Exam 1 Flashcards
Causes of sacroiliac dysfunction
psoas short leg syndrome- deep sulcus on short leg side, long leg becomes axis of rotation and since neutral mechanics, opposite sulcus is deep postural imbalance L5 problems disc problems simple trauma viscerosomatic reflexes
Describe thoracic and lumbar motions in walking
thorax rotates to the left and lumbar side bends to left
torsional locking at LS junction as body of sacrum is moving left
shift weight to left foot to lift right
Describe the sacral axis in walking
the vertical center of gravity moves to superior pole of the left SI, which locks the left oblique axis and allows for more rotation to the left, so sacral base moves down on the right to conform to lumbar curve
Describe action of quads and inferior pole of SI
when right foot moves forward, quadriceps tenses on that side
tension at inferior pole of right SI where left oblique and inferior transverse axis meet
locks as weight swings forward allowing slight anterior movement of innominate on inferior transverse axis
Describe the weight swing in walking
movement increased by backthrust of restraining ground
tension on hamstring starts
weight swings up to crest of femoral support there is slight posterior movement of right innominate on inferior transverse axis
9 osteopathic principles
- body is unit
- structure and function reciprocally related
- body has self regulatory mechanisms
- body has inherent capacity to defend itself and to repair itself
- normal adaptability is disrupted or environment overcomes body’s capacity for maintenance, disease ensues
- rational treatment based on previous principles
- movement of body fluids is crucial to health
- nerves crucial to controlling fluids of body
- somatic components are not only manifestations of disease but factors that maintain diseased state
Muscle energy technique
a system of diagnosis and treatment in which the patient voluntarily move the body as specifically directed by the physician; this directed pt action is from a precisely controlled position, against a defined resistance by the physician
Indications of ME
mobilize joints
stretch tight muscle and fascia
improve local circulation
alter related respiratory and circulatory fxn
balance neuromusc relationships to alter muscle tone
Oculocervical/oculogyric reflex
pt makes eye movements and certain cervical and muscles reflexively contract and antagonist muscles relax
Respiratory assist
direct forces of respiration while using fulcrum to direct somatic dysfunction through barrier
Postisometric relaxation
following increased tension on golgi tendon organ receptors, there is refractory period in which there is a muscle relaxation (lengthening)
Joint mobilization using muscle force
like HVLA but pt actively contracts muscle to cause movement
use pt positioning and muscle contractions to restore motion
Reciprocal inhibition
contract an agonist to relax antagonist
Absolute contraindications to ME
fracture, dislocation or severe joint instability at treatment site
uncooperative pt
Relative contraindications
moderate to severe muscle strain
advanced osteoporosis
severe illness; post surgical, pt on monitor in ICU with MI
Intervertebral motions
flexion/extension
sidebending
rotation
f/e= facets align backward and medial- couple with ventral dorsal translatory slide
sidebend=couple with contralateral lateral translatory slide- SR translate left
Rotation= couple with disc compression
Latissimus Dorsi
Origin: T7-12, iliac crest, thoracolumbar fascia
Insertion: humerus at intertubercular groove
Action: adduct, extend, internally rotate arm and extension/sidebending of lumbar spine
Innervation: Thoracodorsal C6-8
Gluteus maximus
Origin: thoracolumbar fascia, dorsal sacrum, sacrotuberous ligamnt, ilium
Insertion: IT band, greater tuberosity of femur
Action: extend hip and stabilize torso
Innervation: Inferior gluteal nerve (L5,S1-2)
Erector spinae
Origin and insertion: sacrum to cervical
Iliocostalis, longissimus, spinalis
Action: bilateral contraction for extension
unilateral contraction for extension and ipsilateral sidebending
antagoinzed by rectus abdominis
Anterior innominate rotators
TFL QL Iliocostal internal abdominal oblique lat dorsi
Tensor fascia latae
origin: anterior lateral iliac crest
insertion: anterolateral tibia below plateau
Quads
Origin; rectus femoris- AIIS
Insertion: tibial tuberosity via patellar ligament
Posterior innominate rotators
hamstrings- semitendinosis, biceps femoris, semimembranosus
piriformis
external abd oblique
gluteus maximus
Quadratus lumborum
origin: 12th rib, lumbar transverse processes
Insertion: iliolumbar ligament, iliac crest
Action: bilateral contraction creates extension
unilateral contraction causes extension with ipsilateral sidebending
Innervation:t12 L4
Multifidus
postural muscles
action: control and stabilize vertebral motions
psoas major
origin: T12-L5
Insertion: lesser trochanter of femur
Action: flex and internally rotate hip
innervation: L1-3 (2-4)
Iliolumbar ligament
Attach: transverse of L4 and L5 and iliac crest
insertion: increase stability at lumbosacral jxn- commonly strained in traumatic injuries
first ligament to become tender with lumbar posture changes- tender in 1” superior and lateral to psis on the crest
TFL
o: anterior lateral iliac crest
I: anterolateral tibia below plateau
Quadriceps
O: rectus femoris- AIIS
Insertion: tibial tuberosity via patellar ligament
Hamstrings
O: ischial tuberosity
I: lateral condyle of tibia
Anterior ilium rotators
TFL, QL, iliocostal muscle, internal abdominal oblique, latissimus dorsi
posterior ilium rotators
gluteus maximus semitendinosus biceps femoris semimembranosus piriformis (weak) external abdominal oblique
Psoas syndrome Key lesion
L1 L2- lesions act like type II, rest of spine acts like type I
