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OrthoIII Sectional exams > Ortho III Final- Pelvis/ SI > Flashcards

Ortho III Final- Pelvis/ SI Flashcards

1
Q

What 3 muscles attach to the sacrum?

A

IMP

-illiacus, multifidus, piriformis

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2
Q

The pelvic ring consists of _ joints. Differences b/w men and women occur at _. Females have a _ sacrum that is _ _, and appears _.

A

Pelvic ring consists of 3 joints

Differences occur at PUBERTY

Females have a SHORTER sacrum that is ANTERIORLY ROTATED, and appears HYPERLORDOTIC

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3
Q

The articular surface of the SI joint: -_ segment is shorter; _ segment is longer. Is _ in females, but still _ -.

A

CRANIAL segment is shorter

CAUDAL segment is longer

Is SMALLER in females but still spans S1-S3

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4
Q

The sacrum is _ until puberty and then develops _ _ _. Is built for _.

A

The sacrum is SMOOTH until puberty and then develops IRREGULAR SURFACE AREA.

Is built for stability

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5
Q

The pelvis is stabilized posteriorly by _, due to a lack of _. The main function is to _ _ in all _.

A

Pelvis stabilized posteriorly by LIGAMENTS, due to lack of a CAPSULE.

The main function is to LIMIT MOTIONS in all PLANES

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6
Q

Anteriorly the ligaments are _ to _ and _. Makes them difficult to _ but stress to them can _ _.

A

Anteriorly the ligaments are DEEP to MUSCLE and VISCERA.

Makes them difficult to PALPATE, but stresses to them can CAUSE PAIN

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7
Q

Anatomically the pelvis is _, and movement _ _. IT functions to _ _ _ _ .

A

The pelvis is COMPLEX, and movement OCCURS TOGETHER.

It functions to DISTRIBUTE WEIGHT BEARING FORCES

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8
Q

How many degrees of movement are there in the pelvis?

A

6 DEGREES OF MOVEMENT

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9
Q

The _ and _ forces react with each other, and the _ _ complete the _ _ or _ _ mechanism.

A

The GROUND and TRUNK FORCES react with each other, and the LIGAMENTOUS STRUCTURES complete the SCREW HOME OR SELF LOCKING mechanism

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10
Q

Lumbopelvic rhythm: Normal standing position with lumbar concavity, _ _ is directly _ _ _

A

Normal standing position with lumbar concavity, BODY WEIGHT is directly OVER THE HIPS

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11
Q

Lumbopelvic Rhythm: With flattening of the lumbar spine (flexion) the pelvis _ _, hips and pelvis _ _.

A

The pelvis ROTATES ANTERIORLY, hips and pelvis MOVE POSTERIORLY

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12
Q

Lumbopelvic Rhythm: Reversal of the lumbar curve (extreme flexion) the pelvis _ _ to the fullest with the pelvis and hips _ _.

A

Reversal of the lumbar curve (extreme flexion) the pelvis ROTATES ANTERIORLY to the fullest with the pelvis and hips DISPLACED POSTERIORLY

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13
Q

During gait: the torso swings _ _ out of phase with the pelvis with the axis being at -. The Innominate _ _ with swing switching to an _ direction at midstance.

A

The torso swings 180 DEGREES out of phase with the pelvis with the axis being at T12-L1

The Innominate ROTATES POSTERIORLY with swing, switching to an ANTERIOR-WARD direction at midstance

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14
Q

Gait: the sacrum is at _ _ about the _ _ _ on heel strike. (Ex- at _ heel strike, sacrum is in _ _ around the _ _ _)

A

The sacrum is at IPSILATERAL ROTATION about the IPSILATERAL OBLIQUE AXIS on heel strike.

Ex: at RIGHT heel strike, sacrum is in RIGHT ROTATION around the RIGHT OBLIQUE AXIS

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15
Q

During the subjective examination patients with SI pain will most likely complain of pain in the _ _, _, and _ (in that order)

A

Most likely to complain of pain in the LOWER BACK, BUTTOCK and THIGH

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16
Q

MOI: forceful golf, baseball or hockey slap shot; horizontal thrust to the the knee (dashboard injury); and a forceful diagonal pattern such as chopping wood, tennis serve or swinging a sledge hammer can all cause?

A

Anterior innominate rotation

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17
Q

MOI: repeated unilateral standing, fall on the IT, vertical thrust onto extended leg (miss curb/ step), lifting in a forward bend position with locked leg, and hyper flexion/ hyper abduction injury to the hips during intercourse in females can all cause?

A

Posterior innominate rotation

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18
Q

MOI: fall onto buttocks, forceful vertical thrust on an extended leg (misstep/ leg bracing during MVA); or a fall or injury resulting in EROM of hip ER can cause?

A

Can cause INNOMINATE OUTFLARE

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19
Q

MOI: fall or injury resulting in EROM of hip IR can cause? Not _ _, can be seen in sports such as _.

A

Can cause INNOMINATE INFLARE

Not AS COMMON, can be seen in sports such as SNOWBOARDING

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20
Q

When slipping and falling injuries usually occur?

A

Usually occur on the landing side

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21
Q

MOI: forceful misstep, fall onto buttock, and prolonged single limb stance or assymetrical weight bearing can cause?

A

Can cause INNOMINATE upslip

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22
Q

Which types of innominate injuries can occur due to a forceful misstep with leg extended? (3)

A

Posterior rotation
OUTFLARE
Upslip

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23
Q

Which innominate injuries can occur due to a fall on the buttocks? (2) What innominate injuries can occur to prolonged or repeated unilateral/ single limb standing? (2)

A

FALL ON BUTTOCKS: Outflare, upslip

PROLONGED SL STANCE: Posterior rotation, upslip

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24
Q

Sacral bilateral dsyfunctions can occur due to a _ on _ or other _ _. Don’t usually happen due to __ _ and _

A

Can occur due to a FALL ON BUTTOCKS or other DIRECT TRAUMA

Don’t usually happen due to EVERYDAY WEAR AND TEAR

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25
Q

_ _ _ are similar to bilateral sacral dysfunctions, but may have a ambulatory or injury while running component to it.

A

SACRAL TORSION INJURIES are similar to . .. .

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26
Q

What are aggravating factors that you may see in a patient with SI pain in the clinic? (6)

A

SOUP With Prawns

  • stairs
  • obesity
  • unilateral standing
  • prolonged standing
  • walking
  • pregnancy
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27
Q

What are easing factors that are associated with SI/ Pelvic injury? (3)

A

SLaB

  • sitting
  • lying supine
  • belt support
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28
Q

A healthy person will change positions up to _ _ in an _ _ sleep period

A

A healthy person will change positions up to 50 TIMES in a 8 HOUR sleep period

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29
Q

With _ _ the cardinal and earliest sign is erosion of the SIJ manifested by pain and stiffness of the SIJ and lumbar spine for the _ _ _ of the . ( pain)

A

With ANKYLOSING SPONDYILITIS the cardinal and earliest sign is erosion of the SIJ manifested by pain and stiffness of the SIJ and lumbar spine for the FIRST FEW HOURS of the DAY (MORNING pain)

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30
Q

What are 3 special questions you might want to ask in patients presenting with SIJ pain?

A

Have you recently fallen on your buttocks?

Have you had a sudden jolt o your leg, like a misstep off of a curb?

Have you recently been chopping wood or shoveling snow?

31
Q

Unless there is _ _ the SI joint is usually not first on the hypothesis list. Usually complete a _ or _ evaluation first or at least _ those _.

A

Unless there is DIRECT TRAUMA the SI joint is usually not the first on the hypothesis list.

Usually complete a HIP OR LUMBAR evaluation first or at least CLEAR THOSE JOINTS.

32
Q

What test is being described: the patient can localize the pain with 1 finger, area pointed to immediately inferior and medial to the PSIS within 1 cm, and the patient consistently points to the same area over 2 trials. What does it indicate?

A

FORTIN FINGER TEST

It indicates that the the SI joint might be the problem

33
Q

What are 3 things to look for when observing a patient in standing?

A 
Pelvic obliquity (anterior or posterior rotation)
Lumbar lordosis (excessive or decreased)
Muscle tone (butt grippers)
34
Q

What are the 6 SI joint provocation tests?

A

SSSS FG

  • SI distraction
  • SI compression
  • sacral compression/ thrust
  • SLR
  • Femoral compression
  • Gaenslens test
35
Q

What are the 6 provocation tests that Laslett looked at? Which one of the 6 we learned in class is NOT part of the Laslett article?

A

GG DC ST

  • Gaenslens (right and left)
  • distraction
  • compression
  • sacral thrust
  • thigh thrust

There is NO SLR test

36
Q

How many tests were considered positive to identify an increased probability of SIJ inolvement? (2) What is the significance of 0/6 of the tests being positive?

A

3 out of 6 OR 2 out of the first 4 (all but Gaenslen’s) were considered to indicate SIJ involvement

If 0/6 tests were positive you can rule out SIJ pain

37
Q

What was the most reliable and sensitive test? Most Specific?

A

Femoral Compression/ Thrust was the most reliable and sensitive test

SIJ Distraction was the most specific

38
Q

What are the SIJ positional fault (dynamic) tests? (5)

A

SSS ML

  • standing flexion
  • sacral rotation
  • sacral flexion and extension
  • March test (Gillet’s)
  • Leg rotation test
39
Q

What test is being described: patient is supine with test hip off of plinth in extension and contralateral hip flexed to end range, therapist provides extension force to the test leg and counter flexion force to the contralateral side? What is a positive result?

A

Gaenslen’s test

Positive result is reproduction of symptoms

40
Q

What test is being described: Pt is standing with therapist behind palpating inferior portion of PSIS, ask patient to slowly bend forward, PSIS should move together. What is a positive result? (2)

A

Standing Flexion test

Positive result: if one side moves first or further
- that side is the involved side

41
Q

What test is being described: Pt. standing holding onto chair/ table for balance, therapist is behind palpating the inferior portion of the PSIS on test side and the S2 SP, pt lifts and flexes Ipsilateral hip and knee, pt then repeats movement with contralateral leg.

A

Gillet’s or March test

42
Q

What is a positive result for the Ipsilateral leg in March’s test? Contralateral leg? What is the normal for each test?

A

Ipsilateral leg- if both innominate and sacrum move together it is considered positive (posterior rotation limitation)
- normal pelvis should rotate first then the sacrum should move

Contralateral leg- if both innominate and sacrum move together is is considered positive (anterior rotation limitation)
-normally you should feel the sacrum move first then the innominate

43
Q

What test is being described: patient stands with back to therapist, PT is behind patient sitting/ kneading with thumbs just medial to the PSIS on the sacral base, pt laterally flexes to one side and then the other, PT notes the depth and symmetry of the sacrum on the same side as lateral flexion.

A

Sacral rotation test

44
Q

What is normal movement for left lateral flexion during the sacral rotation test? What would be considered a positive test?

A

During left lateral flexion the sacrum rotates to the right around a right oblique axis causing the sacral base on the LEFT TO MOVE ANTERIORLY (deeper)

If there was no movement or if the left sacral base popped out/ became more superficial then the test would be considered positive

45
Q

What test is being described: patient stands with back to therapist, PT kneels or sits behind patient with index fingers on ASIS and thumbs on PSIS (or on top of illiac crest if you can’t reach), pt marches a couple times to ‘reset’ pelvis, then patients is asked to ER one hip and then the other, test is repeated with IR. PT notes degree of innominate and hip rotation.

A

Leg rotation test

46
Q

What would be a normal innominate excursion during hip ER and IR? Compared to what equivalent of hip excursion? What would be considered a positive result of the leg rotation test?

A

Normal innominate excursion is 5 DEGREES during hip IR and ER, with 45 DEGREES hip ROM

Test would be considered positive if the movement of the innominate was less than 5 degrees with 45 degrees of hip IR or ER, or markedly less ROM when compared bilaterally
if test is too close to call then it is considered negative

47
Q

What test is being described: pt is standing, PT is kneeling or sitting behind patient with thumbs just medial to the PSIS on the sacral base, pt bends forward, and then it is repeated with pt. bending backwards. PT notes the symmetry and amount of movement and palpates for nutation and counter nutation of the sacral base.

A

SACRAL FLEXION AND EXTENSION TEST

48
Q

Sacral flexion assess sacral nutation during _ _. Sacral extension assess sacral counter nutation during _ _.

A

Sacral flexion assess sacral nutation during LUMBAR EXTENSION

Sacral extension assess sacral counter nutation during LUMBAR FLEXION

49
Q

What 3 things should you assess in supine?

A

Leg length discrepancy

Excessive hip rotation (ER/ IR)

Pelvic obliquity

50
Q

Supine to long sit: if there is a leg length discrepancy in supine and the patient comes to long sit position and it is still the same then?

A

Then pt has an actual leg length discrepancy

51
Q

If a patient has an innominate posterior rotation dysfunction then in supine the right leg will appear _ and in long sitting both legs _ _ or right leg is _.

A

Then in supine the right leg will appear SHORTER and in long sitting both legs ARE SYMMETRICAL or right leg is LONGER

52
Q

If a patient has a Anterior rotation dysfunction on the right: in supine the right leg will appear _, and in long sitting both legs _ _ or right leg appears _.

A

In supine the right leg will appear LONGER, and in long sitting both legs APPEAR SYMMETRICAL or right leg appears SHORTER

ALS

53
Q

To check pelvic obliquity in supine you should palpate _ to _ and look to see if one is _ or _ to the other.

A

You should palpate INFERIOR TO ASIS and look to see if one is SUPERIOR OR INFERIOR to the other

54
Q

When checking for excessive hip ER or IR in supine you should palpate _ to _ and check by _ _ to _ _.

A

You should palpate MEDIAL TO ASIS and check by MEASURING ASIS TO UMBILICUS DISTANCE

55
Q

When checking for pelvic obliquity in prone you should palpate just _ to the _, and look to see if one is more _ or _ to the other.

A

When checking for pelvic obliquity in prone you should palpate just MEDIAL TO THE PSIS, and look to see if one is more SUPERIOR OR INFERIOR to the other.

56
Q

When checking for outflare versus inflare in prone what are you assessing?

A

Outflare: PSIS will be closer to spine on out flared side

Inflare: PSIS will be farther away from spine on inflared side

57
Q

The _ _ _ _ runs vertically from inferior margin of PSIS to sacrum and is palpated just _ to _. Purpose is to check _ _.

A

The LONGER POSTERIOR SI LIGAMENT runs vertical from inferior margin of PSIS to sacrum and is palpated just INFERIOR TO PSIS.

Purpose is to check ANTERIOR ROTATION

58
Q

The _ _ _ _ runs medially and inferiorly from the medial margin of the PSIS to the S1 and S2 transverse tubercles. Is palpated just _ to _. Checks _ _ and _ _.

A

The SHORT POSTERIOR SI LIGAMENT runs medially . . .

Is palpated just MEDIAL TO PSIS

Checks INNOMINATE MEDIAL and ANTERIOR ROTATION

59
Q

Dysfunction of which ligament is associated with decreased lumbar lordosis, frontal plane pelvic instability during gait and Sagittal plane hip restrictions?

A

LONG POSTERIOR SI LIGAMENT

60
Q

Which ligament is associated with increased lumbar lordosis and increased frontal plane instability during gait? (2)

A

Short posterior SI and sacrotuberous ligament

61
Q

The _ _ travels between the _ _ _ of the sacrum to the _ _. Is palpated at the _ between _ _ _ and _ _.

A

The SACROTUBEROUS LIGAMENT travels between the INFERIOR LATERAL BORDER of the sacrum to the ISCHIAL TUBEROSITY

Is palpated at the MIDPOINT between INFERIOR LATERAL ANGLE AND ISCHIAL TUBEROSITIES

62
Q

The axis of rotation of the sacrum is named for?

A

Named for the top corner

63
Q

Anteriorly rotated innominate/ held in anterior rotation (osteopathic language) is the same as _ _ _ _ (movement science language). What is the difference between the two types of language?

A

Is the same as LIMITED INNOMINATE POSTERIOR ROTATION

The difference is language is that :
Osteopathic- looks at what IT IS doing
Movement science- looks at what IT CAN’T do

64
Q

Muscle energy techniques involve _ _ _ action. Meaning?

A

Involve REVERSED ORIGIN-INSERTION action

Meaning with AROM insertion moves towards origin, with MET it moves the opposite- origin towards insertion with the distal joint partner fixed(similar to CKC)

65
Q

MET to the illiacus muscle corrects innominate _ _ _, stuck _ by resisting knee and hip flexion.

A

Corrects innominate POSTERIOR ROTATION DYSFUNCTION, stuck POSTERIORLY

66
Q

MET of the illiacus muscle corrects an _ _ _ with leg figure 4 position

A

Corrects an INNOMINATE INFLARE DYSFUNCTION

67
Q

MET of the illiacus muscle with the leg in flexion, adduction and IR (FADIR) position corrects an _ _ _.

A

Corrects an INNOMINATE OUTFLARE DYSFUNCTION

68
Q

MET of the sartorius muscle with the leg in FADIR position corrects an _ _ _

A

Corrects an INNOMINATE OUTFLARE DSYFUNCTION

69
Q

MET of the gluteus Maximus muscle with the hip and knee flexed and resisting extension corrects an _ _ _ _

A

Corrects an INNOMINATE ANTERIOR ROTATION DSYFUNCTION

70
Q

MET to the piriformis muscle with the hip flexed at 60 degrees (pure _ _ occurs at this degree) will correct _ _ _ both _ and _. When performing the treatment side is _.

A

With the hip flexed at 60 degrees (pure ADDUCTION ACTION occurs at this degree) will correct BACKWARD SACRAL TORSIONS BOTH LOR AND ROL.

When performing the treatment side is DOWN

71
Q

MET to the multifidus muscle in the position of lower back rotational manipulation- except using an isometric contraction instead, will correct _ _ _ both _ and _. Treatment side is?

A

Will correct FORWARD SACRAL TORSIONS both LOL AND ROR

Treatment side is UP

72
Q

MET to the gluteus medius muscle with knee and hip flexed to 90 degrees on treatment side and resisting adduction force, is used to correct _ _ _.

A

Used to correct INNOMINATE INFLARE DSYFUNCTION.

73
Q

Balancing the pubes or shotgun technique is used to correct an _ _ _ by pulling the pubis bone _.

A

Used to correct an INNOMINATE UPSLIP DYSFUNCTION by pulling the pubis bone INFERIORLY

OrthoIII Sectional exams (5 decks)

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