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34 Cards in this Set
- Front
- Back
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Functionally, what are the innominates and sacrum viewed as?
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Innominates = part of lower extremity bone
Sacrum = part of vertebral axis |
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Describe iliosacral dysfunction
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reflect appendicular problems
involve innominate and pubes + standing flexion (forward bending) test |
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Describe sacroiliac dysfunction
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reflect axial problems
involve sacrum in relation to ilia and lumbars + seated flexion test |
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What tests do you do for an iliosacral dysfunction?
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ASIS
Pubic Tubercles Medial Malleoli Sacral Sulci PSIS Ischial Spine Standing Flexion test ASIS Compression test |
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At what level can the iliac crests be found?
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L4/5 disk space
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At what level are the PSISs found?
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S1
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What is the normal motion of the innominates?
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rotate anteriorly and posteriorly about inferior transverse axis of sacrum
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Which innominate dysfunction is rare and walking tends to reduce it?
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Inferior innominate shear
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What are the findings seen in superior innominate shear?
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on the side of dysfunction:
iliac crests more superior ASIS more superior PSIS more superior pubic ramus more superior (tubercle) medial malleolus cephalad (short leg) |
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What are the findings seen in inferior innominate shear?
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on side of dysfunction:
iliac crests inferior ASIS inferior PSIS inferior pubic ramus more inferior medial malleolus inferior (long leg) |
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Which type of innominate dysfunction causes back and pelvic pain?
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the shears (superior and inferior)
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Which type of innominate dysfunction causes inguinal/groin pain and knee pain?
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posterior innominate rotation
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What are the findings seen in posterior innominate rotation?
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on the side of dysfunction:
ASIS more superior (cephalad) PSIS more inferior pubic rami are even medial malleolus superior (short leg) |
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Which muscles are posterior rotators of the innominate?
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gluteus maximus muscle
semitendiosis muscle biceps femoris muscle semimembranous muscle piriformis muscle external abdominal oblique muscle |
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What are the findings seen in anterior innominate rotation?
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on side of dysfunction:
ASIS is inferior PSIS is superior pubic rami are equal medial malleolus is inferior (long leg) |
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Which innominate dysfunction is associated with hamstring pain and may have posterior thigh pain?
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anterior innominate rotation
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What are the anterior ilium rotators?
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tensor facial latae muscle
quadratus lumborum ilocostal muscles internal abdominal oblique muscles latissimus dorsi muscle |
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What are the findings seen in ilial inflares?
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positive standing flexion test
ASIS closer to midline PSIS lateral sacral sulcus is wide |
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What are the findings seen in ilial outflares?
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on side of dyfunction:
positive standing flexion test ASIS further from midline (lateral) PSIS medial sacral sulcus narrow |
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Abducting muscles the hip
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gluteus maximus
gluteus medius gluteus minimus |
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Adducting muscles of the hip
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illiacus muscle
obturator internus muscle piriformis muscle gemelli muscles coccygeus muscle adductor minimus and magnus muscles |
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Which type of innominate dysfunction is associated with constipation, urinary symptoms, dypareunia, supra pubic pain?
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pubic shears
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Describe the motion of the pubes
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rotate about a transverse axis when walking, weight shift, and childbirth
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What are the findings seen in a pubic shear?
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ASIS appear symmetrical but pubes are displaced so that one is superior or inferior to the other
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Which structure is tender or tense during a superior/inferior pubic shear?
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inguinal ligament on side of dysfunction
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What are the superior pubic symphysis muscles?
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rectus abdominus
pyramidalis muscle |
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What are the sacral palpatory landmarks when testing for a sacral dyfunction?
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sacral base
sacral sulcus inferior Lateral Angle (ILA) Sacrotuberous ligament |
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Describe the superior transverse axis of the sacrum
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the cranial primary respiratory mechanism creates motion around this axis
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Describe the middle transverse axis of the sacrum
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sacral base anterior and posterior (FB/BB) occur around this axis
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Describe the inferior transverse axis of the sacrum
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the innominates rotate around this axis
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What are the motion tests performed for a sacral dysfunction?
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Spring test
Sphinx test L5 Sacrum |
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Which Sacral somatic dyfunctions are non-physiologic?
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unilateral sacral shears = Unilateral Sacral flexion and extension (usually caused by trauma)
**dysfunction that does not occur around an axis |
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Why are the oblique axes so significant?
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They are the axes of walking:
when you step with your left foot, your sacrum rotates towards the right on the right oblique axis (ROR); when you step with your right foot, you have a LOL **lumbar spine rotates in the opposite direction of the sacrum (step with your left, lumbar vertebrae rotate left) |
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Increased parasympathetic tone to the distal ureter and bladder causes:
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S2-4
- relaxation of the internal urinary sphincter - increased peristalsis of the ureters - increased bladder wall tone |
