Innominates Flashcards

1
Q

What are innominates?

A

Hip bones

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2
Q

What are the important bony landmarks?

A
Iliac crests
ASIS
Pubic tubercles
Medial Malleoli 
PSIS
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3
Q

What are the pelvic ligaments that stabilize the pelvis?

A

Iliolumbar
Sacroiliac - anterior and posterior
Sacrospinous
Sacrotuberous

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4
Q

What does muscle tension do for the pelvis and what can it lead to?

A

Stabilizes pelvis but can also lead to pain and somatic dysfunction

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5
Q

Form closure

A

SI joint stabilized by gravity and shape of joint (sacrum and innominate bones)

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6
Q

Force closure

A

SI joint stabilized by joint compression by muscles, ligaments, thoracolumbar fascia (all non-bone things)

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7
Q

Form closure and Force closure are important for?

A

Stable foundation for trunk and to transmit force with gait

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8
Q

SI joint pain is _____ % of chronic low back pain

A

15-25%

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9
Q

What are the 3 innominate motions?

A

Innominate rotation
Innominate and pubic shear
Innominate flare

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10
Q

When testing for innominate dysfunction what are you comparing bony landmarks to?

A

The contralateral side!

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11
Q

If an innominate rotates anterior, describe the locations of the ASIS and PSIS

A
ASIS = inferior
PSIS = superior
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12
Q

If an innominate rotates posterior, describe the locations of the ASIS and PSIS

A
ASIS = superior
PSIS = inferior
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13
Q

At what stage in walking is the innominate rotated posteriorly?

A

Heel strike

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14
Q

At what stage in walking is the innominate rotated anteriorly?

A

Toe off

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15
Q

What motions of the innominates are generally pathologic and cause pain?

A

Shear and flare

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16
Q

Innominate shear

A

ENTIRE innominate is superior or inferior

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17
Q

Pubic shear

A

ONLY PUBIC TUBERCLES are superior or inferior

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18
Q

Innominate flare

A

ASIS is more medial or lateral compared to opposite side - measure relative to umbilicus

19
Q

Innominate inflare

A

ASIS more medial

20
Q

Innominate outflare

A

ASIS more lateral

21
Q

What are the 3 sacral motions?

A

Flexion (nutation)
Extension
Oblique axis rotation

22
Q

The sacrum flexes and extends around what axis?

A

Transverse axis

23
Q

Sacral nutation

A

Flexion

24
Q

When the sacrum flexes around the transverse axis, what tips forward?

A

Sacral base

25
Q

The sacrum rotates around what axis?

A

Oblique

26
Q

What is an oblique axis?

A

Vertical axis slightly tilted

27
Q

How is the sacral oblique axis named?

A

For which sacral base (R/L top corner) it passes through

28
Q

Ex. Left oblique axis with right rotation. What is the sacral movement?

A

Top right sacral base rotates posteriorly

29
Q

4 steps to assessing innominates for somatic dysfunction

A
  1. Screen innominates for somatic dysfunction (TART)
  2. Lateralization tests
  3. Palpate bony landmarks
  4. Diagnose innominate somatic dysfunction
30
Q

How do you screen innominate for somatic dysfunction (step 1)?

A

Have them stand, and you sit behind them and assess for posterior spine/innominates TART - find one side that is worse

31
Q

What are the lateralization tests (step 2)?

A

ASIS compression test

Standing flexion test

32
Q

ASIS compression test

A

Posteromedial compression of both ASIS

- find which side is more resistant to compression

33
Q

Standing flexion test

A

Have patient stand and you monitor both PSIS’s with your thumbs. Have patient bend over and see which PSIS moves SUPERIORLY

34
Q

For the lateralization tests, the dysfunctional sides move how?

A

ASIS compression test - harder end feel

Standing flexion test - PSIS moves superior

35
Q

What are the bony landmarks to palpate (step 3)?

A
Iliac crests
ASIS
Pubic tubercles
Medial malleoli
PSIS
36
Q

Anterior rotated innominate

A

Iliac crests and pubic tubercles = EVEN
ASIS and medial malleolus = INFERIOR
PSIS = SUPERIOR

37
Q

Posterior rotated innominate

A

Iliac crests and pubic tubercles = EVEN
ASIS and medial malleolus = SUPERIOR
PSIS = INFERIOR

38
Q

Superior innominate shear

A

ALL boney landmarks are SUPERIOR

39
Q

Inferior innominate shear

A

ALL boney landmarks are INFERIOR

40
Q

Innominate inflare

A

ASIS more medial

41
Q

Innominate outflare

A

ASIS more lateral

42
Q

Superior/Inferior pubic shear

A

Pubic tubercle ONLY is either superior or inferior compared to other side

43
Q

What should you do before you begin the ASIS compression test?

A

Reset the hips!

- Have patient push hips toward sky and then back down