Innominates revisited Flashcards
Why is firm placement of the thumb on the PSISs necessary to properly diagnose the sacrum?
Prevent the tissue from sliding and giving erroneous results
True or false: flexion of the spine carries the sacrum anteriorly
True
What causes the discordant PSIS movement with the standing/seated flexion test?
Restriction of the innominate
If there is a discrepancy in the seated/standing flexion test in that one side moves first, but the other moves farther, which side should you diagnose as positive?
Go with the side that moves first
Is paradoxical motion of the PSIS with seated/standing flexion considered a positive test?
Yes
What happens to the sacrum at the extreme end of trunk flexion?
Counter-nutates
What is the test that identifies the side of restricted pelvic motion for pubic and iliosacral dysfunctions?
Seated and standing flexion
What are the causes of false positives with the seated/standing flexion? (3)
- Tightness of the contralateral hamstrings
- Tightness of the ipsilateral QL
- Asymmetric muscle development
True or false: the motion of the join is abnormal every time the patient bends at the waist, all day long
True
What is the most common innominate dysfunction?
Anterior/posterior innominate rotations
What are the two etiologies of upslipped innominates?
- Subluxation secondary to a sprained ligament
- Dislocation secondary to a torn ligament
How do you determine which innominate is high/low?
Based on the seated/standing flexion test
What is the second most common SD of the innominates?
Up-slipped innominates
When the patient with an up-slipp is standing, which crest appears high?
Trick question–The sacrum is low, but the crests are of equal height
When the patient with an up-slip is supine, which crest appears high?
Side of dysfunction will manifest as higher
What are you observing with a positive seated flexion test?
Abnormal movement of the sacrum on the ilium
Which way does the ilum rotate with sacral flexion? What does this cause?
The ilium rotates anteriorly with sacral flexion, which elevated the PSIS bilaterally
What is the cause of the movement of the PSIS with a seated flexion?
Restriction on one side causes the SI joint to lock prematurely
True or false: the direction of the PSIS movement is the diagnostic criteria for a seated/standing flexion test, not the unilateral movement
False–The unilateral movement, not the direction of the PSIS is the diagnostic criteria
Which side of the seated/standing flexion test is the restricted side: the one that moves farther, or the one that moves slightly
Farther
True or false: the lumbar spine and the sacrum always move in opposite directions
False– not always
What are the major muscles of the LE that affect the SI joint? (3)
- Hamstrings
- Gastroc
- Soleus
What are the major muscles of the torso that affect the SI joint? (3, hint: all are posterior)
- QL
- Lat dorsi
- Iliocostalis
What is the effect of lateral curvature of the spine?
- Increased energy to maintain posture
- Increased wear/tear on the spine
