Exam 2 Flashcards
Category 2
Sacro iliac weight-bearing dysfunction
Cat 2 flow
Lower extremity psoas and iliofemoral, scaral cup, trap fibers
UMS/LLL - yes = block cat 2,
no = check and adjust C1 and L5
UMS/LLL - yes = block cat 2
No = manually adjust SI joint
Strong arm fossa? Yes = stairstep and figure 8 long leg, short leg
No = basic II cranial
Thickest and strongest ligament of the joint
Interosseous ligament of the sacroiliac joint
Largest syndesmosis in the body and dwarfs the relative size of the auricular surfaces
Interosseous sacroiliac ligament
This ligament is thought to strongly resist joint separation as well as vertical and anteroposterior translations
Interosseous sacroiliac ligament
Cycle initiated by chronic somatic dysfucntion, which may result in muscle atrophy which can be further expected to reduce proprioceptive output from atrophied muscles. The lack of proprioceptive inhibition of nociceptors at the dorsal horn of the spinal cord would result in chronic pain and a loss of standing balance
Study suggest relationship between chronic pain, somatic dysfucntion, muscle atrophy and standing balance
Discs are not a significant cause of ___ SI joint dysfucntions are very common cause of __
Low back pain
The ___ is 20 times more vulnerable to axial compression and twice as susceptible to axial overloading as lumbar segment
Bending, lifting, twisting
SI joint
SI joint dysfunction have been demonstrated to be the major biomechanical cause of
Lumbar disc degeneration
In study of 1000 consecutive patients with low back pain, ___ had a mechanical dysfunction of the sacroiliac joints as a major cause of their LBP
98%
The presence ofunilateral low back pain alerts the clinician that a patient may have a
SI problem
Of 88 patient with LBP, __ had evidence of SI joint dysfunction
71
If a dysfunction of the SIJ’s were to compromise the movement of the sacrum, this would cause a
Considerable increase in the shear forces on the disc
SIJ dysfunction has been demonstrated to be the major cause of
Lumbar disc degeneration
In sports requiring repetitive, unidirectional movement, _____ is understandable
Pelvic shear and/or torsional force is understandalbe
The SI joint is reported as a common source of __ in school children
LBP
If the SIJ is incompetent, the NS is intact, the muscle strength to control pelvic position will be inhibited due to reflex activity. Can be implied by
Diminished motor performance of muscles which control pelvic position
Leg length differences may be the prime cause of ___
SIJ complaints
Only tests for ___ had consistently acceptable results
Palpation for pain
Lumbar mopal might be valid but had poor
Reliability
SI joint mopal seems slightly reliable, but literature does not show
Validity
Leg checks correlated with radiographic measurements, but consensus on method and interpretation is
Lacking
In females, pelvic floor muscles have the capacity to
Increase stiffness of the pelvic ring. And can generate a backward rotation of the sacrum in both sexes
Tucking chin exacerbates
Posterior occiput and reduces atlas dysfunction
Cross arms crunch exacerbates
Lumbar posteriority, creastes short leg and weak muscle
Cross arms crunch corrects
Antero or spondylo, legs balance
Cat 2 blocking
High block = top of iliac crest horizontal
Low block = LLL 45 degrees
Trap fiber palpation
Ruffinispray endings
7 fibers
Mechanical fixation associated with cat 2
Trap fiber 1
C1
T1,2,10
Trap fiber 2
C2,
T3, 11, 12
Trap fiber 3
C3
T4/5
L1
Trap 4
C4
T6
L2
Trap fiber 5
C5
T7
L3
Trap fiber 6
C6
T8
L4
Trap fiber 7
C7
T9
L5
Psoas procedure
Test - arms overhead, fingers point toward doc, one short = psoas
Correction - opposite knee up, doc grabs lateral butt, hand on lateral belly button breathe in an out as out, push in and repeat
Iliofemoral procedure
Test - internally rotate both feet
Correction - pull on greater trochanter on opp side
Dejarnette leg check
Use traction, thumbs on medial malleolus
Maintain head and eye coordination, upright posture and balance, and conscious realization of spatial orientation and motion
Vestibulospinal tracts
Vestibulospinal tracts Stabilizes head position by
Innervating the neck muscles, which helps with head coordination and eye movement
Vestibulospinal tract controls antigravity extensor muscles in the legs that help maintain
Upright and balanced posture
Leg checks and posture analysis are based on actions of the
Vestibulospinal tracts
UMS
PI ilium
LLL
AS ilium
Upper fossa pain
Medial knee pain
Short leg side
PI ilium
Lower fossa pain
Lateral knee pain
Long leg side
AS ilium
Most reliable analysis
Palpatory pain
Gold standard of cat 2 tests and gold standard of determining PI or AS ilium
UMS and LLL
The sacral cup adjustment affects a posteriorly subluxated sacral segment which might otherwise interfere with
Proper SI joint re-alignment subsequent to cat 2 blocking
A posterior sacral segment may affect the strength of the ___ hip extensors
Ipsilateral and/or contralateral
Restores tone to hip extensors. It is sometimes useful when blocking alone cannot stablize the fossae
Sacral cup adjustment
Whichever cup strengthens the weakened leg receives a
Rapid thumb toggle or activator adjustment
Cat 2 blockign removes
Sagittal plane iliac rotation (PI and AS)
Cat 2 blocking does not stress
The sacro iliac ligaments
anterior pelvic stabilization
Palpate sartorius and rectus abdominus in the arm fossa test
Allow ligaments to heal via collagen gelation
Blocks
Placing the blocks produces an angular torque to teh ligaments that hvae been stretched are allowed to
Tighten and shorten
Blocks ligaments which have become shortened are allowed to
Stretch, which causes capillaries to release a hydrosol into the area which condenses to hydrogel permitting stabilization adn a nutritive medium thereby facilitating regrowth of affected ligament and/or disc tissues
Pre and post cat 2 blocking muscle strength evaluation performed on patients
Data collected on 16 patients
8 muscles tested bilaterally
15/16 mucles tested stronger post blockign
SI joint laxity values _____ during both applications of pelvic belt
Decreased significantly
Significantly decreases moblility of SI joints
Application of pelvic belt
Decrease of mobility is larger with the belt positioned just
Cuadal to the ASIS than at level of pubic symphysis
Cat 2
SI subluxation Unilateral body drop Dural sutural subluxation Temporomandibular/maxillary subluxation Lateral sway Medial and lateral knee tension Medial and lateral heel tension
Cat 1
SI fixation Bilateral Dural meningeal respiratory fixation Anteroposterior sway AP heel tension
Used to balance the cranium after cat 2 blockign
Basic 2 cranial
Basic 2 cranial flexes
The sphenobasilar synchondrosis
Basic 2 cranial
S-I on inhale
I-S on exhale
Used if arm fossa does not strengthen on blocking
Basic 2 cranial
Basic 2 cranial contacts
Frontal and occiput
Dejarnette cervical mobilization
Cervicla stairstepping
Cervicla stairstepping balances
Cervical musculature
Cervical stairstepping performed in ___ plane
Mid-sagittal
More info on cervical stairstepping can be found during
Lateral translation (transverse plane
Restriction getting from one step to the next gives you
Level of fixation
