The pelvis maintains a critical role in…
- biomechanical function and balance
- Reproduction
- Elimination
- Vascular and Lymphatics
When do the three bones of the pelvis completely fuse?
late teens
What are true ligaments? accessory?
- bone to bone
2. attach at another ligament, tendon, or other fascia
Where do the following anterior ligaments attach?
- Sacrospinous
- Iliolumbar
- Anterior Sacroiliac Ligament
- Inguinal Ligament
- sacrum to spine of the ischium
- from ilia to 5th lumbar vertebrae
- covers much of the sacroiliac joint
- ASIS to superior pubic rami
Where do the following posterior ligaments attach?
- Sacrotuberous
- Posterior Sacroiliac Ligament
- sacrum to ischial tuberosity
2. covers much of sacroiliac joint
What is the role of the pubic symphysis?
- lies anteriorly between surfaces of the pubic bones
- each joint’s surfaces is covered with hyaline cartilage, and is linked by fibrocartilage
- suprior public L. lies above the joint, and inferior public L. lies below
If you have dysfunction in a hip flexor, what kind of rotation/shear of the innominate/pubes occurs?
anterior rotation, inferior shear
What type of rotation does increased hamstring tension cause?
posterior rotation of the innominate
What does the Trendelenburg Sign test for?
whether the patient has adequate hip abductor strength (specifically gluteus medius)
What can abnormal contraction of the piriformis cause?
sciatic
Symptoms of groin pull/hernia can be caused by dysfunction in what back muscle?
quadrates lumborum - it irritates ilioinguinal and iliohypogastric nerves
What is the only hip rotator that connects directly to the sacrum?
Piriformis
What makes up the gravitational line?
- auditory meatus
- acromion process
- greater trochanter
- body of L3
- anterior 1/3 of sacrum
- lateral condyle and the knee
- lateral malleolus
What does it mean when an innominate is “shear”?
one innominate can move superior or inferior relative to the sacrum or other innominate
What does it mean when an innominate is “flare”?
an innominate can out-flare or in-flare as measured by the position of the ASIS relative to midline
What are the steps for Pelvis SD Dx?
Lateralization test (which side has the SD) –> palpation of landmarks –> dx
What structures are used to diagnose the innominate?
PSIS, ASIS, Iliac crests, Pubic tubercles, Medial malleoli heights
*Medial malleoli heights are the least reliable
What structures are used to diagnose pubic SD or subluxation?
pubic tubercles
What can ischial tuberosity’s be used to diagnose?
small hemipelvis (one side of the pelvis is congenitally smaller)
