LECTURE 4A

Question 1

isolated SI joint probs are common TRUE OR FALSE

Answer 1

false: RARE

Question 2

SI joint is the ____ understood joint in the body

Answer 2

least
SI joint does not MOVE
(or if it does move, moves minimally)

Question 3

SI joint most commonly refers where

Answer 3

LBP
or hip
*mechanical/non-specific LBP

Question 4

___% of people with non-specific LBP have SI joint pain

Answer 4

15-30%

Question 5

women have a __, ___ pelvis than men

Answer 5

wider, flatter pubic arch (U SHAPE)
wider bigger pelvic inlet

Question 6

sacrum concavity is on the ____ side

Answer 6

anterior

Question 7

what muscle originates at anterior aspect of S2, 3, 4:

Answer 7

pirformis

Question 8

what 2 mm directly produce SI joint motion?

Answer 8

1. pirformis
2. pubococcygeal

Question 9

what motions do the pirformis do?

Answer 9

1. hip external rotation, hip abduction
2. when hip flexes over 90, pirformis becomes hip IR

Question 10

LBP and hip dysfunction is ___ than SIJ dysfunction

Answer 10

way more common
1. LBP + SIJ
2. hip + SIJ

Question 11

___% of people with LBP have ____ related pain

Answer 11

15-30% have SI joint related pain!

Question 12

what muscle really likes infection

Answer 12

iliopsoas
(absess, hematoma)
1. TB
2. osteomyelitis

Question 13

most common complaint of SI joint dysfunction

Answer 13

TTP over region of PSIS

Question 14

what are other complaints of SI joint pain?

Answer 14

pain with transitional movements (sitting to standing, standing to sitting/lying)
2. SLS activity pain (stairs, gait)
3. end range SLR active pain (after 90)
4. prolonged sit/standing

Question 15

SACRAL NUTATION

Answer 15

base: anterior
apex: posterior
innominates are posterior (posterior pelvic tilt, decreased lumbar lordosis)

Question 16

SI joint exam is ALWAYS performed in addition to:

Answer 16

1. lumbar spine exam
   OR
2. hip joint exam
   OR both

Question 17

what is the most reliable for SI joint special tests?

Answer 17

provocation and stress tests are MOST RELIABLE
*pain provoking (bc dichotomous: yes or no)

Question 18

what muscles attaches to the sacrum on the posterior side?

Answer 18

erector spinae
multifidi
glute max
Thoracolumbar fascia

Question 19

The ___ of each innominate articulates with the sacrum to form the SI joint

Answer 19

ilium

Question 20

anterior SI ligaments do waht

Answer 20

bind sacrum and ilia LIMIT ALL MOTIONS
*pain generators

Question 21

interosseous ligaments of SI joint do what?

Answer 21

LIMIT anterior and inferior movement of the sacrum
*most important ligament! binds sacrum to ilia

Question 22

palpation of this ligament indicates SI joint dysfunction

Answer 22

Interosseous SI ligaments

Question 23

posterior SI joint ligaments limit what rotation?

Answer 23

anterior iliac rotation (sacral counternutation)
*pain generators!

Question 24

which SI joint ligament serves as an attachment for erector spinae, glute max, and TL fascia?

Answer 24

posterior SI joint ligaments

Question 25

Sacrotuberous ligament limits WHAT

Answer 25

posterior iliac rotation *sacral nutation Isch tub to PSIS-continues with biceps femoris tendon

Question 26

sacrospinous ligament limits what?

Answer 26

posterior iliac rotation (sacral nutation) *goes from ischial spine to sacrum

Question 27

what is known as the arch support or keystone of the pelvis?

Answer 27

pubic symphysis *common source of groin pain in athletes

Question 28

Which muscles work in coordination to assist in lumbopelvic stability?

Answer 28

pelvic floor! levator ani (PR, PC, IC, C)

Question 29

posterior pelvic/LE muscles

Answer 29

1. Erector spinae 2. QL 3. glute max 4. glute med 5. glute min 6. TFL 7. Pirformis 8. adductors 9. hamstrings

Question 30

anterior pelvic muscles

Answer 30

abs TFL iliopsoas quads/rectus femoris adductors

Question 31

posterior oblique system

Answer 31

latissimus dorsi + contralateral glute max thoracolumbar fascia

Question 32

anterior oblique system

Answer 32

EO + IO contralateral hip adductors anterior abdominal fascia

Question 33

lateral muscle system includes...

Answer 33

glute med and glute min, contra hip adductors

Question 34

inner muscle system is made of what?

Answer 34

1. multifidi 2. TA 3. pelvic floor 4. diaphragm

Question 35

inner muscle system (diaphragm, TA, multidifi, pelvic floor) do what?

Answer 35

stabilize the SI joint (like a coke can)

Question 36

posterior portion of the SI joint is innervated by

Answer 36

posterior rami of L3-S3

Question 37

nutation of sacrum is limited by...

Answer 37

SI, ST, sacrospinous ligaments

Question 38

sacral counternutation is limited by

Answer 38

SI ligaments (close pelvic outlet with counternutation)