Innominates

Question 1

What are the key influences on the body by the innominate?

Answer 1

painless gait and trunk control, balance, lymphatic, GI and GU system

Question 2

What are the bones of the innominate?

Answer 2

Ilium, pubis, ischium

Question 3

What are the key joints of the pelvis?

Answer 3

2 SI joints, 1 pubic symphysis, 2 hip joints

Question 4

What are the major anterior bony landmarks of the pelvis?

Answer 4

iliac crest, anterior superior iliac spine, anterior inferior iliac spine, pubic tubercle/symphysis

Question 5

What are the major posterior bony landmarks of the pelvis?

Answer 5

posterior superior iliac spine, posterior inferior iliac spine, ischial tuberosity

Question 6

What are the common ligaments of the innominates and sacrum that cause pain due to overuse

Answer 6

iliolumbar, posterior superioriliac, sacrospinous, sacrotuberous

Question 7

What does the pelvis do for body systems?

Answer 7

support sGI and GU systems, lymphatic trunks from LE, pelvic floor and diaphragm

Question 8

What are the biomechanical functions of the innominate?

Answer 8

foundation of trunk, maintain stability of trunk during movement, transmit force during gait

Question 9

What are the primary motions of innominate rotation?

Answer 9

rotates anterior (toe off during walking), rotates posterior (heel strike during walking), shear, in flare, out flare

Question 10

What tests are used to lateralize the dysfunction?

Answer 10

ASIS compression, standing flexion

Question 11

What is the ASIS compression test?

Answer 11

posterior medial compression to assess SI joint

Question 12

What is the standing flexion test?

Answer 12

assess ability of SI joint to stabilize during motion, PSIS will move superior on dysfunctional side

Question 13

What are the steps of diagnosing and treating innominate dysfunction?

Answer 13

1. Lateralization test
2. palpate landmarks
3. Diagnose somatic dysfunction
4. Treat
5. Reasses

Question 14

What landmarks are important to identify in an innominate diagnosis?

Answer 14

PSIS, ASIS, iliac crest heights, medial malleoli, ASIS to midline, pubic tubercle

Question 15

What is an anterior innominate rotation?

Answer 15

Superior PSIS, inferior ASIS, inferior malleoli, iliac crests even

Question 16

What is a posterior innominate rotation?

Answer 16

PSIS inferior, superior ASIS, superior malleoli, iliac crests even

Question 17

What is a superior innominate shear?

Answer 17

PSIS superior, ASIS superior, Malleoli superior, Iliac crest superior, pubic tubercle superior

Question 18

What is an innominate shear?

Answer 18

PSIS inferior, ASIS inferior, Malleoli inferior, iliac crest inferior, pubic tubercle inferior

Question 19

What is an outflare of innominate?

Answer 19

ASIS to midline longer on side of dysfunction

Question 20

What is an inflare of innominate?

Answer 20

ASIS to midline shorter on side of dysfunction

Question 21

What is a superior pubic shear?

Answer 21

pubic tubercle superior

Question 22

What is an inferior pubic shear?

Answer 22

pubic tubercle inferior

Question 23

What is the supine treatment for an anterior innominate rotation?

Answer 23

patient supine, physician passively flexes patients hip until the edge of the restrictive barrier is reached – ME

Question 24

What is the prone treatment for a posterior innominate rotation?

Answer 24

patient prone, physician extends patients hip until restrictive barrier is reached – ME

Question 25

What is the treatment for superior innominate shear?

Answer 25

Pt supine, physician grasps tibia and fibula above angle, internally rotate and abduct pt leg and apply axial traction

Question 26

What is the treatment for inferior innominate shear?

Answer 26

Pt supine, physician grasps pt tibia and fibula, internally rotate and abduct pt leg and apply cephalad compression

Question 27

What is the treatment for inflare of innominate?

Answer 27

Pt supine, knee and hip flexed, foot placed on lateral side of opposite knee, abduct and externally rotate until barrier is reached

Question 28

What is the treatment for outflare of innominate?

Answer 28

pt supine, knee and hip flexed, foot placed on lateral side of opposite knee, adduct and internally rotate until barrier is reached

Question 29

What is the pubic dysfunction shotgun treatment?

Answer 29

Flex hips to 45 degrees and knees to 90 degrees, use isometric contractions and alternate between adduction and abduction

Question 30

What is the superior pubic shear MET?

Answer 30

Pt supine, abduct and extend leg off table, have pt flex hip medially toward ceiling to activate adductor muscles

Question 31

What is the inferior pubic shear MET?

Answer 31

Pt supine, flex and adduct until barrier is reached, have patient try to abduct and extend hip for 3-5 seconds

Question 32

What is the setup for posterior innominate rotation BLT?

Answer 32

pt seated, doc holding tibias, push up on IPSI leg and pull down on CONTRA leg to attain balance point, have pt rotate trunk towards SD until IPSI leg draws upward

Question 33

What is the setup for anterior innominate rotation BLT?

Answer 33

pt seated, doc holding tibias, pull down on IPSI leg and push up on CONTRA leg, have pt rotate trunk away from SD until CONTRA leg draws up