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OS2 Midterm > Sacrum > Flashcards

Sacrum Flashcards

1
Q

Where are the sacral base and apex?

A
  • sacral base - next to L5 (superior)

- sacral apex - next to the coccyx (inferior)

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2
Q

What does the inferior lateral angle of the sacrum signify?

A

where the sacrum angulates towards the apex

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3
Q

What does the sacrum articulate with?

A
  • L5 superiorly
  • coccyx inferiorly
  • innominate on either side through SI joints
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4
Q

Do males or female have more well developed SI joints after puberty?

A

males more well developed; females less developed allowing for mobility during childbirth

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5
Q

Long dorsal SI L. attachment

A

connects PSIS to lateral aspect of 3rd and 4th sacral segments

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6
Q

When does the long dorsal SI L become stretched?

A
  • when the sacrum is rotated posteriorly
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7
Q

Which muscle attaches to the sacrotuberous L.?

A

gluteus maximus M.

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8
Q

Which muscle connects the UE w/ the sacrum?

A

latissimus dorsi M.

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9
Q

What 3 muscles make up the elevator ani?

A
  • puborectalis M.
  • pubococcygeus M.
  • ilioccygeus M.
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10
Q

Name 6 muscles that make up the pelvic diaphragm

A
  • piriformis M.
  • ischiococcygeus M.
  • obturator internus M.
  • puborectalis M.
  • pubococcygeus M.
  • ileoccygeus M.
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11
Q

What is the form closure of the sacrum?

A

self-locking mechanism based on how the joints physically fit the pelvis and sacrum together

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12
Q

What is the force closure of the sacrum?

A

self-locking mechanism due to external forces compressing the sacrum to keep it in place (gravity, loading forces, muscles, fascia, and ligaments)

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13
Q

How are oblique axis named?

A

named according to the side of the body the superior end of the axis is located

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14
Q

What happens to the sacrum as the lumbar spine is flexed?

A

sacrum is extended

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15
Q

What happens to the sacrum as the lumbar spine is extended?

A

sacrum is flexed

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16
Q

What is another name for sacral extension? What happens to the sacrum in this motion?

A

counternutation - base moves posteriorly, apex moves anteriorly

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17
Q

What is another name for sacral flexion? What happens to the sacrum in this motion?

A

nutation - base moves anteriorly, apex moves posteriorly

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18
Q

What is lumbarization?

A

First sacral segment becomes an additional lumbar vertebrae

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19
Q

What is sacralization?

A

incomplete separation and differentiation of L5 - takes on characteristics of sacral vertebrae

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20
Q

Name 4 sacral static tests

A
  • sacral sulcus
  • L5 (rotation)
  • inferior lateral angle (ILA)
  • 4 digit examination
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21
Q

How do you find the sacral sulcus?

A

find the PSIS w/ thumbs -> move thumbs medially and inferiorly -> check for symmetry

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22
Q

How do you find the inferior lateral angle?

A
  • palpate w/ heel of hand midline down to where the sacrum drops anteriorly
  • place thumb near thenar eminence to feel ILA
  • place other thumb roughly symmetrical to the first
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23
Q

How do you perform a 4 point evaluation?

A
  • place index fingers in sacral sulci
  • place thumbs at ILAs
  • evaluate for symmetry
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24
Q

What type of testing is the seated forward bending test? What is its abbreviation?

A

lateralization - tells side of dysfunction - SeFBT

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25
Q

With what type of dysfunction with the SeFBT be negative?

A

in bilateral dysfunctions

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26
Q

On what side will the SeFBT be positive in unilateral and torsion dysfunctions?

A
  • unilateral: positive on side of dysfunction

- Torsion: positive on opposite side of axis (2nd letter of dx)

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27
Q

What are 2 sacral active motion tests and what do they examine?

A
  • backward bending test (BBT) (sphinx)
  • respiratory motion
  • examine flexion and extension motion
28
Q

What does a positive and negative BBT show?

A

negative BBT: flexed sacrum

positive BBT: extended sacrum

29
Q

In which directions should the sacral base move during the respiratory motion test?

A

inhalation: base should move posteriorly
exhalation: base should move anteriorly

30
Q

Name 2 sacral passive motion tests and what they both show

A
  • lumbar spring test (LS) - shows flexion/extension

- oblique axis passive motion - shows dysfunctional oblique axis

31
Q

How do you perform a lumbar spring test? What does a positive test look like?

A
  • pt lying prone
  • heel of your hand placed over spinous process of lumbar spine
  • push spine towards the table to extend it
  • Positive if the lumbar spine does not move well into extension
32
Q

What do both positive and negative lumbar spring tests indicate?

A
  • negative = flexed sacrum

- positive = extended sacrum

33
Q

How do you perform an oblique axis passive motion test?

A
  • pt is prone
  • place monitoring finger on sacral sulcus and heel of opposite hand on contralateral ILA
  • apply anterior pressure w/ heel of hand at ILA and monitor for posterior motion of opposite sulcus
34
Q

At what level is the middle transverse axis located? What type of dysfunction will be found here?

A

S2 anteriorly; dysfunction will be bilateral

35
Q

At what level is the inferior transverse axis?

A

S3

36
Q

At what level is the superior transverse axis?

A

S2 posteriorly

37
Q

On what side will there be a deep sacral sulcus along the left/right oblique axis?

A

opposite side of the posterior/caudal ILA

38
Q

On what side will there be a deep sacral sulcus along the transverse axis?

A

same side as the posterior/caudal ILA

39
Q

Along which axis are torsion, unilateral, and bilateral dx restricted?

A
  • torsion: oblique axis
  • unilateral: vertical axis
  • bilateral: middle transverse axis
40
Q

What type of torsions are held anteriorly and posteriorly?

A
  • anterior = flexed

- posterior = extended

41
Q

How do you a name sacral torsion dx?

A
  • first part named for rotation of sacrum (direction its facing)
  • second part named for axis (left or right)
42
Q

Difference in naming flexed/extended sacral torsions

A
  • flexed will be the same letter (left on left/right on right)
  • extended will be opposite letter (left on right/right on left)
43
Q

What will the SeFBT, BBT, and LS show with a L/L ST? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT positive on the right
  • LS and BBT negative (sacrum already stuck in flexion)
  • deep sacral sulcus on right
  • posterior ILA on left
44
Q

What will the SeFBT, BBT, and LS show with a R/R ST? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT positive on the left
  • LS and BBT negative (sacrum already stuck in flexion)
  • deep sacral sulcus on the left
  • posterior ILA on the right
45
Q

What will the SeFBT, BBT, and LS show with a L/R ST? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT positive on the left (side of dysfunction)
  • LS and BBT positive (sacrum stuck in extension, can’t flex)
  • deep sacral sulcus on the right
  • posterior ILA on the left
46
Q

What will the SeFBT, BBT, and LS show with a R/L ST? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT positive on the right
  • LS and BBT positive (sacrum stuck in extension, can’t flex)
  • deep sacral sulcus on the left
  • posterior ILA on the right
47
Q

What type of unilateral SDs are held anteriorly and posteriorly?

A
  • anteriorly = flexed

- posteriorly = extended

48
Q

On what side will the deep sacral sulcus be for unilateral SDs?

A

on the same side as the posterior ILA

49
Q

What will the SeFBT, BBT, and LS show with a RSF (right sacrum flexed)? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • unilateral
  • SeFBT positive on the right
  • LS and BBT negative (sacrum already flexed)
  • deep sacral sulcus on the right
  • posterior ILA on the right
50
Q

What will the SeFBT, BBT, and LS show with a LSF (left sacrum flexed)? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • unilateral
  • SeFBT positive on the left
  • LS and BBT negative (sacrum already flexed)
  • deep sacral sulcus on the left
  • posterior ILA on the left
51
Q

What will the SeFBT, BBT, and LS show with a LSE (left sacrum extended)? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • unilateral
  • SeFBT positive on the left
  • LS and BBT positive (sacrum stuck in extension, can’t flex)
  • deep sacral sulcus on the right
  • posterior ILA on the right
52
Q

What will the SeFBT, BBT, and LS show with a RSE (right sacrum extended)? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • unilateral
  • SeFBT positive on the right
  • LS and BBT positive (sacrum stuck in extension, can’t flex)
  • deep sacral sulcus on the left
  • posterior ILA on the left
53
Q

What will the SeFBT show with a bilateral sacrum flexed? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT negative (no lateralization)

- bilateral deep sacral sulci and posterior ILA

54
Q

What will the SeFBT show with a bilateral sacrum extended? On which side will you find the deep sacral sulcus and posterior ILA?

A
  • SeFBT negative (no lateralization)

- bilateral shallow sacral sulci (no deep) and anterior ILA (no posterior)

55
Q

What does it mean to say L5 is compensated or uncompensated?

A
  • compensated if rotated in the opposite direction of the sacrum (balance)
  • uncompensated if rotated in the same direction as the sacrum (no balance)
56
Q

What should be treated first if L5 is uncompensated?

A

L5 before the sacrum

57
Q

What type of SD are L/L ST and R/R ST?

A

flexed

58
Q

What type of SD are L/R ST and R/L ST?

A

extended

59
Q

What does a flexed sacrum mean for L5 mechanics?

A

flexed sacrum means a neutral (Type 1) L5

60
Q

What does an extended sacrum mean for L5 mechanics?

A

extended sacrum means a non-neutral (Type 2 flexed/extended) L5

61
Q

In what direction should L5 be sidebent and rotated on the sacrum?

A

L5 should be rotated in opposite direction of sacrum (compensated)
- L5 should be sidebent toward the oblique axis of the torsion (opposite of rotation)

62
Q

What should L5 be if you have a R/R ST?

A

L5 should be rotated left and sidebent right

63
Q

What should L5 be if you have a L/L ST?

A

L5 should be rotated right and sidebent left

64
Q

What should L5 be if you have a L/R ST?

A

L5 should be rotated right and sidebent right

65
Q

What should L5 be if you have a R/L ST?

A

L5 should be rotated left and sidebent left

OS2 Midterm (5 decks)

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