Final Exam SI Joint Flashcards
What 3 structures fuse at the acetabulum to form each innominate?
Ilium
Ischium
Pubic Bone
Each of the 2 innominates articulates with the __, forming the ___, and with each other at the __ __
sacrum
SI joint
Symphisis pubis
The sacrum is a __ and __ bone located between the 2 innominates
strong
triangular
Sacrum provides stability and transmits the weight of the body from the mobile __ __ to the __ region
vertebral column
pelvic
The iliac joint surfaces are formed from __
fibrocartilage
The sacral surfaces are formed from __ __
hyaline cartilage
The hyaline cartilage is __-__x thicker than the fibrocartilage
3-5
The SI joint is a __ articulation, or __
synovial
Diarthrosis
The Anterior Sacral Ligament (ASL) is an __-__ thickening of the __ __
anterior-inferior
fibrous capsule
The Anterior Sacral ligament is relatively __ and __ compared to the rest of the SI ligaments
weak
thin
Anterior Sacral Ligament extends between the __ and __ borders of the __ Auricular surface and the __ border of the __ auricular surface
anterior inferior Iliac Anterior Sacral
Interosseous ligament is a __ ligament located __ to the __ __ ligament
short
deep
dorsal SI
Interosseous ligament forms the major connection between the __ and the __, filling the irregular space __-__ to the joint:Between the __ sacral crest, and the __ __
sacrum innominate posterior-superior lateral iliac tuberosity
The dorsal S/I ligament (__ligament) connects the ___ (and a small part of the iliac crest) with the lateral crest of __ and __
long
PSIS
S3
S4
Dorsal SI ligament is a __ and __ ligament
tough
strong
Sacral __ (anterior motion) of the sacrum appears to __ the Dorsal SI ligament whereas __ (posterior motion) __ the ligament
Nutation
slacken
counternutation
tauten
The sacrospinous ligament is made of __ large fibrous bands, broadly attached by its base to the __, the lateral __, and partly blended with the __ __ ligament - deep to the __ ligament
3 PSIS sacrum sacroiliac sacrotuberous
Sacrospinous ligament stabilizes against __ of the __
nutation
sacrum
Sacrospinous ligament counteracts against __ and __ migration of the __ __ during __ __
dorsal
cranial
sacral apex
weight bearing
Sacrotuberous ligament extends from __ __ to lateral margins of __, __, and __- lower borders of the ligament continuous with the __ __ tendon
ischial tuberosity ilium sacrum coccyx biceps femoris
Sacrotuberous Ligament counteracts against __ of the __
nutation
sacrum
Pubic Symphisis is classified as a symphisis as it has no __ tissue and contains a __ __
synovial
fibrocartilagenous disc
Bone surfaces of pubic symphisis are covered with __ __, but are kept apart by the presence of the __
hyaline cartilage
disc
__ muscles attach directly to the sacrum and/or innominate. These muscles primarily function to __ the SI joint rather than to __ it
35
stabilize
move
Piriformis primarily functions to produce __ __ and __ of the __
external rotation
abduction
Piriformis is also though to function as an __ __ and __ of the hip if the hip joint is flexed beyond __ degrees.
internal rotator
abductor
90
The piriformis is capable of restricting __ __ motion
SI joint
The term “Pelvic Floor Muscles” primarily refers to the __ __, a muscle group composed of the (3)
Levator Ani
Pubococcygeus
Puborectalis
Iliococcygeus
Levator Ani muscles join the __ muscles to complete the __ __
coccygeus
pelvic floor
Pelvic floor muscles work in a coordinated manner to increase __ __ pressure, provide __ support during defecation, inhibit __ activity, help to support the pelvic __, and assist in __ stability
intra-abdominal rectal bladder organs lumbopelvic
Anterior part of SI joint likely receives innervation from the __ rami of __-__ roots
posterior
L2-S2
The pelvic area must function to absorb the majority of the lower extremity __, while still permitting __ to occur
rotation
motion
It is likely that the movement of the pelvis is in the nature of deformations and slight __ motions areound a number of undefined __, with the joints of the pelvic ring deforming in response to body __ and __ reaction forces.
gliding
axes
weight
ground
Note : There is very little agreement, either among disciplines, or even
within disciplines about the biomechanics of the pelvic complex. The
results from the numerous studies on mobility of the sacroiliac joint
have led to a variety of different hypotheses and models of pelvic
mechanics over the years
Just Sayin.
In the osteopathic model, the __ rotates around 2 __ axes. The Innominates are capable of rotating __ and __
sacrum
oblique
anteriorly
posteriorly
In the chiropractic model, as one innominate flexes, the ipsilateral sacral base moves __ and __, and as the other innominate extends, the sacral base on that side moves __ and __
anterior
inferior
posterior
superior
In the biomechanical model, when the sacrum nutates, or __, relative to the innominate, a __ glide occurs between the two L-shaped articular surfaces of the __ joint. The shorter of the 2 lengths, level with __, lies in a __ plane. The longer length, spanning __-__, lies in an __ plane
flexes linear SI S1 vertical S2-4 A-P
• Under the premise that a relationship between pelvic asymmetry and
low back pain exists, orthopedic, osteopathic, and physical therapy
texts promote the use of __ provoking (symptom-based) tests and __ (mechanical-based) tests that include __
(positional) and __ (motion or functional) tests
pain
biomechanical
static
dynamic
PT with history SIJ dysfunction may present with a history of __ pain awakening the patient from sleep upon __ in bed
sharp
turning
PT with history SIJ dysfunction may present with pain from __, ascending or descending __, __ from __ position, or hopping or standing on involved leg.
walking
stairs
standing
sitting
PT with history SIJ dysfunction may present with positive ___ at, or near, the end of range, pain, and sometimes limitation on __ and __ side bending of the trunk
SLR
extension
ipsilateral
Given the number of ___ in the vicinity of the S/I joint, a thorough systems review is needed to rule out a __ source for the symptoms
organs
visceral
*Note: • An examination of posture is performed to check for the
presence of asymmetry
• However, as pelvic landmark asymmetry is probably the
norm, ‘positive findings’ are to be expected
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An altered positional relationship within the pelvic girdle should only be
considered positive if a mobility restriction of the __ and/or __ __ is also found
Si joint
pubic symphisis
Weight bearing and non-weight bearing kinetic tests are designed to assess the __ occurring at the __ during patient generated movements. The tests assess the mobility of the __ and the ability of the sacrum to __ (ipsilateral test), and to __ __ (contralateral test)
osteokinematics SIjoint innominate nutate side bend
Si joint stress tests are believed to be sensitive for severe __ or __ __ tears
arthritis
ventral ligament
What are the SI joint stress tests?
Gaenslen’s
Lewin-Gaenslen’s
Hibb’s
Fabere
Acute Phase Intervention goals
• Decrease pain, inflammation, and muscle spasm
• Increase weight bearing tolerance, where appropriate
• Promote healing of tissues through sufficient stabilization
(may require belt)
• Increase pain-free range of S/I joint motion
• Regain soft tissue extensibility around the pelvic region
• Regain neuromuscular control
• Allow progression to the functional stage
Functional Phase Intervention goals
To significantly reduce or to completely resolve
the patient’s pain
• To restore full and pain-free S/I joint range of
motion
• To integrate the lower kinetic chains into the
rehabilitation
• Complete restoration of gait, where appropriate
• The restoration of pelvic and lower quadrant
strength and neuromuscular control
