Pelvis II Flashcards
If a patient presented with somatic dysfunctions of the pelvis, what symptoms would they have?
–Sacroiliac pain –Generalized hip pain –Inguinal/groin pain –Low back pain –Leg pain (hamstrings, quads) –Knee pain –Referred pain to head, neck
What are the three things necessary to diagnose a somatic dysfunction of the pelvis?
Bilateral assessment of 1) anterior and 2) posterior landmarks. 3) One test of liberality.
What are the diagnostic tests of laterality?
Standing flexion test
AP compression tests (aka. rocking the pelvis, ASIS compression test, or Iliac compression test).
If there is a positive standing flexion test on the right, what do you see?
Observation: Full flexion on the right right PSIS is superior.
If there is a positive standing flexion test on the right, what type of dysfunction could this be?
innominate, pubic, or hip muscle imbalance dysfunction
A patient shows a positive AP Compression test on the left, what do you see?
The left side has the greatest resistance to pressure on the ASIS, and thus is the side of somatic dysfunction
What are the possible somatic dysfunctions of the pelvis?
Rotation (innominate)
Shears
Flares
Describe innominate rotations
Movements of the ilium anteriorly or posteriorly around a theoretic right-left axis
(like a car wheel rotating forward or rotating backward)
During a normal walking cycle, the most anterior an innominate is…..? The most posterior an innominate is ….?
The most anterior an innominate is a toe-off.
The most posterior an innominate is a heel strike.
A patient is diagnosed with a right anterior innominate, what do you see?
ASIS inferior on right (affected side)
PSIS superior on right (affected side)
What are some symptoms of an anterior innominate rotation somatic dysfunction?
Sciatica
Gluteal Pain
Hamstring pain/tightness
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?
A posterior innominate
What are type symptoms of a posterior innominate rotation somatic dysfunction?
- Inguinal pain
- Groin pain
- Quadriceps tightness
What is an innominate shear?
Translatory movement of the ilium in the coronal plane to either superior or inferior.
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?
rightsuperior innominate shear
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?
left inferior innominate shear
What are the symptoms of an innominate shear?
pelvic pain
sacroiliac pain
pain at the PSIS
What are the causes of a innominate shear?
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
What is an innominate flare? How do you test for it?
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.
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?
left inflared innominate
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?
left outflared innominate
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?
right inflared innominate
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?
outflared innominate
What are symptoms of innominate flare somatic dysfunction?
SI pain
Hip/pelvic pain
Groin pain/tightness
What are examples of causes of innominate flares?
Pregnancy
Delivery
Pelvic compression/trauma
Chronically externally or internally rotated legs
Name three findings of a Right Anterior Innominate
Right ASIS inferior
Right PSIS superior
(+) Standing Flexion Test on the right or (+) AP compression Test on the right
Name three findings of a Left Posterior Innominate
Left ASIS superior
Left PSIS inferior
(+) Standing Flexion Test on the left or
(+) AP compression Test on the left
Name three findings of a Right Inflared Innominate
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
Name three findings of a Left Superior Innominate Shear
Left ASIS superior
Left PSIS superior
(+) Standing Flexion Test on the left or
(+) AP compression Test on the left
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
C. Right anterior innominate
?
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
B. Left inflared innominate?
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
A. Right posterior innominate
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
D. Left inferior innominate shear
