Can back pain caused by symptom-giving sacroiliac joint relaxation ...

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The broad ligament of the uterus In simple terms, the broad ligament of the uterus can be described as a subperitoneal space disposed in the frontal plane, filled with connective and adipose tissue and pervaded by supplying structures for the uterus and the vagina. The superior margin of the broad ligament forms a kind of "clothes line" which suspends the peritoneum and, like a septum, separates the pelvic bowl into the vesicouterine and the rectouterine excavation. [35, 40] The round ligament of the uterus The round ligament (ligamentum teres uteri) originates on both sides of the uterus at the uterine horns, goes down anterolaterally to the inguinal region, passes through the inguinal canal and continues on to the labium majus pudendi (large pudendal lip). The round ligament develops in the female embryo from the lower gubernaculum. It Fig. 1E: Round ligaments of uterus [3] consists of tight connective tissue and smooth muscle cells, and its function is to maintain the uterus in anteflexion. [3, 35, 40] During pregnancy it has to be very elastic in order to enable the growth of the uterus. The round ligament shows a fourfold length expansion during these nine months. [3] The suspensory ligament of the ovary Laterally the broad ligament of the uterus forms, in its extension, a real ligament which joins the ovary, the infundibulum and the posterior aspect of the fallopian tube loosely to the lateral pelvic wall and the fascia of the psoas muscle. This ligament is called suspensory ligament of the ovary or, in clinical contexts, infundibulopelvic ligament. [18, 35, 40] Master’s Thesis Wolfgang Aspalter 16
The sacrouterine ligaments The sacrouterine ligaments attach at the level of the uterine isthmus and connect the uterus to the sacrum and the rectum. They constitute a posterior reinforcement of the rectouterine folds and prevent the cervix from moving in the direction of the urinary bladder and the symphysis. [3, 40] 1.1.4. Innervation Innervation of the SIJ The joint capsule is innervated by dorsal branches coming from S1, S2 and S3. [24, 58] Innervation of the uterus The uterus is innervated by sympathetic nerve branches coming out from the vertebral segments T10 to L2, running via the splanchnic nerves down to the celiac ganglion and superior and inferior mesenteric ganglion as well as to the renal plexus. These nerves extend, either together with blood or lymphatic vessels or as independent nerve fibres, to the hypogastric plexus and the uterovaginal plexus. There is discussion about a post-ganglionary innervation coming from the four sacral ganglia and the ganglion impar. [18] The uterus also has a parasympathetic innervation coming out from the vertebral segments S2 to S4 and extending to the uterovaginal plexus. 1.1.5. Muscular structures The pelvic floor, the abdominal wall and the thoracic diaphragm are three anatomic regions that play a central role in pregnancy and that are subject to major changes during this period. [35] Any further detail in the description of the muscular structures would go beyond the scope of this study. Master’s Thesis Wolfgang Aspalter 17
Page 1 and 2: Can back pain caused by symptom-giv
Page 3 and 4: Acknowledgements Many people have h
Page 5 and 6: Abbreviations +LR Likelihood ratio
Page 7 and 8: 1.4.1. General aspects of pregnancy
Page 9 and 10: 0. Introduction Can osteopathic tre
Page 11 and 12: 1. Background 1.1. Anatomy 1.1.1. T
Page 13 and 14: The sacrotuberous ligament The sacr
Page 15: The thoracolumbar fascia is a very
Page 19 and 20: contribute to this locking mechanis
Page 21 and 22: 1.3. Pathophysiology In the literat
Page 23 and 24: 1.3.4. Symptom-giving pelvic girdle
Page 25 and 26: 1.4. Changes in pregnancy 1.4.1. Ge
Page 27 and 28: 1.4.4. Posture and postural changes
Page 29 and 30: Diaphragmatic excursion is increase
Page 31 and 32: Differences in cellular activity ha
Page 33 and 34: The following is a schematic repres
Page 35 and 36: Independent variables: o Whole grou
Page 37 and 38: 3.2.3. Therapy In each of the three
Page 39 and 40: 3.4.1. General osteopathic SIJ test
Page 41 and 42: 3.4.2. Pain provocation SIJ test Pr
Page 43 and 44: Fig. 3J: Pelvic torsion right Fig.
Page 45 and 46: 3.4.3. Palpation The sensitivity to
Page 47 and 48: 3.4.4. Areas of pain I asked the pa
Page 49 and 50: one point was added. An individual
Page 51 and 52: 3.6. Statistics For the evaluation
Page 53 and 54: 4. Evaluation 4.1. Evaluation of th
Page 55 and 56: Active straight leg raise test (ASL
Page 57 and 58: 4.2.4. Significance of the test res
Page 59 and 60: oth dependent variables, i.e. pain
Page 61 and 62: Z (RDQ) Z (VAS) RW 0.735 0.416 PT1W
Page 63 and 64: Psychosocial aspects of the diagnos
Page 65 and 66: Palpation to assess tenderness show
Page 67 and 68:
tests according to Laslett [31] and
Page 69 and 70:
[13] Goerke K. (2006): Taschenatlas
Page 71 and 72:
[43] Östgaard H.C., Andersson G. (
Page 73 and 74:
[70] Wojtys E.M., Huston L.J., Lind
Page 75 and 76:
List of tables Table 3A Specific va
Page 77 and 78:
Annex Annex A Patientenzettel Annex
Page 79 and 80:
Annex B Zustimmung zur Teilnahme an
Page 81 and 82:
Master’s Thesis Wolfgang Aspalter
Page 83 and 84:
Master’s Thesis Wolfgang Aspalter
Page 85 and 86:
Annex E Roland Morris Fragenkatalog
Page 87 and 88:
Annex G Schmerz 10,00 9,00 8,00 7,0
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Can back pain caused by symptom-giving sacroiliac joint relaxation ...

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