Lecture #10 - Pelvic and SI Joint Anatomy and Motion
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Questions and Answers

What are the three main functions of the pelvis, represented by the acronym 'canadian plan benefits'?

The pelvis contains and protects viscera, and bears the weight of the trunk and upper body.

What structural difference exists between the male and female pelvis?

The female pelvis is wider and shallower, while the male pelvis is narrower but longer and deeper.

Identify the location where the three pelvic bones meet and provide its name.

The three pelvic bones meet at the acetabular fossa.

Which landmarks on the pelvis would you examine for positional faults, and which one would you not palpate?

<p>You would palpate ASIS, PSIS, AIIS, and PIIS, but not the AIIS for positional faults.</p> Signup and view all the answers

How is the shape of the sacrum described, and what is the reasoning behind this shape?

<p>The sacrum is shaped like an inverted triangle, with the base positioned at the top.</p> Signup and view all the answers

Explain the position of the coccyx in relation to the sacrum.

<p>The coccyx is positioned distal and inferior to the sacrum.</p> Signup and view all the answers

What landmark aligns with the L4 vertebrae level in the pelvis?

<p>The iliac crest aligns with the L4 level or the L4/L5 interspace.</p> Signup and view all the answers

What is unique about the discal material found between the vertebrae in the sacrum compared to the intervertebral discs in other regions?

<p>The discal material in the sacrum is not functional in the same capacity as the intervertebral discs in the cervical, thoracic, or lumbar regions.</p> Signup and view all the answers

Why is the irregularity of sacroiliac joint surfaces considered beneficial?

<p>It increases the stability of the sacroiliac joints.</p> Signup and view all the answers

On which aspect of the sacrum are the sacral sulci located?

<p>They are located on the lateral aspect of the sacrum.</p> Signup and view all the answers

How many sacral sulci are there?

<p>There are two sacral sulci: one on the right and one on the left.</p> Signup and view all the answers

What structures run through the canal located deep to the median sacral crest?

<p>The spinal sacral nerve roots and the coccygeal nerves.</p> Signup and view all the answers

What do the anterior sacral foramina allow for?

<p>They allow the anterior rami of the spinal nerves to exit.</p> Signup and view all the answers

Why might nerve compression occur at the sacral foramina?

<p>Because structures such as osteophytes or inflammation can encroach on the holes.</p> Signup and view all the answers

What anatomical feature of the sacrum is considered similar to the inferior angle of the scapula?

<p>The inferior lateral angle of the sacrum.</p> Signup and view all the answers

How many coccygeal vertebrae are typically fused in the coccyx?

<p>There are usually four coccygeal vertebrae fused, but it can vary from three to five.</p> Signup and view all the answers

What allows movement at the coccygeal vertebrae?

<p>Movement is allowed by fibrous joints.</p> Signup and view all the answers

What are the two potential anatomical anomalies that can affect the total count of vertebral segments?

<p>Sacralization and lumbarization.</p> Signup and view all the answers

What do the sacral cornua form at the inferior end of the sacrum?

<p>They form the left and right cornula.</p> Signup and view all the answers

Which parts of the sacrum are assessed during dynamic positional fault assessment?

<p>The left sacral sulcus, right sacral sulcus, left inferior angle, and right inferior angle.</p> Signup and view all the answers

What is the primary reason for the low occurrence of disc herniation in the sacrum?

<p>There are no functional discs in the sacrum.</p> Signup and view all the answers

What role does the median sacral crest play in spinal structure?

<p>It serves as a bony landmark along the midline of the sacrum.</p> Signup and view all the answers

What should you do if coccyx injury is suspected?

<p>Refer to someone who can properly assess and manage those injuries.</p> Signup and view all the answers

What structures do the sacroiliac joint connect?

<p>It links the axial and inferior appendicular skeleton.</p> Signup and view all the answers

Why is the sacroiliac joint considered unique?

<p>It is essentially suspended and has somewhat vertical surfaces that create an unusual joint structure.</p> Signup and view all the answers

What role do ligaments play in the stability of the sacroiliac joint?

<p>They provide form closure by stabilizing the joint through anatomical fitting.</p> Signup and view all the answers

Between which vertebrae is the lumbosacral joint located?

<p>Between the L5 and S1 vertebrae.</p> Signup and view all the answers

What is the primary function of the iliolumbar ligament?

<p>It stabilizes the last lumbar vertebra (L4, L5) and the ilium.</p> Signup and view all the answers

Why does the pubic symphysis often receive less attention compared to other pelvic joints?

<p>It is perceived to have minimal movement, affecting its clinical relevance.</p> Signup and view all the answers

What magnifying effect does a dysfunction in the pubic symphysis have?

<p>It can magnify dysfunction at the back of the pelvis.</p> Signup and view all the answers

What type of joint is the sacroiliac joint categorized as?

<p>It is classified as both synovial and fibrous.</p> Signup and view all the answers

What creates dynamic stability in the sacroiliac joint?

<p>The contraction of muscles that have direct or indirect attachments in the area.</p> Signup and view all the answers

Which two joints are emphasized as not being assessed within this course?

<p>The sacrococcygeal and intercoccygeal joints.</p> Signup and view all the answers

What is the anatomical positioning of the interosseous ligaments in the sacroiliac joint?

<p>They are situated between the articular surfaces of the sacrum and the ilium.</p> Signup and view all the answers

What do the short posterior SI ligaments provide within the sacroiliac joint?

<p>They provide additional support as the shortest SI ligaments.</p> Signup and view all the answers

Which joint often requires assessment alongside the sacroiliac joint due to their interdependence?

<p>The lumbar spine joint (L4-L5-S1).</p> Signup and view all the answers

What is the specific long posterior SI ligament that receives the most attention?

<p>The long dorsal ligament.</p> Signup and view all the answers

How many sacrotuberous ligaments are present on each side of the pelvis?

<p>There is one sacrotuberous ligament on each side.</p> Signup and view all the answers

Which ligament is deep to the sacrotuberous ligament?

<p>The sacrospinous ligament.</p> Signup and view all the answers

What primary function do the sacrotuberous ligaments serve?

<p>To limit anterior movement of the sacrum, also known as flexion or nutation.</p> Signup and view all the answers

Name one factor that contributes to hypermobility in the pelvic region, particularly during childbirth.

<p>Hormonal laxity.</p> Signup and view all the answers

What attachments do most muscles have to the pelvis, sacrum, or coccyx?

<p>Through fascial connection.</p> Signup and view all the answers

What is the primary function of the piriformis muscle during hip movement?

<p>To externally rotate the femur.</p> Signup and view all the answers

Which three muscles are identified as particularly important for the force-closure of the SI joint?

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

What significant nerve comes off the sacral plexus?

<p>The sciatic nerve.</p> Signup and view all the answers

Where does the spinal cord terminate?

<p>Between L1 and L2.</p> Signup and view all the answers

What is the role of the filum terminale?

<p>To anchor the spinal cord at the coccyx.</p> Signup and view all the answers

How does flexing the hip significantly beyond 60 degrees affect the function of the piriformis?

<p>It gains the ability to internally rotate the femur.</p> Signup and view all the answers

What creates laxity in the pelvic ligaments during pregnancy?

<p>Hormones associated with childbirth.</p> Signup and view all the answers

What anatomical feature forms an 'X' shape at the low back area due to muscle fiber direction?

<p>The contraction of the gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

What major vascular structure runs anteriorly to the vertebral bodies in the lumbar region?

<p>The abdominal aorta.</p> Signup and view all the answers

At what point does the abdominal aorta bifurcate?

<p>At the L4 level.</p> Signup and view all the answers

What arteries do the common iliac arteries further branch into?

<p>External and internal iliac arteries.</p> Signup and view all the answers

What is the curvature of the sacrum called?

<p>Kyphotic.</p> Signup and view all the answers

What ligament primarily restricts sacral extension?

<p>Long dorsal ligament.</p> Signup and view all the answers

Name three muscles important for force closure of the SI joint during ambulation.

<p>Gluteus maximus, latissimus dorsi, piriformis.</p> Signup and view all the answers

What are the five nerve roots that form the sciatic nerve?

<p>L4, L5, S1, S2, S3.</p> Signup and view all the answers

What idea regarding sacral motion has been debunked by research?

<p>That no motion occurs at the sacrum and ilium.</p> Signup and view all the answers

In which medical realm is the approach to the sacrum heavily influenced?

<p>Osteopathy.</p> Signup and view all the answers

During nutation, in what direction does the sacral base move?

<p>Anteriorly.</p> Signup and view all the answers

Which ligament primarily limits nutation?

<p>Sacrospinous ligament.</p> Signup and view all the answers

What happens to the ilium when the sacrum flexes?

<p>The ilium rotates posteriorly and medially.</p> Signup and view all the answers

What is the loose-pack position of the SI joint associated with?

<p>Counternutation.</p> Signup and view all the answers

What implications does early or excessive counter-nutation have?

<p>It typically indicates instability in the lumbar spine.</p> Signup and view all the answers

What happens to the sacrum during a right rotation of the pelvis?

<p>The sacrum nutates to the right side and counter-nutates to the left.</p> Signup and view all the answers

How do the innominate bones react when the body side bends to the right?

<p>The innominate bones side bend to the right and the sacrum rotates to the left.</p> Signup and view all the answers

What type of rotation occurs when the hip is flexed?

<p>Flexion of the hip causes posterior rotation of the innominate bone.</p> Signup and view all the answers

Can you name the five axes of sacral rotation?

<p>The five axes are the superior, middle, transverse, left oblique, and right oblique axes.</p> Signup and view all the answers

What are the four types of oblique axis rotations?

<p>The types are L on L, R on L, R on R, and L on R.</p> Signup and view all the answers

What does the acronym SAACC stand for in reference to sacral assessments?

<p>SAACC stands for Superoinferior translation, Anterior movement, Anteroposterior translation, Cephalic and caudal of the sacrum on the ilium, and Cephalic and caudal of the ilium on the sacrum.</p> Signup and view all the answers

List one active movement of the spine or hip that stresses the sacroiliac joint.

<p>Spine flexion stresses the sacroiliac joint.</p> Signup and view all the answers

Which muscles are involved in hip abduction that stresses the SI joint?

<p>The gluteus medius is the primary muscle involved.</p> Signup and view all the answers

What are the two main points highlighted by the interactions between the spine, SI, and hip joints?

<ol> <li>They are inter-related, and 2. You cannot assess one without considering the others.</li> </ol> Signup and view all the answers

What direction does the innominate move during hip extension?

<p>The innominate bone rotates anteriorly during hip extension.</p> Signup and view all the answers

What is the primary role of the pelvic floor muscles?

<p>To support pelvic organs and maintain posture.</p> Signup and view all the answers

How do the iliac crests relate to the lumbar spine in terms of alignment?

<p>The iliac crests align with the L4 vertebrae level.</p> Signup and view all the answers

Identify two key functions of the sacral base and explain their importance.

<p>The sacral base provides support to the spine and transmits weight to the pelvis.</p> Signup and view all the answers

What effect does dysfunction or malpositioning of pelvic bones have on muscle attachment sites?

<p>It may lead to altered biomechanical function and muscle imbalances.</p> Signup and view all the answers

How does the shape of the coccyx relate to its position relative to the sacrum?

<p>The coccyx is positioned distal and inferior to the sacrum.</p> Signup and view all the answers

Explain the significance of the articulating surfaces of the sacroiliac joint.

<p>They provide stability and allow for limited motion required for load transfer.</p> Signup and view all the answers

What landmarks are critical for assessing positional faults in the pelvic region?

<p>The ASIS and PSIS are primary landmarks for such assessments.</p> Signup and view all the answers

Discuss the impact of the sacral sulci on the function of the sacrum.

<p>The sacral sulci guide the movement of sacral nerves and contribute to spinal stability.</p> Signup and view all the answers

What can cause a dysfunction at the sacrum which affects the articulation between L5 and S1?

<p>A positional fault or dysfunction of the sacroiliac joints can cause this.</p> Signup and view all the answers

How does the shape of the sacroiliac joint support its unique stability?

<p>Its L-shaped configuration with irregular surfaces allows for interlocking stability.</p> Signup and view all the answers

What anatomical feature contributes to the force closure of the sacroiliac joint?

<p>The contraction of muscles with direct and indirect attachments in the area.</p> Signup and view all the answers

What role do ligaments play in the stability of the lumbosacral joint?

<p>Ligaments provide structural support and limit excessive movement.</p> Signup and view all the answers

What impact does slight dysfunction in the pubic symphysis have on pelvic mechanics?

<p>It can magnify dysfunctions occurring at the sacroiliac joints.</p> Signup and view all the answers

What joint features both synovial and fibrous components?

<p>The sacroiliac joint exhibits both synovial and fibrous characteristics.</p> Signup and view all the answers

Which ligaments are primarily involved in the stabilization of the sacroiliac joint?

<p>The posterior sacroiliac ligaments and interosseous ligaments.</p> Signup and view all the answers

Why is the sacroiliac joint considered rarely assessed despite its importance?

<p>It's often perceived as having minimal movement.</p> Signup and view all the answers

What are the attachments of the iliolumbar ligament, and why is it significant?

<p>It attaches between L4, L5 vertebrae and the ilium, serving as a key stabilizer.</p> Signup and view all the answers

Why do sacral sulci not qualify as components of the sacrum?

<p>They are spaces or grooves located posterior to the sacrum between the ilium and sacrum.</p> Signup and view all the answers

What type of joint is classified as having both significant stability and movement capabilities, specifically in the pelvis?

<p>The sacroiliac joint is classified as a synovial joint with significant stability.</p> Signup and view all the answers

What forms the sacral hiatus?

<p>It is formed by the cornua on either side of the sacrum.</p> Signup and view all the answers

How is the dynamic stability of the sacroiliac joint achieved during weight-bearing activities?

<p>Through the contraction of the muscle groups around the joint.</p> Signup and view all the answers

What anatomical structure is the inferior lateral angle of the sacrum similar to?

<p>It is similar to the inferior angle of the scapula.</p> Signup and view all the answers

In what way does the pubic symphysis serve as a pivot point in the pelvis?

<p>It connects the left and right pubis, facilitating limited movement.</p> Signup and view all the answers

What anatomical changes during pregnancy can affect pelvic ligament laxity?

<p>Hormonal changes lead to increased laxity in the pelvic ligaments.</p> Signup and view all the answers

How many points of palpation are considered when assessing the sacrum?

<p>Four points of palpation are used for a dynamic positional fault assessment.</p> Signup and view all the answers

What causes variability in the location of the sacral sulcus according to literature?

<p>The sacral sulcus is described as being medial to the PSIS, but its exact positioning can vary as medial, inferior, or superior.</p> Signup and view all the answers

What contributes to the stability of the sacroiliac joints over time?

<p>The irregularity of the joint surfaces increases stability within reason.</p> Signup and view all the answers

Where are the anterior sacral foramina positioned in relation to the median sacral crest?

<p>The anterior sacral foramina are located lateral to the median sacral crest.</p> Signup and view all the answers

What allows for the movement of coccygeal vertebrae?

<p>Movement is facilitated by fibrous joints.</p> Signup and view all the answers

What characterizes the median sacral crest?

<p>The median sacral crest consists of bumps down the midline of the sacrum.</p> Signup and view all the answers

What are the two structures running through the space deep to the median sacral crest?

<p>The spinal/sacral nerve roots and coccygeal nerves.</p> Signup and view all the answers

What anatomical anomaly involves the fused sacral vertebrae?

<p>Sacralization is one of the anomalies that can affect the vertebral count.</p> Signup and view all the answers

What is a potential issue that can occur due to the presence of anterior sacral foramina?

<p>Nerve compression can occur at these sites.</p> Signup and view all the answers

What role does the coccygeal structure play in the overall composition of vertebral segments?

<p>Including the coccyx, there are a total of 33 vertebral segments in the vertebral column.</p> Signup and view all the answers

What is the primary role of the long dorsal SI ligament?

<p>To limit posterior movement of the sacrum.</p> Signup and view all the answers

What is the anatomical route of the sacrotuberous ligament?

<p>It runs from the inferior lateral angle of the sacrum to the ischial tuberosity.</p> Signup and view all the answers

Identify two key factors contributing to hypermobility in the pelvic region during childbirth.

<p>Laxity secondary to hormones and the birthing process.</p> Signup and view all the answers

How do most muscles attach to the structures of the pelvis, sacrum, and coccyx?

<p>Through fascial connections.</p> Signup and view all the answers

What pelvic ligament is located deep to the sacrotuberous ligament?

<p>Sacrospinous ligament.</p> Signup and view all the answers

Name the three muscles important for the force-closure of the SI joint.

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

What is the most significant nerve from the sacral plexus?

<p>The sciatic nerve.</p> Signup and view all the answers

Describe the movement function of the piriformis when the hip is flexed past 60 degrees.

<p>It gains the ability to internally rotate the femur.</p> Signup and view all the answers

What unique arrangement do the fibers of certain muscles create at the low back area?

<p>An 'X' shape.</p> Signup and view all the answers

What structural components anchor the cauda equina at the coccyx?

<p>The filum terminale.</p> Signup and view all the answers

What is the primary function of the sacrospinous ligament?

<p>To stabilize the pelvis by connecting the ischial spine to the inferior lateral angle of the sacrum.</p> Signup and view all the answers

What is the relationship between piriformis action and hip flexion?

<p>Piriformis acts as an external rotator until the hip flexes past 60 degrees, after which it can internally rotate.</p> Signup and view all the answers

What creates the laxity in pelvic ligaments during pregnancy?

<p>Hormones associated with pregnancy.</p> Signup and view all the answers

List two important functions associated with the sacrotuberous ligament.

<p>It limits anterior movement of the sacrum and provides pelvic stability.</p> Signup and view all the answers

How does the contraction of the key muscles affect the stability of the SI joint during weight-bearing activities?

<p>It provides a force that helps stabilize the joint.</p> Signup and view all the answers

What is the associated movement of the innominate bone during hip flexion?

<p>Posterior rotation.</p> Signup and view all the answers

How does the sacrum rotate when the innominate bones side bend to the right?

<p>The sacrum will rotate to the left.</p> Signup and view all the answers

Identify the four types of oblique axis rotations mentioned.

<p>L on L, R on L, R on R, L on R.</p> Signup and view all the answers

What does the acronym GEMLAT represent in the context of force closure muscles?

<p>Gluteals, Erector spinae, Multifidus, Latissimus dorsi, Abdominal obliques, Transverse abdominus.</p> Signup and view all the answers

What is the impact of hip adduction on the sacroiliac joint?

<p>It stresses the SI joint.</p> Signup and view all the answers

Describe the movement of the pelvis during right sacral rotation.

<p>The pelvis moves towards the right.</p> Signup and view all the answers

What are the implications of hip external rotation on the pelvis?

<p>It causes outflare of the innominate bones.</p> Signup and view all the answers

What does unilateral hip extension cause in terms of innominate bone movement?

<p>Anterior rotation of the opposite innominate bone.</p> Signup and view all the answers

List the two primary highlights from the inter-related movements of the spine, SI joint, and hip.

<p>They are inter-related and assessing one must include the others.</p> Signup and view all the answers

What should be considered when understanding sacral axes in relation to pathologies?

<p>Their movement patterns and interactions can vary based on the source or philosophy.</p> Signup and view all the answers

What structure runs anteriorly to the vertebral bodies in the lumbar region up to the L4 level?

<p>The abdominal aorta.</p> Signup and view all the answers

What arteries do the common iliac arteries bifurcate into?

<p>The external and internal iliac arteries.</p> Signup and view all the answers

What ligament primarily limits sacral extension?

<p>The long dorsal ligament.</p> Signup and view all the answers

Which muscles are critically important to the force closure of the sacroiliac joint during movement?

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

What is the main implication of excessive early counter-nutation during trunk flexion?

<p>It typically indicates instability in the lumbar spine.</p> Signup and view all the answers

What is the direction of movement for the sacral base during nutation?

<p>The sacral base moves anteriorly.</p> Signup and view all the answers

What structures limit nutation at the sacroiliac joint?

<p>The sacrotuberous, sacrospinous, short posterior, and anterior sacroiliac ligaments.</p> Signup and view all the answers

What ligament primarily limits counter-nutation?

<p>The long dorsal ligament.</p> Signup and view all the answers

Which direction does the ilium rotate when the sacrum undergoes nutation?

<p>The ilium rotates posteriorly and medially.</p> Signup and view all the answers

What is the curvature of the sacrum described as?

<p>Kyphotic.</p> Signup and view all the answers

What happens to the sacrum and ilium during the first 45-60 degrees of trunk flexion?

<p>Both the sacrum and innominate bone undergo anterior rotation.</p> Signup and view all the answers

Which nerve roots form the sciatic nerve?

<p>L4, L5, S1, S2, and S3.</p> Signup and view all the answers

What misconception regarding sacral motion has research debunked?

<p>The idea that no motion occurs at the sacrum and ilium.</p> Signup and view all the answers

What are the strong structural features of the pelvis that indicate its rigidity?

<p>The pelvis is a strong, relatively rigid structure that bears the weight of the trunk and connects the axial skeleton to the inferior appendicular skeleton.</p> Signup and view all the answers

Identify two functions of the muscles that attach to the pelvis.

<p>The muscles that attach to the pelvis facilitate locomotion and maintain posture.</p> Signup and view all the answers

In what orientation does the female pelvis differ compared to the male pelvis?

<p>The female pelvis is wider and shallower, while the male pelvis is narrower but longer and deeper.</p> Signup and view all the answers

How does dysregulation of the pelvic bones potentially impact the anatomical landmarks?

<p>Dysfunction and malpositioning of the bones may affect the alignment and palpability of pelvic landmarks.</p> Signup and view all the answers

What unique shape characterizes the sacrum, and what is the significance of this shape?

<p>The sacrum is shaped like an inverted triangle, with the base on top, which supports its role in weight distribution and spinal stability.</p> Signup and view all the answers

What anatomical aspect of the sacrum differs in function compared to intervertebral discs in other regions?

<p>The discal material between the vertebrae in the sacrum is not functional in the same capacity as intervertebral discs in other spinal regions.</p> Signup and view all the answers

What role does the irregularity of the sacroiliac joint surfaces play in its function?

<p>The irregular surfaces of the sacroiliac joint facilitate better stability and connection between the sacrum and ilium.</p> Signup and view all the answers

How many vertebrae are fused in the sacrum, and what is the relevance of this fusion?

<p>Five vertebrae are fused in the sacrum, which provides structural integrity and stability to the lower spine.</p> Signup and view all the answers

What happens to the sacrum when we rotate to the right?

<p>The sacrum rotates to the right and nutates to the right side.</p> Signup and view all the answers

How does side bending to the right affect the sacrum and innominate bones?

<p>During right side bending, the innominate bones side bend to the right and the sacrum rotates to the left.</p> Signup and view all the answers

What is the relationship between hip flexion and innominate movement?

<p>Hip flexion is associated with a posterior rotation of the innominate bone.</p> Signup and view all the answers

Can you name the four types of oblique axis rotations?

<p>The four types are L on L, R on L, R on R, and L on R.</p> Signup and view all the answers

List any three joint play assessments of the sacrum/pelvis.

<p>Superoinferior translation of the symphysis pubis, anterior movement of the sacrum on the ilium, and caudal movement of the ilium on the sacrum.</p> Signup and view all the answers

What role do the GEMLAT muscles play regarding pelvic stability?

<p>The GEMLAT muscles contribute to force closure and stabilizing the sacroiliac joint.</p> Signup and view all the answers

Identify one movement that stresses the sacroiliac joint and its associated muscle.

<p>Spine flexion stresses the SI joint while engaging the abdominals.</p> Signup and view all the answers

What is the significance of the sacral axes during movement?

<p>The sacral axes facilitate various rotations, impacting the biomechanics of the pelvis and spine.</p> Signup and view all the answers

How does hip external rotation influence the associated innominate movement?

<p>Hip external rotation is associated with an outflare of the innominate bone.</p> Signup and view all the answers

What do the active movements that stress the SI joint indicate about the spine and hip relationship?

<p>These movements show that any hip or spinal action will impact the sacroiliac joint.</p> Signup and view all the answers

What is the primary reason the sacroiliac joint is considered a unique joint?

<p>It is essentially suspended and features an unusual configuration of vertically oriented surfaces.</p> Signup and view all the answers

Describe the role of the ligaments in the stability of the sacroiliac joint.

<p>They provide significant structural support and create form closure essential for maintaining joint stability.</p> Signup and view all the answers

What stabilizing component is also known as force closure in the sacroiliac joint?

<p>The dynamic stability created by the contraction of muscles attached to the region.</p> Signup and view all the answers

Why is the pubic symphysis often considered less significant in assessment compared to other pelvic joints?

<p>It is perceived to have minimal movement, which reduces its clinical attention despite its pivotal role.</p> Signup and view all the answers

What is the function of the iliolumbar ligament?

<p>It acts as a key stabilizer between the last lumbar vertebrae (L4, L5) and the ilium.</p> Signup and view all the answers

How do the irregular surfaces of the sacroiliac joint contribute to its stability?

<p>They create an interlocking mechanism that enhances the joint's congruency.</p> Signup and view all the answers

What is a significant outcome of dysfunction in the sacroiliac and sacrum joints?

<p>It often leads to a dysfunction between L5 and S1 vertebrae.</p> Signup and view all the answers

Why is the posterior SI ligament predominantly significant for joint stability?

<p>It provides most of the support along with other surrounding ligaments.</p> Signup and view all the answers

How many pubic symphysis joints exist, and why is this relevant?

<p>There is only one pubic symphysis, which is significant due to its role in pelvic stability.</p> Signup and view all the answers

How does the shape of the sacroiliac joint's ligaments influence stability?

<p>The L-shaped formation of the ligaments contributes to the joint's structural stability.</p> Signup and view all the answers

Identify the importance of assessing the sacroiliac joint in conjunction with other pelvic joints.

<p>Assessment of the sacroiliac joint is crucial as it correlates with the lumbar spine and hip joint functionality.</p> Signup and view all the answers

What type of joint is the pubic symphysis categorized as, and what characterizes its function?

<p>The pubic symphysis is a cartilaginous joint characterized by limited movement.</p> Signup and view all the answers

Where is the sacral sulcus located?

<p>It's located posterior to the sacrum between the ilium and sacrum.</p> Signup and view all the answers

What forms the walls of the sacral hiatus?

<p>The walls are formed by the cornua of the sacrum.</p> Signup and view all the answers

What anatomical feature is similar in concept to the inferior lateral angle of the sacrum?

<p>It is similar to the inferior angle of the scapula.</p> Signup and view all the answers

What makes the anterior sacral foramina relevant in anatomy?

<p>They are the sites where anterior rami of spinal nerves exit.</p> Signup and view all the answers

What role does the median sacral crest play?

<p>It serves as a central feature along the sacrum, providing structural integrity.</p> Signup and view all the answers

What arterial structure runs anteriorly to the vertebral bodies in the lumbar region before bifurcating?

<p>The abdominal aorta.</p> Signup and view all the answers

How many vertebrae are fused within the coccyx?

<p>Typically, four coccygeal vertebrae are fused.</p> Signup and view all the answers

What phenomenon might lead to an increase in vertebral segment count?

<p>Sacralization and lumbarization can lead to an increased segment count.</p> Signup and view all the answers

What are the two main arteries formed after the bifurcation of the abdominal aorta?

<p>The left and right common iliac arteries.</p> Signup and view all the answers

What anatomical structures exit through the posterior sacral foramina?

<p>The posterior rami of the spinal nerves exit through these foramina.</p> Signup and view all the answers

Which ligament is primarily responsible for restricting sacral extension?

<p>The long dorsal ligament.</p> Signup and view all the answers

Why is disc herniation uncommon in the sacrum?

<p>There are no functional intervertebral discs in the sacrum.</p> Signup and view all the answers

What three muscles contribute significantly to force closure of the sacroiliac joint during movement?

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

Which ligament limits nutation of the sacrum during movement?

<p>Sacrospinous ligament.</p> Signup and view all the answers

What is palpitated to assess positional faults of the sacrum?

<p>The left and right sacral sulci and inferior angles are palpated.</p> Signup and view all the answers

What contributes to the dynamic stability of the sacroiliac joint?

<p>Ligaments and muscle forces provide dynamic stability.</p> Signup and view all the answers

What is the effect of trunk flexion on the motion of the sacrum?

<p>It begins with anterior movement of the sacral base, which then transitions to counter-nutation.</p> Signup and view all the answers

Which spinal structures are located deep to the median sacral crest?

<p>Sacral and coccygeal nerve roots run through the space.</p> Signup and view all the answers

What causes further compression and form closure of the sacroiliac joint during nutation?

<p>Anterior movement of the sacrum alongside posterior rotation of the ilium.</p> Signup and view all the answers

Which nerve roots come together to form the sciatic nerve?

<p>L4, L5, S1, S2, and S3.</p> Signup and view all the answers

Which part of the sacrum is described as having a deeper curve?

<p>The upper portion of the sacrum has a deeper anterior curve.</p> Signup and view all the answers

What is the general concept proven by research regarding sacral motion?

<p>Motion does occur at the sacrum and ilium.</p> Signup and view all the answers

In what plane does the base of the sacrum move during nutation?

<p>Anteriorly.</p> Signup and view all the answers

What is the relationship between hamstring tightness and early counter-nutation during pelvis motion?

<p>Tight hamstrings can influence early counter-nutation and lead to lumbar instability.</p> Signup and view all the answers

What role do dynamic stabilizers play in sacroiliac joint stability?

<p>They enhance stability during both nutation and counter-nutation.</p> Signup and view all the answers

During trunk flexion, how does the sacrum respond after the initial anterior rotation?

<p>It starts to counter-nutate after 60 degrees of flexion.</p> Signup and view all the answers

What happens to the sacrum when the ilium rotates posteriorly?

<p>The sacrum flexes anteriorly.</p> Signup and view all the answers

What is the primary role of the long dorsal ligament in the sacroiliac joint?

<p>To limit posterior movement of the sacrum.</p> Signup and view all the answers

Describe the tissue quality of the sacrotuberous ligament.

<p>It feels almost like bone due to its thickness.</p> Signup and view all the answers

How does the piriformis muscle function differently when the hip is flexed past 60 degrees?

<p>It gains the ability to internally rotate the femur.</p> Signup and view all the answers

What are two factors contributing to hypermobility in the pelvic area during pregnancy?

<p>Hormonal laxity and the birthing process.</p> Signup and view all the answers

Which ligaments are primarily involved in stabilizing the sacroiliac joint during weight-bearing activities?

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

At which specific points does the sacrotuberous ligament run?

<p>From the inferior lateral angle of the sacrum to the ischial tuberosity.</p> Signup and view all the answers

Which ligament is located deep to the sacrotuberous ligament?

<p>The sacrospinous ligament.</p> Signup and view all the answers

What is a common misconception about the tightness of the piriformis muscle?

<p>That it is commonly short, tight, or strong.</p> Signup and view all the answers

How do most muscles attach to the pelvis, sacrum, or coccyx?

<p>Through fascial connection.</p> Signup and view all the answers

What is the effect of muscle fiber direction on the stability of the low back area?

<p>It forms an 'X' shape which contributes to joint stability.</p> Signup and view all the answers

What injury mechanism is often associated with ligament injuries during sports?

<p>Traumatic forces.</p> Signup and view all the answers

What is the role of the median sacral artery in the pelvic region?

<p>It supplies blood to the structures in the pelvic area.</p> Signup and view all the answers

How does the sacral plexus contribute to the nervous system in the pelvis?

<p>It gives rise to several significant nerves, most notably the sciatic nerve.</p> Signup and view all the answers

What anchors the cauda equina at the coccyx?

<p>The filum terminale.</p> Signup and view all the answers

What are the two main groups of muscles that attach to the pelvic region?

<p>Abdominal wall and pelvic floor.</p> Signup and view all the answers

What is the main reason the female pelvis is different from the male pelvis?

<p>The female pelvis is wider and shallower to facilitate childbirth.</p> Signup and view all the answers

Identify the landmark on the pelvis that aligns with the PSIS and its corresponding vertebra.

<p>PSIS aligns with the S2 vertebra.</p> Signup and view all the answers

What is the significance of the acetabular fossa in pelvis anatomy?

<p>It is the place where the three pelvic bones meet.</p> Signup and view all the answers

Which pelvic landmark is noted for outgoing muscular attachments but is not palpated for positional faults?

<p>AIIS.</p> Signup and view all the answers

How does the sacrum's shape affect its function?

<p>The sacrum is shaped like an inverted triangle to support the weight of the upper body.</p> Signup and view all the answers

What is unique about the discal material found between the sacral vertebrae compared to other regions?

<p>It is not functional in the same capacity as intervertebral discs in other regions.</p> Signup and view all the answers

What is the effect of dysfunction or malpositioning of pelvic bones on the landmarks?

<p>They may affect the palpation and assessment of these landmarks.</p> Signup and view all the answers

What is the primary function of the long dorsal ligament?

<p>To limit posterior movement of the sacrum.</p> Signup and view all the answers

Where does the sacrotuberous ligament run?

<p>From the inferior lateral angle of the sacrum to the ischial tuberosity.</p> Signup and view all the answers

What is the role of hormones during childbirth concerning pelvic ligaments?

<p>They create laxity in the ligaments, allowing for pelvic expansion.</p> Signup and view all the answers

What is the primary reliance of the sacroiliac joint for stability?

<p>Ligaments.</p> Signup and view all the answers

What movement potential does the piriformis gain when the hip is flexed past 60 degrees?

<p>Internal rotation of the femur.</p> Signup and view all the answers

Where is the lumbosacral joint located?

<p>Between the L5 and S1 vertebrae.</p> Signup and view all the answers

What is the anatomical significance of the pubic symphysis?

<p>It serves as a pivot point at the front of the pelvis.</p> Signup and view all the answers

Identify one muscle that provides significant stability to the sacroiliac joint.

<p>Gluteus maximus.</p> Signup and view all the answers

What effect does a small dysfunction at the pubic symphysis have on the sacroiliac joint?

<p>It magnifies dysfunction at the back.</p> Signup and view all the answers

What creates the dynamic stability in the SI joint?

<p>Muscular contractions from specific muscles.</p> Signup and view all the answers

How do force closure muscles contribute to the stability of the sacroiliac joint?

<p>They provide dynamic stability during weight-bearing activities.</p> Signup and view all the answers

Which ligaments contribute predominantly to the stability of the sacroiliac joint?

<p>The posterior SI ligaments and interosseous ligaments.</p> Signup and view all the answers

What primary function do the muscles contributing to the force closure of the SI joint serve?

<p>They stabilize the sacroiliac joint during movement.</p> Signup and view all the answers

What unique shape is characteristic of the sacroiliac joint?

<p>L-shaped.</p> Signup and view all the answers

How do most muscles attach to structures on the sacrum, pelvis, or coccyx?

<p>Through fascial connections.</p> Signup and view all the answers

What interdependence exists among the lumbar spine, sacroiliac joints, and hip joint?

<p>They function as a trifecta that must be assessed together.</p> Signup and view all the answers

What significant nerve arises from the sacral plexus?

<p>The sciatic nerve.</p> Signup and view all the answers

Why might the sacrococcygeal and intercoccygeal joints not be assessed in this course?

<p>They are not considered significant for assessment.</p> Signup and view all the answers

Which ligament is primarily impacted during the childbirth process due to stress?

<p>The sacrotuberous ligament.</p> Signup and view all the answers

What ligament forms a critical stabilizing structure between the last lumbar vertebra and the ilium?

<p>Iliolumbar ligament.</p> Signup and view all the answers

What anatomical structure anchors the cauda equina at the coccyx?

<p>The filum terminale.</p> Signup and view all the answers

What kind of joint is the pubic symphysis classified as?

<p>A cartilaginous joint.</p> Signup and view all the answers

What is a common misconception about the piriformis muscle's condition?

<p>That it is short, tight, and strong.</p> Signup and view all the answers

What are the two components that join to form the sacroiliac joint?

<p>The sacrum and the ilium.</p> Signup and view all the answers

What contributes to the interlocking mechanism that stabilizes the sacroiliac joint?

<p>The congruency of the bones and their irregular surface features.</p> Signup and view all the answers

What is the primary reason for the interdependence of the sacrum and SI joints?

<p>To address positional faults and ensure proper load transfer.</p> Signup and view all the answers

What role do sacral sulci play in the anatomy of the sacrum?

<p>Sacral sulci are not actual structures but spaces that allow for palpation, indicating relative positioning between the sacrum and ilium.</p> Signup and view all the answers

Describe the orientation of the median sacral crest.

<p>The median sacral crest runs down the midline of the sacrum and is formed by the fused spinous processes of the sacral vertebrae.</p> Signup and view all the answers

What anatomical structures are associated with the anterior sacral foramina?

<p>The anterior sacral foramina provide passage for the anterior rami of sacral spinal nerves.</p> Signup and view all the answers

Identify the main types of nerve roots passing through the sacral hiatus.

<p>The sacral hiatus primarily transmits the terminal branches of sacral and coccygeal nerves.</p> Signup and view all the answers

What is the significance of the left and right inferior lateral angles on the sacrum?

<p>They are important landmarks for palpating and assessing static and dynamic positional faults of the sacrum.</p> Signup and view all the answers

How does the kyphotic curve of the sacrum affect its anatomy?

<p>The kyphotic curve leads to a deeper anterior surface at the upper portion of the sacrum compared to S3-S5.</p> Signup and view all the answers

How does the anatomy of the sacral cornua differ between individuals?

<p>The sacral cornua consists of projections from the left and right sides of the inferior sacrum, and their shape and prominence can vary among individuals.</p> Signup and view all the answers

What can cause potential nerve compression at the sacral foramina?

<p>Nerve compression may occur due to osteophyte encroachment, inflammation, or connective tissue issues near the sacral foramina.</p> Signup and view all the answers

What factors contribute to the rarity of disc herniation at the sacral level?

<p>The rarity is primarily due to the absence of functional intervertebral discs in the sacrum.</p> Signup and view all the answers

Why is the assessment of sacral nerve roots crucial during neurological evaluations?

<p>It is essential for identifying signs of nerve root compression, which can lead to specific neurological symptoms linked to dermatomes and myotomes.</p> Signup and view all the answers

How many vertebral segments are in the typical adult vertebral column, including the sacrum and coccyx?

<p>There are typically 33 vertebral segments in an adult vertebral column, including five sacral and four coccygeal vertebrae.</p> Signup and view all the answers

What anatomical implications does the coccyx have in terms of movement?

<p>The coccyx allows for limited movement due to the presence of fibrous joints connecting the fused coccygeal vertebrae.</p> Signup and view all the answers

Why are the posterior sacral foramina distinct from the anterior ones?

<p>The posterior sacral foramina allow the posterior rami of the sacral spinal nerves to exit, differing in their function from the anterior foramina.</p> Signup and view all the answers

How does variability in literature regarding sacral sulcus positioning affect anatomical studies?

<p>Variability can complicate palpation and assessments, as practitioners may have different interpretations of sacral sulcus locations.</p> Signup and view all the answers

When the hip flexes, what is the associated movement of the innominate bone?

<p>The innominate bone undergoes posterior rotation.</p> Signup and view all the answers

Identify the direction of pelvic movement when side bending occurs to the right.

<p>The pelvis moves towards the right side.</p> Signup and view all the answers

What does the acronym GEMLAT refer to in relation to the pelvic region?

<p>GEMLAT stands for Gluteus Medius, Erector Spinae, Multifidus, Latissimus Dorsi, Abdominal Obliques, and Transverse Abdominis.</p> Signup and view all the answers

What are the four types of oblique axis rotations classified in sacral movements?

<p>They are L on L, R on L, R on R, and L on R.</p> Signup and view all the answers

Describe the interaction between hip and spine movements with respect to the sacroiliac joint.

<p>Movements at the hip and spine significantly impact the function and stability of the sacroiliac joint.</p> Signup and view all the answers

What joint play assessments are primarily conducted for the sacrum and sacroiliac joint?

<p>They include superoinferior translation of the pubis, cephalic-caudal movements of the sacrum on the ilium, and inferior-superior glide of the ilium.</p> Signup and view all the answers

List the nine active movements that stress the sacroiliac joint.

<p>The movements include spine flexion, extension, left/right rotation, left/right side bending, hip flexion, abduction, adduction, internal rotation, and external rotation.</p> Signup and view all the answers

How does the movement of the sacrum differ from the movement of the innominate bones during hip extension?

<p>During hip extension, the sacrum rotates anteriorly while the ilium rotates posteriorly.</p> Signup and view all the answers

What is the significance of understanding the sacral axes of rotation?

<p>It is crucial for diagnosing and managing sacroiliac joint pathologies.</p> Signup and view all the answers

What arteries arise from the bifurcation of the abdominal aorta at the L4 level?

<p>The left and right common iliac arteries.</p> Signup and view all the answers

Which ligament is the primary restrictor of sacral extension?

<p>The long dorsal ligament.</p> Signup and view all the answers

What is the curvature of the sacrum classified as?

<p>Kyphotic.</p> Signup and view all the answers

Which three muscles are vital for the force closure of the sacroiliac joint during ambulation?

<p>Gluteus maximus, latissimus dorsi, and piriformis.</p> Signup and view all the answers

What should occur to the sacral base during flexion of the trunk?

<p>The sacral base moves anteriorly.</p> Signup and view all the answers

What is the consequence of early counter-nutation during trunk flexion?

<p>It typically indicates instability in the lumbar spine.</p> Signup and view all the answers

Which ligaments are noted for limiting nutation at the sacroiliac joint?

<p>Sacro tuberous and sacrospinous ligaments.</p> Signup and view all the answers

How do the innominate bones move during unilateral rotation?

<p>The innominate bone on the side of rotation posteriorly rotates, while the opposite side anteriorly rotates.</p> Signup and view all the answers

What is the role of the median sacral artery?

<p>It provides blood supply to the posterior pelvic region.</p> Signup and view all the answers

What happens to the ilium during counternutation?

<p>The ilium moves anteriorly and laterally.</p> Signup and view all the answers

How does the sacrum move during nutation?

<p>The sacrum flexes anteriorly.</p> Signup and view all the answers

What effect does trunk flexion have on the sacrum and innominate bones?

<p>For the first 60 degrees, both the innominate and sacrum rotate anteriorly.</p> Signup and view all the answers

How does the median sacral crest contribute to spinal structure?

<p>It serves as an attachment site for ligaments and muscles.</p> Signup and view all the answers

What is the meaning of 'form closure' in relation to the SI joint?

<p>It refers to the stability achieved through the joint's bony architecture.</p> Signup and view all the answers

Which of the following bones is NOT one of the pelvic bones?

<p>Sacrum</p> Signup and view all the answers

The female pelvis is typically narrower and deeper than the male pelvis.

<p>False</p> Signup and view all the answers

What is the name of the place where the three pelvic bones meet?

<p>acetabular fossa</p> Signup and view all the answers

The primary muscles attaching to the pelvis include the abdominal wall and the ________.

<p>pelvic floor</p> Signup and view all the answers

Which of the following landmarks would NOT be palpated for positional faults?

<p>AIIS</p> Signup and view all the answers

Match the pelvic landmarks to their associated alignment.

<p>Iliac crest = L4 level PSIS = S2 Ischial tuberosity = L5 level Pubic tubercle = L4/L5 interspace</p> Signup and view all the answers

The sacrum is shaped like an inverted triangle, with the base at the top and the apex at the bottom.

<p>True</p> Signup and view all the answers

What is the function of the sacral sulci?

<p>They stabilize the sacroiliac joints.</p> Signup and view all the answers

The anterior sacral foramina allow the posterior rami of the spinal nerves to exit.

<p>False</p> Signup and view all the answers

The ______ connects the sacrum and the ilia.

<p>sacroiliac joint</p> Signup and view all the answers

Match the following sacral structures with their descriptions:

<p>Sacral cornua = Projections medially from the inferior sacrum Median sacral crest = Bumps down the middle of the sacrum Sacral hiatus = Opening at the end of the sacrum Anterior sacral foramina = Holes allowing nerve exit at the front</p> Signup and view all the answers

Which structure is described as a shallow groove posterior to the sacrum?

<p>Sacral sulcus</p> Signup and view all the answers

The coccyx is formed by the fusion of three to five vertebrae.

<p>True</p> Signup and view all the answers

What anatomical feature runs through the canal deep to the median sacral crest?

<p>Spinal/sacral nerve roots and coccygeal nerves.</p> Signup and view all the answers

The space between the anterior and posterior aspects of the sacrum is primarily for ______.

<p>nerves</p> Signup and view all the answers

Match each sacral foramina with their function:

<p>Anterior sacral foramina = Exit for anterior rami of spinal nerves Posterior sacral foramina = Exit for posterior rami of spinal nerves</p> Signup and view all the answers

What position do you place your thumbs to palpate the sacral sulci?

<p>Medial and slightly superior to the PSIS</p> Signup and view all the answers

Disc herniation is more common in the sacrum compared to other spinal regions.

<p>False</p> Signup and view all the answers

Name one reason that could lead to nerve root compression in the sacral region.

<p>Osteophyte encroachment or inflammation.</p> Signup and view all the answers

What is primarily relied upon for the stability of the sacroiliac joint?

<p>Ligaments</p> Signup and view all the answers

The lumbosacral joint is the point of connection between the L4 and L5 vertebrae.

<p>False</p> Signup and view all the answers

The _______ between the last lumbar vertebra/L4, L5 and ilium is a key stabilizer of the pelvis.

<p>iliolumbar ligament</p> Signup and view all the answers

Match the following pelvic ligaments with their primary functions:

<p>Iliolumbar = Stabilizes L4 and L5 Sacroiliac = Connects sacrum and ilium Pubic = Connects left and right pubis Short Posterior SI = Provides stability within the SI joint</p> Signup and view all the answers

What happens when there is a dysfunction in the pubic symphysis?

<p>It magnifies dysfunction at the back.</p> Signup and view all the answers

There are two pubic symphyses in the human body.

<p>False</p> Signup and view all the answers

Which vertebra is typically the starting point of the lumbosacral joint?

<p>L5</p> Signup and view all the answers

The _______ ligaments contribute to the dynamic stability of the sacroiliac joint.

<p>force closure</p> Signup and view all the answers

Match the pelvic articulations with their descriptions:

<p>Sacroiliac = Connects axial and inferior appendicular skeleton Lumbosacral = Transitions from lumbar to sacral curvature Pubic Symphysis = Pivot point at the front of the pelvis Sacrococcygeal = Articulation between sacrum and coccyx</p> Signup and view all the answers

What is the primary function of the sacroiliac joint?

<p>Support and stabilization for the pelvis</p> Signup and view all the answers

The sacroiliac joint joint surfaces have irregular shapes that can enhance stability.

<p>True</p> Signup and view all the answers

What two joints are identified as not being assessed in the course?

<p>Sacrococcygeal and intercoccygeal</p> Signup and view all the answers

Force closure is created by the contraction of muscles that have _______ attachments in the area.

<p>direct and indirect</p> Signup and view all the answers

What is the associated innominate movement when the hip is flexed?

<p>Posterior rotation</p> Signup and view all the answers

What is a characteristic of the sacroiliac joint's shape?

<p>L-shaped</p> Signup and view all the answers

The pelvis rotates towards the side of sacral nutation.

<p>True</p> Signup and view all the answers

The primary function of the proximal ligaments in the sacroiliac joint is for __________.

<p>stability</p> Signup and view all the answers

Match the hip movements to their associated movements of the innominate:

<p>Flex = Posterior Rotation Ext = Anterior Rotation ABD = Superior Glide ADD = Inferior Glide</p> Signup and view all the answers

Which of the following joints must be assessed alongside the sacroiliac joint due to their interdependence?

<p>Pubic symphysis</p> Signup and view all the answers

All hip movements have no impact on the sacroiliac joint.

<p>False</p> Signup and view all the answers

List two movements of the spine that stress the sacroiliac joint.

<p>Spine FLEX, Spine EXT</p> Signup and view all the answers

Which muscle is primarily responsible for the hip external rotation (ER)?

<p>Piriformis</p> Signup and view all the answers

The acronym GEMLAT represents the muscles involved in __________ closure.

<p>force</p> Signup and view all the answers

There is one sacrotuberous ligament on each side of the pelvis.

<p>True</p> Signup and view all the answers

The sacrotuberous ligament runs from the inferior lateral angle of the sacrum to the __________.

<p>ischial tuberosity</p> Signup and view all the answers

Which hormone creates laxity in pelvic ligaments during childbirth?

<p>Relaxin</p> Signup and view all the answers

The piriformis muscle functions exclusively as an external rotator of the femur.

<p>False</p> Signup and view all the answers

Name one of the three muscles identified as particularly important for the force-closure of the SI joint.

<p>Gluteus maximus</p> Signup and view all the answers

The sacral plexus is predominantly formed by the __________ rami.

<p>anterior</p> Signup and view all the answers

What is the primary role of the sacrospinous ligament?

<p>To stabilize posterior movement of the sacrum</p> Signup and view all the answers

The piriformis is only active during open kinetic chain movements.

<p>False</p> Signup and view all the answers

How many different nerves come off the sacral plexus?

<p>Eight</p> Signup and view all the answers

Match the following ligaments with their primary functions:

<p>Long dorsal ligament = Limit posterior movement Sacrotuberous ligament = Limit anterior movement Sacrospinous ligament = Deep stabilization</p> Signup and view all the answers

The __________ runs from the PSIS to about L4.

<p>long dorsal ligament</p> Signup and view all the answers

What artery bifurcates from the abdominal aorta at the L4 level?

<p>Median sacral artery</p> Signup and view all the answers

Which component anchors the nerve roots down to prevent excessive movement?

<p>Filum terminale</p> Signup and view all the answers

Nutation refers to the anterior movement of the sacral base.

<p>True</p> Signup and view all the answers

Laxity in the pelvic region during pregnancy is solely due to the physical process of childbirth.

<p>False</p> Signup and view all the answers

What are the two main directions of rotation for the ilium during trunk flexion and what may occur due to this action?

<p>Posterior and medial; compression between the ilium and sacrum.</p> Signup and view all the answers

The _______________ artery bifurcates from the abdominal aorta.

<p>median sacral</p> Signup and view all the answers

Match the ligaments with their functions related to the sacroiliac joint:

<p>Long dorsal = Limits counter-nutation Sacrospinous = Limits nutation Sacro tuberous = Provides stability Short posterior SI ligaments = Limits nutation</p> Signup and view all the answers

Which of the following muscles is NOT identified as important for the force closure of the SI joint?

<p>Rectus abdominis</p> Signup and view all the answers

The sacral ligaments are primarily passive restrictors of sacral motion.

<p>True</p> Signup and view all the answers

List the nerve roots that form the sciatic nerve.

<p>L4, L5, S1, S2, S3</p> Signup and view all the answers

The primary ligament that limits nutation is the _______________.

<p>sacro tuberous ligament</p> Signup and view all the answers

In which position is the close-packed position of the SI joint?

<p>Nutation</p> Signup and view all the answers

Research has confirmed that no motion occurs at the sacrum and ilium.

<p>False</p> Signup and view all the answers

What is the term used to describe the posterior movement of the sacral base?

<p>Counternutation</p> Signup and view all the answers

The pelvis is heavily influenced by the field of _______________.

<p>osteopathy</p> Signup and view all the answers

Match the following structures with their corresponding functions:

<p>Gluteal arteries = Supply blood to the gluteal region Gonadal arteries = Supply blood to the reproductive organs Median sacral artery = Supplies blood to the sacral region Coccygeal plexus = Supplies blood to the coccyx</p> Signup and view all the answers

The sacrum features five fused vertebrae.

<p>True</p> Signup and view all the answers

What connects the axial skeleton to the inferior appendicular skeleton?

<p>Pelvis</p> Signup and view all the answers

The acetabular fossa is the location where the three pelvic bones (ilium, ischium, and pubis) meet, referred to as the ______.

<p>acetabulum</p> Signup and view all the answers

Match the following pelvic landmarks with their functions:

<p>ASIS = Muscle attachment for hip flexors PSIS = Landmark for sacral alignment Pubic tubercle = Muscle attachment for abdominal muscles Ischial tuberosity = Sit bone support</p> Signup and view all the answers

Which of the following landmarks is aligned with the S2 vertebra?

<p>PSIS</p> Signup and view all the answers

The coccyx is positioned superior and lateral to the sacrum.

<p>False</p> Signup and view all the answers

Name the two functions of the muscles attaching to the pelvis.

<p>Locomotion and Posture</p> Signup and view all the answers

What movement in the hip is associated with inferior glide of the innominate bone?

<p>Hip adduction</p> Signup and view all the answers

The movement of the pelvis during hip extension is anterior rotation.

<p>True</p> Signup and view all the answers

Name one type of oblique axis rotation of the sacrum.

<p>L on L, R on L, R on R, L on R</p> Signup and view all the answers

The primary function of the GEMLAT acronym is to identify __________ muscles contributing to force closure in the SI joint.

<p>stabilizing</p> Signup and view all the answers

Match the following hip movements with their associated innominate movements:

<p>Hip flexion = Posterior rotation Hip extension = Anterior rotation Hip internal rotation = Inflare Hip external rotation = Outflare</p> Signup and view all the answers

How many main axes of rotation are identified for the sacrum?

<p>5</p> Signup and view all the answers

Side flexion of the spine causes the innominate bones to bend to the opposite side.

<p>False</p> Signup and view all the answers

List two active movements that stress the SI joint.

<p>Spine flexion, Hip abduction</p> Signup and view all the answers

The acronym SAACC stands for the five joint play assessments of the __________.

<p>sacrum/sacroiliac and pubis</p> Signup and view all the answers

Which muscle is primarily responsible for stressing the SI joint during hip flexion?

<p>Iliacus</p> Signup and view all the answers

The pubic symphysis is a joint that allows significant movement.

<p>False</p> Signup and view all the answers

What do the posterior SI ligaments primarily contribute to?

<p>Stability of the sacroiliac joint</p> Signup and view all the answers

The sacroiliac joint primarily relies on ______ for stability.

<p>ligaments</p> Signup and view all the answers

Match the following pelvic joints with their descriptions:

<p>Sacroiliac = Joint connecting the axial and appendicular skeleton Lumbosacral = Joint between L5 and S1 vertebra Pubic symphysis = Joint with minimal movement Sacrococcygeal = Articulation between the sacrum and coccyx</p> Signup and view all the answers

What is the position of the sacral sulci in relation to the PSIS?

<p>Medial and slightly superior</p> Signup and view all the answers

What leads to the unusual shape of the sacroiliac joint?

<p>The bony irregularities and ligaments</p> Signup and view all the answers

The sacroiliac joint is both synovial and fibrous in nature.

<p>True</p> Signup and view all the answers

The anterior sacral foramina and posterior sacral foramina refer to the same structures on different surfaces.

<p>True</p> Signup and view all the answers

What are the two joints that are not assessed in this course?

<p>Sacrococcygeal and Intercoccygeal joints</p> Signup and view all the answers

How many sacral vertebrae are there?

<p>Five</p> Signup and view all the answers

The left and right sacral cornua are located at the ________ end of the sacrum.

<p>inferior</p> Signup and view all the answers

The ______ between the left and right pubis is an integral part of the pubic symphysis structure.

<p>interpubic fibrocartilaginous disc</p> Signup and view all the answers

Match the structures with their functions/descriptions:

<p>Sacral hiatus = Opening where sacral and coccygeal nerves run through Median sacral crest = Bumps down the middle of the sacrum Anterior sacral foramina = Allows anterior rami of spinal nerves to exit Sacral sulcus = Space between ilium and sacrum</p> Signup and view all the answers

Match the ligament to its location:

<p>Iliolumbar = Between L4, L5, and ilium Pubic ligaments = Across the interpubic disc Sacroiliac ligaments = At the sacroiliac joint Short posterior SI ligament = Within the sacroiliac joint</p> Signup and view all the answers

What part of the pelvis is typically referred to as a pivot point?

<p>Pubic symphysis</p> Signup and view all the answers

What anatomical feature creates a connection between the sacrum and coccyx?

<p>The coccygeal vertebrae</p> Signup and view all the answers

There are traditionally four sacral sulci.

<p>False</p> Signup and view all the answers

Force closure in the sacroiliac joint is created solely by ligament tension.

<p>False</p> Signup and view all the answers

What causes the irregularity of the sacroiliac joint surfaces over time?

<p>Increased stability</p> Signup and view all the answers

What causes dysfunction in the lumbosacral joint?

<p>Positional faults or dysfunction in the sacrum and SI joints</p> Signup and view all the answers

The level of the vertebral column typically consists of a total of _________ segments.

<p>33</p> Signup and view all the answers

The lumbosacral joint is located between the ______ and ______ vertebra.

<p>L5 and S1</p> Signup and view all the answers

What is a potential issue associated with the anterior sacral foramina?

<p>Nerve compression</p> Signup and view all the answers

Coccygeal vertebrae are typically fused together.

<p>True</p> Signup and view all the answers

What caused the irregularity of surfaces in the sacroiliac joints?

<p>Development over time</p> Signup and view all the answers

______ is often considered a region causing impingement on sacral nerve roots due to disc issues.

<p>Lumbosacral region</p> Signup and view all the answers

Match the following anatomical variations with their descriptions:

<p>Sacralization = Lumbar vertebra becomes sacral Lumbarization = Sacral vertebra becomes lumbar Disc herniation = Uncommon in the sacrum Coccygeal mobility = Allowed by fibrous joints</p> Signup and view all the answers

The sacrotuberous ligament is located on the back side of the pelvis.

<p>True</p> Signup and view all the answers

The ______________ ligament runs from the inferior lateral angle of the sacrum to the ischial tuberosity.

<p>sacrotuberous</p> Signup and view all the answers

Match the following muscles with their primary function in relation to the SI joint:

<p>Gluteus maximus = Force closure of the SI joint Latissimus dorsi = Assist with pelvic stability Piriformis = Support posterior pelvic movement</p> Signup and view all the answers

What structure does the sciatic nerve come off of?

<p>Sacral plexus</p> Signup and view all the answers

Hormones associated with childbirth can increase the stability of pelvic ligaments.

<p>False</p> Signup and view all the answers

Which is the primary ligament identified as especially important in limiting anterior movement of the sacrum?

<p>Sacrotuberous ligament</p> Signup and view all the answers

The _______________ is particularly important for hip external rotation in an open kinetic chain.

<p>piriformis</p> Signup and view all the answers

What is the term for the process that may create instability in pelvic ligaments during childbirth?

<p>Laxity</p> Signup and view all the answers

What structure does the abdominal aorta bifurcate into?

<p>Left and right common iliac arteries</p> Signup and view all the answers

The primary passive restrictor of sacral extension is the short posterior ligament.

<p>False</p> Signup and view all the answers

There are two sacrotuberous ligaments located on each side of the pelvis.

<p>False</p> Signup and view all the answers

List the three muscles identified as particularly important for force closure of the sacroiliac joint.

<p>Gluteus maximus, latissimus dorsi, piriformis</p> Signup and view all the answers

What are the two major factors contributing to hypermobility during childbirth?

<p>Laxity secondary to hormones and the birthing process</p> Signup and view all the answers

The left and right common iliac arteries further branch into their own respective __________ arteries.

<p>external and internal iliac</p> Signup and view all the answers

The anterior rami of the spinal cord contribute to the formation of the _______________ plexus.

<p>sacral</p> Signup and view all the answers

Match the following terms with their respective descriptions:

<p>Nutation = Anterior movement of the sacral base Counternutation = Posterior movement of the sacral base Long dorsal ligament = Primary limiter of counter nutation Sacrospinous ligament = Secondary stabilizer of the sacroiliac joint</p> Signup and view all the answers

Match the following ligaments with their locations:

<p>Long dorsal ligament = From PSIS to L4 Sacrotuberous ligament = From inferior lateral angle of sacrum to ischial tuberosity Sacrospinous ligament = Between ischial spine and inferior lateral angle of the sacrum</p> Signup and view all the answers

What direction does the base of the sacrum move during nutation?

<p>Anteriorly</p> Signup and view all the answers

Research has proven that no motion occurs at the sacrum and ilium.

<p>False</p> Signup and view all the answers

The curvature of the sacrum is described as __________.

<p>kyphotic</p> Signup and view all the answers

What happens to the sacrum during the first 45-60 degrees of trunk flexion?

<p>It anteriorly rotates</p> Signup and view all the answers

The sacral plexus is formed by five nerve roots: L4, L5, S1, S2, and S3.

<p>True</p> Signup and view all the answers

Nutation occurs when the sacral base moves __________.

<p>anteriorly</p> Signup and view all the answers

Match the following components with their respective roles:

<p>Piriformis = Dynamic stabilizer of SI joint Gluteus maximus = Force closure of SI joint Latissimus dorsi = Support during ambulation Sacrospinous ligament = Limit nutation</p> Signup and view all the answers

Study Notes

Pelvic and SI Joint Anatomy and Motion

  • Spinal Curvatures:

    • Cervical spine (C-spine) - lordotic
    • Thoracic spine (T-spine) - kyphotic
    • Lumbar spine (L-spine) - lordotic

  • Pelvis:

    • Structure: Strong and relatively rigid structure
    • Functions: Contains and protects viscera; bears weight of trunk and upper body; connects axial and inferior appendicular skeletons
    • Muscle Attachments: Abdominal wall and pelvic floor muscles
    • Muscle Functions: Locomotion and posture
    • Pelvic Differences: Female pelvis is wider and shallower than male, which is narrower and deeper
    • Pelvic Bones: 3 pelvic bones (ilium, ischium, pubis) forming the os coxae or innominate bones
    • Acetabular Fossa: Point where the 3 bones meet
    • Muscle Attachment Points: ASIS, PSIS, AIIS, PIIS, pubic tubercle, ischial tuberosity; AIIS is not typically palpated for positional faults
    • Innominate Bone Landmarks: Provides several landmarks and relative points for assessment
    • Landmarks Affected by: Dysfunction and/or malpositioning of bones
    • Landmarks and Vertebra Alignment: Iliac crest aligns with L4/L5 interspace, PSIS aligns with S2

  • Sacrum:

    • Structure: Formed by 5 fused vertebrae; intervertebral disc material is absent in mature adults; shape is an inverted triangle, based on top
    • Sacral Base: Circle-like structure, similar to lumbar vertebral body
    • Sacral Promontory: Anterior projection of the base.
    • Sacral Apex: Tapering end, not a point
    • Coccyx Position: Distal and inferior to the sacrum
    • Auricular (Articular) Surfaces: Irregular surfaces, increasing stability of SI joints. Situated on lateral aspects of sacrum, articulating with ilia surfaces.
    • Sacral Sulci: Spaces posterior to sacrum, between ilium and sacrum, 2 located - medial, potentially slightly superior to PSIS
    • Sacral Cornua: Projections at inferior sacrum; left and right, forming the cornua that can be the arch between those. Could be considered along midline.
    • Median Sacral Crest: Bumps along midline, deep to which are spinal/sacral and coccygeal nerves
    • Sacral Hiatus: Hole at inferior sacrum, surrounded by cornua, for nerve exit.
    • Inferior Lateral Angle: Sharp angling (medially) of sacrum's lateral borders
    • Other Palpation Marks for Sacrum Assessment: Left and right sacral sulci and inferior lateral angles
    • Anterior Sacral Foramina: Holes allowing exit of nerve/ nerve rami structures
    • Posterior Sacral Foramina: Posterior counterpart of anterior Sacral foramina
    • Nerve Compression: Potential for nerve compression at foramina by osteophytes or inflammation
    • Sacral Disc Herniation: Uncommon due to lack of functional discs.

  • Coccyx:

    • Structure: Formed by 4 (range 3-5) fused vertebrae
    • Movement: Fibrous joints permitting some movement
    • Vertebral Segments: 33 vertebral segments in total
    • Anomalies: Sacralization and lumbarization
    • Examination: Internal examination required; refer to appropriate specialist for suspected issues.

  • Pelvic Articulations:

    • Sacroiliac (SI) Joint:
      • Function: Links axial and inferior appendicular skeletons. Predominantly synovial joint. Characterized by irregular surfaces and extensive ligaments (form closure)
      • Uniqueness: Suspended vertically, with congruency creating stability. Movement related to force closure
      • Ligament Emphasis: Posterior SI ligaments are essential for stability
      • Force Closure: Dynamic stability due to muscle contraction; important during weight bearing activities.
      • Shape: L shaped.
    • Lumbosacral (LS) Joint: Between L5 and S1 vertebrae; often impacted in clinical situations due to stress from spine/ leg loading. Interconnected with L4-L5-S1, lumbar spine, SI joints, hip joint.
    • Pubic Symphysis: Fusion of left and right pubis bones, with interpubic disc. Minimal movement but key pivot point for pelvis; small movements can magnify back issues
    • Sacrococcygeal Joint: Articulation between sacrum apex and 1st coccygeal vertebra
    • Intercoccygeal Joint: Potentially fibrous; less emphasis given.
    • Joints Not Assessed: Sacrococcygeal and intercoccygeal

  • Pelvic Ligaments:

    • Iliolumbar Ligament: Main stabilizer between L4/L5/L5 and ilium.
    • Sacroiliac Ligaments: 4 parts (anterior, short posterior, interosseous, long posterior); interosseous is key for fibrous nature of the joint; various orientations and depths of the ligaments
    • Pubic Ligaments: Superior and inferior ligaments, plus anterior and posterior ligaments blending with capsule
    • Sacrotuberous Ligament: Runs from inferior lateral sacrum to ischial tuberosity limiting anterior sacral movement
    • Sacrospinous Ligament: Deep to sacrotuberous ligament, between ischial spine and inferior lateral sacrum, limiting anterior sacral movement.

  • Ligament Injuries: Sprains, commonly related to traumas, pregnancy, and childbirth due to stress on ligaments during childbirth/ laxity from hormones

  • Pelvic Muscles: 27 muscles attach to pelvis/sacrum/coccyx, often via fascial connections: (List of muscles provided)

    • Emphasize piriformis: ER (OKC/mostly), hip ext/abd; function varies based on hip degree of flexion

  • Sacroiliac Joint force closure muscles: Gluteus maximus, latissimus dorsi, piriformis

  • Neurovascular Structures:

    • Sacral Plexus: Formation of 8 spinal nerves including the Sciatic nerve.
    • Sciatic Nerve: Key, emanating from sacral plexus, terminating between L1-l2
    • Iliac Arteries/Veins & Gluteal Arteries/Veins, Gonadal/Rectal Arteries/Veins, Median Sacral Artery/Vein: Major blood supply.
    • Coccygeal Plexus: Plexus involving nerve fibers.

  • Pelvic Movements and Ligament Relations:

    • Nutation/Sacral Flexion: Anterior sacral base movement; posterior and medial innominate rotation; close-packed position of SI joint. Limited by sacro-tuberous, sacrospinous, and anterior SI ligaments
    • Counternutation/ Sacral Extension: Posterior sacral base movement; anterior and lateral innominate rotation; loose-packed position of SI joint. Limited by long dorsal and short posterior ligaments.
    • Pelvis Rotation: Innominate rotation causes same-side sacral rotation and nutation/counternutation;
    • Pelvic Sidebending: Innominate side bending occurs and sacral rotation occurs oppositely
    • Sacral Axes: 5 axes of rotation (superior, middle, transverse, left oblique, right oblique)
    • Joint Play Assessments: (SAACC): Various translations/glides of sacrum/ilium/pubic symphysis
    • SI Joint Stressors: 9 Active movements stressing SIJ, including spine flexion/extension/rotation/side bending and hip movements.

  • Recap:

    • SI joints, lumbar spine, and hip joints have strong interrelations
    • Diagnoses/ assessment need to consider all 3 regions.

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Description

This quiz explores the anatomy and motion of the pelvic and sacroiliac (SI) joints. It covers spinal curvatures, pelvic structure, muscle attachments, and the differences between male and female pelvises. Test your understanding of these fundamental aspects of the human skeletal system.

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