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PHTH 565 Pelvis > Pelvis > Flashcards

Pelvis Flashcards

1
Q

What are the functional units of the pelvis? Stability is provided by what?

A
  • 2 innominate
  • sacrum
  • bilateral hip jts and L5/S1
  • Stability is provided by
    o Form closure
    o Force closure
  • the stability comes from the interlocking grooves and ridges
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2
Q

What equates to a stable system?

A

passive system = jt congruency and ligamentus support

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3
Q

What are the major lig supports at the pelvis

A 
interosseous 
ventral and dorsal SI ligament
sacrotuberous
sacrospinous 
long dorsal lig
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4
Q

What are the most important muscles for the pelvis

A

muscles that cross perpendicular to jt surfaces
ex. glut max and TA
OPTIMAL alignment is balance btw form and force closure

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5
Q

What is the self locking mechanism of the pelvis

A

The fact that its kept stable via form and force closure

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6
Q

What do we know regarding the biomech. arthrokinematics; and total ROM of the pelvis

A

axis of motion is not known same with arthrokin. there is a total of 4degrees of movt.

  • need this movt. for shock absorption…
  • thought asymmetry = pain
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7
Q

Does the Innominate rotate or nutate

A

INNOMINATE = ROTATION

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8
Q

DOES THE sacrum rotate or nutate?

A

Sacrum = nutation (sacral nod) = flexion

* sulcus deepens

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9
Q

What is the most stable position for the SI jt

A

Nutation (flexion) b/c it tensions the sacrotuberous and spinous ligaments

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10
Q

What does counter nutation equate to

A

extension of sacrum
sulcus is shallow and base tips back
“unstable position of SI”

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11
Q

what are some differential diag for pelvic girdle pain syndrome (PGPS)

A
  • inflam condition (AKS)
  • Systemic disease reiters
  • peliv inflam disease
  • visceral dysfunction
  • lumbar spine and hip dysfun
  • *get them to draw pain diagram very good tool**
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12
Q

Your pt presents with SI symptoms do you send them for Xray?

A

NO dont show anything
Nor does MRI
Unless u think tumor or AKS

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13
Q

Do active tests tell you what is wrong in the pelvis

A

No u need to do passive tests to get an idea of what is going on

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14
Q

What are some general outcome measures for PGP

A

Quebec back pain disability scale
Oswestry back pain disability questionnaire
Disability rating index

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15
Q

What increases your chance for pelvic pain postpartum?

A

Having asymmetry jt laxity during prego

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16
Q

What do you need to consider when clinically diagnosing PGP

A

1) rule out LBP; ask about P. W. prolonged sitting or standing, location of shading on P. diagram
2) SI jt. P - Posterior Pelvic pain provocation test (P4 test), Fabers (P. must be in SI jt.), Gaenslens tests & TOP over long dorsal lig.
3) Pub. sym dys - TOP >5sec; modified trendelenburg
4) Mechanical Pelvic issues - Active straight leg raise (ASLR) give form closure/then try force then together see if P. decreases–if form helps = SI belt ; if Force = muscle training

17
Q

A patient has an option of MRI or PT Ax for diagnosis what would you recommand to them

A

PT most effect in SI jt dysfunc

18
Q

Pt has SI dysfunction what are the recommendations for Rx

A

exs. including water exs for pregnant women

SI belts short periods

19
Q

What is a + gaenslens; FABRS & P4 test?

A 
Gaenslens = P. at SI jt 
P4 = P in SI region 
FABRS = SI patho P. in SI region
20
Q

What are the pain provocation test of the pelvis?

A

1) Gaenslens test
2) FABRS
3) P4
4) Cyriax
5) Palpation
6) Modified trendel.
7) Active SLR

21
Q

What is indicative of SI/public sum path?

A

local P. at SI jt or pubic symphysis

22
Q

When doing the cyriax test what position gives you ant traction and post compression

A
  • supine with hands crossed over
23
Q

What are the criteria needed to call something a lesion

A

ex ant lesion would mean on PASSIVE testing the innom. can not move post.
** if there is no restriction passively then its a positionally = muscle fault

24
Q

What are common lesions to the pubic sym

A

Women - peri-partum, can be superior or inf.

men - post herination, of post abd wall

25
Q

where cna you have lesions to the pelvis

A

pubic sym
innominantes
sacral

26
Q

Anterior innominate lesion could be caused by what?

A

Shortened quads/ lengthened hamstrings/or a loss of form closure

27
Q

what is the most stable position of the sacrum and what else can it effect?

A

Nutation

- influence the L5/S1 segment

28
Q

Whats the difference b/w a positional fault and a lesion?

A 
Lesion = capsule/ligament/articular surfaces
Positional = muscle
29
Q

What are the positional findings for R ant. innominate lesion: ASIS; Iliac crest, psis; active mobil. (kinetic/fwd bend); passive ant rotate and post.

A 
ASIS - higher maybe not 
PSIS- hight Rt 
Kinetic - + ipsi and contra 
FBT - Rt psis more cranial 
Passive - will move well ant but NO movt post.
30
Q

what are some Rx’s for the pelvis

A

1) passive physio mobs
- I or II acute painful / III-IV non irritable jt. resistance > P.
2) MET
3) muscle balance
- belts (form closure), force closure (muscle)

31
Q

What is MET therapy

A

PT that involves active contraction a precisely controlled direction at varying levels of intensity against a distinctly executed counterforce applied by operator
-contract relax technique
MUST BE PAIN FREE AND GENTLE*
manips not good on SI b/c so limited in movt.
- 3-7 sec hold

32
Q

When would you use MET therapy?

A
  • acute injuries (only going to R1)
  • muscle resistance to movt. or end feel
  • imbalance
  • spasm
  • segmental stab eg. the spine
33
Q

If you want to increase ant innom. rotation what position would you put them in

A

more hip ext. (side lying or prone)

Posterior = hip flexion (not passed 70)

34
Q

What are the Rx parameters

A

3x 3-7 sec hold

* you need to FEEL WHAT THE MUSCLES are doing and go with the one that works

PHTH 565 Pelvis (1 decks)

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