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Chapter 4.4

OT 215 Chapter 4.4: Chapter 4.4 Pelvic Girdle and Lower Limb

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Colorado State University
Occupational Therapy
OT 215

❖ Pelvic Girdle and Lower Limb ➢ Your pelvic girdle consists of your two hip bones that articulate with each other at the symphysis pubis and posteriorly with the sacrum (a triangular-shaped bone in your lower back) ■ This forms the bowl-shaped pelvis ➢ The two joint between your hip bones and the sacrum are called sacroiliac joints ➢ The pelvic girdle has these functions ■ Supports the axial skeleton ■ Transmits the upper body’s weight to the lower limbs ■ Provides attachments for the lower limbs ■ Protects the internal reproductive organs, urinary bladder, and distal segment of the large intestine ➢ Each of your hip bones is actually a fusion of three bones: the ilium, ischium, and pubis ■ The fusion occurs in the region of the acetabulum, a cup-shaped cavity on the lateral surface of the hip bone that receives the head of the femur, or thigh bone ➢ The lower part of the pelvis is formed by the lower ilium, ischium, and pubic bones that surround a short canal-like pelvic cavity, through which the rectum, vagina, and urethra pass ■ In females, the infant passes down this canal during childbirth ➢ WORD PRONUNCIATION ELEMENTS DEFINITION acetabulum ass-eh-TAB-you-lum Latin vinegar cup The cup- shaped cavity of the hip bone that receives the head of the femur to form the hip joint femur FEE-mur Latin thigh The thigh bone femoral (adj) FEM-oh-ral S/ -al pertaining to Pertaining to R/ femor- femur the femur ilium ILL-ee-um Latin groin Large wing- shaped bone at the upper and posterior part of the pelvis ischium IS-kee-um Greek hip Lower and ischia (pl) IS-kee-ah S/ -al pertaining to posterior part of ischial (adj) IS-kee-al R/ ischi- ischium, hip the hip bone bone Pertaining to the ischium pelvis PEL-viss Latin basin Basin-shaped ring of bones, ligaments, and muscles at the base of the spine. Also, any basin-shaped cavity, like the pelvis of the kidney pelvic (adj) PEL-vik S/ -ic pertaining to Pertaining to R/ pelv- pelvis the pelvis pubis PYU-bis Latin pubis Alternative pubic (adj) PYU-bik S/ -ic pertaining to name for the R/ pub-pubis pubic bone Pertaining to the pubic bone sacroiliac say-kroh-ILL-ih-ak S/ -ac pertaining to The joint joint JOINT R/C sacr/o-sacrum between the F -ili- ilium sacrum and the R ilium symphysis SIM-feh-sis Greek grow together Two bones symphyses SIM-feh-seez joined by (pl) fibrocartilage; in this case, the two pubic bones ❖ Disorders of the Pelvic Girdle (LO 4.1, 4.2, and 4.8) ➢ Sacroiliac (SI) joint strain is a common cause of lower back pain ■ Unlike most joints, the SI joint is designed to move only ¼ of an inch during weight-bearing and forward-bending movements ■ Its main function is to provide shock absorption for the spine ■ Because stretching in the SI joint ligaments makes this joint overly mobile, it’s more susceptible to wear and tear, including painful arthritis ➢ A clinical examination, joint X-ray (radiology), and CT scan may be used to diagnose the presence of sacroiliac strain ■ Standard treatment involves stabilizing the joint with a brace and strengthening the lower back muscles with physical therapy ■ Occasionally, arthrodesis (fixation or stiffening of a joint by surgery) of the joint is necessary ➢ Diastasis symphysis pubis sometimes occurs during pregnancy. ■ It is caused by excessive stretching of pelvic ligaments, which widens the joint between the two pubic bones ● This leads to pain and difficulty in walking, climbing stairs, and turning over in bed ■ During pregnancy, however, hormones generally enable connective tissue in the SI joint area to relax so the pelvis can expand enough to allow birth without causing SI joint strain ➢ WORD PRONUNCIATION ELEMENTS DEFINITION arthrodesis ar-THROW-dee-sis S/ -desis to fuse Fixation or R/CF together stiffening of a arthr/o- joint joint by surgery brace BRACE Old English to Appliance to fasten support a part of the body in its correct position diastasis die-ASS-tah-sis Greek separation Separation of normally joined parts radiology ray-dee-OL-oh-jee S/ -logy study of The study of radiologist ray-dee-OL-oh-jist R/CF radi/o-radiation, X- medical S/ rays imaging -logist one who Medical studies, specialist specialist in the use of X-rays and other imaging techniques stable STAY-bell Latin steady Steady, not stabilize STAY-bill-ize S/ -ize action varying R/ stabil- steady, fixeTo make or hold firm and steady ❖ Bones and Joints of the Hip and Thigh ➢ Your hip joint is a ball-and-socket mechanism formed by the head of your femur (thigh bone) and the acetabulum (cup-shaped hip socket) of your hip bone ➢ The labrum is the articular cartilage that forms a rim around the hip joint socket, cushioning the joint and helping to keep your femoral head in place in the socket ➢ FInally, the hip joint is secured by a thick joint capsule reinforced by strong ligaments that connect the neck of the femur to the rim of the hip socket ❖ Disorders and Injuries of the Hip Joint (LO 4.2 and 4.8) ➢ Hip pointer, often a football-related injury, is a blow to the rim of the pelvis that leads to bruising of the bone and surrounding tissues ➢ Osteoarthritis is common in the hip as a result of aging, weight bearing, and repetitive use of the joint ■ The cartilage on both the acetabulum and the head of the femur deteriorates, causing friction between the bones of the femoral head and the acetabulum that leads to pain and loss of mobility ➢ Rheumatoid arthritis can also affect the hip, beginning in the synovial membrane and progressing to destroy cartilage and bone ➢ Avascular necrosis of the femoral head is the death (necrosis) of bone tissues when the blood supply is cut off (avascular), usually as a result of trauma ➢ Fractures of the neck of the femur occur as a result of a fall, most commonly in elderly women with osteoporosis ❖ Surgical Procedures of the Hip Joint (LO 4.2 and 4.8) ➢ Arthroplasty, a total replacement of the hip joint with a metal prosthesis, is the most common hip surgery today ■ Here, the diseases parts of the joint are removed and replaced with artificial parts made of titanium and other metals, ceramics, and plastics ➢ Arthrodesis is a surgical procedure that fixates or stiffens a joint ➢ WORD PRONUNCIATION ELEMENTS DEFINITION arthrodesis ar-THROW-dee-sis S/ -desis to fuse Fixation or arthroplasty AR-throw-plas-tee R/CF together stiffening of a S/ arthr/o- joint joint by surgery R/CF -plastyreshaping Surgery to by surgery repair, as far as arthr/o- joint possible, the function of a joint avascular a-VAS-cue-lar S/ -ar pertaining to Without a blood P/ a- without supply R/ -vascul- blood vessel labrum LAY-brum Latin lip-shaped Cartilage that forms a rim around the socket of the hip joint necrosis neh-KROH-sis Greek death Pathologic necrotic (adj) neh-KROT-ik S/ -tic pertaining to death of cells or R/CF necr/o- death tissue Pertaining to or affected by necrosis prosthesis PROS-thee-sis Greek addition An artificial part prosthetic pros-THET-ik S/ -ic pertaining to to remedy a (adj) R/CF prosthet- defect in the prosthesis body Pertaining to a prosthesis ❖ The Knee Joint (LO 4.2 and 4.9) ➢ Each of your knees is a hinged joint formed with these four bones: ■ The lower end of the femur, shaped like a horseshoe ■ The flat upper end of the tibia ■ The flat triangular patella (kneecap), embedded in the patellar tendon and articulating with the femur ■ The fibular, which forms a separate joint-the tibiofibular joint- by articulating with the tibia ➢ Within the knee joint, two crescent-shaped pads of cartilage-the medial and lateral menisci-lie on top of the tibia and articulate with the femur ■ This cartilage helps to distribute weight more evenly across the joint surface to minimize wear and tear ➢ The knee joint has a fibrous capsule, lined with synovial membrane that secretes synovial fluid to lubricate the joint ➢ Four ligaments hold the knee joint together: the medial and lateral collateral ligaments located outside the joint and the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) located insid
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