Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
115 Cards in this Set
- Front
- Back
What is the direction of sacral motion with lumbar extension?
|
Nutation around MTA
Sacral base moves anterior |
|
What is the direction of sacral motion with lumbar flexion?
|
Counter nutation around MTA
Sacral base moves posterior |
|
What should be the position of L5 with sacral dysfunction?
|
Compensatory
|
|
What if L5 is non-compensatory to the sacral dysfunction?
|
Make type II dx and treat it
|
|
Who came up with sacral motions due to respiration?
|
Fred Mitchell, Sr.
|
|
What does exhalation cause in terms of movement of the sacrum?
|
Flexion/nutation
Sacral base moves anterior |
|
What does inhalation cause in terms of movement of the sacrum?
|
Extension/counter-nutation
Sacral base moves posterior |
|
How does the illium move in relation to the sacrum?
|
Follows the sacral BASE
|
|
What causes leg length differences in sacral dysfunctions?
|
Sacral dysfunctions induce ilial rotations because they are connected
|
|
What motion test will you use for ilio-sacral motion (Legs, pubes, Ilia)?
|
Standing forward bending test
|
|
What motion test will you use for sacro-iliac motion (sacrum)
|
Seated forward bending test
|
|
What does the backward bending test test for?
|
Ability of sacrum to flex/nutate
|
|
Symptoms
+ standing forward bending test (right side) Superior Right Iliac crest Sup. right ASIS Sup. Right Pube Short Left Leg |
Right Sup. Innominate shear
|
|
What muscles are associated with Sup. Innominate shears?
|
Abdominals
Thoraco-lumbar fascia |
|
syptoms of a Sup. Innominate shear?
|
Low Back Pain
Lateral thigh Pain SI pain Pelvic congestion History of fall on ischial tuberosity |
|
What will be the best indicator of Sup. Innominate shear?
|
History of fall on ischial tuberosity
|
|
Muscles involved with an inferior innominate shear?
|
Gluteals
IT band |
|
On a right superior pubic shear what leg will be longer?
|
Right
|
|
symptoms of a superior pubic shear?
|
supra-pubic pain
constipation urinary symptoms dyspareunia LBP Anterior thigh pain |
|
muscles involved witha sup. pubic shear?
|
Abdominals
**Plus adductors |
|
On a left inferior pubic shear what leg is shorter?
|
Left
|
|
Muscles involved with inferior pubic shears?
|
Adductors
|
|
symptoms of Inf. pubic shears?
|
Same as Right sup. pubic shear
|
|
In LSF what leg would be longer?
|
Left
|
|
Ligaments of the LSF?
|
iliolumbar
Anterior Sacroiliac |
|
symptoms of LSF?
|
LBP
SI pain pain with sitting difficult to forward bend difficult getting up and down from a chair |
|
Ligaments of RSE?
|
iliolumbar
posterior sacroiliac |
|
symptoms of RSE?
|
LBP
difficulty bending backward "bent over to pick up something and can't get back up" |
|
Main muscle involved with sacral torsions?
|
Piriformis
|
|
Other muscles involved with sacral torsions?
|
Piriformis
Pelvic floor muscles |
|
Ligaments involved with sacral torsions?
|
Sacrotuberous
Sacrospinous |
|
Symptoms of sacral torsions/
|
SI pain
LBP Sciatic pain Bowel complaints |
|
List the components of the SNS:
|
T12-L4
sacral sympathetic trunks |
|
What does the pelvic sphlanic and the sacral plexus supply?
|
left colon and pelvis viscera
|
|
The sciatic nerve is close association with what muscle?
|
piriformis
|
|
What can cause sciatica-pain referred to the posterior thigh?
|
piriformis hypertonicity
|
|
List the spinal levels of the muscular branch of the sacral plexus:
|
L4-S3
|
|
muscles involved with innominate rotations?
|
SARTORIUS
Rectus femoris hamstrings |
|
symptoms of innominate rotations?
|
Ant. and Post. thigh pain
Inguinal pain knee pain hamstring tightness pelvic congestion |
|
What is the order to treat the pelvis?
|
Legs
Innominate shears Pubic shears L5 Sacrum Ilial rotations and flares Psoas |
|
What muscles make up the pelvis diaphragm?
|
obt. internus
piriformis coccygeus levator ani |
|
What muscles make up the urogenital diaphragm?
|
deep perineal and sphincter urethrae
|
|
What nervous control is the lymphatic channels under?
|
sympathetic
|
|
The lymphatics follow:
|
arterial supply
|
|
The ilia is part of the __________bone and functionally a part of the _________.
|
innominate bone
lower extremity |
|
What type of articulation is the SI joint?
|
L-shaped
|
|
Which type of cartilage:
sacral side: ilial side: |
sacral-hyaline
ilial-fibrocartilage |
|
What type of ligaments are the following: anterior sacroiliac, interosseus, and posterior sacroiliac?
|
true ligaments
|
|
What are the accessory ligaments?
|
iliolumbar, sacrotuberous, sacrospinous
|
|
What muscles provide stability of the pelvis?
|
erector, quad laborum
|
|
_______________have expansions to the posterior sacroiliac and iliolumbar liagaments?
|
multifidi
|
|
What influences sacral motion via attachement to the sacrotuberous ligaments?
|
hip extensors
|
|
_______________often involved in lumbopelvis dysfunction.
|
iliopsoas
|
|
What is the superior transverse axis?
|
craniosacral flex/ext and respiration
|
|
What is the middle transverse axis?
|
spinal flexion/extension
|
|
Walking and combined spinal motion are what axis?
|
left and right oblique
|
|
Anterior movement of the sacral base around a transverse axis is called.
|
flexion/nutation-posterior is exstension-
|
|
What is the Sphinx test?
|
backward bending test
|
|
The seated flexion test: the PSIS on the dysfunctional side does what?
|
rides up-tests for sacroiliac dysfunction
|
|
What is a positive sphinx test?
|
sacrum will not flex+positive test
|
|
Walking and combined spinal motion are what axis?
|
left and right oblique
|
|
Anterior movement of the sacral base around a transverse axis is called.
|
flexion/nutation-posterior is exstension-
|
|
What is the Sphinx test?
|
backward bending test
|
|
The seated flexion test: the PSIS on the dysfunctional side does what?
|
rides up-tests for sacroiliac dysfunction
|
|
What is a positive sphinx test?
|
sacrum will not flex+positive test
|
|
Which side of the positive side in a lumbar spring test?
|
the side with stiffness or lack of spring
|
|
What are the three importanat landmarks for sacral diagnosis?
|
sacral sulcus, ILA, and L5
|
|
With the left sacrum flexed, what will the position of the left sacral sulcus be?
|
deep
|
|
What muscle is involved in sacral torsions?
|
piriformis and pelvis flooe muscles
|
|
What is LIPSLIP?
|
Lower ext
Innominates Pubes Lumbars Sacrum Ilia Psoas/iliopsoas |
|
What links the spine and lower extremities?
|
SI joint
|
|
The SI joint has a flat surface that lies almost parallel to what?
|
maximal plane of load
|
|
Dysfunction of the SI joint causes what?
|
neuromyofascialmuscloligamentous injury
|
|
List the three components of the ventral musculature.
|
EO, IO, TA
|
|
List the dorsal musculature:
|
lat dorsi, glut max, ITB, piriformis, iliopsoas
|
|
Function of the sacrotuberous ligament:
|
resists flexion
|
|
Function of posterior SI:
|
resists extension
|
|
SI mechanism: is it active or passive?
|
passive
|
|
1st 65 % of flexion is from the ________and the next 30% from the ________.
|
lumbars
hip |
|
Gait causes rotatory motion at the____________.
|
pubes
|
|
Sacral stability is influenced by what two muscles?
|
glut max
lat dorsi |
|
Force closures=
|
external compression-stability
|
|
Form closures=
|
inherent stability from shape and fit
|
|
Red flags: what are they
|
not going to list them, if we do not know them, than we should be in nursing
|
|
3 bones that make up the innominate?
|
Ischium
Ilium Pubis |
|
What type of joint is the symphysis pubis?
|
Fibrocartilaginous
|
|
What is the function of the symphysis pubis?
|
Joins the two innominates
|
|
What is the shape of the sacroiliac (SI) joint?
|
L-shaped
|
|
What is the function of the SI joint?
|
Joins the innominates to the sacrum
|
|
Name 6 ligaments that suspend the SI joints.
|
Anterior Sacroiliac
Interosseous Posterior Sacroiliac Sacrotuberous Sacrospinous Iliolumbar |
|
Which pelvis has more height, male or female?
|
Male
|
|
Which pelvis has a greater transverse diameter, male or female?
|
Female
|
|
Which pelvis has a larger, more rounded inlet and outlet, male or female?
|
Female
|
|
Which pelvis has a larger infrapubic angle, male or female?
|
Female
|
|
Functionally, what are the innominates viewed a part of?
|
Lower extremity bones
|
|
Functionally, what is the sacrum viewed a part of?
|
Vertebral axis
|
|
How many axes of motion are there in terms of the sacrum?
|
5 (three transverse, two oblique)
|
|
In terms of the sacrum, where does the superior transverse axis lie?
|
Level of L2 (respiratory/cranial axis)
|
|
In terms of the sacrum, where does the middle transverse axis lie?
|
Between the upper and lower limbs of the SI joint (postural flexion/extension)
|
|
In terms of the sacrum, where does the inferior transverse axis lie?
|
Posterior-Inferior SI joint (innominate rotation)
|
|
What is the main motion of the innominates?
|
Rotation anteriorly and posteriorly
|
|
What axis does innominate rotation go about?
|
Inferior transverse axis
|
|
What do Iliosacral dysfunctions involve?
|
Innominates and pubes
|
|
What do Sacroiliac dysfunctions involve?
|
Sacrum in relation to ilia and lumbars
|
|
Name 5 landmarks used to assess anterior pelvic dysfunction.
|
Iliac crests
ASIS Pubic tubercles Medial malleoli PSIS |
|
What does the standing flexion test (SFT) tell you?
|
+ indicates the side of iliosacral dysfunction
|
|
Describe findings for a Superior Innominate Shear.
|
+SFT on side of dysfxn.
Iliac crest more superior ASIS, PSIS, Pubes more superior Short leg |
|
Describe findings for an Inferior Innominate Shear.
|
+SFT on side of dysfxn.
Iliac crest more inferior ASIS, PSIS, Pubes more superior Long leg |
|
Describe findings for superior pubic shear.
|
+SFT on side of dysfxn.
Pubic tub. is superior ASIS is symmetric Long Leg |
|
Describe findings for an inferior pubic shear.
|
+SFT on side of dysfxn.
Pubic tub. is inferior ASIS is symmetric Short Leg |
|
Describe findings for an anterior ilial rotation.
|
+SFT on side of dysfxn.
ASIS more inferior Long leg Everything else symmetric Hamstring tightness |
|
Describe findings for a posterior ilial rotation.
|
+SFT on side of dysfxn.
ASIS more superior Short leg Everything else symmetric |
|
Describe findings for an ilial inflare.
|
+SFT on side of dysfxn.
ASIS closer to the midline |
|
Describe findings for an ilial outflare.
|
+SFT on side of dysfxn.
ASIS further from midline |
|
What is the main arterial supply to the pelvic region?
|
Internal iliac arteries
|