Flashcards

1
Q

True and false pelvis

A
  • Pelvis divides into true (lesser - which contains the viscera) & false (greater - above the true pelvis) pelvis
    • Iliopectineal line → subdivides false pelvis from true pelvis
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2
Q

Difference between female and male pelvis shape

A
  • Wider and shorter pelvis and have wider pubic arches
  • 50% of females have gynaecoid shaped pelvis
  • 30% of females have android pelvis
    • Narrower, longer & funnel shaped → complications of birth
  • 20% of females have Anthropoid shaped pelvis (ape-like)
    • Or 2% have paltypelloid
  • Most males have android shaped pelvis
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3
Q

Difference between male and female pelvic inlet

A
  • Female pelvis:
    • Wide inlet
    • Ischial spine does not project MED as much
  • Male pelvis
    • Heart shaped inlet
    • Ischial spine projects into MED plane
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4
Q

Line of gravity and pelvic tilt

A
  • Tilt: Pubis becomes INF (in line with lumbosacral joint)
    • Accommodated by changes in the lumbar spine & aligns with center of gravity
  • Females have a greater pelvic tilt (due to lumbar lordosis)
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5
Q

Key features of the Hip bone

A
  • Epiphyseal plate b/w 3 bones at the acetabulum
  • Ilium: contains the obturator foramen (covered by membrane → gives rise to muscles)
  • Ischium: Ischial spine → projected MED may obstruct birth of fetus
  • Pubis: G/L Sciatic notch
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6
Q

Plane: Tip of coccyx to pubis

A

Ovaries located at this plane

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7
Q

Pelvic inlet/outlet shape

A
  • Outlet: Diamond shape (narrower in males)
    • Divides into urogenital triangle and anal triangle
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8
Q

3 different pelvic planes

A
  • Narrow pelvic plane (plane of least dimensions): S4 → INF pubis (where head has to pass)
  • Tip of coccyx to pubis
  • Line of gravity plane: Lumbosacral joint to INF pubis
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9
Q

Dimensions of the pelvic cavity size and fetus size

A
  • Avg pelvic cavity = 11cm diameter
  • Vortex presentation of fetus (Chin twd chest) = 9.5cm diameter
  • Brow presentation of fetus (Chin up) = 13.5cm → problematic for child birth
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10
Q

Apertures of the pelvis

A
  • Pelvic inlet
  • ANT sacral foramen
  • Obturator canal
  • GSF → to LL
  • LSF → perineum & gluteal regions
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11
Q

How is the pelvis the most important skeleton for forensic identification

A
  • Size and shape → male/female
  • Transverse ridges and groove present in symphysis of younger adults (teen to late 20s)
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12
Q

Mechanical structure of the pelvis

A
  • 2 bony arches:
    • POS arch → sacrum → acetabulum
    • ANT arch → Pubic arch → bear weight in sitting
  • Bones organised in trabaculae → resist forces
  • Transfer of forces → pelvis acts as struts → allows movement and load transfer
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13
Q

Movements affecting the pelvic bone

A
  • Stance → weight from trunk to pelvis
    • Pelvis wants to tilt further fwd (nutation) ~S2 vertebrae
    • But Little movement takes place due to ligaments in the joint of pelvis
  • Movement ~ 2-8o
    • Occurs from a lying down position to standing position
    • Movements increase during late pregnancy (due to relaxin hormone → relax ligaments)
      • Complications with POST pregnancy → SI joint pain → ligaments retighten in wrong way
      • Refer pain to MED/LOWER buttocks
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14
Q

Sacroiliac joint

A
  • Synovial ANT
  • Fibrous POS
  • Held together by strong lig → prevents movement/nutation
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15
Q

Ligaments of the sacroiliac joint

A
  • Sacroiliac (interosseous)
  • Sacrospinous (GSF)
  • Sacrotuberous (LSF)
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16
Q

Reverse keystone effect

A
  • Sacrum pushed downwards from standing
  • Forces sacrum to pull ligaments tighter → joints stronger by drawing iliac bones together
17
Q

How can there be a force closure at the sacroiliac joint

A
  • Gluteals + lats → muscular sling from on side to the other of the body
    • Important to maintain integrity of sacroiliac joint
    • Weak gluteal and lats → may lead to instability of sacroiliac joint
18
Q

Features of the pubic symphysis

A
  • Second cartilaginous disc
    • May split during pregnancy
  • Reinforced by lig SUP & INF
19
Q

Pubic symphysitis

A
  • Due to pull from ANT ab wall muscles and ADD longus
20
Q

Pelvic fractures

A
  • Due to trauma
  • Common in children - ligaments attachment is stronger than bone
21
Q

What is the ring phenomenon

A
  • Fracture on one side → fracture diametrically opposite on the other side