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Manual II > Pelvis > Flashcards

Pelvis Flashcards

1
Q

The ilium, ischium and pubis form the

A

Innominate Bones

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2
Q

What’s the difference between the iliosacral and sacroiliac joints?

A

Iliosacral is ground up

Sacroiliac is top down

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3
Q

True or false; you can only have sacroiliac problems if you were pregnant

A

False

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4
Q

True or false; SI does not cause LBP

A

False

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5
Q

What are the 3 bones of the innominate?

A

• Ilium • Ischium • Pubis

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6
Q

Stability= ________+_________ performance

A

Static and dynamic performance

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7
Q

How many sacral vertebrae are there?

A

5 fused

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8
Q

How many sacral discs are there?

A

0

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9
Q

Greater and lesser sciatic foramina are split by the ___________

A

sacrospinalous lig

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10
Q

True or false; the innominate is highly perfused

A

True- rich in marrow

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11
Q

Which part of the sacrum articulates with L5 disc?

A

Promontory

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12
Q

How are the superior articular sacral facets oriented?

A

Coronal

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13
Q

The sciatic nerve is between…

A

The periformis and operator internus

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14
Q

True or false; there is a cartilagenous disc between the sacrum and coccyx

A

True

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15
Q

The Sacral _____ houses nerves

A

Sacral canal

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16
Q

The PSIS is around which sacral level?

A

S2

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17
Q

True or false; bony anatomy can be asymmetrical

A

True

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18
Q

What do you call the transverse processes of S5?

A

Inferior lateral angle (ILA)

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19
Q

What is the facet orientation of the lumbosacral junction?

A

Coronal 45-90

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20
Q

What is the promontory inclination?

A

50 degrees

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21
Q

What is the angle of the disc between L5 and S1?

A

16

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22
Q

What is the sacral inclination?

A

23

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23
Q

What are the slippage safe guards of the lumbosacral junction?

A

Facet orientation of L5-S1 junction

Disc shape

Iliolumbar Ligaments

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24
Q

How many bones are in the coccyx?

A

4 bones

The last 3 are fused

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25
Q

True or false; the coccyx serves as a myofascial attachment, especially for the pelvic floor

A

True

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26
Q

What type of joint is the SI joint?

A

Amphiarthrodial

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27
Q

Which sacral segments make up the part above the “ankle of the boot”? Below?

A

Above: S1
Below: S2& S3

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28
Q

Is the sacral articular surface or the Ilial articular surface coated in hyaline cartilage to be more mobile?

A

Sacral

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29
Q

Is the sacral articular surface or the Ilial articular surface thicker?

A

Sacral

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30
Q

Is the sacral articular surface or the Ilial articular surface relatively concave?

A

Sacral

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31
Q

Is the sacral articular surface or the Ilial articular surface coated in fibrocartilage for weight bearing?

A

Ilial

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32
Q

Is the sacral articular surface or the Ilial articular surface thinner?

A

Ilial

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33
Q

Is the sacral articular surface or the Ilial articular surface convex?

A

Ilial

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34
Q

The sacral articular surface has the greatest motion occuring in females between …

A

25 and 45 years of age

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35
Q

In _____% of the population, the opposing joint surfaces are flat and parallel; thus creating the potential
for shearing and instability.

A

10-15%

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36
Q

Is the male or female pelvis thinner?

A

Female

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37
Q

Is the male or female pelvis lighter?

A

Female

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38
Q

Is the male or female pelvis broader?

A

Female

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39
Q

How wide is the female pelvic outlet?

A

125mm

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40
Q

Does the male or female pelvis have a smaller, smoother surface?

A

Female

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41
Q

Does the male or female pelvis have a rectangular sacrum?

A

Female

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42
Q

Are male or female pelvises more influenced by relaxin ?

A

Female

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43
Q

It the male or female pelvis thicker?

A

Male

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44
Q

It the male or female pelvis heavier?

A

Male

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45
Q

It the male or female pelvis more vertical?

A

Male

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46
Q

What is the width of a male pelvic outlet?

A

80mm

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47
Q

Does the male or female pelvis have a larger, regular surface?

A

Male

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48
Q

Does the male or female pelvis have a triangular sacrum?

A

Male

49
Q

What is the center of gravity in a female?

A

Behind the hip S3

50
Q

What is the center of gravity in a male?

A

Through the hip S2

51
Q

What is the purpose of the anterior SI lig?

A

Prevent ventral gapping

52
Q

What is the function of the posterior SI lig?

A

Prevent dorsal gapping

53
Q

What is the function of the Long Dorsal SI lig?

A
  • Prevents sacral counter-nutation

* Prevents anterior innominate rotation

54
Q

The long dorsal SI ligament comes under tension when the sacral base is in a pathologically induced ____________ position.

A

counter-nutated

55
Q

True or false; the long dorsal SI ligament may inhibit the gluteus maximus

A

True due to arthrokinetic reflex.
Reflex weakness of the ipsilateral gluteus maximus. As a result, the hamstring becomes hypertonic which, through the biceps femoris/ sacrotuberous ligament connection, further counter-nutates the ipsilateral sacral base. This sets up a vicious cycle of pain, dysfunction and muscle weakness.

56
Q

What is the function of the sacrotuberous ligament?

A

• Prevents posterior iliac
rotation
• Prevents sacral nutation

57
Q

Which nerve can entrap the prudential nerve?

A

Sacrotuberous lig

58
Q

What is the function of the sacrospinous ligament?

A

• Prevents posterior iliac
rotation
• Prevents sacral nutation

59
Q

What is the function of the iliolumbar ligament?

A
  • Prevents L4 and L5 contra-lateral rotation

* Prevents ilial rotation posteriorly

60
Q

True or false; the anterior and posterior longitudinal ligaments stop in the lumbar spine

A

False; run to sacrum

61
Q

What kind of joint is the pubic symphysis?

A

Syndesmosis

62
Q

True or false; a normal amount of shear and rotation may occur in the pubic symphysis

A

True

63
Q

Which ligaments support the pubic symphysis?

A
  • Inferior Arcuate
  • Superior Pubic
  • Ant/Post Pubic
64
Q

What is the axis of rotation for the iliosacral complex?

A

Pubic symphysis

65
Q

What are the 3 intermediate muscles of the pelvic floor?

A
  • Levator Ani (3)
  • Coccygeus
  • Piriformis
66
Q

Although each muscle of the pelvic floor performs a unique task, they collectively function as a unit to…

A

support and suspend the pelvic contents

67
Q

What are the 4 systems of outer force closure?

A

Posterior oblique

Anterior oblique

Deep longitudinal

Lateral

68
Q

Which components make up the posterior oblique system?

A

contra lateral lats. dorsi/ T-L fascia -> ipsi. glut. max.

69
Q

Which components make up the anterior oblique system?

A

contralateral ext. obliques -> ipsi. int. obliques, hip adductors via anterior abdominal fascia

70
Q

Which components make up the deep longitudinal system?

A

contralateral erector spinae via deep lamina of T-L fascia -> ipsi. sacrotuberous lig. and biceps femoris

71
Q

Which components make up the lateral system?

A

ipsi. glut. medius/minimus

and ipsilateral hip adductors

72
Q

Form closure of a motion segment is undermined by a deficit in …

A

normal inter-segmental stability

73
Q

Impaired motor control of deep (local) segmental muscles (force closure) results in…

A

compensatory activation of torque-producing multi-segmental (global) musculature.

74
Q

Lumbar spine pathology may account for LBP and/or lower extremity symptoms which results in secondary…

A

The articular/neuromuscular deficits

75
Q

What are the components of the biomechanical treatment model?

A
  1. Mobilize/manipulate segmental hypomobility.
  2. Stabilize clinical segmental instability as follows:
    a. Attain neutral spinal position.
    b. Activate the local segmental muscles of core stability
    c. Motor control of the pelvic floor (especially the pubococcygeus).
  3. Strengthen the multi-segmental, spinal muscles.
76
Q

What are the principles of stabilization training?

A

⦿ Isometric contraction of specific muscle
⦿ Low load exercise
⦿ Neutral joint position
⦿ Kinesthetic awareness
⦿ Facilitation of inhibited muscle
⦿ Pain-free exercise
⦿ Perform frequently and regularly to target Type I fibers
⦿ Progress holding time of isometric contraction

77
Q

The sacroiliac region receives innervation from the anterior rami of ______ and posterior rami of______.

A

Anterior: L2-S2
Posterior: L4-S4

78
Q

As you inhale…
The thoracic spine _______
The lumbar spine _______
The sacrum _______

A

The thoracic spine extends
The lumbar spine flexes
The sacrum counter-nutates

79
Q

As you exhale…
The thoracic spine _______
The lumbar spine _______
The sacrum _______

A

The thoracic spine flexes
The lumbar spine extends
The sacrum nutates

80
Q

Which sacral axis is impacted by respiration?

A

Superior transverse axis

81
Q

Which sacral axis is impacted by craniosacral motion?

A

Superior transverse axis

82
Q

Which sacral axis is impacted by lumbosacral motion?

A

Middle transverse axis

83
Q

Which sacral axis is impacted by gait?

A

Inferior transverse axis

84
Q

Between which phases of gait is the ilium posteriorly rotated?

A

Heel strike to foot flat

85
Q

Between which phases of gait is the ilium anteriorly rotated?

A

Mid stance to toe off

86
Q

During single leg stance, which direction may my hip rotate?

A

Posterior

87
Q

When weight bearing, is it more natural for a pubic symphyseal shift to go superiorly or inferiorly?

A

Superior

88
Q

My patient has an iliosacral shear dysfunction and a pubic symphysis dysfunction. Which do I treat first?

A

Iliosacral shear

89
Q

My patient has an iliosacral shear dysfunction and an SI joint dysfunction. Which do I treat first?

A

Iliosacral shear

90
Q

My patient has an iliosacral shear dysfunction and a Hip joint dysfunction. Which do I treat first?

A

Iliosacral joint

91
Q

My patient has an iliosacral shear dysfunction and a Type II dysfunction. Which do I treat first?

A

Iliosacral shear

92
Q

My patient has an iliosacral shear dysfunction and a type I dysfunction. Which do I treat first?

A

Iliosacral shear

93
Q

My patient has an iliosacral shear dysfunction and a sacroiliac joint dysfunction. Which do I treat first?

A

Iliosacral shear

94
Q

My patient has an iliosacral shear dysfunction and a iliosacral nonshear dysfunction. Which do I treat first?

A

Shear

95
Q

My patient has a pubic symphysis dysfunction and a sacroiliac joint dysfunction. Which do I treat first?

A

Pubic symphysis dysfunction

96
Q

My patient has a pubic symphysis dysfunction and a hip joint dysfunction. Which do I treat first?

A

Pubic symphysis

97
Q

My patient has a pubic symphysis dysfunction and a type II dysfunction. Which do I treat first?

A

Pubic symphysis

98
Q

My patient has a pubic symphysis dysfunction and a type I dysfunction. Which do I treat first?

A

Pubic symphysis

99
Q

My patient has a pubic symphysis dysfunction and an iliosacral non-shear dysfunction. Which do I treat first?

A

Pubic symphysis

100
Q

My patient has a unilateral sacroiliac joint dysfunction and a hip joint dysfunction. Which do I treat first?

A

SI

101
Q

My patient has a unilateral sacroiliac joint dysfunction and a Type II dysfunction. Which do I treat first?

A

SI

102
Q

My patient has a unilateral sacroiliac joint dysfunction and a type I dysfunction. Which do I treat first?

A

SI

103
Q

My patient has a unilateral sacroiliac joint dysfunction and a bilateral SI joint dysfunction dysfunction. Which do I treat first?

A

Unilateral

104
Q

My patient has a unilateral sacroiliac joint dysfunction and an iliosacral non-shear dysfunction . Which do I treat first?

A

SI

105
Q

My patient has a hip joint dysfunction and a type II dysfunction. Which do I treat first?

A

Hip

106
Q

My patient has a hip joint dysfunction and a type I dysfunction. Which do I treat first?

A

Hip

107
Q

My patient has a hip joint dysfunction and a bilateral SI joint dysfunction. Which do I treat first?

A

Hip

108
Q

My patient has a hip joint dysfunction and a iliosacral non-shear dysfunction. Which do I treat first?

A

Hip

109
Q

My patient has a type II dysfunction and a type I dysfunction. Which do I treat first?

A

Type II

110
Q

My patient has a type II dysfunction and a bilateral SI joint dysfunction. Which do I treat first?

A

Type II dysfunction

111
Q

My patient has a type II dysfunction and an iliosacral non-shear dysfunction. Which do I treat first?

A

Type II

112
Q

My patient has a type I dysfunction and a bilateral SI joint dysfuntion. Which do I treat first?

A

Type I

113
Q

My patient has a type I dysfunction and an iliosacral non-shear dysfunction. Which do I treat first?

A

Type I

114
Q

My patient has a bilateral SI dysfunction and an iliosacral non-shear dysfunction. Which do I treat first?

A

SI

115
Q

Pt presents with

C: groin pain common
H: missed soccer kick (“hit
the ground”)
A: pubic tubercle inferior on affected side
R: (+) standing flexion test
T: TTP, inguinal ligament on the affected side at proximal attachment; hypertonic hip adductor muscles on affected side

What is it?

A

Inferior pubic shear

116
Q

Pt presents with

C: groin pain common
H: fall onto ischium; rectus abdominis strain (tight on affected side)
A: pubic tubercle superior on affected side
R: (+) standing flexion test
T: TTP, inguinal ligament on affected side at proximal attachment

What is it?

A

Superior pubic shear

117
Q

Pt presents with

C: SIJ referral
H: vertical fall onto the ischium; missed step off a curb
A: ASIS, PSIS, and iliac crest up on affected side (in stance greater
trochanters level), IT up 6 mm on affected side
R: (+) standing flexion test, (+) stork and reverse stork (upper and lower poles)
T: sacrotuberous lig. lax, TTP at Baer’s point
S: (+) provocation tests

What is it?

A

Iliac upslip/ superior shear

118
Q

Pt presents with

C:  SIJ referral
H:  fall onto buttock in trunk flexion, lifting in trunk flexion with knees locked, intercourse strains
A:  PSIS down/back, ASIS up/back,
medial malleolus short in supine 
R:  (+) standing flexion test, (+) reverse Stork (upper/lower pole), (+) long sitting test (short to long)
T:  tight hamstrings, TTP Baer’s
point, sacrotuberous lig. taut 
S:  (+) provocation tests

What is it?

A

Posterior iliac rotation

119
Q

Pt presents with

C: SIJ referral
H: golfing, baseball, bowling, etc.
A: PSIS up/forward, ASIS down/forward, medial malleolus long in supine
R: (+) standing flexion test, (+) Stork (upper/lower pole), (+) long sitting (long to short)
T: tight iliopsoas, TTP Baer’s point and Long Dorsal SI lig
S: (+) provocation tests (Distraction, Compression, Posterior Shear, Pelvic Torsion tests)

What is it?

A

Anterior iliac rotation

Manual II (11 decks)

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