SI and pelvis Flashcards

1
Q

what is considered the functional pelvic girdle?

A

L4/L5, two innominates, sacrum, two SI joints, pubic joint, and two hip joints

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2
Q

How can we think about the pelvis?

A

it is a force generator as well as a force attenuator. It allows for the absorption of force during running and walking.

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3
Q

what three muscles are most commonly slow to activate in SIJ pain?

A

multifidis, internal oblique, gluteus maximus

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4
Q

what low back issue commonly presents with SIJ pathology as well?

A

disk herniation, be aware that folks with a disk herniation usually have some form of SIJ pain as well

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5
Q

what happens to the SIJ as we age?

A

it changes shape!

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6
Q

what type of joint are the SIJs?

A

planar

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7
Q

how much motion occurs at the SIJ in degrees and mm?

A

1.15 to 2.5 degrees, or less than one mm

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8
Q

what two muscles can influence the sacrotuberous ligament and provide stability to the SIJ via tensioning?

A

glute max, hamstrings

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9
Q

in what motion does the sacrotuberous ligament restrict motion and provide stability? Why is this important?

A

flexion, if people sit slouched and the SI is in extension this mechanism does not work

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10
Q

what innervates the upper and lower region of the SIJ?

A

anterior and posterior rami of L5.

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11
Q

Where does the S2 nerve root go upon exiting the foramen?

A

through the piriformis, need to be aware of.

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12
Q

Does the sacrotuberous ligament control anterior or posterior rotation?

A

posterior

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13
Q

does the long posterior sacroiliac ligament control anterior or posterior rotation?

A

anterior

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14
Q

what is the sacroilitis CPR?

A

thigh thrust, compression, distraction, sacral thrust, gaenslan

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15
Q

how many tests need to be positive in the sacroilitis CPR?

A

3 of 5

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16
Q

what is the stenosis CPR? (5things)

A

bilateral symptoms, leg pain more than back pain, pain during walking/standing, pain relief upon standing, age >48

17
Q

how do you perform gaenslen test?

A

think like a torsion test, symptomatic knee to chest, thomas test position with other leg and give pressure

18
Q

what leg goes to chest on the gaenslen test?

A

symptomatic

19
Q

what is the gold standard for limb length discrepancies?

A

radiographs, look at sacral base position to see if tilted one way or another

20
Q

what two factors affect the sacral base?

A

idiopathic scoliosis, and limb length discrepancy

21
Q

if you determine someone has a limb length discrepancy and decide to correct with a heel lift, within how many mm should it be corrected to?

22
Q

what is a test to rule out pelvic fx?

A

active straight leg raise, if they can’t in ER, high probability of a fx, if they can, low probability of fx

23
Q

what is the most commonly fractured part of the pelvis?

A

pubic ramus

24
Q

is it common to see centralization with SIJ dysfunction?

A

no, this is very rare and usually indicates a lumbar issue

25
what 3 findings help rule in lumbar stenosis and rule out PGP?
older age, absence of symptoms with coughing, full resolution of symptoms with sitting
26
what is the hip CPR for OA?
limited in adduction, flexion, ER/IR at 90 degrees of flexion
27
which two tests of the SIJ cluster should be performed first and why?
thigh thrust and distraction, high sensitivity and specificity
28
do pelvic belts decrease muscle activity?
no, but they help decrease pain which can actually lower inhibition and increase muscle activity
29
what is the purpose of prolotherapy in the SIJ?
cause an inflammatory response that facilitates fibroblastic activity to promote collagen synthesis and provide additional stability