OB Sacrum Lab Flashcards
What are the restrictions to patient positioning in a pregnant woman?
- no prone
- limit supine
- favor seated and left lateral recumbent techniques
- avoid changing positon though to keep patient as comfortable as possible
How do you perform Seated Straight leg raise? Positive test?
- Patient seated slumped forward to cause cervical and thoracic flexion (tighten meninges)
- straighten leg by bracing knee and lifting from the ankle
- Positve test is reproduction of radiating pain
- Lower sensitivity and specificity than normal SLR
What is the FAIR test?
- Flexion, ADduction, Internal Rotation
- Tests for sciating nerve irritation due to piriformis muscle
- Patient lays lateral recumbent with hip up
What is the FABER test?
- Flexion, ABduction, Ext. Rotation
- Positives:
- groin pain= intraarticular issues
- labral tear
- FAI
- OA
- Also Iliopsoas bursitis/strain
- Buttock pain
- SI joint dysfxn
- groin pain= intraarticular issues
How do you set up the thomas test and what is it testing?
- Tests for tight hip flexors (psoas)
- Patient is suupine with both legs hanging off table and then pull one knee to the chest extending the other
- Postive test is the inability to fully extend the leg or the leg raises off of the table
SLR positive?
- Pain over lateral leg at 15-30
- IT band
-
Neurologic Pain btw 30-60
- Lumbar disc herniation L4-S1 nerve roots
- Lumbosacreal radiculopathy
- Sciatic neuropathy
- Pain > 70
- mechanical LBP due to strains or joint disease
- pathology of hips or SI joint
- Hamstring or glutes tightness
ROM for sidebending, flexion, ext, and rotation of the lumbars?
How do you set up a patient with L1-3 N RRSL for seated MET? What is the treatment and Is this a type 1 or 2 SD?
- Type 1 SD
- Set up patient by having them take their ipsilateral hand to the PTP and place it behind their neck and hold that elbow with the other hand.
- Physician steps away from PTP
- Place hand on opposite bicep going over only one
- L2 NRLSR is the treatment
How do you set up a patient for seated L2 ERrSr MET?
- Type 2 SD
- Set up patient by having them take their ipsilateral hand to the PTP and place it behind their neck and hold that elbow with the other hand.
- Physician steps away from PTP
- Place hand on opposite bicep going over both biceps
- Tx is L2 FRlSl
How do you move a patient to rotate and side bend in a lateal recumbent positon for lumbars?
- In type one and type two dysfunctions the rotation is the same because the PTP is always down
- Control rotation by pulling the bottom arm or rotating the top shoulder
- control sidebending by drawing the bottom arm inferiorly to rotate opposite of the rotation or superiorly to rotate the same direction as rotation
How do you set up a L3-5 N Rl Sr lateral recumbent MET?
- PTP down physician facing patient
- Caudal hand or thigh flexes patients knees & hips
- Cephalad hand monitor
- Patients top leg is flexed and lowered off table causing anterior roattion of the pelvis
- Grasp the table side arm and pull anteriorly and inferiorly moving the patients top shoulder posteriorly
Describe set up for lateral recumbent MET L4 F RlSl.
Set up for L4 E RlSl lateral recumbent MET.
What does NUDR stand for and when is it used?
- Neutral dysfxn, ptp Up, patient force Down, lateral Recumbent position
What is SUUE?
What is FDDR?
Laying left lateral recumbent (PTP down) describe set up for L3-5 NRlSr
Describe setup for Left Lateral recumbent L4 ERrSr (PTP up)
Describe setup for Left lateral recumbent (PTP down) L4 F RlSl
Describe OB roll HVLA?
How does innominate diagnosis in a pregnant woman differ?
Cant use PSIS findnig, instead have to use Iliac crests
BLT Seated right Anterior rotated innominate setup?
BLT Left posteiorly rotated innominate set up?
How does the sacrum move in response to lumbar flexion?
extends
How does sacrum rotate in response to lumbar rotating to the left?
Sacrum rotates right (opposite)
What will the axis be if the lumbars are sidebending right?
Right (same as lumbar SB)
Internal rotation of legs encourages sacral ___, by gapping the ___ SI joint.
Internal rotation of the legs encourages sacral extension, by gapping the posterior SI joint.
External rotation of the legs encourages sacral ___, by gapping the ___ SI joint.
External rotation of the legs encourages sacral flexion by gapping the anterior SI joint.
Treatment for LUE MET?
MET for LUF
- Int. rotate leg to gap posterior SI joint
- monitor with heel of hand on left ILA
- Resist flexion with exhalation and encourage extension with inhalation
Seated setup for sacral flexion?
Setup for seated sacral extension
MET tx setup for L on L torsion.
Need to go to direct barrier so Right rotation on a left axis
- modified SIM → left lumbar rotation (causes right sacral rotation)
- Lumbar flexion of hips causes sacral base extension
- Lumbar side bending ankles off table
- patient directs force of ankles up
Seated L on L flexed sacral base setup?
- need to take to direct barrier so rotate right on left axis
- rotate lumbar left to cause sacral right rotation
- flex lumbar to cause sacral base extension
- lumbar sidebending to left to match sacral axis
- activating force is return to neutral
Tx for L on R MET.
- lumbar rotate left (rotate shoulders posterior) to cause sacral right rotation
- lumbar extension (flex hips) to cause sacral flexion
- lumbar sidebend right (flex and drop top knee to the floor) to match axis
- push top knee up for activating force
Seated L on R setup?
- rotate lumbars left to cause right sacral rotation
- extend lumbars to flex sacrum
- sidebend right to match axis
What are the venous and lymphatic changes with pregnancy?
- Increasae interstitial fluid
- diaphragm restrictions
- inc venous pressure
