Pelvic and SI Dysfunction Flashcards
1
Q
3 Functions of the SI joint
A
- Transfer load from trunk to legs
- Absorb LE motion/forces
- Dissipate force before it reaches the L-spine
2
Q
3 Parts of the Osseous ring
A
- Ilium
- Sacrum
- Pubis
3
Q
Term: Inter-related movement between the lumbar and pelvic joints
A
Lumbopelvic rhythm
4
Q
Term: L4-S1
A
Lumbosacral Junction
5
Q
Facets L5-S1
- Orientation
- Function
- Coupling
A
- Frontal/Caudal (the rest of the L-spine in sagittal plane)
- WB (on base of sacrum)
- SAME direction
6
Q
Structure: Attached from L4/L5 TP to iliac crest and restricts lumbopelvic motion
A
Iliolumbar ligament
7
Q
Portion of Iliolumbar Ligament: Tight with flexion
A
Posterior
8
Q
Portion of Iliolumbar Ligament: Tight with extension
A
Anterior
9
Q
Portion of Iliolumbar Ligament: Tight with rotation and SB
A
Superior
10
Q
Structure: Blends into quadratus lumborum
A
Iliolumbar ligament
11
Q
2 Features that add stability to the sacrum
A
- Triangle shape
- Ridges and depressions
12
Q
Joint Type: Anterior SI joint
A
Diarthrodial (synovial)
13
Q
Joint type: Posterior SI Joint
A
Syndesmosis
14
Q
2 Types of articulating surfaces in the SI joint
A
- Sacral surface covered in hyaline cartilage
- Iliac surface covered in fibrocartilage
15
Q
4 Characteristics providing stabilty to the SI Joint
A
- 2 joint types in one capsule
- 2 types of cartilage prevent gliding
- Irregular joint surfaces add friction
- Extensive ligaments surrounding joint
16
Q
Structure: Sacral surface/vertical plane level with S1
A
Short Arm of the Sacrum
17
Q
Structure: sacral surface/AP plane level with S2 to S4
A
Long Arm of the Sacrum
18
Q
Term: Sacrum moving on ilium
A
Sacroiliac motion
19
Q
Term: Innominate moving on the sacrum
A
Iliosacral motion
20
Q
Term: Innominate
A
Ilium
21
Q
Term: Lumbar motion
A
Sacroiliac motion
22
Q
Term: Flexion of the sacrum
A
Nutation
23
Q
Term: Sacrum moving anterior and inferior
A
Nutation
24
Q
Term: Extension of the sacrum
A
Counternutation
25
Term: Sacrum moving superior and posterior
Counternutation
26
Term: Unilateral nutation and counternutation
Sacral Axial rotation
27
Axis: Axial rotation
Hypothetical oblique axis
Left oblique = right side moving
Right oblique = left side moving
28
Term: Hip motion
Iliosacral motion
29
Term: ASIS inferior, PSIS superior
Anterior rotation
30
Term: ASIS superior, PSIS inferior
Posterior Rotation
31
Functional Biomechanics: Trunk forward bend
Sacrum nutates, then counternutates
Innominates rotate anteriorly
32
Functional Biomechanics: Trunk backward bending
Sacrum nutates/counternutates/remains relatively stable
Innominates rotate posteriorly
33
Functional Biomechanics: Hip flexion
Sacrum nutates
Unilateral innominate posterior rotation
34
Functional Biomechanics: Hip extension
Sacrum counternutates
Unilateral innominate anterior rotation
35
Term: Passive stability of bones, joints, and ligaments
Form closure
36
Term: Active/dynamic stability of muscle, fascia, or motor control
Force closure
37
Structure: Blends into biceps femoris and gluteus medius
Sacrotuberous ligament
38
4 (Local) Muscles of the Pelvic Girdle Inner Tube
1. TA
2. Multifidus
3. Diaphragm
4. Pelvic floor
39
4 (Global) Muscles of the Pelvic Girdle Outer Tube Longitudinal System
1. Erector spinae
2. T/L Fascia
3. Biceps femoris
4. Sacrotuberous ligament
40
4 (Global) Muscles of the Pelvic Girdle Outer Tube Anterior Oblique System
1. Internal obliques
2. External obliques
3. Abdominal fascia
3. Contralateral adductors
41
3 (Global) Muscles of the Pelvic Girdle Outer Tube Posterior Oblique System
1. Latissimus dorsi
2. Contralateral gluteus maximus
3. T/L fascia
42
Term: Systems that compress the SI joint
Outer tube oblique systems
43
3 (Global) Muscles of the Pelvic Girdle Outer Tube Lateral System
1. Gluteus medius
2. Gluteus minimus
3. Contralateral adductors
44
Term: System the copresses the SI joint, prevents shearing in SB, and aids in load transfer
Outer Tube Lateral System
45
2 Muscles that attached directly to the sacrum
1. Piriformis
2. Biceps femoris
46
Structure: When tight rotates the sacrum
Piriformis
47
Structure: When tight counternutates the sacrum
Biceps femoris/HS
48
Condition: MOI can include trauma, pregnancy, chronic L/S or hip problems, pelvic floor dysfunction
SI Joint dysfunction
49
Condition: Body chart can include unilateral pain, buttock pain, LBP, or posterior leg pain to knee
SI Joint Dysfunction
50
Condition: Aggravating Factors
- WB activities: standing, single leg stance, hopping, running
- Ascending/descending staris
- Pain with change of position: sit to stand, moving in bed
SI Joint Dysfunction
51
Term: Most reliable predictor of SI joint dysfunction
Pain provocation tests
3/5 + has modest predictive power
52
2 mobility tests that assess SI motion
1. Lumbar flexion
2. Lumbar extension
53
2 mobility tests that assess IS motion
1. Gillet flexion
2. Hip extension
54
Describe how sacral dysfunction is named
Named after directio nof rotation and direction of axis
55
Condition:
- Difficulty with activities requiring posterior rotation
- ASIS anterior and inferior
- PSIS superior
- Functionally long leg
- Decreased hip flex and posterior rotation
Anteriorly Rotated Ilium
56
Condition:
- Difficulty with activities requiring anterior rotation
- ASIS posterior and superior
- PSIS inferior
- Functionally short leg
- Decreased hip extension and anterior rotation
Posteriorly rotated ilium
57
Condition:
- Entire ilium higher
- ASIS/PSIS superior
- May have decreased anterior/posterior rotation
- Decreased hip ABD strength
Upslip
58
Condition: ASIS more medial and PSIS more lateral
Inflare
59
Condition: ASIS more lateral and PSIS more medial
Outflare
60
MET: Correction of ilial anterior rotation
Isometric gluteal(/HS) contraction
61
MET: Correction of ilial posterior rotation
Isometric hip flexion contraction
62
CPR to Predict success of lumbopelvic manipulation
1. \< 18 on fear avoidance
2. sx \< 15 days
3. No sx distal to knee
4. L-spine hypomobility at any level
5. Either hip with \> 35 degree IR
63
Condition:
- Pain with change in position
- Deep shift/clunk
- Difficulty with WB activities
- Positive stability tests
- Active SLR +
- Pain provocation +/-
Hypermobile Pelvic Girdle
