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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