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Topic: Sacrotuberous

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	Pelvis and Acetabular fractures
		Distally, the pelvic outlet is bordered by the inferior pubic rami, the ischium, and the sacrotuberous ligaments to the distal sacrum and coccyx.
		Posteriorly, the sacroiliac joints, stabilized by the anterior and posterior (ventral and dorsal) sacroiliac ligaments and the interosseous ligaments, and the sacrotuberous and sacrospinous ligaments are important in maintaining the stability of the pelvic ring.
		As the lateral force is directed inwards, the sacrotuberous and sacrospinous ligaments are shortened rather than stressed and are rarely disrupted; therefore, these fracture are not typically associated with increased pelvic volume.
	www.teambone.com /chapters/adult_trauma/ace.html (2583 words)

	Gray, Henry. 1918. Anatomy of the Human Body. Page 309
		—The sacrospinous ligament is thin, and triangular in form; it is attached by its apex to the spine of the ischium, and medially, by its broad base, to the lateral margins of the sacrum and coccyx, in front of the sacrotuberous ligament with which its fibers are intermingled.
		The greater sciatic foramen is bounded, in front and above, by the posterior border of the hip bone; behind, by the sacrotuberous ligament; and below, by the sacrospinous ligament.
		The lesser sciatic foramen is bounded, in front, by the tuberosity of the ischium; above, by the spine of the ischium and sacrospinous ligament; behind, by the sacrotuberous ligament.
	www.bartleby.com /107/pages/page309.html (623 words)

	AMTA > Anatomical and Biochemical considerations related to assessment of Pelvic Dysfunction
		The sacrotuberous ligament limits sacral nutation, and will be tensioned by hamstrings contraction or stretch due to fascial linkage between biceps femoris and the lateral portion of the sacrotuberous ligament (Saunders et al, 1997).
		It is reasonable to postulate that weakness in gluteus maximus, the deepest layer of abdominals, multifidus, or lattisimus dorsi could decrease the effect of thoracolumbar fascia on maintaining SIJ force closure, and increase its susceptibility to injury.
		The orthogonal plane of the sacrotuberous ligament as visualised by MRI.
	www.amta.com.au /article1.html (1799 words)

	Sacrospinous ligament - Wikipedia, the free encyclopedia
		The sacrospinous ligament (small or anterior sacrosciatic ligament) is thin, and triangular in form; it is attached by its apex to the spine of the ischium, and medially, by its broad base, to the lateral margins of the sacrum and coccyx, in front of the sacrotuberous ligament with which its fibers are intermingled.
		It is in relation, anteriorly, with the Coccygeus muscle, to which it is closely connected; posteriorly, it is covered by the sacrotuberous ligament, and crossed by the internal pudendal vessels and nerve.
		Laxity of this ligament alomg with the sacrotuberous ligament allows for this posterior rotation to occur.
	en.wikipedia.org /wiki/Sacrospinous_ligament (238 words)

	Chapter 31: The bones, joints and walls of the pelvis
		The sacrotuberous ligament converts the sciatic notches into foramina, which are separated from each other by the sacrospinous ligament (see figs.
		The lateral and posterior walls are separated by the sacrotuberous and sacrospinous ligaments and by the greater and lesser sciatic foramina.
		The posterior wall, formed by the sacrum and coccyx, is lined laterally by the piriformis and coccygeus muscles.
	www.dartmouth.edu /~humananatomy/part_6/chapter_31.html (1884 words)

	[No title] (Site not responding. Last check: 2007-10-31)
		Together with the sacrotuberous ligament, it converts the greater and lesser sciatic notches into greater and lesser sciatic foramina.
		It is the area that is lateral to the anal canal and inferior to the pelvic diaphram.
		The anterior recesses are the parts of the ischioanal fossa that extend above the perineal membrane, and the posterior recesses extend deep to the sacrotuberal membrane and superior to the gluteus maximus.
	www-personal.umich.edu /~benwei/cgi-data/shared/linked/Perineum(PQ).doc (2582 words)

	ACVC 2001 - Perineal Hernia Repair
		If the patient cannot ambulate on its hind leg or exhibits severe hind leg pain (i.e., ipsilateral to the side of hernial repair) and the sacrotuberous ligament was utilized in the closure, it is likely that one of the sutures placed around the sacrotuberous ligament has entrapped the sciatic nerve.
		When using the sacrotuberous ligament in hernial repair, care should be taken to use its leading edge instead of encircling it as the close proximity of the sacrotuberous ligament and sciatic nerve may result in sciatic nerve entrapment.
		If the surgeon suspects sciatic nerve entrapment the patient should be immediately anesthetized, the hernial repair re-explored, sutures placed around the sacrotuberous removed, and the hernia re-repaired using the leading edge of the sacrotuberous ligament.
	www.vin.com /VINDBPub/SearchPB/Proceedings/PR05000/PR00410.htm (1683 words)

	Carnivore Anatomy Lab 6 Introduction
		Because of the absence of a sacrotuberous ligament, proximal muscle fibers of the biceps femoris m.
		in the cat (in the dog the proximal muscle fibers attach to the sacrotuberous ligament and remain with the biceps femoris m.).
		You might regard the patella as a sesamoid bone within the tendon of the quadriceps femoris m., rather than calling the connection between the patella and tibia a "patella ligament".
	vanat.cvm.umn.edu /carnLabs/Lab06/Lab06.html (326 words)

	WebLecture-Pelvis-Lec16 (Site not responding. Last check: 2007-10-31)
		This posterior view shows that, on each side, the sacrotuberous and sacrospinous ligaments cross in a modified "X". When viewed posteriorly, it is evident that the sacrotuberous ligament is the more exteriorly placed of the two ligaments, as the ischial tuberosity projects more posteriorly than the ischial spine with the pelvis in anatomical position.
		The sacrotuberous ligament crosses a longer interval making it relatively longer than the sacrospinous ligament.
		The blue structure peeking out from beneath the inferior border of the sacrotuberous ligament is the tendon of the long head of the biceps femoris which has two sites of attachment: one on the tendon, the other on the upper border of the ischial tuberosity.
	oac.med.jhmi.edu /weblec/templatev1/lec16.html (214 words)

	AMTA > The Integrated Pelvis
		sacrotuberous lig.- attaches from the ischeal tuberosity to the inferior lateral angle (ILA) of the sacrum.
		Fascial connections between gluteus maximus and contralateral latissimus dorsi via the T-L fascia are directed at 90º to the joint surface and so their combined action increase stabilisation of the joint.
		Stabilisation of the lumbo-pelvic region is maintained by activation of specific muscles, and the subsequent generation of forces onto interconnecting fascia and ligaments to produce lateral compressive forces that approximate the joint surfaces (force closure) (Hodges, 1998a; Vleeming et al, 1995a; Vleeming et al, 1995b).
	www.amta.com.au /article2.html (1474 words)

	Pudendal Nerve Resources - Prolotherapy and PNE (Site not responding. Last check: 2007-10-31)
		Robert, he said that I had the "worst entrapment he'd ever seen" because my sacrotuberous ligament, which is normally about 2mm in diameter, had grown to 2cm in diameter and was completely burying both pudendal nerves.
		Most of my butt pain is very close to, if not at, the insertion point of the sacrotuberous ligament on the end of my ischial tuberosities.
		My sacrotuberous ligament became so swollen and tight that I could actually feel it like a thick tightrope wire stretched across each buttock.
	www.pudendalnerve.info /forums/pnforum/showthread.php?t=268 (538 words)

	Sacroiliac Revisited: The Importance of Ligamentous Integrity
		These include the sacrotuberous ligament, the sacrospinous ligaments, the iliolumbar ligaments, and the long posterior sacroiliac ligaments.
		Evaluate the sacrotuberous ligaments for tenderness with digital pressure along three areas, all at junctions of the ligament and bone: 1.
		She pointed to her sacrotuberous ligament and said, "This is one of my most painful areas." I proceeded to examine the ligaments of her pelvis, as described above, and found significant tenderness and laxity in the sacrotuberous and sacrospinous ligaments.
	www.chiroweb.com /archives/23/14/10.html (1797 words)

	[No title] (Site not responding. Last check: 2007-10-31)
		Posterolateral: on each side by the sacrotuberous ligament Posterior: tip of coccyx The perineum is diamond-shaped and can be subdivided into two triangles by drawing a line between the two ischial tuberosities.
		Find the external anal sphincter muscle, which encircles the anal canal, and again identify the inferior rectal nerve and vessels that supply the external anal sphincter and the lower part of the anal canal.
		Cut the sacrotuberous ligament in the middle and reflect its ends.
	www.utmed.com /studynotes/gross/LAB41THEFEMALE.doc (1164 words)

	Chronic Perineal Pain Caused by Pudendal Nerve Entrapment: Anatomy and CT-Guided Perineural Injection Technique -- ...
		Pudendal nerve emerges from pelvis inferior relative to piriformis muscle and enters gluteal region medial relative to sciatic nerve, superficial relative to sacrospinous ligament, and deep relative to sacrotuberous ligament.
		Thin-slice CT scans obtained at level of ischial spine show sacrospinous (short arrows, A) and sacrotuberous (long arrows, A) ligaments and calcified internal pudendal artery (arrowhead, A) marking location of pudendal bundle.
		In thin-section CT scans obtained at level of pudendal canal, calcified internal pudendal artery (arrowhead, C) marks site of pudendal bundle in canal, and fat plane between neurovascular bundle and obturator internus muscle is clearly seen (arrow, C).
	www.ajronline.org /cgi/content/figsonly/181/2/561 (1119 words)

	Chronic Perineal Pain Caused by Pudendal Nerve Entrapment: Anatomy and CT-Guided Perineural Injection Technique -- ...
		Segment of sacrotuberous ligament also has been removed, revealing pudendal nerve.
		Note location of falciform process of sacrotuberous ligament, which is possible site for pudendal nerve entrapment.
		Photograph of axial section acquired at level of ischial spine after CT-guided injection of fluorescein dye and insertion of embolization coil shows sacrospinous (short arrow) and sacrotuberous (long arrow) ligaments and pudendal neurovascular bundle stained yellow in interligamentous space.
	www.ajronline.org /cgi/content/full/181/2/561 (2429 words)

	Piriformis Syndrome: Part I
		Besides backache, the piriformis muscle contracture and associated adhesions has been related to radiating pain from the sacrum to the hip joint over the gluteal region to the posterior thigh, coccydynia,4 dyspareunia, male impotency5, and oblique axis rotation of the sacrum with its effect on the total spine up to the atlanto-occipital region.5
		According to Gray6 and Freiberg7 the piriformis arises from the anterior sacrum between the second to fourth anterior sacral foramina, from the margin of the greater sciatic foramen and from the anterior surface of the sacrotuberous ligament, the anterior sacrospinous ligament and the capsule of the sacroiliac joint.
		In a study by Freiberg and Vinke11 on 10 cadavers it was found that after raising the leg 25 degrees, the sacrotuberous ligament becomes taut because of its attachment to the ischial tuberosity and the hamstrings.
	www.chiroweb.com /hg/09/13/28.html (1073 words)

	Anatomy of Pelvic Arteries Adjacent to the Sacrospinous Ligament: Importance of the Coccygeal Branch of the Inferior ...
		and sacrotuberous ligaments and that of the coccygeal and gluteal
		of the sacrospinous ligament and pierces the sacrotuberous ligament
		and sacrotuberous ligaments was attempted in all pelvises.
	www.greenjournal.org /cgi/content/full/94/6/973 (1728 words)

	XII. Surface Anatomy and Surface Markings. 9. Surface Anatomy of the Perineum. Gray, Henry. 1918. Anatomy of the Human ...
		Behind in the middle line is the tip of the coccyx.
		—The margin of the Glutæus maximus forms the postero-lateral boundary, and in thin subjects, by pressing deeply, the sacrotuberous ligament can be felt through the muscle.
		The only other muscles influencing surface form are the Ischiocavernosus covering the crus penis, which lies on the side of the pubic arch, and the Sphincter ani externus, which, in action, closes the anal orifice and causes a puckering of the skin around it.
	bartleby.com /107/287.html (312 words)

	Articles
		In the late swing phase of gait, dorsiflexion of the foot in preparation for heel strike generates tension in the peroneus longus.
		Vleeming (7) indicates that approximately 18 percent of that force is transferred into the biceps femoris, which works to tension the sacrotuberous ligament, stabilizing the sacrum and ilium at heel strike.
		If the belt user has developed the habit of responding to the exteroception provided by the belt by pushing the abdominal wall outward (which will inhibit the TVA), then it is very likely the brain may up-regulate the recruitment of the biceps femoris in an attempt to stabilize the thoracolumbar fascia.
	www.chekinstitute.com /articles.cfm?select=17 (3667 words)

	Human Anatomy - Lab 13 Step 6 (Site not responding. Last check: 2007-10-31)
		To view the pudendal nerve and internal pudendal vessels, retract (or cut and remove a piece of) the sacrotuberous ligament [held by the retractor] near its attachment to the sacrum.
		The pudendal nerve, internal pudendal vein and internal pudendal artery pass posterior to the ischial spine between sacrospinous ligament [probe; retractor holds the sacrotuberous ligament] and sacrotuberous ligament.
		The further course of the pudendal nerve and internal pudendal vessels will be studied when the perineum is dissected.
	ect.downstate.edu /courseware/haonline/labs/l13/060103.htm (114 words)

	eMedicine - Fractures, Pelvic : Article Excerpt by: Charles Sheppard, MD, FACEP
		Grade I - Associated widening (slight) of pubic symphysis or of the anterior sacroiliac (SI) joint, while sacrotuberous, sacrospinous, and posterior SI ligaments remain intact
		Grade II - Associated widening of the anterior SI joint caused by disruption of the anterior SI, sacrotuberous, and sacrospinous ligaments, while posterior SI ligaments remain intact
		Vertical shear (VS) involves symphyseal diastasis or vertical displacement anteriorly and posteriorly, which is usually through the SI joint, though occasionally through the iliac wing or sacrum.
	www.emedicine.com /emerg/byname/fractures-pelvic.htm (608 words)

	hip module: SS/ST ligaments (Site not responding. Last check: 2007-10-31)
		The sacrospinous and sacrotuberous ligaments do not have direct contact with the hip joint.
		The sacrotuberous ligament extends from the sacrum to the ischial tuberosity.
		It helps form the lesser sciatic foramen from the lesser sciatic notch.
	www.dartmouth.edu /~anatomy/hip/hipligaments/ligaments7.html (227 words)

	[No title]
		No, the answer is B. The sacrotuberous ligaments form the lateral boundaries of the anal triangle.
		Which muscle overlies the sacrotuberous ligament, thus forming part of the lateral border of the anal triangle?
		the posterior recess of the ischiorectal fossa is found between the pelvic diaphragm and the sacrotuberous ligament
	kumc.edu /research/medicine/pharmacology/CAI/webCAI/anatomy/tk13.wbc (1725 words)

	Abstracts (Site not responding. Last check: 2007-10-31)
		APC 1 - Rupture of anterior SI ligs, attenuation of sacrospinous and sacrotuberous ligs.
		APC 2 - Rupture of sacrospinous and sacrotuberous ligs.
		Rupture of anterior SI, posterior SI,sacrospinous, sacrotuberous ligs
	www.hwbf.org /ota/s2k/refs/class.htm (85 words)

	Pudendal Nerve Entrapment Syndrome: Diagnosis and Treatment
		2) crosses the sacrospinous ligament and dives under the sacrotuberous ligament
		In other patients, the sacrotuberous or sacrospinous ligaments must be cut or trimmed.
		Overall, surgical treatments for pudendal nerve entrapment syndrome are new and success rates are not as good as with other type of nerve entrapment.
	www.nervemed.com /Injections/PudendalInj_files/Pudendal_Nerve.html (241 words)

	WSAVA 2001 - TRANSPOSITION OF THE SACROTUBEROUS LIGAMENT BY A NEW TECHNIQUE FOR THE TREATMENT OF COXOFEMORAL LUXATION ...
		TRANSPOSITION OF THE SACROTUBEROUS LIGAMENT BY A NEW TECHNIQUE FOR THE TREATMENT OF COXOFEMORAL LUXATION IN DOGS
		Purpose: to assess the technique of surgical transposition the sacrotuberous joint ligament to act as the ligamentum teres for the treatment of coxofemoral luxation in dogs.
		Results: the ligament was successfully transposed into the femur to ensure survival, and coalescence was achieved between the bone at the end of the ligament and the bony tissue in the femoral tunnel.
	www.vin.com /VINDBPub/SearchPB/Proceedings/PR05000/PR00224.htm (284 words)

	Anterior Posterior Compression Injuries - Wheeless' Textbook of Orthopaedics
		- stretched but intact anterior SI, sacrotuberous, and sacrospinous ligaments,intact posterior SI ligaments;
		- widened anterior SI joint; disrupted anterior SI, sacrotuberous, and sacrospinous ligaments, intact posterior SI ligaments;
		- disrupted anterior SI, sacrotuberous, and sacrospinous lig;
	www.wheelessonline.com /ortho/anterior_posterior_compression_injuries (440 words)

	Has Anyone hurt their SacroTuberous Ligament? - Bodybuilding.com Forums
		Save Up To 50% Off Of Retail Store Prices In The Bodybuilding.com Store!
		Does anyone have an injury from squats or deadlifts involving the sacrotuberous ligament?
		If you have any suggestions on expediting the healing process that would be helpful.
	forum.bodybuilding.com /showthread.php?t=600762 (75 words)

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