Ilium

14 Ilium

Orientation and general presentation (Figs 14.1 & 14.2)

The joint cavity of the hip joint, or acetabulum (IAC), is oriented laterally, whereas the obturator foramen (1) and the greater sciatic notch (2) have an inferior and a posterior position, respectively. The iliac crest (3) is on top and shows a widening called the crest tubercle (ICT). The sharp anterior superior iliac spine (IAS) is located on the anterior aspect of (3). The posterior superior iliac spine (IPS) is located on the other side of (3) and is less sharp. The posterior inferior iliac spine (IPI) is found below IPS. The posteroinferior aspect of the ilium shows a large tuberosity – the ischium or ischial tuberosity (IIT). Both ilia articulate anteriorly by the pubic joint (IPJ), which has a well pronounced anterior pubic edge. The inferior ramus (4) runs between IPJ and ITT. The pubic spine (IPP) is located about 2 cm from IPJ. Each ilium articulates with a femur (5) through the joint surface found within IAC. This crescent-shaped joint surface is called the lunate surface (6).

Figure 14.1 Ilium (3D model).

A Position in pelvis: anterior view. Isolated bone: B lateral view; C medial view.

Figure 14.2 Ilium (anatomic specimens).

Position in the pelvis: A anterolateral view; B anterior view. C Superior landmarks: laterosuperior view. D Ischial tuberosity: lateroinferior view. E anterior view. F Acetabulum: lateral view.

Ilium – Anterior Superior iliac spine (IAS)[R,L] ISB H|Anim

Landmark IAS

Prominent anterior and superior end of the iliac crest (see Figs 14.1 & 14.2).

The palpator stands next to the standing subject.

Place your hand on the subject’s flank, with your fingers on the anterior part of the iliac crest.

Follow the anterior part of the iliac crest forwards (blue arrow).

At the anterior extremity of the iliac crest, your finger will feel a prominent bony bump, under which it can get around, below and to the side.

This is IAS. Select the most prominent point of IAS.

IAS is relatively superficial, just under the skin, and is usually easily palpable. However, palpation may be more difficult on obese subjects.

Observe the ilium from a lateral view. Follow the anterior part of the iliac crest anteriorly (blue arrow) until you reach the most anterior point. Select the tip of the spine.

Then turn the model 90° to an anterior frontal view. Make sure that the selected landmark is positioned correctly on the center of IAS.

Ilium – Posterior Superior iliac spine (IPS)[R,L] ISB H|Anim

Landmark IPS

Prominent posterior and superior end of the iliac crest (see Figs 14.1 & 14.2).

The palpator stands behind the standing subject.

Place your thumb on the posterior part of the iliac crest.

Move down and backwards over the iliac crest just to the point where the thumb feels a prominent bony bump (IPS).

Select the tip of IPS (actually, your finger will reach the lateral aspect of IPS because of the orientation of the ilium).

Manual palpation tip

• For some subjects, small cutaneous hollows are visible above the buttocks. Landmark IPS is found deep in these hollows.

Observe the ilium from a posterolateral view. Go backwards (dotted blue arrow) on the posterior part of the iliac crest until IPS is met. Select its center (slightly lateral).

Next, view the model from a posterior view. Make sure that the selected landmark is correctly located slightly lateral to the center of IPS.

Tags: Color Atlas of Skeletal Landmark Definitions Guidelines for Repr

Sep 9, 2016 | Posted by admin in MANUAL THERAPIST | Comments Off

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