Pelvis: Difference between revisions
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== Description == | == Description == | ||
[[File:Gray241.png|alt=Bones of the pelvis|thumb|260x260px]]The pelvis consists of the sacrum, the coccyx, the ischium, the ilium, and the pubis.<ref name=":1">White TD, Black MT, Folkens PA. [https://books.google.co.za/books?hl=en&lr=&id=oCSG2mYlD90C&oi=fnd&pg=PP1&dq=+.+Human+osteology.+&ots=VnpEcJPCWD&sig=Ful9Jtenlzzw4M4nniLS00LstnM#v=onepage&q=.%20Human%20osteology.&f=false Human osteology.] Academic press; 2011.</ref><ref name=":0">Lewis CL, Laudicina NM, Khuu A, Loverro KL. [https://anatomypubs.onlinelibrary.wiley.com/doi/pdf/10.1002/ar.23552 The human pelvis: Variation in structure and function during gait.] The Anatomical Record 2017;300(4):633-42.</ref> The structure of the pelvis supports the contents of the abdomen while also helping to transfer the weight from the spine to the lower limbs.<ref name=":2">Magee DJ. [https://books.google.co.za/books?hl=en&lr=&id=cxu0BQAAQBAJ&oi=fnd&pg=PP1&dq=Orthopedic+physical+assessment.&ots=mqGLvPFASn&sig=Jf3KLqp1lfiYQYoeVU2fMhEhhvs#v=onepage&q=Orthopedic%20physical%20assessment.&f=false Orthopedic physical assessment.] Elsevier Health Sciences; 2013.</ref> During [[gait]], the joints within the pelvis work together to decrease the amount of force transferred from the ground and lower extremities to the spine and upper extremities.<ref name=":2" /> | [[File:Gray241.png|alt=Bones of the pelvis|thumb|260x260px]]The pelvis consists of the [[sacrum]], the [[Coccyx Fractures|coccyx]], the ischium, the [[ilium]], and the pubis.<ref name=":1">White TD, Black MT, Folkens PA. [https://books.google.co.za/books?hl=en&lr=&id=oCSG2mYlD90C&oi=fnd&pg=PP1&dq=+.+Human+osteology.+&ots=VnpEcJPCWD&sig=Ful9Jtenlzzw4M4nniLS00LstnM#v=onepage&q=.%20Human%20osteology.&f=false Human osteology.] Academic press; 2011.</ref><ref name=":0">Lewis CL, Laudicina NM, Khuu A, Loverro KL. [https://anatomypubs.onlinelibrary.wiley.com/doi/pdf/10.1002/ar.23552 The human pelvis: Variation in structure and function during gait.] The Anatomical Record 2017;300(4):633-42.</ref> The structure of the pelvis supports the contents of the abdomen while also helping to transfer the weight from the spine to the lower limbs.<ref name=":2">Magee DJ. [https://books.google.co.za/books?hl=en&lr=&id=cxu0BQAAQBAJ&oi=fnd&pg=PP1&dq=Orthopedic+physical+assessment.&ots=mqGLvPFASn&sig=Jf3KLqp1lfiYQYoeVU2fMhEhhvs#v=onepage&q=Orthopedic%20physical%20assessment.&f=false Orthopedic physical assessment.] Elsevier Health Sciences; 2013.</ref> During [[gait]], the joints within the pelvis work together to decrease the amount of force transferred from the ground and lower extremities to the spine and upper extremities.<ref name=":2" /> | ||
== Osteology == | == Osteology == |
Revision as of 01:48, 5 November 2021
Description[edit | edit source]
The pelvis consists of the sacrum, the coccyx, the ischium, the ilium, and the pubis.[1][2] The structure of the pelvis supports the contents of the abdomen while also helping to transfer the weight from the spine to the lower limbs.[3] During gait, the joints within the pelvis work together to decrease the amount of force transferred from the ground and lower extremities to the spine and upper extremities.[3]
Osteology[edit | edit source]
- Sacrum
- Coccyx
- Two innominate bones, which consist of the:
- Ischium
- Ilium
- Pubis[1]
Joint Articulations[edit | edit source]
There are three articulations within the pelvis:
- Inferiorly between the sacrum and the coccyx
- Posteriorly between the sacrum and each ilium (sacroiliac (SI) joint)
- Anteriorly between the pubic bodies (pubic symphysis).[2]
Other articulations:
The pelvis and femur articulate via the acetabulum[1]
Ligaments[edit | edit source]
Ligaments of the Pelvis[edit | edit source]
- Iliolumbar ligament
- Lateral lumbosacral ligament
- Sacrotuberous ligament
- Sacrospinous ligament
Sacroiliac Ligaments[edit | edit source]
- Ventral/Anterior sacroiliac ligament
- Dorsal/Posterior sacroiliac ligament
- Interosseous sacroiliac ligament
Sacrococcygeal Ligaments[edit | edit source]
- Ventral/Anterio sacrococcygeal ligament
- Dorsal sacrococcygeal ligament
- Lateral sacrococcygeal ligament
Pubic Symphysis Ligaments[edit | edit source]
- Superior pubic ligament
- Inferior pubic ligament
- Anterior pubic ligament
- Posterior pubic ligament
Muscles[edit | edit source]
There are 36 muscles that attach to the sacrum or innominates. The purpose of these muscles is primarily to provide stability to the joint not to produce movement.[5]
Muscles that attach to the sacrum or innominates are:
Sex-specific differences[edit | edit source]
The female pelvis consists of a wider sacrum and a wider subpubic angle when compared to males. The female pelvis’ ischial spines are also less prominent than the male’s ischial spines.[6][7][8] The male pelvis’ sacrum is generally longer and more curved with a narrower sub-pubic arch.[8] In females a wider pelvic aperture is needed as it functions as the birth canal during labour.[6][7][9][10][11]
Clinical Examination[edit | edit source]
Assessment[edit | edit source]
Prior to the assessment of the sacroiliac joint both the lumbar spine and hip should be assessed and any underlying pathology should be ruled out.
Special Tests[edit | edit source]
SI Joint stress tests[edit | edit source]
- Anterior gapping test
- Sacroiliac distraction test
- Sacrotuberous ligament stress test
- Sacral compression test
- Rotational stress test
Leg Length tests[edit | edit source]
- Prone test
- Standing leg length test
- Functional leg length test
Other Special Tests[edit | edit source]
- Seated Flexion test (Piedallu's Sign)
- Supine long sitting test
- Sign of the buttock
- Posterior pelvic pain provocation test
- Gaenslen test
- Yeoman's test
- FABER (Figure-Four) test
- Fortin Finger Test
- Straight leg raise
- Gillet's test (Stork test)
Outcome Measures[edit | edit source]
Pathology/Injury[edit | edit source]
- Pubic symphysis dysfunction
- Spondyloarthritis
- Pregnancy related pelvic pain
- Pelvic fractures
- Sacroiliitis
Resources:[edit | edit source]
- ↑ 1.0 1.1 1.2 White TD, Black MT, Folkens PA. Human osteology. Academic press; 2011.
- ↑ 2.0 2.1 Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: Variation in structure and function during gait. The Anatomical Record 2017;300(4):633-42.
- ↑ 3.0 3.1 Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2013.
- ↑ Anatomy Zone. Bones of the Pelvis. Available from: https://youtu.be/3v5AsAESg1Q [last accessed 27/01/2020]
- ↑ Calvillo O, Skaribas I, Turnipseed J. Anatomy and pathophysiology of the sacroiliac joint. Current review of pain 2000;4(5):356-61.
- ↑ 6.0 6.1 Kurki HK. Pelvic dimorphism in relation to body size and body size dimorphism in humans. Journal of Human Evolution 2011;61(6):631-43.
- ↑ 7.0 7.1 Meindl RS, Lovejoy CO, Mensforth RP, Carlos LD. Accuracy and direction of error in the sexing of the skeleton: implications for paleodemography. American Journal of Physical Anthropology 1985;68(1):79-85.
- ↑ 8.0 8.1 Tague RG. Sexual dimorphism in the human bony pelvis, with a consideration of the Neandertal pelvis from Kebara Cave, Israel. American Journal of Physical Anthropology 1992;88(1):1-21.
- ↑ Rosenberg KR. The evolution of modern human childbirth. American Journal of Physical Anthropology.1992;35(S15):89-124.
- ↑ Lovejoy CO. The natural history of human gait and posture: part 2. Hip and thigh. Gait & posture 2005;21(1):113-24.
- ↑ Abitbol MM. The shapes of the female pelvis. Contributing factors. The Journal of reproductive medicine 1996;41(4):242-50.