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Spine > Pelvis and SIJ > Flashcards

Pelvis and SIJ Flashcards

1
Q

Signs and symptoms of pelvic dysfxn:

A 
localized pain 
SI displacement
abnormal motor pattern with SI motion
\+ ASLR test
pain with SI provocation
painful to stand on one leg
pain with sitting
pain with sit > stand
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2
Q

When descending stairs, how does the SI move?

A

stance side: anterior to neutral

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3
Q

When ascending stairs, how does the SI move?

A

stance side: posterior rotation

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4
Q

SIJ motion at initial contact on R:

A

R ilium rotates posterior

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5
Q

SIJ motion at midstance on R:

A

R ilium rotates anteriorly but not past neutral

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6
Q

SIJ motion at pressing on R:

A

R ilium rotates anteriorly past neutral

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7
Q

Unilateral ilial torsion can be caused by:

A

trauma
hormonal induced laxity
overuse

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8
Q

Unilateral ilial torsion is demonstrated by:

A

asymmetry of ASIS and PSIS

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9
Q

Describe normal lumbopelvic rhythm:

A

hips, pelvis, and l-spine

in flexion: 70 degrees hips, 40 degrees l-spine

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10
Q

Describe how the multifidus stabilizes the sacrum/SIJ:

A

co-contraction with transversus and pelvic floor muscles

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11
Q

Define Upslip:

A

One ilia has higher ASIS and PSIS

can occur with upward jar to leg

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12
Q

Define Downslip:

A

One ilia has lower ASIS and PSIS

can occur with childbirth

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13
Q

Need to differentiate ilial upslips and downslips from:

A

LLD

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14
Q

What is an ilial inflare?

A

ASIS on one side is closer to midline than the other

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15
Q

What is an ilial outflare?

A

ASIS on one side is farther from midline than the other

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16
Q

Ilial inflares/outflares are usually secondary to:

A

ant/post torsion

unlikely to see true inflares/outflares

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17
Q

Pubic ramus upslip/downslip may be associated with

A

ilial torsion

18
Q

Pubic ramus downslip may be associated with

A

childbirth

19
Q

Sprain of SI ligaments is usually a result of:

A

acute injury secondary to trauma

20
Q

Spymphyseal strains are usually related to:

A

inflammation secondary to mechanical stress

may be seen with pregnancy due to weight of fetus on pubis

21
Q

Osteotis Pubis = symphysitis; usually related to:

A

overuse injury secondary to repetitive activities placing strain on pubic symphysis
(running, kicking, abdominal sit-ups)

22
Q

Pubic symphysis diastasis is treated conservatively with ____ mm gap.

A

< 25 mm

23
Q

____ mm gap is called pubic symphysis diastasis.

A

> 13 mm

24
Q

Normal pubic symphesis gap is:

A

4 mm

25
Q

What is the normal amount of gapping with pregnancy?

A

increases by 2-3 mm

26
Q

Define pubic symphysis diastasis:

A

separation usually during childbirth that creates significant instability (can also happen with trauma)

27
Q

While most pelvis and SIJ conditions are more prevalent in women, what flag should be considered for men?

A

consider AS
1st sign is often bilateral SI pain unrelated to activity
refer to rheumatologist

28
Q

The lumbosacral joint is made up of:

A

L5-S1 facet joints

29
Q

Describe the composition of the SIJ:

A

Part synovial and part fibrocartilaginous

sacrum: hyaline articular cartilage
ilia: fibrocartilage

30
Q

SIJ nerve receptors are located in:

A

joint capsule and ligaments

31
Q

What level is the sacral axis of motion?

A

S2

32
Q

Describe nutuation:

A

sacral flexion
base of sacrum tilts forward relative to ilium
l-spine extension

33
Q

Describe counternutation:

A

sacral extension
base of sacrum tilts posteriorly relative to ilium
l-spine flexion

34
Q

What breath cycle corresponds to nutation and counternutuation?

A

nutation: exhalation
counternutation: inhalation

35
Q

What gravitation forces act on the pelvis?

A

GFR through LE and hip create posterior and superior sheer

Trunk creates sacral nutation moment and inferior sheer stress

36
Q

Passive and dynamic stability elements of the pelvis include:

A

form closure and force closure

37
Q

Define force closure

A

dynamic stability from myofascial structures for SIJ

38
Q

Define form closure

A

passive stability of SIJ from joint surfaces and ligaments

39
Q

The loading force of the body is transmitted through the spine to the sacrum which is wedged between the ilia by:

A

form closure

40
Q

Compressive forces are needed to resist shear of SIJ surfaces with heavy, abrupt loading and prolonged loading (creep). These forces are provided by:

A

muscles (force closure)

Posteriorly: Lat dorsi, TL fascia, glut. max. and ITB

Anteriorly: Obliques, transverse and rectus abdominus

41
Q

How is the CPP of the SIJ obtained?

A

force closure

Transversus abdominis and obliques pull ilia toward midline

Spine (8 decks)

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