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ECOS 2 Pre-Midterm > Sacral Somatic Dysfunction > Flashcards

Sacral Somatic Dysfunction Flashcards

1
Q

LSF/LSE

A

Left Sacral Flexion/Extension

- Unilateral

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2
Q

RSF/RSE

A

Right Sacral Flexion/Extension

- Unilateral

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3
Q

BSF/BSE

A

Bilateral Sacral Flexion/Extension

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4
Q

L/L ST

A

Left rotation on a Left axis Sacral Torsion

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5
Q

L/R ST

A

Left rotation on a Right axis Sacral Torsion

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6
Q

R/R ST

A

Right rotation on a Right axis Sacral Torsion

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7
Q

R/L ST

A

Right rotation on a Left axis Sacral Torsion

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8
Q

What are the steps to sacral testing?

A
  1. Static Testing

2. Motion Testing

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9
Q

What are the Static Tests for sacral testing?

A

Sacral sulcus
Inferior lateral angle (ILA)
L5 rotation for torsions

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10
Q

Describe the setup for the sacral sulcus static test

A

Palpate PSIS with thumbs and then move them medially and inferiorly
- Check for symmetry

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11
Q

If the sacral sulcus static test feels deeper on one side compared to the contralateral side, it is considered?

A

Anterior

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12
Q

If the sacral sulcus static test feels shallower on one side compared to the contralateral side, it is considered?

A

Posterior

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13
Q

Describe the setup for the Inferior Lateral Angle static test (ILA)

A

Palpate with heel of hand down midline sacrum until it drops anteriorly

  • Place 1 thumb on side of hand to feel ILA and then mirror its placement with the other thumb
    • Compare each side for anterior/posterior and superior/inferior
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14
Q

What shape can be used to diagram the physical exam findings of the sacrum?

A

Home plate

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15
Q

What are the 3 categories of motion testing for sacral testing?

A

Lateralization
Active motion
Passive motion

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16
Q

What is the lateralization test for sacral motion testing?

A

Seated Forward Bending Test

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17
Q

What does a (+) Seated Forward Bending Test tell you?

A

Unilateral - side of dysfunction

Torsion - opposite side of axis

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18
Q

When will a Seated Forward Bending Test be negative?

A

With a bilateral dysfunction!

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19
Q

Describe the setup for the Seated Forward Bending Test for sacral motion

A
  • Pt seated with feet on the floor and the physician’s eyes level with the PSIS
  • Physician’s thumbs are placed on the inferior aspect of the PSIS
    – Pt instructed to bend forward
    (+) = one of physicians thumbs moves superior!
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20
Q

What are the active motion tests for sacral motion testing?

A
  1. Backward Bending (sphinx) Test

2. Respiratory Motion Test

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21
Q

Describe the setup for the Backward Bending (sphinx) Test

A

Pt lies prone and physician’s thumbs are placed in the sacral sulcus on each side (inferomedial to PSIS)
- Pt instructed to bend backward
(+) = asymmetrical sacral sulci throughout bending

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22
Q

What does a (+) Backward Bending Test indicate?

A

EXTENDED sacrum

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23
Q

What does a (-) Backward Bending Test indicate?

A

Flexed sacrum - sacral sulci appear symmetrical during movement

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24
Q

Describe the setup for the Respiratory Motion Test

A

Pt lies prone and physician places hand over sacrum and other hand on top of 1st hand

  • Have patient breathe in and out
    • During inhalation = sacrum posterior
    • During exhalation = sacrum anterior
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25
Q

What are the passive motion tests for sacral motion testing?

A

Lumbar Spring Test

Oblique Axis passive motion test

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26
Q

What does the lumbar spring test tell you?

A

If sacrum is flexed or extended

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27
Q

Describe the setup for the lumbar spring test

A

Pt lies prone and physician places hand over spinous processes of lumbar spine
- Then presses downward attempting to induce extension

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28
Q

(+) test for a lumbar spring test feels like and indicates?

A

Feels resistant to compression (extension)

(+) = EXTENDED sacrum

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29
Q

(-) test for a lumbar spring test indicates?

A

Flexed sacrum

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30
Q

What 2 tests will have the same results?

A

Backward Bending Test (BBT) AND

Lumbar Spring Test (LS)

31
Q

What does the Oblique Axis passive motion test tell you?

A

Used to confirm torsion or not

32
Q

How is the axis determined with the oblique axis passive motion test?

A

Side around which there is the GREATEST MOTION

33
Q

Describe the setup for testing for a left oblique axis using the oblique axis passive motion test

A
  • Doc’s left thumb over LEFT ILA
  • Doc’s right thumb is over RIGHT SACRAL BASE
    • Applies alternating pressure between thumbs to assess motion
34
Q

What are the sacral axes?

A 
Superior transverse axis - S2 posteriorly
Middle transverse axis - S2 anteriorly 
Inferior transverse axis - S3
Left and Right oblique axes
Vertical Axis
35
Q

What type of dysfunction will you find around the middle transverse sacral axis?

A

BILATERAL FINDINGS

  • both sacral bases anterior
  • both ILAs posterior
    • or vice versa
36
Q

Innominate motion is around which sacral axis?

A

Inferior transverse axis - S3

37
Q

Describe the dysfunction that will be found around either a Left Oblique or Right Oblique axis

A

It will have an anterior sacral sulcus on the OPPOSITE side of the posterior ILA
OR
Posterior sacral sulcus on the OPPOSITE side of the anterior ILA

38
Q

Describe the dysfunction that will be found around the vertical axis

A

It will have an anterior sacral sulcus on the SAME side as the posterior ILA
OR
Posterior sacral sulcus on the SAME side as the anterior ILA

39
Q

Unilateral sacral dysfunctions are restricted around what axis?

A

Vertical axis

40
Q

Bilateral sacral dysfunctions are restricted around what axis?

A

Middle transverse axis

41
Q

Torsion sacral dysfunctions are restricted around what axis?

A

Oblique axis

42
Q

Unilateral sacral dysfunctions are restricted around the vertical axis. If there is an anterior sacral sulcus, where will the posterior ILA be?

A

SAME SIDE

43
Q

Describe RSF

A

Right sacrum flexed

  • Anterior Right sacral sulcus
  • Posterior Right ILA
44
Q

With a RSF, what are the results of the seated forward bend test and the BBT/LS tests?

A

(+) seated forward bend on the RIGHT

(-) BBT/LS

45
Q

Describe LSF

A

Left sacrum flexed

  • Anterior Left sacral sulcus
  • Posterior Left IlA
46
Q

With a LSF, what are the results of the seated forward bend test and the BBT/LS tests?

A

(+) seated forward bend on the LEFT

(-) BBT/LS

47
Q

Describe LSE

A

Left sacrum extended

  • Posterior Left sacral sulcus
  • Anterior Left ILA
48
Q

With a LSE, what are the results of the seated forward bend test and the BBT/LS tests?

A

(+) seated forward bend on the LEFT

(+) BBT/LS

49
Q

Describe RSE

A

Right sacrum extended

  • Posterior Right sacral sulcus
  • Anterior Right ILA
50
Q

With a RSE, what are the results of the seated forward bend test and the BBT/LS?

A

(+) seated forward bend on the RIGHt

(+) BBT/LS

51
Q

Bilateral sacral dysfunctions are restricted around the middle transverse axis. How do the sacral sulci present?

A

EQUAL

52
Q

With bilateral sacral dysfunctions, what is the result of the seated forward bend test?

A

NEGATIVE

53
Q

Describe BSF

A

Bilateral sacral flexed

  • Both sacral sulci anterior
  • Both ILA posterior
54
Q

Describe BSE

A

Bilateral sacral extended

  • Both sacral sulci posterior
  • Both ILA anterior
55
Q

What is the static test specific for testing for torsion dysfunctions?

A

L5 rotation

56
Q

What is the motion test specific for testing for torsion dysfunctions?

A

Oblique axis passive motion test

57
Q

Describe L/L ST

A

Left rotation on Left axis sacral torsion

  • Anterior Right sacral sulcus and Posterior Left sacral sulcus
  • Posterior Left ILA and Anterior Right ILA
58
Q

With L/L ST, what are the results of the seated forward bend test and BBT/LS tests?

A

(+) seated forward bend on RIGHT (OPPOSITE OF AXIS)

(-) BBT/LS

59
Q

Describe R/R ST

A

Right rotation on Right axis sacral torsion

  • Anterior Left sacral sulcus and Posterior right sacral sulcus
  • Posterior Right ILA and Anterior Left ILA
60
Q

With R/R ST, what are the results of the seated forward bend test and BBT/LS?

A

(+) seated forward bend on LEFT (OPPOSITE OF AXIS)

(-) BBT/LS

61
Q

Describe L/R ST

A

Left rotation on Right axis sacral torsion

  • Posterior Left sacral sulcus and Anterior Right sacral sulcus
  • Anterior Right ILA and posterior Left ILA
62
Q

With L/R ST, what are the results of the seated forward bend test and BBT/LS?

A

(+) seated forward bend test on the LEFT

(+) BBT/LS

63
Q

Describe R/L ST

A

Right rotation on Left axis sacral torsion

  • Posterior Right sacral sulcus and Anterior Left sacral sulcus
  • Anterior Left ILA and posterior Right ILA
64
Q

With R/L ST, what are the results of the seated forward bend test and BBT/LS?

A

(+) seated forward bend test on the RIGHT

(+) BBT/LS

65
Q

L5 should be rotated ____ to the way the sacrum is rotated

A

OPPOSITE

66
Q

Which way does L5 sidebend?

A

TOWARDS OBLIQUE AXIS of torsion

67
Q

If L5 is not rotated opposite of the sacrum, it is considered?

A

Uncompensated

68
Q

L/L and R/R ST… is L5 flexed or extended or neutral?

A

Neutral

69
Q

L/R and R/L ST… is L5 flexed or extended or neutral?

A

Flexed/Extended

70
Q

L/L and R/R ST is considered flexed or extended?

A

Flexed

71
Q

L/R and R/L ST is considered flexed or extended?

A

Extended

72
Q

Ex. R/R ST. Describe L5.

A

R/R ST = flexed

L5 = Neutral; Rotated LEFT; Sidebent RIGHT

73
Q

Ex. R/L ST. Describe L5.

A

R/L ST = extended

L5 = F/E; Rotated LEFT; Sidebent LEFT

ECOS 2 Pre-Midterm (14 decks)

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