Module 3 Unit 3 Flashcards by Avery A

How many sacral segments are fused in adulthood?

5 sacral segments

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Is the posterior surface of the sacrum concave or convex? What curve is this? Where does it articulate?

Convex; kyphosis

It articulate with the lateral edges of the ilium

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What is the shape of the sacral base? Where does it face?

Oval/round
anterior/superior

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What is the clinical importance of sacral promontory?

Osteophytes with spondyolisthesis of L5

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What are the portions of the posterior sacrum?

Pedicles
Laminae
Tubercles
Sacral canal

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Is the superior articular process of the sacrum concave or convex? What directions do they face?

Concave
Faces posterior and medial

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What are the ‘wings’ of the sacral called? This is a common diagnosis for what?

Ala

Common location for stress fractures in osteoporotic patients

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What are the typical sacral insufficiency fracture pattern? How are they classified?

Occurs when the quality of the sacral bone has become insufficient to handle the stress of weight bearing

They are classified into 3 zones.

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What are the portions of the anterior surface of the sacrum?

4 osseous ridges
4 pair of sacral foramina
- ventral rami of sacral nerves
Apex of sacrum articulates w/ coccyx
- oval facet

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What are the portions of the posterior surface of the sacrum?

Convex top to bottom
Rough
- Median sacral crest (3-4 tubercles)
- Intermediate sacral crest
- Lateral sacral crest
Sacral hiatus
- No fusion of 5th laminae
4 dorsal sacral foramina
- dorsal rami
Sacral cornu
Sacral groove
- Fused lamina
Lateral sacral crest
- Remnant TP’s fused together

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What are the portions of the lateral surface of the sacrum?

Wide superiorly
Transverse and costal remnants fuse
Large articular surface
- Auricular surface
- From S1-S2
- Thick hyaline cartilage
— 3x that of ilium

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What are the shape of the sacral canal? What directions does it open to?

Triangular shaped

Opens superiorly and inferiorly

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How many segments of the coccyx? What are the shape of the facets? What are the horns of the coccyx called?

4 segments

Oval facets

The horns are called cornu

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What are the 3 portions of the pelvic girdle?

Ilium, Ischium, Pubic bones

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What are is the Y-shaped epiphyseal plate called? What are the junctions that make up the Y-shaped epiphyseal plate?

Triradiate Cartilage is made up of ischium, ilium, and pubis

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When does the triradiate cartilage close in males and females?

Closure/ fusion for males at 15-16 years old and females at 13-14 years old

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What are the difference between a male and female pelvis?

Male pelvis:
- Taller
- Narrower
- V-shaped/conical

Female pelvis:
- Shorter
- Wider
- Cylindrical
— Sacrum/coccyx don’t curve forward as much
— Ischial spines

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What are the anterior borders of the ilium? What are they attachment sites for? What part of the acetabulum?

Anterior superior iliac spine (ASIS) attachment for sartoius
Anterior inferior iliac spine (AIIS) attachment for rectus femoris

Top of the acetabulum

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What are the posterior borders of the ilium? What are the notches? Where does it merge on the posterior side?

Posterior superior iliac spine
Greater sciatic notch
- Merges with the ischium

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How much of the medial surface of the ilium is the anterior and the posterior portions?

Iliac fossa - Anterior 2/3
Sacropelvic area - Posterior 1/3

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What does the sacropelvic area of the ilium?

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Articular surface - fits in the surface of the sacrum
Iliac tuberosity - sacroiliac ligaments attach
Pelvic surface - bends into the iliopectinal line

What is the pelvic brim?

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A line from the sacral promontory to the upper part of the pubic symphysis

What is the false pelvis?

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Lies above the pelvic brim - contains the ASIS and AIIS

What is the true pelvis?

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Lies below the pelvic brim - contains the PSIS and most ischium and pubis

What is the pelvic axis?

Path of baby during birth - between the false pelvis and true pelvis

What are the directions are the anterior aspect and posterior aspect and size (convex or concave) (large or small)? What is it an attachment to?

Anterior aspect - convex and small Posterior aspect - concave and large Attachment for the iliacus muscle

What are the gluteal surfaces and what muscles attach there?

Inferior gluteal line - Rectus femoris attaches below AIIS Anterior gluteal line (middle line) - gluteus minimus attaches below; gluteus medius attaches above Posterior gluteal line - Gluteus Maximus attaches behind

What are the major landmarks on the ischium?

Body & ramus Ischial spine - separates greater/lesser sciatic notch

What is considered the sit bone? What attaches to it?

Ischial tuberosity Muscles: biceps femoris Semimembranosis Semitendinosis

What is the ramus of the ischium?

The ramus curves forward and connects with the pubis

What connects the two pubis bones?

Symphysis

What ligament attaches from the ASIS and pubic tubercle?

Inguinal ligament

What is the hip socket called? What 3 bones make it?

Acetabulum Inferior portion of the Ilium, Posterior portion of the pubis, anterior portion of the ischium

What is the obturator foramen? How do the shapes differ in males vs females?

Ischium and pubis Females: Smaller/triangular Males: Larger/oval

Describe the Obturator canal. What runs through the canal?

Blood vessels & obturator nerve exit pelvis, into thigh - Obturator nerve = L2-4 nerve roots This nerve innervates - Obturator externus - Adductor magus, longus, brevis - Gracilis

Where does the iliolumbar continue?

Upper band - attaches to the posterior portion of iliac crest Lower band (limbo sacral ligament) - attaches to the anterior lateral portion of the sacral ala

Why is the iliolumbar ligament and lumbosacral ligament clinically significant?

If there is asymmetry can cause deviation from normal biomechanical forces.

What are the attachment points of the anterior sacroiliac ligament?

Thickening of the anterior and inferior portions of the SI joint capsule

Where does the inguinal ligament attach? What does it protect?

Connects ASIS to pubic tubercle Protects soft tissues underneath - nerve - artery - vein - lymphatics (NAVL)

What does the anterior sacrococcygeal ligament resemble?

Anterior Longitudinal Ligament

Where are the pubic ligaments located?

Superior - across the top of the pubic symphysis Inferior - Bottom of pubic symphysis (AKA: arcuate ligament)

Where does the Mamillo-Accessory Ligament (MAL) attach? What runs through the foramen?

From the maxillary process to accessory process medial branch of the posterior ramus - Innervation: facet joints and some fibers of multifidus

Where do the long and short posterior sacroiliac ligaments run? What directions are the fibers in the long and short ligaments?

Long - vertical fibers - Connects: S3-4 tubercles; intermediate & lateral crests, PSIS, Sacrotuberous ligament Short - horizontal fibers - Connects: S1-2 tubercles, iliac tuberosity, PSIS

What is the strongest ligament? Where does it attach?

Interosseous sacroiliac ligament attaches at the sacrual and iliac tuberosities

What does the articular ligament hold together?

Margins of the auricular surfaces of the sacrum and ilium

What does the sacrotuberous ligament attach to? What tendon does it blend with?

Connects to inferolateral sacrum and ischial tuberosity; also connects to PIIS/PSIS Blends with tendon of the long head of the biceps femoris

What shape is the sacrospinous ligament? Where does it connect? Where does it limit movement?

Triangular shape Connects: - lateral portion of sacrum and coccyx to ischial spine Limits movement between the sacrum and ilium/ischium

What muscle and nerve passes through the great sciatic foramen?

Piriformis - O: anterior sacrum - I: greater trochanter - A: external rotation of hip Sciatic nerve - Deep/inferior to piriformis

What makes up the lesser sciatic foramen? What muscle and nerve passes through?

Anterior border: body of ischium Posterior border: sacrotuberous ligament Superior border: Sacrospinous ligament & ischial spine Muscle and nerve passing though: - Obturator internus - Obturator nerve

What are the posterior sacrococcygeal ligaments? What does the more superficial ligament protect?

Superficial: Continuation of the ligamentum flavum - Protects the S5 and coccygeal nerves Deep: Continuation of the PLL - From the posterior ‘body’ of S5 - To the surface of coccyx

Where does the lateral sacrococcygeal ligament connect? What does it form?

Connects to the inferior/lateral sacrum to transverse process of coccyx Forms the foramen for S5 nerve root

Where does the intercornual ligament attach?

Between sacral cornu and coccygeal cornu on same side (fibers run vertically)

Module 3 Unit 3 Flashcards

(52 cards)