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Documente Profesional
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Angelo Bartsch J.
Cristin Cuadra G.
Aspectos(Osteolgicos(
Recuerdo-Anatmico-
Vs
3 Grados de Libertad
Movilidad
Rgida
Estable
Aspectos(Osteolgicos(
Recuerdo-Anatmico-
Aspectos(Osteolgicos(
Recuerdo-Anatmico-
Aspectos(Osteolgicos(
Recuerdo-Anatmico-
Aspectos(Osteolgicos(
Alineacin-de-las-Estructuras-
Android (male)
Platypelloid
Gynecoid (female)
Anthropoid
Figure 35.22: Shapes of four major types of pelves are based on the ratio between the transverse and conjugate diameters.
AC. The transverse diameter is greater than the conjugate. D. The opposite is true.
Aspectos(Osteolgicos(
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Chapter 35 | STRUCTURE AND FUNCTION OF THE BONES AND JOINTS OF THE PELVIS
Body weight force
140
a
b
30
Figure 35.26: The lumbosacral angle (a) is formed by the intersection of lines drawn between the long axis of the fifth lumbar
vertebra and the sacrum. It results from a forward sacral inclination (b) and wedge-shaped lower lumbar intervertebral discs and
bodies. As the sacral inclination and lumbar lordosis increase, the
lumbosacral angle decreases, and vice versa. The sacral inclination is greater in the female, while the lumbosacral angle is
greater in the male. W, superincumbent weight.
scientific studies has found its way into clinical and basic sci-
Aspectos(Osteolgicos(
Alineacin-de-las-Estructuras-
639
Clinical Relevance
1 2
L5
Aspectos(Osteolgicos(
PERIARTICULAR
Standing
transfer
Sitting
transfer
Aspectos(Osteolgicos(
Relacin-mecnica-
Aspectos(Artrolgicos(
Cpsula-Ar7cular>-Ligamentos-
Aspectos(Artrolgicos(
Cpsula-Ar7cular>-Ligamentos-
Aspectos(Artrolgicos(
Cpsula-Ar7cular>-LigamentosDorsal sacroiliac
ligament
Sacrospinous
ligament
Sacrotuberous
ligament
Iliolumbar
ligament
Sacrospinous
ligament
Sacrotuberous
ligament
Lumbosacral
ligament
Ventral
sacroiliac
ligament
C
Figure 35.32: Ligaments of the sacroiliac joint. A. Dorsal view. B. Medial view. C. Ventral view.
Aspectos(Artrolgicos(
Cpsula-Ar7cular>-Ligamentos-
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Ejes-y-Planos-de-Movimiento645
Osteocinem2ca(
Chapter 35 | STRUCTURE AND FUNCTION OF THE BONES AND JOINTS OF THE PELVIS
Farabeuf
Bonnaire
Weisl
Figure 35.34: Sagittal plane motion of the sacrum. In nutation,
the base of the sacrum moves ventrocaudally and its apex moves
dorsocranially; this occurs when the sacrum is loaded from
above, in trunk flexion, or in bilateral hip flexion. The base of
the sacrum moves in the opposite direction during trunk extension and bilateral hip extension, when it counternutates.
Osteocinem2ca(
Ejes-y-Planos-de-Movimiento-
Osteocinem2ca(
Simtricos-
Promontory
Ridge projecting along the anterior e
body of S1.
Nutation
Counternutation
A
B
Figure 17-4. Sacroiliac joint motions. (A) Nutation occurs
when the sacral promontory moves anteriorly and inferiorly
while the tip of the coccyx moves in the opposite direction.
(B) Counternutation occurs when the sacral promontory
moves posteriorly and superiorly while the tip of the coccyx
moves in the opposite direction.
Ala
Lateral flared wings that are actual
transverse processes.
Foramina
Located on the anterior (pelvic) a
surfaces are four pair of foram
serve as the exit for the anterio
divisions of the sacral nerves. T
foramina are larger.
Asimtricos-
Osteocinem2ca(
ythm
Osteocinem2ca(
Ritmo-Lumboplvico-
Figure 35.38: Common lumbopelvic rhythm. A. Normal standing posture. B. During the first 45! of trunk flexion, most motion results
from lumbar and sacral flexion causing the sacrum to nutate and the lumbar curve to flatten. C. In extreme trunk flexion, the lumbar
spine continues to flatten and the pelvis rotates about the femoral heads, while the sacrum paradoxically counternutates.
Osteocinem2ca(
254
PART III
Movimiento-Plvico-
ASIS
Pubic symphysis
Pubic symphysis
Pubic symphysis
Neutral
A
ASIS
ASIS
Anterior tilt
B
Posterior tilt
C
Figure 17-13. Pelvic movement in the sagittal plane. (A) The anterior superior iliac spine (ASIS) and the pubic symphysis
should be in the same vertical plane. (B) Anterior tilt occurs when the pelvis tilts forward, moving the ASIS anterior to the
pubic symphysis. (C) Posterior tilt occurs when the pelvis tilts backward, moving the ASIS posterior to the pubic symphysis.
Movimiento-Plvico-
Osteocinem2ca(
d by groups of muscles
elvis tilts in the antering muscle groups prog. 17-19). To tilt the
nk extensors, primarily
orly while the hip flexrsely, to tilt the pelvis
up anteriorly while the
s pull down posteriorly
muscle groups are actin opposite directions
CH
Pelvis remains
fairly level
Right hip abductors
Back extensors
Trunk flexors
Hip extensors
Rangos-de-Movimiento-Normal-
644
Osteocinem2ca(
Method(s)
Subjects
Pitkin and
Pheasant
1936
Inclinometry
Living subjects
Strachan et al.
1938
Cadavers
Weisl 1955
Movement of sacral
promontory via radiography
Living subjects
Mennell 1960
Living subjects
Colachis et al.
1963
Living subjects
Kapandji 1974
None
Frigerio 1974
Biplanar radiography
Cadavers and
living subjects
Egund et al.
1978
Roentgen stereophotogrammetry
Living subjects
with hypoor hypermobile SIJs
Wilder et al.
1980
Dried bony
specimens
Reynolds 1980
Stereoradiography
Cadaver
Miller et al.
1987
Cadavers
Scholten et al.
1988
Biomechanical model
Model
Sturesson et al.
1989
Stereoradiography
Living subjects
Smidt et al.
1995
Living subjects
Smidt et al.
1997
Computed tomography
Cadavers
En el plano sagital
entre 1 a 8, con
la media de 2 y 3.
Traslacin caudal
del sacro entre 0,5
y 8mm, con media
2-3mm
Probably these movements around the Y- and Zaxes reflect the wide variation in the anatomy of
the SIJ (Solonen 1957). The movements around the
X-axis and the helical axis did not show statistical
differences, thus it can be said that the innominates
move around the sacrum as a unit or the sacrum
moves symmetrically between the ilia.
Rangos-de-Movimiento-Normal-
Osteocinem2ca(
Supine to sitting
X
Z
9:35:37 AM
Atrocinem2ca(
Traslacin-
nd four men
d only 2.5 of
.51.6 mm of
ducted in the
al (2000) felt
955, Colachis
verestimated
f SIJ mobility
ed those of
ge values for
g 1.8 of rotan) for the men
m translation)
es were noted
ed that more
ation should
sling 1995).
ablished that
used to meashas recently
onie Damen
ations across
b, 1997, 1999,
SIJ is variable
NUTATION/COUNTERNUTATION OF THE
Figure 6.7 When the sacrum nutates, its articular surface
SACRUM
glides inferoposteriorly relative to the innominate.
Nutation and counternutation are osteokinematic
terms that describe how the sacrum moves relative
to the innominates regardless of how the pelvic girdle
is moving relative to the lumbar spine and femora.
Nutation of the sacrum occurs when the sacral
Sacral counterNutation
Anterosuperior
Glide
Osteocinem2ca(
Limitantes-del-MovimientoMsculos(que(refuerzan(y(estabilizan(la(ar2culacin(
sacroiliaca(
1.>-Erector-Espinal2.>-Mul7do-Lumbar3.>-Grupo-Muscular-Abdominal----a.-Oblicuos-Internos-y-externos----b.-Rectos-Abdominal----c.-Transverso-abdominal4.>-Isquio7biales-
Mecnica(Muscular(
Patrones-de-Reclutamiento-
Mecnica(Muscular(
Interaccin-de-Torques-
Funcionalidad(
Torque(Extensor(Generado(
Torque((Nm)(
1.>-Msculos-Extensores-
200-
2.>-Ligamentos-
72-
Funcionalidad(
Funcionalidad(
Funcionalidad(
Aplicacin-de-ConocimientosAdquiridos-
Aplicacin-de-ConocimientosAdquiridos-
Relaxed standing
Standing, performing
vasalva
Measurements of Pressures in the Intervertebral
Disc Wilke
et almaneuver
757
Wilke
Measurements
of Pressures
the Intervertebral
al Standing,
757
easurements
of Pressures
in theinIntervertebral
Disc Disc
Wilke
et al et757
bent forward
Funcionalidad(
Position
Relaxed standing
0.50
Relaxed
standing
0.50
Relaxed
standing
0.50
Climbing
stairs,
one
stair
at
a time
Standing, of
performing
vasalva
maneuver
0.92
by muscle
spasms
thatvasalva
resolved
with
training
the back
musStanding,
performing
vasalva
maneuver
0.92
Standing,
performing
maneuver
0.92
Climbing
stairs,
two
stairs
at
bent forward
1.10a time
cles.Standing,
TwoStanding,
years
the experiment,Standing,
the subject
reported
bent forward
1.10 Walking down stairs, one stair at a time
bent after
forward
1.10 no
further episodes of back pain, and an MRI investigation did not
Walking down stairs, two stairs at a time
Sitting relaxed, without backrest Lifting 20 kg, bent over with
0.46round back
show
anySitting
change
of the
treated
discSitting
in comparison
with
the
relaxed,
without
backrest
0.46
Sitting
relaxed,
without
backrest
0.46
actively straightening the back
0.55 school
Lifting 20 kg as taught in back
Sitting
actively
straightening
the back
Sitting
actively
straightening
the back
status
before
the
experiment.
Sitting with maximum0.55
flexion0.55 Holding 20 kg close to the0.83
body
with maximum
0.83supporting the elbows
SittingSitting
with maximum
flexionflexion
0.83 tight
Sitting bent forward with
0.43
Holding
20
kg,
60
cm
away
from the chest
bent forward
withsupporting
tight supporting
the elbows
0.43
SittingSitting
bent forward
with tight
the elbows
0.43chair
Results
Sitting
slouched
into the
0.27
slouched
into
the chair Standing up from a chair
SittingSitting
slouched
into the
chair
0.27 0.27
1.10
Standing
up
from
a
chair
1.10 Pressure increase during night (over a period of 7 hr)
Standing
up
from
a
chair
1.10
All positions and activities were achieved or performed
0.530.65
0.530.65
Walking with tennis shoes
0.530.65
0.530.65
0.12
0.11
0.25
0.15
0.38
0.700.80
0.50
0.92
1.10
0.46
0.55
0.83
0.43
0.27
1.10
0.530.65
0.530.65
0.350.95
0.350.85
0.500.70
0.301.20
0.380.60
0.300.90
2.30
1.70
1.10
1.80
0.100.24
0.530.65
0.530.65
related measurements
were recorded usually
Jogging with hard street shoes
0.350.95
Jogging
with hard
shoes shoes Jogging with tennis shoes
0.350.95
Jogging
withstreet
hard street
0.350.95
0.350.85 some training.
pretrials; activities
Measurements
Intervertebral
Disc required
Wilke et al 757
Jogging
with
tennis
shoes shoes of Pressures in the
0.350.85
Jogging
with tennis
0.350.85
after two
Ejercicios(
Ejercicios(