Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OMM > L19-20: Innominates I-II > Flashcards

L19-20: Innominates I-II Flashcards

1
Q

Articulations at the pelvis

A
  1. ) Sacroiliac joint
  2. ) Pubic symphysis
  3. ) Femoral heads with acetabulum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How to detect short leg syndrome?

A
  • If after OMM treatment, pt is evaluated in standing position and iliac crests and greater trochanters are both lower on same side, possible patient will need to be evaluated for short leg syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a small hemipelvis?

A
  • Pelvis is shorter on one side, very rare. Detected when pts are sitting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Landmarks of pelvis

A
  • Iliac crests
  • ASIS
  • AIIS
  • Pubic symphysis/tubercles
  • PSIS
  • IT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name motions of the innominate on the sacrum

A
  1. ) Inflare (medial) / outflare (lateral)
  2. ) Anterior and posterior rotation
  3. ) Superior and inferior translatory motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe how movement of thigh, causes lumbar spine movement

A
  • Innominate follows thigh, thigh follows innominate
  • Innominate follows sacrum, sacrum follows innominate
  • Sacrum follows lumbar spine, lumbar spine follows sacrum
  • L-spine follows sacrum, which follows innominates, which follows femur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe innominate motion during walking cycle

A
  • Right foot out places right innominate in posteriorly rotated position
  • Right innominate moves posterior to anterior as right heel strikes ground
  • Left foot out places left innominate in posteriorly rotated position
  • Left innominate moves posterior to anterior as left heel strikes ground
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe translatory movement of innominates when standing on each leg

A
  • When on left leg, left innominate is translated superiorly

- When on right leg, right innominate is translated superiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe innominate motion with respiration

A
  1. ) Inhalation: diaphragm moves inferior, L-spine flexes, sacrum extends, outflare of innominates
  2. ) Exhalation: diaphragm moves superior, L-spine extends, sacrum flexes, inflare of innominates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What conditions could treating the innominates address?

A
  • Pain: LBP, hip pain, knee pain
  • Gait problems
  • Running problems
  • Postural stress in neck, head, knees, feet etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name innominate somatic dysfunctions

A
  1. ) Hip musculature strain patterns/tender points
  2. ) Hip musculature asymmetry in length/tightness
  3. ) Pubic SDs: compression, shears
  4. ) Iliosacral SDs: flare, rotations, shears
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tests to diagnose inflared/outflared innominate

A
  1. ) Inflared innominate = Standing flexion test + on side with ASIS closest to midline
  2. ) Outflared innominate = Standing flexion test + on side with ASIS further away from midline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pt has standing flexion test positive on left side. ASIS on left is further from midline than ASIS on right. What could be wrong with the innominate?

A
  • Outflared left innominate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to treat an inflared innominate?

A
  • Treat with muscle energy using figure 4 position.
  • If inflare on left, place left ankle over left knee. Physician’s hand over right ASIS and left knee. Muscle energy by having pt push against hand on knee, keep traction on ASIS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to treat an outflared innominate?

A
  • Treat with muscle energy using modified piriformis stretch position. If right outflare, place right hip at 90 degrees, grasp medial right PSIS, other hand on right knee. Physician adducts right femur to barrier (but keep pressure downwards to prevent over rotation of pelvis), maintain lateral traction to PSIS. Muscle energy by having pt abduct.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to diagnose pubic symphysis somatic dysfunction?

A
  • History: Pelvic pain, groin pain, hip pain or/and LBP
  • Physical: Positive standing flexion test, Assume pubic compression (bones closer together than they should be) if there is standing flexion test positive and pt isn’t pregnant, Palpate pubic tubercle on side of + STFT for tissue texture changes and/or tenderness
17
Q

Treatment for pubic symphysis compressions? What muscles are you using to treat?

A

1.) Isolytic/isometric technique treats compression (always done, unless pregnant). This may also treat pubic shears
**Not done in pregnant pt
Muscles used: adductors of hip

18
Q

Treatment for superior pubic shear? What muscles are you using to treat?

A
  • Hang leg that corresponds to pubic bone that is sheared superiorly off table
  • Hold ASIS on opposite side to stabilize and have pt use hand to hold themselves on table
  • Physician exerts downward force on knee, pt asked to bring knee towards opposite shoulder
    Muscles used: adductors of hip
19
Q

Treatment for inferior pubic shear? What muscles are you using to treat?

A
  • Flex hip that corresponds to pubic bone that is sheared inferiorly. Physician on table sitting. Place hand over SI joint, flex hip until motion felt there. Other hand is cupping the IT, driving it more superiorly til motion is felt
  • Pt extends hip – drives leg toward physician – do muscle energy. After relaxation, flex hip and drive IT superiorly – til 4th barrier.
    Muscles used: extensors of hip
20
Q

How to diagnose innominate rotations?

A
  1. ) History: LBP, hip pain
  2. ) Physical (test, landmark, test): STFT+, ASIS position (whether superior or inferior on side of +STFT), ASIS motion test (if ASIS inferior, motion easier inferiorly)
21
Q

Pt has STFT+ on left, left ASIS is superior and motion of tissue over left ASIS resists anteriorly (goes posteriorly). Diagnosis?

A
  • Posterior rotation of left innominate
22
Q

For innominate rotations, what are the correlations between ASIS position and tissue motion over ASIS?

A
  • keep vowels together
  • Anterior (think moving down and forward) motion goes with inferior position
  • Posterior (think moving up and backwards) motion goes with superior position
23
Q

What could be occurring if ASIS position and tissue motion over ASIS do not correlate?

A
  • Something else, such as upslipped innominate, lumbar sidebending, etc.
24
Q

How to treat innominate rotations? Muscles used for anterior? For posterior?

A
  • ME for anterior / posterior rotations. Anterior is same as inferiorly sheared pubic bone without hand on and driving IT. Muscles used: extensors of the hip.
  • Posterior is same as superiorly sheared pubic bone except direction of isometric contraction is towards same shoulder. Muscles used: flexors of the hip.
  • OR HVLA for anterior / posterior rotations. Anterior (leg in air): leg raised 30 degree and slightly abducted. Posterior (leg in plane): slight abduction. Both with dorsiflexion of foot and internal rotation.
25
Q

Who could be diagnosed with an upslip (aka superior innominate shear)?

A
  • History of trauma or LBP (fell on IT or knee, stepped in hole, missed step, lat dorsi pull, QL pull)
  • Runners
  • Pts who site with one leg underneath their body
  • Truck drivers, farmers who place weight on same side when leaving truck or tractor
  • MVC with foot on break
26
Q

What on physical exam could indicate innominate upslip?

A
  • Positive STFT without anterior or posterior rotation of innominate
  • Tenderness at PSIS (may or may not be on same side of dysfunction)
27
Q

How to diagnose an innominate upslip?

A
  • Requires 3 out of 5 landmarks to be superior on side of upslip, of which one must be IT. Other landmarks to choose from: PSIS, iliac crest, ASIS, pubic tubercle
  • Also, must have + STFT on superior side
28
Q

Treatment of innominate upslip?

A
  • HVLA (with stabilizing using opposite ILA): pt prone

- Muscle energy: pt supine, plane of table for motion, non-upslipped leg is against physicians thigh – pushes against

29
Q

Describe steps to evaluate innominate SDs

A
  1. ) StFT
  2. ) Reseat pelvis
  3. ) Evaluate muscle imbalances and strain patterns, treat if necessary
  4. ) Evaluate for inflares/outflares, treat if necessary
  5. ) Treat any pubic compressions, which there will be if pos StFT and pt not pregnant
  6. ) Evaluate pubic bones, treat if necessary
  7. ) Evaluate rotations, treat if necessary
  8. ) Repeat StFT
  9. ) If negative StFT, done with innominate
  10. ) If positive StFT, check for upslip, treat if needed
  11. ) Repeat StFT
  12. ) If negative StFT, done with innominate
  13. ) If positive StFT, may be more complicated issue such as short leg syndrome or short hemipelvis

OMM (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions