ESHS 120 Exam 3 Pelvic Girdle

pelvic bones

ilium, ischium, pubis

iliac crest

upper margin of iliac bones

iliac fossa

The broad, slightly concave inner surface of the ilium.

obturator foramen

opening in hip bone formed by the pubic and ischial rami

pubic symphysis

cartilaginous joint at which two pubic bones fuse together; allows some movement to facilitate childbirth

ASIS (anterior superior iliac spine)

the top point of the iliac crest in front

AIIS (anterior inferior iliac spine)

a bony projection on the ilium below the ASIS

PSIS (posterior superior iliac spine)

the top point of the iliac crest in back

PIIS (posterior inferior iliac spine)

Lies inferior to the PSIS and serves as an attachment for the sacrotuberous ligament

ishial tuberosity

'butt bone'
origin of hamstrings

greater sciatic notch

allows blood vessels and the large sciatic nerve to pass from the pelvis posteriorly into the thigh

lesser sciatic notch

inferior to ischial spine

sacrum and coccyx

single bones that result from the fusion of several vertebrae

sacroiliac joint

the joint between the sacrum and the ilium; connection the axial and appendicular skeletons

acetabulofemoral joint
bones + joint type

femur + acetabulum of pelvic bone
ball & socket (enarthrodial joint)

acetabulofemoral
movements°

flexion: 0 - 130°
extension: 0 - 30°
abduction: 0 - 35°
adduction: 0 - 30°
internal rotation: 0 - 45°
external rotation: 0 - 50°

acetabulofemoral
ligaments

- iliofemoral (Y)
- pubofemoral
- teres
- acetabular labrum
- ishiofemoral

iliofemoral (Y) ligament

anteriorly; prevents hyperextension

pubofemoral ligament

anteroinferiorly; limits excessive extension & abduction

teres ligament

deep in acetabulum + femur head depression: slightly limits adduction

acetabular labrum

lip of fibrocartilage that surrounds outer margin of the acetabulum on the hip bone
enhances stability + provide shock absorption; can be torn

ischiofemoral ligament

posterior ligament of the hip that goes from ischium to femur; limits internal rotation

hip flexors

iliopsoas (iliacus + psoas major), sartorius, pectineus, rectus femoris, tensor fasciae latae

hip adductors

adductor longus, adductor brevis, adductor magnus, gracilis, pectineus

hip extensors

gluteus maximus, biceps femoris, semitendinosus, semimembranosus, external rotators, adductor magnus?

hip abductors

gluteus medius, gluteus minimus, tensor fascia latae, gluteus maximus, external rotators, sartorius?

hip internal rotators

gluteus medius, gluteus minimus, tensor fasciae latae

6 deep external rotators

hip external rotation

piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior, quadratus femoris

hip external rotators

gluteus maximus + piriformis, quadratus femoris, obturator internus, obturator externus, superior gemellus, inferior gemellus

ilipsoas

hip flexion
hip external rotation

rectus femoris

hip flexion
knee extension

sartorius

hip flexion + abduction + some external rotation
knee flexion + weak internal rotation

pectineus

hip flexion, adduction, external rotation

adductor brevis

hip adduction w/ external rotation
- assists in hip flexion

adductor longus

hip adduction, w/ external rotation
- assists in hip flexion

adductor magnus

hip adduction w/ external rotation + extension

gracilis

hip adduction + internal rotation
weak knee flexion + internal rotation

semitendinosus

hip extension + internal rotation
knee flexion w/ internal rotation

semimembranosus

hip extension + internal rotation
knee flexion w/ internal rotation

biceps femoris

hip extension + external rotation
knee flexion w/ external rotation

gluteus maximus

hip extension + external rotation
- upper fibers assist in abduction
- lower fibers assist in adduction

gluteus medius

hip abduction

gluteus minimus

hip abduction w/ internal rotation + flexion

tensor fasciae latae

hip abduction + flexion
knee external rotation

typical causes of pelvic injury

significant trauma

anterior-posterior (AP) compression fracture

widening pelvic ring +
widening SI joint, causing internal bleeding

lateral compression fracture

Most common type of pelvic ring fracture?
side impact
may cause displaced fractures of pubis bone causing damage to organs

vertical shear injury

disruption in pelvic girdle, SI joint, ligaments, blood vessels
may lead to pelvic injury instability and severe internal bleeding

apophysitis

inflammation of growth plate w/ muscle attachments
- associated w/ muscle overuse
- common in growing teens

SI dysfunction

lower back and buttock pain to lower hip, groin, or upper thigh (one side or both)

SI dysfunction causes

- injury
- arthritis
- pregnancy
- infection
- repetitive stress activities

pelvic floor dysfunction

men + women affected
- leaking urine and failing to reach the bathroom
- pass air from the anus or vagina bending over or lifting
- reduced sensation in the vagina
- tampons dislodge or fall out
- bulge at the vaginal opening
- sexual dysfunction

pelvic floor functions

1. pelvic organ support
2. bladder + bowel control
3. passing of urine + feces
4. sexual function
5. breathing
6. pregnancy + childbirth

hip osteoarthritis

degenerative arthritis characterized by the wearing away of the cartilage in the hip joint
- 2nd most common

hip osteoarthritis symptoms

- groin pain
- outer thigh pain
- buttocks pain
- difficulty walking
- worse in the morning
- limited ROM
- + FABER's test

FABER/Patrick's Test

flexion, abduction & ER of the hip
a. (+) sign: pain
b. Indications: problem with hip or SI joint

femoral acetabular impingement (FAI)

- one or both hip joints irregularly shaped, rubbing against each other
- may be due to malformation of acetabulum

FAI symptoms

- groin pain
- hip pain
- buttocks pain
- after intense activity
- ages 20-45

snapping hip syndrome

- snapping sensation or popping sound in movement
- muscle or tendon moves over bony protrusion in hip

snapping hip syndrome
muscles

anterior: IT band, rectus femoris, iliopsoas
posterior: biceps femoris

hip bursitis

inflamed bursa
- greater trochanter of hip bone
- iliopsoas bursa; groin area of hip

slipped capital femoral epiphysis

femoral head is displaced from femoral neck due to growth plate separation
- grade 1, 2, 3

piriformis syndrome

compression of the sciatic nerve by the piriformis muscle
- pain + numbness of buttock and down back of the leg

piriformis syndrome causes

- trauma of hip or buttocks
- piriformis muscle hypertrophy in athletes
- sitting for prolonged periods
- bipartite (separated?) piriformis muscle