Pelvic Exam

Question 1

How is the iliolumbar ligament palpated?

Answer 1

• Roll off posterior edge of iliac crest
• Find L4/ L5 interspace
• Move down to L5, and palpate back towards the iliac crest
• Palpate rope like ligament

Question 2

How can the PSIS be distinguished from fatty deposits in the low back?

Answer 2

• Pt standing
• Pt flexes hip causing anterior pelvic rotation
• PSIS will slip under the palpation finger
• Fatty nodules will not move

Question 3

How is the sacral sulcus palpated?

Answer 3

• Drop medially and inferiorly from the PSIS into the deep sacral sulcus.

Question 4

How is the inferor lateral angle of the sacrum palpated?

Answer 4

• Palpate along the sacral sulci

- When the innominate turns continue downwards and feel for the angle

Question 5

How is the piriformis palpated?

Answer 5

• Make a T of the greater trochanter, ichial tuberosity, and coccyx.
• Piriformis will be the base of the T

Question 6

How are the ischial tuberosities palpated?

Answer 6

• Ask for consent first
• Find gluteal fold
• Fall off the fold
• Come superiorly
• Palpate into tuberosities

Question 7

What 2 impairments may be palpated at the ischial tuberosities during palpation?

Answer 7

• Ischial bursitis

- Hamstring inflammation/ irritation

Question 8

How are the pubic tubercles palpated?

Answer 8

• Obtain consent
• Palm the abdomen
• Walk the hand down
• Find it, and feel it with the thumbs
• Can have female patient find it themselves and use their thumbs as dummy thumbs
• May palpate the pubic symphysis for pain

Question 9

How can the ASIS be palpated more consistently?

Answer 9

• Move the thumb directly under the ASIS

Question 10

In what positions should the pelvic landmarks be palpated?

Answer 10

• Standing
• Sitting
• Supine
• Prone

Question 11

What 10 landmarks should be palpated during the pelvic exam?

Answer 11

• Iliac crest
• Ilio-lumbar ligament
• PSIS
• Sacral sulcus
• S2
• Sacral inferior lateral angles
• Piriformis
• Ischial tuberosities
• ASIS
• Pubic tubercles/ pubic symphysis

Question 12

What is the 4 (or 5) item test cluster for SIJ dysfunction?

Answer 12

• Thigh thrust
• Sacral thrust
• Distraction
• Compression
• Gaenslen’s (?)

Question 13

What are the 4 other special test for the pelvic girdle?

Answer 13

• FABER’s
• Squish test
• Active SLR
• Sign of the buttock