Chapter 6 - Innominate and Sacrum Flashcards
True pelvic ligaments
Anterior, posterior, and interosseous SI ligaments
Accessory pelvic ligaments - w/ origins and insertions
Sacrotuberous - ILA –> ischial tuberosity
Sacrospinous - sacrum –> ischial spines
Iliolumbar - TP of L4-L5 –> medial iliac crest
Pelvic ligament that divides the greater and lesser sciatic foramen
Pelvic ligament that is FIRST painful in lumbosacral decompensation
Sacrospinous
Iliolumbar
Pelvic diaphragm muscles
Also called ___ pelvic muscles
Levator ani
Coccygeus
“TRUE”
Piriformis - origin and insertion
Actions?
O = inferior anterior sacrum I = greater trochanter
Externally rotate thigh
Extends and Abducts WHEN FLEXED
Piriformis hypertonicity - subject to what?
Pain to where?
Sciatic pain
To the KNEE (not below)
Axis for innominate rotation
Inferior transverse (S4)
Axis for sacral respiratory movement
Superior transverse (S2)
Axis for sacral craniosacral movement
This motion is called ____
Superior transverse (S2) - same as respiratory
Inherent (craniosacral)
Axis for sacral postural movement (flexion/extension)
At terminal flexion of the sacrum, _____
Middle transverse (S3)
The sacrotuberous ligaments become taut, pulling the sacral base posteriorly
While walking on the LEFT leg, the sacrum moves about a ____ axis
While walking on the RIGHT leg, the sacrum moves about a ____ axis
This motion is called ____
LEFT oblique axis
RIGHT oblique axis
Dynamic
Anterior innominate SD - cause?
Posterior innominate SD - cause?
Tight quadriceps
Tight hamstrings
Other names for superior innominate shear (2)
Causes (2)
Innominate upslip, Superior innominate subluxation
Fall on buttock, mis-step
Superior pubic shear - causes (2)
Abnormal test findings? (3)
Trauma
Tight rectus abdominus
Superior pubic bone
Positive standing flexion test
ASIS compression restriction
Inferior pubic shear - causes (2)
Abnormal test findings?
Trauma
Tight adductors
Inferior pubic bone
Positive standing flexion test
ASIS compression restriction
*****3 rules about sacral torsions in regards to L5
- L5 sidebent = same side sacral oblique axis
- L5 rotated = sacrum rotates the opposite way
- ***Seated flexion is positive on OPPOSITE side of axis
Using the 3 rules of sacral torsions…
If L5 is F RR SR, the sacrum will be ____
Rotated LEFT on a RIGHT oblique axis
Positive lumbosacral spring test means _____
POSTERIOR sacral base
Anterior sacral torsion…findings for the MOVING ILA?
Posterior sacral torsion…findings for the MOVING ILA?
ANY sacral torsion…findings for the lumbar curvature?
Posterior and slightly INFERIOR
Anterior and slightly SUPERIOR
CONVEX to the OPPOSITE side of the axis
Sacral springing is restricted at R sulcus, L and R ILA
Sacral springing is present at the L sulcus
Diagnosis?
R on R sacral torsion
Positive seated flexion on the LEFT
Springing motion present at the R ILA only
Positive lumbosacral spring test
Positive backward bend test
What will L5 be?
L on R sacral torsion
L5 SR RR (flexed or extended)
Positive backward bend test = ?
Posterior motion at the sacral base
“Sacral rotation on an oblique axis”…define?
Treatment?
Sacral torsion + L5 rotated to SAME SIDE
Correct the L5 dysfunction first
Bilateral sacral dysfunctions…axis? Same as what?
Middle transverse (S3) - same as POSTURAL motion
Bilateral sacral dysfunction…seated flexion test finding?
NEGATIVE (falsely)
Flexion bilateral sacral dysfunction…lumbar curve?
Extension bilateral sacral dysfunction…lumbar curve?
INCREASED
DECREASED
Post-partum - common dysfunction in the mother?
Bilateral sacral flexion
Unilateral sacral flexion…ipsilateral ILA findings?
Significantly INFERIOR
Slightly POSTERIOR
Unilateral sacral flexion…describe
SB TOWARD, Rotate FORWARD
Unilateral sacral extension…describe
SB AWAY, Rotate BACKWARD
Unilateral sacral extension…ipsilateral ILA findings?
Significantly SUPERIOR
Slightly ANTERIOR
