OMM Final Flashcards
hip flexors
iliacus* psoas* (iliosoas) rectus femoris sartorius
rectus femoris origin/insert
AIIS
patella
sartorius origin/insert
ASIS
medial tibia
hip extensors
semimembranosus
semitendinosus
biceps femoris
gluteus maximus
adductors
adductor magnus* adductor brevis* adductor longus* gracilis pectineus
abductors
gluteus medius
gluteus minimus
tensor fascia lata
piriformis fxn
ext rotation*
abduction
extension
what makes piriformis special
only rotator that connects to sacrum
only muscle on ant surface of sacrum
male pelvis
narrow pubic arch acute pubic angle rounded iliac crest heart shaped pelvic opening sacral promontory not in line w/ pelvic brim
female pelvis
broad pubic arch obtuse pubic angle broad/flat iliac crest oval shaped pelvic opening sacral promontory in line w/ pelvic brim
innominate dysfunctions
rotational: ant or post
shear: sup or inf
flare: int or ext
steps of innominate dx
ID dysfuntion side:
standing flexion test
(reset pelvis)
ASIS compression
ID dysfunction:
ASIS/PSIS positions
(reset pelvis)
Leg lengths
standing flexion test findings
side that moves first/furthest is side of dysfunction (+)
ASIS compression test findings
side that’s harder to press in dysfunction side (+)
ASIS/PSIS position findings
ASIS lo, PSIS hi --> ant rot ASIS hi, PSIS lo --> post rot ASIS hi, PSIS hi --> sup shear ASIS lo PSIS lo --> inf shear ASIS med, PSIS lat --> .inflare ASIS lat, PSIS med --> outflare
leg length findings
short –> post rotation or sup shear
long –> ant rot or inf shear
even –> in/outflare
ME innominate ant rot
pt supine flex hip/knee monitor PSIS 3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate post rot
pt supine, dysfunctional leg off table stabilize opp ASIS extend hip to barrier 3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate inflare
pt supine stabilize opp ASIS flex hip 90 abduct to barrier 3-5 x for 3-5 s final stretch return, RESET, reassess
ME innominate outflare
pt supine monitor dysfunctional PSIS flex hip 90 adduct into barrier pull PSIS lat during contraction 3-5 x for 3-5 s final stretch return, RESET, reassess
HVLA innominate superior shear
pt supine dr @ foot of table grasp tib/fib, int rot apply traction to barrier thrust return, RESET, reassess
sacrum fusion
5 unfused at birth
fusion begin @ 16
complete @ 26
muscles of sacrum (+fxns)
gluteus maximus (extend, abduct hip)
multifidus
piriformis (ext rotation, weak extension)
sacroiliac motion
nutation (~flexion)
counternutation (~extension)
primary axis of sacroiliac mvmt
sup transverse axis (respiratory axis)
permanent
sacroiliac mvmt w/ resp
nutation (flex) @ exhalation
counternutation (ext) @ inhalation
secondary axis of sacroiliac mvmt
oblique axis
temporary (when we walk)
axis = locked side = closed SI joint
L5 flex/extend –>
sacral extend/flex
L5 sidebend –>
axis on same side
sidebent L –> (?) on L
L5 rotate –>
motion to opposite side
rotated L –> R (on ?)
type I vs II lumbar dysfunction –>
I –> ant rot
II –> post rot
ant torsions
physiologic (occur normally)
L on L
R on R
post torsions
non-physiologic (not normal)
L on R
R on L
tx for ant torsions
use gluteus maximus to pull dysfunctional base post
tx for post torsions
use piriformis to pull dysfunctional base ant
sacral shear dysfunctions
R/L unilateral flexion shear
R/L unilateral extension shear
bilateral flexion shear
bilateral extension shear
R/L unilateral flexion shear
R/L half of sacrum moves ant
R/L unilateral extension shear
R/L half of sacrum moves post
sacral dx steps
seated flexion test spring test sacral sulcus inferior lateral angle (need 3/4)
seated flexion test findings
ID dysfunctional side
feet planted
first/furthest = + = dysfunctional
opp side = axis
spring test findings
compression in sphinx
no recoil = + = post displacement of base (extension –>. RoL, LoR, UniER, UniEL, biE)
sacral sulcus (place)
medial to PSIS
inf lat angle (place)
inferior to PSIS by a few cm
SS/ILA findings (R axis)
deep SS L, deep ILA L (RoR)
deep SS R, deep ILA R (LoR)
deep SS L, deep ILA R (uniFL)
deep SS R, deep ILA L (uniEL)