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Treatment & Planning I > Quiz 2 (pelvis) > Flashcards

Quiz 2 (pelvis) Flashcards

1
Q

Symphysis pubis capsular pattern

A

Pain when joints are stressed

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2
Q

Symphysis pubis resting position

A

Not applicable

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3
Q

Sacroiliac joint capsular pattern

A

Pain when joints are stressed

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4
Q

Sacroiliac joint resting pattern

A

Not applicable

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5
Q

2 joints in the pelvis

A

Sacroiliac joint
Symphysis pubis

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6
Q

Sacroiliac joint ligaments

A

Anterior sacroiliac ligament
Posterior sacroiliac ligament
Interosseous membrane

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7
Q

Primary stabilizer of the sacroiliac joint

A

Interosseous ligament

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8
Q

3 other ligaments related to the sacroiliac joint

A

Iliolumbar ligament
Sacrospinous ligament
Sacrotuberous ligament

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9
Q

What counteracts forward tiliting of the sacrum at the top end?

A

Sacrospinous & sacrotuberous ligament

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10
Q

Symphysis pubis ligaments

A

Superior pubic ligament
Inferior pubic ligament
Posterior pubic ligament
Anterior pubic ligament

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11
Q

What muscles influence the symphysis pubis mobility?

A

Adductor group & rec ab

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12
Q

Anterior rotation of the innominate

A

ASIS down, PSIS up

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13
Q

Posterior rotation of the innominate

A

ASIS up, PSIS down

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14
Q

Outflare of the innominate

A

ASIS away, PSIS towards

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15
Q

Inflare of the innominate

A

ASIS towards, PSIS away

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16
Q

Sacral flexion/nutation

A

Top of sacrum goes anteriorly

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17
Q

Sacral extension/counternutation

A

Top of sacrum goes posteriorly

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18
Q

Important history questions for pelvis assessment

A

-Pregnant or recent pregnancy?
-Sleeping position?
-Mechanism of injury? - falling on butt, sudden jarring, lifting/twisting
-Symptoms related to the menstrual cycle?

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19
Q

Pelvis mechanisms of injury (3)

A

-Falling on butt
-Sudden jarring
-Lifting/twisting

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20
Q

Sacroiliac joint pain referal

A

-Slightly medial and inferior to the PSIS or in the buttock and/or posterior lateral thigh and upper calf
-Iliac fossa, abdomen and occasionally to groin

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21
Q

Sacroiliac joint pain aggravations

A

Turning in bed, stepping on a step, getting in and out of bed

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22
Q

Posterior sacroiliac ligament pain referral

A

Lateral, posterolateral and posterior medial thigh

23
Q

Posterior sacroiliac ligament pain aggravators

A

Worsens during ovulation and menstrual period

24
Q

Anterior sacroiliac ligament pain referral

A

Buttock and posterior thigh

25
Q

Symphysis pubis joint pain referral

A

Local

26
Q

Symphysis pubis joint pain aggravators

A

Contraction of rec ab or adductors

27
Q

4 ways to evaluate innominate bone mobility

A
  1. PSIS test
  2. Standing hip flexion test (observation only)
  3. Gillet’s test (standing hip flexion test with palpation of S2 and PSIS)
  4. Standing hip flexion test with palpation of lower sacrum and ischial tuberosity
28
Q

How to evaluate movement of the sacrum

A

Sacral sulcus test

29
Q

PSIS test (patient position, examiner action, normal response, positive response, indicates)

A

Position: standing

Examiner: Find PSIS by finding dimples, dropping down 2-3 inches pushing in and then up to hook under them. Move thumbs laterally until they are 8-10 inches apart. Ask patient to flex.

Normal response: No movement initially, the both PSIS elevate at the same time

Positive response: If one elevates immediately or one doesn’t elevate as much as the other after the initial lag

Indicates: hypomobility of the innominate bone on that side

30
Q

Standing hip flexion test observation only (patient position, examiner action, normal response, positive response, indicates)

A

Patient: standing

Examiner: Ask patient to alternately bring hips to 90* and observe buttock

Normal response: Buttock should be round on side of being lifted

Positive response: Patient’s hip hikes up

Indicates: hypomobility of the innominate bone on that side

31
Q

Gillet’s test (patient position, examiner action, normal response, positive response, indicates)

A

Patient: standing

Examiner: Palpate S2 and PSIS, ask patient to bring hip on test side to 90*

Normal response: PSIS drops in relation to S2

Positive response: PSIS goes up in relation to S2

Indicates: hypomobility of the innominate bone on that side

32
Q

Standing hip flexion test with palpation of bottom of sacrum and ischial tuberosity (patient position, examiner action, normal response, positive response, indicates)

A

Patient: standing

Examiner: Palpate lower sacrum and ischial tuberosity, ask patient to bring hip on test side to 90*

Normal response: ischial tuberosity moves lateral on test side

Positive response: ischial tuberosity goes up

Indicates: hypomobility of the innominate bone on that side

33
Q

Sacral sulcus test (patient position, examiner action, normal response, positive response, indicates)

A

Position: standing

Examiner: Find iliac crests and most posteriorly until thumbs are 6 inches apart. Ask patient to extend then flex

Normal response: On extension both thumbs deepen equally. On flexion both thumbs move posteriorly equally

Positive response: The side that does not deepen or move posteriorly as much is the affected side

Indicates: hypomobility of the sacrum on that side

34
Q

4 passive movement tests (pelvis)

A
  1. Gapping test
  2. Squish test
  3. Sacroiliac rocking ligament test
  4. Superoinferior symphysis pubic stress test
35
Q

Gapping test (patient position, examiner action, positive response, indicates)

A

Patient: supine

Examiner: Applies outward pressure to ASIS with crossed arms

PR: Reproduces unilateral gluteal or posterior leg pain

Indicates: Sprain of anterior sacroiliac ligament

36
Q

Squish test (patient position, examiner action, positive response, indicates)

A

Patient: supine

Examiner: Place both hands on patient’s ASIS and iliac crests, then push down and in at 45 degree angle

PR: reproduces pain (often lateral, posteriorlateral or posteriormedial thigh pain)

Indicates: Sprain of posterior sacroiliac ligament

37
Q

Sacroiliac rocking ligament test (patient position, examiner action, positive response, indicates)

A

Patient: supine

Examiner: Passively flexes patient’s hip to same shoulder, opposite shoulder, then opposite elbow

PR: Reproduces pain

Indicates: Sprain of vertical, oblique or horizontal fibres of the SI ligaments (depending on direction) and/or sprain of sacrotuberous ligament

38
Q

Superoinferor symphysis pubic stress test (patient position, examiner action, positive response, indicates)

A

Patient: supine

Examiner: Stands at patient’s side and places heel of one hand over superior pubic ramus on one side and the heel of the other hand under the inferior pubic ramus on other side. Squeeze hands together.

PR: reproduces pain in symphysis pubis

Indicates: sprain of pubic symphysis

39
Q

Resisted movements for pelvis (Isometrics)

A

Hip flexion/extension
Hip adduction/abduction
Trunk flexion

40
Q

How long do you hold pelvic isometrics?

A

Only long enough to determine if pain is reproduced

41
Q

Pelvis special tests

A

Gaenslen’s test
Flamingo test
Baer’s point

42
Q

Gaenslen’s test (patient position, examiner action, positive response, indicates)

A

Patient: side lying with lower leg to chest (holding posterior thigh)

Examiner: Stabilize the pelvis while extending the hip. Patient hugs bottom leg

PR: Pain in SI joint, hip joint or along the L4 nerve root distribustion (lateral thigh, anterior and posteriomedial lower shin, medial malleolus to anterior big toes)

Indicates: Ipsilateral sacroiliac joint lesion, hip pathology or L4 nerve root lesion

43
Q

L4 nerve root distribustion

A

Lateral thigh, anterior and posteriomedial lower shin, medial malleolus to anterior big toes

44
Q

Flamingo test (patient position, examiner action, positive response, indicates)

A

Patient: standing

Examiner: Ask patient to stand on one leg. May ask patient to hop on test side.

PR: pain in symphysis pubis or sacroiliac joint

Indicates: Lesion in symphysis pubis or sacroiliac joint

45
Q

Baer’s point (patient position, examiner action, positive response, indicates)

A

Patient: supine

Examiner: Ask patient to take a deep breath, the exhale. On exhalation press in the iliac fossa, anterior to SI joint

PR: tenderness

Indicates: spasm of the iliacus muscle (due to SI joint infection or sprain of the anterior sacroiliac ligament)

46
Q

Causes of Iliacus muscle spasm

A

SI joint infection or sprain of the anterior sacroiliac ligament

47
Q

Piriformis strain/syndrome signs/symptoms

A

-Localized tenderness
-Low back and hip pain
-Pain on resisted hip extension, lateral rotation and abduction
-If spasm, will have deep sulcus on affected side
-Positive piriformis test
-May have lateral rotation of hip in standing/gait

48
Q

Piriformis syndrome additional signs/symptoms

A

-Radiation down post. thigh to popliteal space when sciatic nerve compressed
-May have poorly defined tingling or numbness in buttock and/or posterior thigh
-If active TrP, may have pain in mid-calf and/or bottom of foot

49
Q

Osteitis pubis signs/symptoms

A

-Local tenderness
-Local swelling
-Pain on resisted hip adduction and trunk flexion
-Aggravated by coughing/sneezing
-Positive flamingo test
-Positive superoinferior symphysis pubis stress test

50
Q

Posterior SI ligament sprain signs/symptoms

A

-Local tenderness
-Positive squish test
-Positive sacroiliac rocking ligament test for affected fibres
-Pain referred to lateral/posteriorlateral/posteriomedial thigh
-Aggravated by side lying with top leg dropped in front of bottom leg

51
Q

Anterior SI ligament sprain signs/symptoms

A

-Positive gapping test
-Positive transverse anterior shear test
-Positive sacroiliac rocking ligament test for affected fibres
-Positive Baer’s point if anterior SI ligament causes iliacus spasm
-Referral into buttock/posterior thigh

52
Q

Ankylosing spondylitis signs/symptoms

A

-Initially has vague discomfort and stiffness in lower back, worse on awakening, eased by exercise
-Breathing becomes restricted
-Marked thoraco-cervical kyphosis and flattening of lumbar lordosis

53
Q
A

Treatment & Planning I (4 decks)

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