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DIT OMM > Sacrum and Innominates > Flashcards

Sacrum and Innominates Flashcards

1
Q

Sacrotuberous ligament

A

ILA to ischial tuberosity

tension helps dx SD of innominate and sacrum

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2
Q

Sacrospinous ligament

A

sacrum to ischial spines

divides greater and lesser sciatic foramen

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3
Q

Iliolumbar ligament

A

TP of L4 and L5 to medial side of iliac crest

First ligament to become painful in lumbosacral decompensation

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4
Q

Primary pelvic muscles (pelvic diaphragm)

A

levator ani

coccygeus muscles

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5
Q

Secondary pelvic muscles

A

partial attachments to true pelvis

Iliopsoas
Obturator internus
Piriformis

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6
Q

Piriformis

A

Inferior anterior aspect of sacrum to greater trochanter of the femur

externally rotates, extends thigh
when hip flexed - abducts thigh

Innervated by S1 and S2

11 percent of population have entire or fibular portion of sciatic nerve run through the belly
-hypertonicity -> buttock pain that radiates down thigh, but NOT below knee

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7
Q

Innominate mechanics

A

rotate around inferior transverse axis of sacrum during walking cycle

innominate anterior and posterior dysfunction occur around that axis

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8
Q

Respiratory motion of sacrum

A

about superior transverse axis of sacrum at S2

Inhalation - base moves posterior
Exhalation - base moves anterior

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9
Q

Inherent (craniosacral) motion

A

about superior transverse axis of sacrum

craniosacral flexion - base moves posteriorly - counternutates

Craniosacral extension - sacral base moves anteriorly or nutates

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10
Q

Postural motion

A

about middle transverse axis of sacrum

Bend forward - sacral base moves anteriorly, terminal flexion - sacrotuberous ligaments become taut, base will move posteriorly

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11
Q

Dynamic motion

A

occurs during ambulation

sacrum engages both oblique axes

Weight bearing on left leg causes left sacral axis to engage

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12
Q

Anterior innominate rotation

A

rotation about inferior transverse axis of sacrum

Tight quadriceps

ASIS inferior
PSIS superior
Long leg ipsilaterally unless anatomical short leg compensation

Positive standing flexion
ASIS restricted to compression ipsilaterally

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13
Q

Posterior innominate rotation

A

Rotation about inferior transverse axis

tight hamstrings

ASIS superior
PSIS inferior
Shorter leg ipsilaterally unless compensatory for anatomical long leg

Positive standing flexion
ASIS restricted to compression ipsilaterally

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14
Q

Superior innominate shear (aka innominate upslip, superior innominate subluxation)

A

fall on ipsilateral buttock or mis step

ASIS and PSIS superior
Pubic rami superior
Shorter leg ipsilaterally

Positive standing flexion
ASIS restricted to compression ipsilaterally

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15
Q

Inferior innominate shear (aka innominate downslip, inferior innominate subluxation)

A

ASIS and PSIS inferior
Pubic rami inferior
Longer leg ipsilaterally

Positive standing flexion
ASIS restricted to compression ipsilaterally

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16
Q

Superior pubic shear

A

trauma or tight rectus abdominus

ASIS and PSIS level
Pubic bone superior

Positive standing flexion test
ASIS restricted to compression ipsilaterally

17
Q

Inferior pubic shear

A

trauma, tight adductors

ASIS and PSIS level
Pubic bone inferior

Positive standing flexion test
ASIS restricted to compression ipsilaterally

18
Q

Innominate inflares

A

innominate rotate medially

ASIS more medial, less distance between ASIS and umbilicus
Ischial tuberosity more lateral

Positive standing flexion
ASIS restricted to compression ipsilaterally

19
Q

Innominate outflares

A

Innominate rotate laterally

ASIS lateral - distance between ASIS and umbilicus increased
Ischial tuberosity more medial

positive standing flexion
ASIS restricted to compression ipsilaterally

20
Q

Sacral torsion rules

A

1: L5 sidebending engages sacral oblique axis on same side
2: L5 rotation -> sacrum rotating opposite way on an oblique axis
3: seated flexion found on opposite side of oblique axis

21
Q

Forward sacral torsion - L on L

A

right super sulcus moves anterior, ILA moves posterior

Right sulcus deep
Left ILA posterior, slightly inferior
Lumbar curve convex to right (sidebent left)

Positive seated on right
Springing motion restricted on Left ILA, poles of left oblique axis
negative lumbosacral spring test

L5 will be NSlRr

22
Q

Forward sacral torsion - R on R

A

right rotation as left superior sulcus moves anterior, right ILA moves posterior

Left sulcus deep
right ILA posterior and slightly inferior
Lumbar curve convex to left (sidebent right)

Positive seated on left
springing restricted on right ILA, poles of right oblique axis
Negative lumbosacral spring test

L5 will be NSrRl

23
Q

Backward sacral torsion - R on L

A

right superior sulcus moves posterior, left ILA moves anterior

right sulcus shallow
Left ILA anterior and slightly superior
Lumbar curve convex to right (side bent left)

Positive seated on right
Spring restricted at right base, poles of left oblique axis
Positive lumbosacral spring test
positive backward bending test

L5 will be nonneutral, SlRl

24
Q

Backward sacral torsion - L on R

A

Left superior sulcus moves posterior, right ILA moves anterior

Left sulcus shallow
Right ILA anterior and slightly superior
Lumbar curve convex left (sidebent right)

Positive seated flexion on left
Springing restricted at left base, poles of right oblique axis
Positive lumbosacral spring test
Positive backward bending test

L5 will be nonneutral, SrRr

25
Q

Bilateral sacral flexion

A

entire sacral base moves anterior about middle transverse axis

Right and left sulci deep
ILAs shallow b/l
Increased lumbar curve (lordosis)

False negative seated flexion - no asymmetry
Springing restricted at both ILAs
Negative lumbosacral spring test

common dysfunction in post-partum patient

26
Q

Bilateral sacral extension

A

Entire sacral base moves posterior about middle transverse axis

Right and left sulci shallow
ILAs deeper b/l
decreased lumbar curve (lordosis)

false negative seated flexion - no asymmetry

Springing restricted at base - b/l sulci
Positive lumbosacral spring test

27
Q

unilateral sacral flexion

A

sacrum shifts anteriorly around transverse axis

Ipsilateral findings:
deep sulcus
ILA significantly inferior, slightly posterior

Positive seated flexion
spring restricted at ILA

28
Q

Unilateral sacral extension

A

sacrum shifts posteriorly around transverse axis

Ipsilateral findings:
shallow sulcus
ILS significantly superior, slightly anterior

positive seated flexion
Spring restricted at sulcus
Positive lumbosacral spring test
Positive backward bending test

DIT OMM (18 decks)

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