Innominates revisited

Question 1

Why is firm placement of the thumb on the PSISs necessary to properly diagnose the sacrum?

Answer 1

Prevent the tissue from sliding and giving erroneous results

Question 2

True or false: flexion of the spine carries the sacrum anteriorly

Answer 2

True

Question 3

What causes the discordant PSIS movement with the standing/seated flexion test?

Answer 3

Restriction of the innominate

Question 4

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?

Answer 4

Go with the side that moves first

Question 5

Is paradoxical motion of the PSIS with seated/standing flexion considered a positive test?

Answer 5

Yes

Question 6

What happens to the sacrum at the extreme end of trunk flexion?

Answer 6

Counter-nutates

Question 7

What is the test that identifies the side of restricted pelvic motion for pubic and iliosacral dysfunctions?

Answer 7

Seated and standing flexion

Question 8

What are the causes of false positives with the seated/standing flexion? (3)

Answer 8

• Tightness of the contralateral hamstrings
• Tightness of the ipsilateral QL
• Asymmetric muscle development

Question 9

True or false: the motion of the join is abnormal every time the patient bends at the waist, all day long

Answer 9

True

Question 10

What is the most common innominate dysfunction?

Answer 10

Anterior/posterior innominate rotations

Question 11

What are the two etiologies of upslipped innominates?

Answer 11

• Subluxation secondary to a sprained ligament

- Dislocation secondary to a torn ligament

Question 12

How do you determine which innominate is high/low?

Answer 12

Based on the seated/standing flexion test

Question 13

What is the second most common SD of the innominates?

Answer 13

Up-slipped innominates

Question 14

When the patient with an up-slipp is standing, which crest appears high?

Answer 14

Trick question–The sacrum is low, but the crests are of equal height

Question 15

When the patient with an up-slip is supine, which crest appears high?

Answer 15

Side of dysfunction will manifest as higher

Question 16

What are you observing with a positive seated flexion test?

Answer 16

Abnormal movement of the sacrum on the ilium

Question 17

Which way does the ilum rotate with sacral flexion? What does this cause?

Answer 17

The ilium rotates anteriorly with sacral flexion, which elevated the PSIS bilaterally

Question 18

What is the cause of the movement of the PSIS with a seated flexion?

Answer 18

Restriction on one side causes the SI joint to lock prematurely

Question 19

True or false: the direction of the PSIS movement is the diagnostic criteria for a seated/standing flexion test, not the unilateral movement

Answer 19

False–The unilateral movement, not the direction of the PSIS is the diagnostic criteria

Question 20

Which side of the seated/standing flexion test is the restricted side: the one that moves farther, or the one that moves slightly

Answer 20

Farther

Question 21

True or false: the lumbar spine and the sacrum always move in opposite directions

Answer 21

False– not always

Question 22

What are the major muscles of the LE that affect the SI joint? (3)

Answer 22

• Hamstrings
• Gastroc
• Soleus

Question 23

What are the major muscles of the torso that affect the SI joint? (3, hint: all are posterior)

Answer 23

• QL
• Lat dorsi
• Iliocostalis

Question 24

What is the effect of lateral curvature of the spine?

Answer 24

• Increased energy to maintain posture

- Increased wear/tear on the spine