Pelvis II

Question 1

If a patient presented with somatic dysfunctions of the pelvis, what symptoms would they have?

Answer 1

–Sacroiliac pain
–Generalized hip pain
–Inguinal/groin pain
–Low back pain
–Leg pain (hamstrings, quads)
–Knee pain
–Referred pain to head, neck

Question 2

What are the three things necessary to diagnose a somatic dysfunction of the pelvis?

Answer 2

Bilateral assessment of 1) anterior and 2) posterior landmarks. 3) One test of liberality.

Question 3

What are the diagnostic tests of laterality?

Answer 3

Standing flexion test

AP compression tests (aka. rocking the pelvis, ASIS compression test, or Iliac compression test).

Question 4

If there is a positive standing flexion test on the right, what do you see?

Answer 4

Observation: Full flexion on the right right PSIS is superior.

Question 5

If there is a positive standing flexion test on the right, what type of dysfunction could this be?

Answer 5

innominate, pubic, or hip muscle imbalance dysfunction

Question 6

A patient shows a positive AP Compression test on the left, what do you see?

Answer 6

The left side has the greatest resistance to pressure on the ASIS, and thus is the side of somatic dysfunction

Question 7

What are the possible somatic dysfunctions of the pelvis?

Answer 7

Rotation (innominate)
Shears
Flares

Question 8

Describe innominate rotations

Answer 8

Movements of the ilium anteriorly or posteriorly around a theoretic right-left axis

(like a car wheel rotating forward or rotating backward)

Question 9

During a normal walking cycle, the most anterior an innominate is…..? The most posterior an innominate is ….?

Answer 9

The most anterior an innominate is a toe-off.

The most posterior an innominate is a heel strike.

Question 10

A patient is diagnosed with a right anterior innominate, what do you see?

Answer 10

ASIS inferior on right (affected side)

PSIS superior on right (affected side)

Question 11

What are some symptoms of an anterior innominate rotation somatic dysfunction?

Answer 11

Sciatica
Gluteal Pain
Hamstring pain/tightness

Question 12

Given a postive seated flexion test on the right, a patient walks in with the ASIS superior on the right side and PSIS inferior on the right side, what type of somatic dysfunction is this?

Answer 12

A posterior innominate

Question 13

What are type symptoms of a posterior innominate rotation somatic dysfunction?

Answer 13

• Inguinal pain
• Groin pain
• Quadriceps tightness

Question 14

What is an innominate shear?

Answer 14

Translatory movement of the ilium in the coronal plane to either superior or inferior.

Question 15

A female patient presents with a right positive AP compression test, right ASIS and right PSIS superior, what type of somatic dysfunction does she have?

Answer 15

rightsuperior innominate shear

Question 16

A female patient presents with a left positive AP compression test, right ASIS and right PSIS superior, what type of somatic dysfunction does she have?

Answer 16

left inferior innominate shear

Question 17

What are the symptoms of an innominate shear?

Answer 17

pelvic pain
sacroiliac pain
pain at the PSIS

Question 18

What are the causes of a innominate shear?

Answer 18

Traumatic
–Stepping down too hard on foot
–Missing a step or a curb
–Falling on buttocks

Sitting unevenly on a surface for extended periods of time

Question 19

What is an innominate flare? How do you test for it?

Answer 19

Movement of the ilium around a superior-inferior axis.
Measurement is made from the xiphoid processor umbilicus to each ASIS and the flare is named non the side of the positive test of laterality.

Question 20

A female patient presents with a left positive AP compression test, and the left ASIS is closer to the midline, what is the somatic dysfunction?

Answer 20

left inflared innominate

Question 21

A female patient presents with a left positive AP compression test, and the left ASIS is further from the midline, what is the somatic dysfunction?

Answer 21

left outflared innominate

Question 22

A female patient presents with a right positive AP compression test, and the right PSIS is further from the natal fold, what is the somatic dysfunction?

Answer 22

right inflared innominate

Question 23

A female patient presents with a right positive AP compression test, and the left PSIS is further from the natal fold, what is the somatic dysfunction?

Answer 23

outflared innominate

Question 24

What are symptoms of innominate flare somatic dysfunction?

Answer 24

SI pain
Hip/pelvic pain
Groin pain/tightness

Question 25

What are examples of causes of innominate flares?

Answer 25

Pregnancy Delivery Pelvic compression/trauma Chronically externally or internally rotated legs

Question 26

Name three findings of a Right Anterior Innominate

Answer 26

Right ASIS inferior Right PSIS superior (+) Standing Flexion Test on the right or (+) AP compression Test on the right

Question 27

Name three findings of a Left Posterior Innominate

Answer 27

Left ASIS superior Left PSIS inferior (+) Standing Flexion Test on the left or (+) AP compression Test on the left

Question 28

Name three findings of a Right Inflared Innominate

Answer 28

Right ASIS closer to the midline Right PSIS further from the midline (+) Standing Flexion Test on the right or (+) AP compression Test on the right

Question 29

Name three findings of a Left Superior Innominate Shear

Answer 29

Left ASIS superior Left PSIS superior (+) Standing Flexion Test on the left or (+) AP compression Test on the left

Question 30

``` A patient presents with the following: + Standing Flexion Test on the Right inferior R ASIS superior R PSIS Diagnosis? ``` ``` A. Right posterior innominate B. Left posterior innominate C. Right anterior innominate D. Right inferior innominate shear E. Left anterior innominate ```

Answer 30

C. Right anterior innominate | ?

Question 31

``` A patient presents with the following: + Standing Flexion Test on the Left left ASIS more medial than the right left PSIS more lateral than the right Diagnosis? ``` ``` A. Right posterior innominate B. Left inflared innominate C. Right anterior innominate D. Right outflared shear E. Right inflared innominate ```

Answer 31

B. Left inflared innominate?

Question 32

``` A patient presents with the following: + Standing Flexion Test on the Right inferior L ASIS superior L PSIS Diagnosis? ``` ``` A. Right posterior innominate B. Left posterior innominate C. Right anterior innominate D. Right inferior innominate shear E. Left anterior innominate ```

Answer 32

A. Right posterior innominate

Question 33

``` A patient presents with the following: + Standing Flexion Test on the Left superior R ASIS superior R PSIS Diagnosis? ``` ``` A. Right superior innominate shear B. Left posterior innominate C. Right anterior innominate D. Left inferior innominate shear E. Left anterior innominate ```

Answer 33

D. Left inferior innominate shear