OB Sacrum Lab Flashcards

1
Q

What are the restrictions to patient positioning in a pregnant woman?

A
  • no prone
  • limit supine
  • favor seated and left lateral recumbent techniques
  • avoid changing positon though to keep patient as comfortable as possible
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2
Q

How do you perform Seated Straight leg raise? Positive test?

A
  • 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
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3
Q

What is the FAIR test?

A
  • Flexion, ADduction, Internal Rotation
  • Tests for sciating nerve irritation due to piriformis muscle
  • Patient lays lateral recumbent with hip up
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4
Q

What is the FABER test?

A
  • Flexion, ABduction, Ext. Rotation
  • Positives:
    • groin pain= intraarticular issues
      • labral tear
      • FAI
      • OA
    • Also Iliopsoas bursitis/strain
    • Buttock pain
      • SI joint dysfxn
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5
Q

How do you set up the thomas test and what is it testing?

A
  • 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
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6
Q

SLR positive?

A
  • 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
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7
Q

ROM for sidebending, flexion, ext, and rotation of the lumbars?

A
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8
Q

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?

A
  • 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
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9
Q

How do you set up a patient for seated L2 ERrSr MET?

A
  • 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
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10
Q

How do you move a patient to rotate and side bend in a lateal recumbent positon for lumbars?

A
  • 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
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11
Q

How do you set up a L3-5 N Rl Sr lateral recumbent MET?

A
  • 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
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12
Q

Describe set up for lateral recumbent MET L4 F RlSl.

A
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13
Q

Set up for L4 E RlSl lateral recumbent MET.

A
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14
Q

What does NUDR stand for and when is it used?

A
  • Neutral dysfxn, ptp Up, patient force Down, lateral Recumbent position
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15
Q

What is SUUE?

A
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16
Q

What is FDDR?

A
17
Q

Laying left lateral recumbent (PTP down) describe set up for L3-5 NRlSr

A
18
Q

Describe setup for Left Lateral recumbent L4 ERrSr (PTP up)

A
19
Q

Describe setup for Left lateral recumbent (PTP down) L4 F RlSl

A
20
Q

Describe OB roll HVLA?

A
21
Q

How does innominate diagnosis in a pregnant woman differ?

A

Cant use PSIS findnig, instead have to use Iliac crests

22
Q

BLT Seated right Anterior rotated innominate setup?

A
23
Q

BLT Left posteiorly rotated innominate set up?

A
24
Q

How does the sacrum move in response to lumbar flexion?

A

extends

25
Q

How does sacrum rotate in response to lumbar rotating to the left?

A

Sacrum rotates right (opposite)

26
Q

What will the axis be if the lumbars are sidebending right?

A

Right (same as lumbar SB)

27
Q

Internal rotation of legs encourages sacral ___, by gapping the ___ SI joint.

A

Internal rotation of the legs encourages sacral extension, by gapping the posterior SI joint.

28
Q

External rotation of the legs encourages sacral ___, by gapping the ___ SI joint.

A

External rotation of the legs encourages sacral flexion by gapping the anterior SI joint.

29
Q

Treatment for LUE MET?

A
30
Q

MET for LUF

A
  • 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
31
Q

Seated setup for sacral flexion?

A
32
Q

Setup for seated sacral extension

A
33
Q

MET tx setup for L on L torsion.

A

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
34
Q

Seated L on L flexed sacral base setup?

A
  • 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
35
Q

Tx for L on R MET.

A
  • 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
36
Q

Seated L on R setup?

A
  • rotate lumbars left to cause right sacral rotation
  • extend lumbars to flex sacrum
  • sidebend right to match axis
37
Q

What are the venous and lymphatic changes with pregnancy?

A
  • Increasae interstitial fluid
  • diaphragm restrictions
  • inc venous pressure