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Flashcards in Spinal Lecture 2 Deck (63)
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1
Q

what type of joint is the symphasis pubis?

A

cartilaginous

2
Q

what is the articular surface of the symphasis pubis?

A

the pubic bodies of each hip bone have a thin hyaline cartilage covering

3
Q

the interpubic disc is strengthened anteriorly by several interlacing collagenous fibrous layers which interweave with fibres of ___ and ___ tendons of the _____

A

external oblique aponeuroses and medial tendons of the recti abdominus

4
Q

what two points does the superior pubic ligament travel between?

A

from pubic tubercle to pubic tubercle and from crest to crest

5
Q

attachment point for the arcuate pubic ligament

A

A1: interpubic disc

A2:inferior pubic rami

FD: Lateral and inferior

6
Q

what is the primary function of the sacroiliac joint?

A

firmly unite the pelvic girlde to facilitate the transmission of weight bearing forces between the upper and lower extremities

7
Q

What type of movement occurs between the ilium and sacrum?

A

Rotation (Limited)

8
Q

structurally the sacroiliac joint is _ joints consisiting of a __ joint and a __ joint.

A

2 joints consisting of a SYNOVIAL PLANE joint and a FIBROSIS joint

9
Q

what are the two articular surfaces of the sacroiliac joint?

A

ear shaped surface on the sacropelvic surface of the ilium and by a similar shaped surface on the alar (wing) of the sacrum

10
Q

what are the articular surfaces of the sacroiliac joint covered with?

A

hyaline cartilage

11
Q

what two points does the fibrous portion of the sacroiliac joint run between?

A

exists between the iliac tuberosity and the upper dorsal surface of the sacrum

12
Q

the two bones of the sacroiliac joint do not contact each other between the iliac tuberosity and the upper dorsal surface of the sacrum, consequently they form a ___ behind which the ___ projects beyond the ___

A

cleft behind which the ilium projects beyond the sacrum

13
Q

what is the cleft of the sacroiliac joint filled with?

A

a dense mass of fibres called the interosseous sacro-iliac ligament

14
Q

behind the cleft of the sacroiliac joint the fibres are known as the __

A

dorsal sacro-iliac ligament

15
Q

what is the massive ligament located posteriorly, forming the chief bond of the SI joint and filling the irregular space posterosuperior to the joint?

A

interosseous sacro-iliac ligament

16
Q

what covers the interosseous sacro-iliac ligament superficially?

A

dorsal sacroiliac ligament

17
Q

the deeper part of the interosseous sacro-iliac ligament has superior and inferior bands passing from depression posterior to ___ and to ___

A

superior and inferior bands passing from depressions posterior to sacral auricular surface to iliac tuberosity

18
Q

does the dorsal sacro-iliac ligament lie anterior or posterior to the interosseous SI ligament?

A

posterior

19
Q

the dorsal SI ligament has several weak __ connecting ___ and __ sacral crests to the ___ and internal lip of the ___

A

has several weak FASICULI connecting INTERMEDIATE and LATERAL sacral crests to the PSIS and internal lip of the ILIAC CREST

20
Q

often inferior fibres from __ and __ sacral segments ascend to ___ forming a separate long posterior sacroiliac ligament

A

inferior fibres from 3rd and 4th sacral segments ascend to PSIS forming a separate long posterior SI ligament

21
Q

What is the Posterior SI Ligament continuous with laterally? Medially?

A

laterally: sacrotuberous ligament
medially: posterior lamina of the thoracolumbar fascia

22
Q

Which ligament strengthens the ventral portion of the SI joint capsule and is most developed on the anterior inferior aspect of the joint?

A

anterior sacro-iliac ligament

23
Q

what two points do the bands of the iliolumbar ligament run between?

A

the iliac crest and the transverse process of the 5th lumbar vertebrae, consist of 5 parts

24
Q

what ligament prevents forward slippage of L5?

A

iliolumbar ligament

25
Q

what ligament limits twisting, forward, back and lateral bending of L5?

A

iliolumbar ligament

26
Q

Which points does the anterior portion of the iliolumbar ligament travel between?

A

A1: anterior inferior border of TP of L5

A2: medial body of L5

27
Q

what two points does the superior portion of the iliolumbar ligament attach to?

A

A1: anterior and posterior fascia that surrounds QL

A2: anterior superior border of L5 TP

28
Q

what points does the posterior aspect of the iliolumbar ligament attach to?

A

attached to the top of the posterior border of the TP and attached to the ilium behind QL

29
Q

What points does the inferior aspect of the iliolumbar ligament attach to?

A

A1: lower border of the TP of L5

A2:SI ligament (anterior)

FD: Inferior and lateral

30
Q

what two points does the vertical aspect of the iliolumbar ligament attach to?

A

the anterior and inferior border of L5 TP and descends vertically to the iliopectineal line

31
Q

What are the medial and lateral attachments of the sacrospinous ligament? FD?

A

Medial attachment: lateral margin of the lower sacrum and coccyx

Lateral attachment: the spine of the ischium

FD: fibres run transversely laterally

32
Q

what ligament does the sacrospinous ligament blend with?

A

the sacrotuberous ligament

33
Q

list the proximal attachments for the sacrotuberous ligament

A

PSIS, PIIS, lower 1/2 of the dorsal surface of the sacrum, lower 1/2 of the lateral sacral crest, lateral margin of the coccyx and blends partially with the dorsal sacro-iliac ligaments

34
Q

list the fibre direction and distal attachments for the sacrotuberous ligament

A

the fibres run down and laterally to attach distally to the medial margin of the ischial tuberosity

35
Q

the posterior surface of the sacrotuberous ligament attaches to the lowest fibres of which muscle

A

lowest fibres of glute max

36
Q

the lower part of the sacrotuberous ligament continues into what tendon?

A

lower part continues into biceps femoris tendon

37
Q

what pierces the sacrotuberous ligament

A

inferior gluteal artery and perforating cutaneous nerve

38
Q

What aspect of l5 – s1 tells you that it can handle lots of weight?

A

It’s width – remember structure dictates function

39
Q

Why is the SI joint a weight transferal joint?

A

It’s a plane joint that relies on the forces of the muscles to hold it together – transfers the force to the coccyxfemoral joint where the thickest cartilage is, where the strongest ligaments and muscles are

40
Q

If you have OA of the hip on only one side you need to consider…

A

the fact that it is likely disfunction that is causing the issue

41
Q

What type of joint is the symphysis pubis weight bearing or weight transferal?

A

Weight transferal

42
Q

Why is the pelvis not a full bony structure

A

The joints allow movement, and important for pregnancy so the pelvic girdle can open

43
Q

What two muscles support the symphysis pubis?

A

Aponeurosis of the external obliques

Rectus abdominus

44
Q

What creates force closure in the SI joints

A

Lats Glutes

45
Q

What two movements must the SI joint allow for?

A

Side bending

Rotation

46
Q

What is the bony configuration of the SI joint?

A

Essentially 2 blocks that fit together – the wedge shape of the sacrum helps to provide stability and it narrows inferiorly

47
Q

What is one of the most common muscle imbalances you will see?

A

Glutes and Hamstrings

48
Q

What will pain do to muscle in the area?

A

Turn them off – pain inhibition

49
Q

How do you test the integrity of the SI joint?

A

Gapping Splaying Keep in mind when you are gapping and splaying the SI joint that it is so strong there realistically will be little to no movement – if there is there is a big problem

50
Q

The orientation of the dorsal SI ligament is..

A

Vertical

51
Q

If there is tension on the sacrotuberous ligament it will place tension on the __ ligament

A

Dorsal SI ligament

52
Q

How do you test the anterior SI ligament?

Is this test functional?

What is this test called, other than gapping or splaying?

A

Pushing out on the ASIS’s – again realistically should not move at all – so think is this test functional? No, its called a pain provocation test

53
Q

How many bands does the iliolumbar ligament have?

A

5 running off of the TP of L4 and L5 – some authors say just L5

54
Q

What are the directions of the 5 bands of the iliolumbar ligament?

A

Anterior

Posterior

Superior

Inferior

Vertical

55
Q

What movement does the iliolumbar ligament prevent?

What is another function/purpose of the iliolumbar ligament

A

Side bending in L4 and L5

Stabilizes the vertebrae (L4-L5) on the innominate bone

56
Q

If you have disfunction of L4-L5 what also may be in disfunction?

A

The innominate bone – clinical relevance: patient could present with a innominate bone disfunction but cause could be traces back to L4 or L5 stuck in a side bent position placing tension on the iliolumbar ligament and thus placing tension on the innominate

57
Q

The iliolumbar ligament will also help prevent ___ from sliding anteriorly (Extremely significant)

A

L4-L5

58
Q

What is the significance of the sacrospinous ligament with regard to foramen?

A

Converts the greater/lesser sciatic notch into foramen

59
Q

What does the sacrotuberous blend with superiorly?

A

Posterior (dorsal) sacroiliac ligament, also goes into the posterior lamina of the thoracolumbar fascia – significant because it disperses the force (force attenuation) so the force is not focal on any one area

60
Q

What does the sacrotuberous blend with inferiorly?

A

Ischial tuberosity – same attachment point as bicep femoris, so remember you are getting a transfer of forces all the way down the leg

61
Q

What other muscles does the sacrotuberous ligament merge with?

A

Glute max

62
Q
A
63
Q
A