Lab 4 Flashcards
If you suspect a patient has a LBP+SI joint problem, what should you do first
First preform lumbar spine exam
never preform only an SIJ exam
Pain with transitional movements is a common sign of what
SIJ problems
If a patient clearly has neurological symptoms and has back pain, should you still do a scanning exam?
yes because you need to know to what extent the neurological system is involved
Pt has pain w/ coughing/sneezing and symptoms decrease with walking
lumbar disc pathology
Pt has pain with flexion or extension and pain with Posterior-anterior joint glides
Lumbar joint pathology
Pt has trendelenburg sign
Pain and decreased ability to squat
positive sign of buttock
Hip joint problem
What are the 4 reasons to preform a full SIJ exam?
Fortin’s sign
Positive SI joint test (gapping or compression)
Tenderness at posterior SI ligaments
Pain/weakness w/ single leg stance
How is the fortin’s sign evaluated?
Pain localized w/ 1 finger point
area is 1cm near PSIS
patient consistently points to same spot in 2 trials
The SIJ gapping test should _______ symptoms
the SIJ compression test should _______ symptoms
recreate symptoms for both
Sacral Thrust test
Pt is prone
Up to 6 thrusts applied straight down to inferior aspect of sacrum (S3)
Postive test - recreation of symptoms
Gaenslen’s test
Pt is in Thomas test position.
Pt pushes one hip further into flexion and the other further into extension.
The test hip is the one with the leg in extension
Positive test- reproduction of symptoms at SI joint or pubic symphysis
If you’re examining R sided SIJ pain, and one of the 5 tests comes back positive on the L side, can this contribute to the CPG?
Yes, positive test on either side can contribute to CPG
Where does your hand need to be placed for the Thigh Thrust test?
Place hand beneath patient’s sacrum, NOT their SIJ
positive test is reproduction of symptoms
What tests are a part of the positive SIJ dysfunction CPG?
Compression
Distraction
Sacral Thrust
Gaeslen Test
Thigh Thrust
What tests are a part of the negative SIJ dysfunction CPR
Compression
Distraction
FABER
Gaeslen
Thigh Thrust
How many tests have to be true for the Positive SIJ CPR?
3 or more
How many tests need to be true for the negative SIJ CPR?
3 or less
Where do you push for the pubic stress test
What kind of SIJ pain is it for?
Pubic rami
Anterior SIJ pain
What is sign of buttock
Pain w/ passive SLR
THEN Pain with passive hip flexion with knee bent to same ROM
Indicates neoplasm, Fracture, Infection, Septic arthritis
Where should you place your fingers to check the alignment of the ASIS?
Inferior to ASIS
What is the advantage of the seated flexion test?
Rules out leg length discrepancy or hamstring length
For the seated and standing flexion tests, which side is hypomobile?
The side the moves more with flexion because it’s stuck and moving with the spine, cant move independently like it’s suppose to
When using the longsitting test what will a longer limb appear as
what about a shorter limb?
Longer Limb- Posterior innominate
Shorter limb- Anterior innominate
What is the landmark to compare leg length with the long sitting test
medial malleoli
Which leg are you testing with Gillet’s (stork) test?
The SLS leg
What is assessed during Gillet’s (Stork) test
Assessing whether or not the PSIS of the elevated leg moves inferior t the sacrum, if it does not then it is a positive test
also a positive test if it reproduces pain
What are the 3 steps of the active SLR test
can you do them out of order?
- Raise leg, see if pain happens
- Apply compression and raise leg, see if pain happens
- activate abdominals and raise leg, see if pain happens
note: You must preform the steps in order
Which part of the active SLR tests for form closure problems?
Part 1 and 2: If they have less pain with manual compression
a compression belt may be indicated as treatment
What part of the active SLR test tests for force closure?
Part 3: If activating their abdominals makes the pain less
How do you interpret the active SLR if both part 2 and part 3 makes the pain better
Combination of force and form closure issues
Review last 9 slides of Lab 4 to learn the manipulations we didn’t cover in lab
