Sacral Diagnostics- Exams/SD Flashcards
What tests must you perform to diagnose a sacral somatic dysfunction?
Seated Flexion, Pelvic Compression, Lumbar Spring, Sphinx Test, 4 digit contact, Side Bend Passive, 4 Point Passive, and Respiratory Motion
Explain the Seated Flexion test for sacral diagnosis
What does the test determine?
What is a positive finding?
Patient seated with feet flat on floor with doc behind patient with thumbs bilaterally monitoring the PSIS
The test determines laterality
A positive test is when one PSIS moves first and furthest
What is the pelvic compression test?
What does the test determine?
What is a positive test finding?
Patient supine with doc at side of table. Bilaterally contact and ASIS and apply a posterior and medial force with your hand one side at a time
Determines laterality
A positive test is a restriction of motion on one side
Explain the Lumbar Spring test
What is a positive test finding and what does it indicate with regards to the position of the sacrum?
Patient prone. Load and spring with the heel of your hand at the patients lumbosacral junction and monitor for any restriction
A positive test is when there is restriction/no spring
Negative test indicates sacral base is anterior
Positive test indicates sacral base in posterior
Explain the Sphinx Test
What do the results indicate?
Patient prone then moves into sphinx position; doctor monitors the patients sacral sulci bilaterally
Sulci become more symmetric- ant torsion or unilateral flexion
Sulci become more asymmetric- post torsion or unilateral extension
Explain the 4 digit contact exam
How do you describe the positions of the sulci?
How do you describe the position of the ILA?
Patient prone. Doctor monitors bilaterally the patients sulci and ILAs
Sulci- are either shallow (post) or deep (ant)
ILA- are either ant or posterior or; superior or inferior
Explain Side Bending Passive exam
What does the test determine?
What is a positive exam finding?
Patient prone; doctor contacts ILA with heel of hand and applies a cephalad force to induce SB; perform bilaterally
Test determines unilateral dysfunction
A positive exam finding is restriction of SB
Explain the right and left oblique axis of the sacrum
ROA- goes from Right sacral sulcus to Left ILA
LOA- goes from Left sacral sulcus to Right ILA
Explain the 4 Point Passive Exam
What does the test diagnose?
What a positive finding?
Patient prone; doctor monitors one sacral sulcus with heel of hand and monitors opposite sides ILA with other heel of hand; doctor applies an anterior force on ILA and monitors for motion at opposite sulcus; perform bilaterally
Test will diagnose a sacral torsion SD
A positive finding is restriction of motion around an oblique axis
Explain the respiratory motion of the sacrum
What are the positive findings and what do they indicate
Patient prone; doctor places cephalad hand at sacral base with fingers pointing towards apex with caudal hand on top facing opposite direction; ask patient to take a deep breath and monitor motion of sacrum
Inhale- sacral base moves posteriorly
Exhale- sacral base moves anteriorly
Restricted on inhalation- bilateral sacral flexion
Restricted on exhalation- bilateral sacral extension
What type of somatic dysfunctions can occur at the sacrum?
Bilateral flexion Bilateral extension Unilateral flexion Unilateral extension Forward torsion (LonL or RonR) Backward torsion (LonR or RonL)
Explain the test findings for a Bilateral Flexion sacral somatic dysfunction
Bilateral Flexion- sacrum lives anteriorly-increased lordosis
Seated flexion test- negative (both sides move at same time and same distance)
Lumbar spring test- negative
4 digit contact- both sulci will be deep and both ILA will be post
Resp- restricted on inhalation
4 point passive- negative
SB passive- negative
Explain the diagnostic findings of a Bilateral Extension sacral somatic dysfunction
Bilateral extension- sacral base lives posteriorly- dec lordosis
Seated flexion- negative test
Lumbar spring- positive test- doesn’t spring
4 digit contact- both sulci shallow and both ILA ant
Resp- restricted on exhalation- cant move anterioly
4 point passive- negative
SB- negative
Explain diagnostic test findings for Unilateral Flexion
Unilateral flexion- one side is anterior and SB that side
Seated flexion- affected side moves first and furthest
Lumbar spring- negative
4 digit contact- affected sulci deep and same side ILA inf/post
4 point passive- negative
Resp- asymmetric
SB- restricted on affected side
Explain diagnostic exam findings for unilateral extension
Unilateral extension- on side is post and SB opposite way
Seated flexion- affected side moves first and furthest
Lumbar spring- positive
4 digit contact- affected sulci shallow and same side ILA sup/ant
Resp- asymmetric
SB passive- restricted on opposite side
4 point passive- negative
