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*OSII > 6. Sacral Lecture > Flashcards

6. Sacral Lecture Flashcards

1
Q

Review the diagnosis slides on slide 3 and 4

A

:)

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2
Q

What are the 4 points of static testing?

A
  1. Sacral sulcus 2. L5 (rotation) 3. Inferior lateral angle 4. 4 digit examination
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3
Q

How would you palpate for the sacral sulcus?

A
  1. Palpate the Posterior Superior Iliac Spine (PSIS) with thumbs 2. Move thumbs medially and inferiorly 3. Check for symmetry (Deep or Shallow Sacral Sulcus)
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4
Q

How do you test for L5 rotation?

A

1.Palpate Lumbar Spine at the level of L5 2.Check for symmetry (L5 Rotation)

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5
Q

How do you palpate for the inferior lateral angle?

A
  1. Palpate with the heel of the hand in midline down sacrum until it drops anteriorly 2. Place one thumb near the thenar eminence to feel the inferior lateral angle of the sacrum 3. Place the other thumb roughly symmetrical to the first 4. Adjust slightly to find the inferior lateral angle 5. Compare each side for posterior/anterior and cephalad/caudal (inferior/superior)
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6
Q

Describe the 4 digit evaluation

A
  1. place fingers int eh sacral sulk 2. place thumbs on the ILAs 3. evaluate for symmetry
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7
Q

Review the documentation part 1 portion to see her diagrams that she had laid out

A

IT doesn’t make a lot of since to make it into a flashie

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8
Q

What are the steps of sacral testing?

A
  1. static testing 2. motion testing 3. diagnosis
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9
Q

What are the 3 aspects involved in static testing?

A
  1. lateralization 2. active motion 3. passive motion
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10
Q

how do you test for lateralization?

A

seating forward bending test

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11
Q

How do you test for active motion?

A

Backward bending test Respiratory motion test

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12
Q

How do you test for passive motion?

A

Lumbosacral spring test Oblique axis passive motion

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13
Q

What is the function of the lateralization test?

A

Tells the side of the dysfunction

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14
Q

A _______ seated forward bending test results in a positive test on the side of the dysfunction

A

unilateral

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15
Q

A _______ seated forward bending test results in a positive test on the opposite side of the axis

A

Torsion

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16
Q

Describe the seated forward bending test steps

A
  1. The patient is seated on a stool or treatment table with both feet flat on the floor. 2. Thephysician’s eyes at the level of the patient’s PSISs. 3.The physician’s thumbs are placed on the inferior aspect of the patient’s PSISs, and a firm pressure is directed on the PSISs. 4. The patient is instructed to forward bend as far as possible within a pain-free range. 5. The test is positive on the side where the thumb (PSIS) moves more cephalad at the end range of motion. A positive seated flexion test identifies the side of sacroiliac dysfunction (motion of the sacrum on the ilium), not the specific type of dysfunction.
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17
Q

What is the function of the active motion tests?

A

The examine the flexion and extension motion

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18
Q

A negative BBT indicates a ________ sacrum

A

flexed

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19
Q

A positive BBT indicates a ______ sacrum

A

extended

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20
Q

The bilateral sacral base should move ______ during inhalation and ______ during exhalation

A

posteriorly anteriorly

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21
Q

What is the function of the lumbar spring?

A

Defines flexion and extension

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22
Q

What is the function of the oblique axis passive motion

A

Defines the dysfunctional oblique axis

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23
Q

A negative lumbar spring is a ______ sacrum

A

flexed

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24
Q

A positive lumbar spring is an _______ sacrum

25
Q

Review the sacral axis

26
Q

Define torsion 1. Which axis is involved? 2. Where might the restriction be?

A

restricted along an oblique axis may be restricted in flexion or extension

27
Q

Define a unilateral diagnosis 1. Which axis is involved? 2. Where might the restriction be?

A

Restricted along an Vertical Axis

May be restricted in Flexion or Extension

28
Q

What axis is shown here?

What motion is it involved in?

A
  • Superior Transverse Axis (S2 posteriorly)
  • Respiratory and Craniosacral Motion
29
Q

What axis is shown here?

What motion is it involved in?

What happens if there is a dysfunction?

A

• Middle Transverse Axis(S2 anteriorly)

  • Postural Motion
  • Dysfunction along this axis will have bilateral findings
30
Q

What axis is shown?

What motions does this contribute to?

A
  • Inferior Transverse Axis (S3)
  • Innominate rotation
31
Q

Which axis is shown?

What dysfunctions occur here?

A

• Left Oblique Axis

Named for the superior portion of the axis

Dysfunction along this axis will have a deep sacral sulcus on the opposite side of the posterior/caudal ILA

32
Q

Which axis is shown?

What dysfunctions occur here?

A

Right Oblique Axis

Named for the superior portion of the axis

Dysfunction along this axis will have a deep sacral sulcus on the opposite side of the posterior/caudal ILA

33
Q

What axis is shown here?

What dysfunction is typically seen here

A
  • Vertical Axis
  • Dysfunction along this axis will have a deep sacral sulcus on the same side as the posterior/caudal ILA
34
Q

A torsion can be restricted anteriorly or posteriorly…

What does it look like for each?

A
  • Held Anteriorly: Flexed or forward torsions
  • Held Posteriorly: Extended or backward torsions
35
Q

How are torsions named?

A
  1. for the rotation of the sacrum
  2. acis that is involved
37
Q

A _______/________ can be classified as a left on left sacral torsion or a right on right sacral torsion

A

Flexed/ Forward

39
Q

A _______/________ can be classified as a left on RIGHT sacral torsion or a right on LEFT sacral torsion

A

Extended/bakwards

40
Q

Describe a left rotation on a left axis sacral torsion

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A

FLEXED

Deep sacral sulcus on the right

Posterior/caudal ILA on the left

setaing forward beding test positive on the right

BBT negative

Lumbar spring negative

42
Q

Describe a right rotation on a right axis sacral torsion

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A

FLEXED

Deep sacral sulcus on the left

Posterior/caudal ILA on the right

seated forward bending test positive on the left

BBT negative

Lumbar spring negative

43
Q

Describe a left rotation on a right axis sacral torsion

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A

EXTENDED

Deep sacral sulcus on the RIGHT

Posterior/caudal ILA on the LEFT

Seated forward bending is positive on the left

BBT is positve

Lumbar spring positive

44
Q

Describe a right rotation on a left axis sacral torsion

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A

EXTENDED

Deep sacral sulcus on the LEFT

Posterior/caudal ILA on the RIGHT

Seated forward bending test positive on the RIGHT

BBT positive

Positive lumbar spring

45
Q

Describe a right sacrum flexed

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A
  • Flexed
  • BBT Negative (gets better)
  • Lumbar spring negative (ease of spring)
  • Deep sacral sulcus on the right
  • Posterior/Caudal ILA on the right
  • Seated forward bending test positive on the right
46
Q

Describe a left sacrum flexed

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A

Flexed

  • BBT Negative (gets better)
  • Lumbar spring negative (ease of spring)
  • Deep sacral sulcus on the left
  • Posterior/Caudal ILA on the left
  • Seated forward bending test positive on the left
47
Q

Describe a left sacrum extended

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A
  • Extended
  • BBT Positive (gets worse or stays the same)
  • Lumbar spring Positive (difficulty of spring)
  • Deep sacral sulcus on the right
  • Posterior/Caudal ILA on the right
  • Seated forward bending test positive on the left
48
Q

Describe a right sacrum extended

  1. positioning
  2. where is the deep sacral sulcus
  3. where would you expect the IL to be
  4. What tests would be positive?
A
  • Extended
  • BBT Positive (gets worse or stays the same)
  • Lumbar Spring Positive (difficulty of spring)
  • Deep sacral sulcus on the left
  • Posterior/Caudal ILA on the left
  • Seated forward bending test positive on the right
49
Q

Describe a bilateral sacrum extended in terms of the

  1. deep sacral sulcus
  2. bilateral posterior/caudal ILA
  3. negative seated forward bending test (no lateralization)
A
  • Bilateral shallow sacral sulcus
  • Bilateral anterior/cephalad ILA
  • Negative Seated forward bending test
50
Q

Describe a bilateral sacrum flexed in terms of the

  1. deep sacral sulcus
  2. bilateral posterior/caudal ILA
  3. negative seated forward bending test (no lateralization)
A
  • Bilateral deep sacral sulcus
  • Bilateral posterior/caudal ILA
  • Negative Seated forward bending test
  • No lateralization
51
Q

L5 should be rotated in the _____ direction of the sacrum for balance

52
Q

L5 Sidebends _______ the oblique axis of a torsion

53
Q

A flexed sacrum means a _______ L5 (Type 1)

54
Q

An extended sacrum means a ________ L5 (type 2)

A

non-neutral

55
Q

Rotation of the sacrum shoud be in the ______ direction of L5

56
Q

L5 beinds toward the _______ _______ _____ _______

A

oblique axis of a torsion

58
Q

Review the last few slides in this lecture because wow this was a freaking doozie

A

its so many pictures

*OSII (39 decks)

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