Sacrum Flashcards

1
Q

Instrumentation break for a posteriorly rotated sacrum?

A

S1 or S2

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2
Q

Fixation finding for a posteriorly rotated sacrum?

A

On the side of the posterior rotation (P-L, PI-L, P-R, PI-R)

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3
Q

Where is the point tenderness for a posteriorly rotated sacrum?

A

S1 and/or S2 tubercles

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4
Q

Where is the spongy edema for a posteriorly rotated sacrum?

A

Posterior superior margin of the SI joint

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5
Q

Where is the prominence that suggests a posteriorly rotated sacrum?

A

Lateral inferior angle of sacrum

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6
Q

Which side of the ilium is the posteriorly rotated sacrum usually on?

A

IN or AS

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7
Q

What is the chief complaint in a patient with a BP?

A

Pain across the lumbosacral junction

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8
Q

Where is the instrumentation break for a BP?

A

Lower 1/3 of the L5 spinous

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9
Q

Where is the fixation for a BP?

A

L5

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10
Q

Where is the edema for a BP?

A

Between L5 and S1

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11
Q

Where is the tenderness for a BP?

A

Over S1 and S2

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12
Q

Where are sudoriferous changes notes for a BP?

A

Over L5 and S1

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13
Q

What test relieves the BP sacrum?

A

Sacral compression test- it may be closing the L5 posterior open disc wedge (flexion malposition)

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14
Q

What test aggravates the BP sacrum?

A

Sacral distraction test- it is increasing the L5 posterior open disc wedge even more (flexion malposition)

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15
Q

Is L5 in a flexion or extension malposition on the sacral base in a BP?

A

Flexion

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16
Q

What angle defines a BP?

A

Less than 36 degrees (0-35)

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17
Q

What radius defines a BP?

A

More than 24 cm (25+)= hypolordosis

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18
Q

Where does the gravitation stress line fall to suggest hypolordosis of the lumbar spine?

A

Posterior to the anterior 1/3 of sacral base

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19
Q

With a BP will the sacral base George’s line be anterior or posterior to the L5 George’s line?

A

Sacral base line will be posterior to L5 line

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20
Q

What is the normal range for sacral base angle?

A

36-45 degrees

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21
Q

What is the normal range for the lumbar radius?

A

19-24 cm

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22
Q

LOC for a spondy?

A

P-A through the L5 disc

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23
Q

TP for a spondy?

A

S-I

24
Q

SCP for a spondy?

A

S2 tubercle

25
Q

Should you use a drop for a spondy?

A

NO

26
Q

What is the chief complaint in a patient with an Apex posterior (AP) sacrum?

A

Lumbosacral pain due to L5-S1 facet syndrome

27
Q

Where is the instrumentation break for an AP sacrum?

A

Lower 1/3 of L5

28
Q

Where is the fixation for an AP sacrum?

A

L5

29
Q

Where is the edema for an AP sacrum?

A

Between L5-S1

30
Q

Where is the tenderness for an AP sacrum?

A

L5 spinous

31
Q

Where are the sudoriferous changes for an AP?

A

Over L5 and S1

32
Q

A positive Kemp’s test may be indicative of what?

A

Facet syndrome- AP sacrum

33
Q

What test relieves the AP sacrum?

A

Sacral distraction test- opens the jammed facets between L5 and S1

34
Q

What test aggravates the AP sacrum?

A

Sacral compression test- further jams the L5 and S1 facets

35
Q

Is L5 in a flexion or extension malposition on the sacral base in an AP?

A

Extension

36
Q

What is the sacral base angle seen with an AP?

A

> 45 degrees

37
Q

What is the radius seen with an AP?

A
38
Q

Normal range for sacral base?

A

36-45 degrees

39
Q

A decreased radius is indicative of what?

A

Hyperlordosis– AP sacrum

40
Q

An increased radius is indicative of what?

A

Hypolordosis– BP sacrum

41
Q

In an AP is the gravitational stress line anterior or posterior to the anterior tip of the sacral base?

A

Anterior to the anterior tip of sacral base– hyperlordosis– anterior weight bearing

42
Q

What constitutes a positive McNabb’s line? What misalignment is it seen with?

A

McNabb’s line is drawn across the inferior plate line of L5- a positive is present when the tip of S1 superior facet is visible above the L5 McNabb’s line

43
Q

What is it termed when there is vertical stenosis of L5-S1 seen with an AP?

A

“Facet imbrication”

44
Q

Any disc angle >15 degrees is a sign of what?

A

Severe facet syndrome

45
Q

What is the LOC for an AP?

A

S-I, P-A arcing thrust

46
Q

Where is the pain for a coccyx misalignment?

A

Lumbosacral or SI pain

Moderate to severe pain over sacrococcygeal articulations

47
Q

What aggravates a coccyx misalignment?

A

Valsalva maneuver
Sitting
Rising from sitting
Defecation

48
Q

How does coccyx appear on the lateral with a CAR/CAL?

A

Apex anteriority

49
Q

How does coccyx appear on the AP lumbopelvic?

A

Base inferiority relative to the sacral apex above (open wedge on that side)

50
Q

An instrumentation break at S1 or S2?

A

Posteriorly rotated sacrum

51
Q

An instrumentation break at lower 1/3 of L5?

A

BP

AP

52
Q

Tenderness over S1 and/or S2?

A

Posteriorly rotated sacrum

BP

53
Q

Edema between L5 and S1?

A

BP

AP

54
Q

Edema at posterior superior aspect of SI?

A

Posteriorly rotated sacrum

55
Q

Tenderness over L5?

A

AP