Pelvis: Difference between revisions
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[[File:Gray241.png|alt=Bones of the pelvis|thumb|348x348px]]The pelvis consists of the sacrum, the coccyx,the ischium, the ilium, and the pubis. <ref name=":1">White, TD., Black, MT., Folkens, PA. Human osteology. Academic press; 2011.</ref><ref name=":0">Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: Variation in structure and function during gait. The Anatomical Record. 2017 Apr;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. Orthopedic physical assessment. Elsevier Health Sciences; 2013 Dec 4.</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|348x348px]]The pelvis consists of the sacrum, the coccyx,the ischium, the ilium, and the pubis. <ref name=":1">White, TD., Black, MT., Folkens, PA. Human osteology. Academic press; 2011.</ref><ref name=":0">Lewis CL, Laudicina NM, Khuu A, Loverro KL. The human pelvis: Variation in structure and function during gait. The Anatomical Record. 2017 Apr;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. Orthopedic physical assessment. Elsevier Health Sciences; 2013 Dec 4.</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" /> | ||
== Anatomy: == | == Anatomy: == | ||
=== Osteology === | === Osteology === |
Revision as of 12:43, 27 January 2020
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]
Anatomy:[edit | edit source]
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.[4]
Muscles that attach to the sacrum or innominates are:
Adductor brevis | Adductor longus | Adductor magnus | Biceps femoris - long head | Coccygeus |
Erector spinae | External oblique | Gluteus maxiumus | Gluteus medius | Gluteus minimus |
Gracilis | Iliacus | Inferior gemellus | Internal oblique | Latissimus dorsi |
Levator ani | Multifidus | Obturator internus | Obturator externus | Pectineus |
Levator ani | Piriformis | Psoas minor | Pyramidalis | Quadratus femoris |
Quadratus lumborum | Rectus abdominis | Rectus femoris | Sartorius | Semimembranosus |
Semitendonosus | Sphincter urethrae | Superficial transverse perineal ischiocavernous | Superior gemellus | Tensor fascia lata |
Transversus abdominus |
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.[5][6][7] The male pelvis’ sacrum is generally longer and more curved with a narrower sub-pubic arch.[7] In females a wider pelvic aperture is needed as it functions as the birth canal during labour.[8][5][9][6][10]
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 pathologist 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 - 70-90deg
- 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 Apr;300(4):633-42.
- ↑ 3.0 3.1 Magee DJ. Orthopedic physical assessment. Elsevier Health Sciences; 2013 Dec 4.
- ↑ Calvillo O., Skaribas I., Turnispeed J., Anatomy and pathophysiology of the SIJ, current science, 2000 (LOE 2A)
- ↑ 5.0 5.1 Kurki HK. Pelvic dimorphism in relation to body size and body size dimorphism in humans. Journal of Human Evolution. 2011 Dec 1;61(6):631-43.
- ↑ 6.0 6.1 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 Sep;68(1):79-85.
- ↑ 7.0 7.1 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 May;88(1):1-21.
- ↑ Abitbol MM. The shapes of the female pelvis. Contributing factors. The Journal of reproductive medicine. 1996 Apr;41(4):242-50.
- ↑ Lovejoy CO. The natural history of human gait and posture: part 2. Hip and thigh. Gait & posture. 2005 Jan 1;21(1):113-24.
- ↑ Rosenberg KR. The evolution of modern human childbirth. Am J Phys Anthropol. 1992;35(S15):89–124.