The Pelvis and Sacroiliac Joints Flashcards
What innervates the SIJ?
dorsal rami of spinal nerves S1-S4
Pain from the SI joint is generally localized in what region?
gluteal (94%)
In the vertical plane, the ASIS should be aligned with what bony landmark?
pubic tubercles
There is normally less than _ degrees of rotation and _ mm of translation at the SI joint.
4
2
What type of joint is the SI joint?
true diarthrodial joint
In the SI joint _____ cartilage on the sacral side moves against ________on the iliac side.
hyaline
fibrocartilage
Which are the most commonly disrupted and/or torn ligaments of the pelvis?
the iliolumbar ligament and the posterior sacroiliac ligament
Which ligaments resist the load of the sacrum relative to the ilium?
The deep anterior, posterior, and interosseous ligaments
What is the most common symptom of SI joint dysfunction?
Pain in the lower back or the back of the hips
What is the most common cause of SI joint dysfunction? What is another cause?
osteoarthritis
pregnancy
How does lumbar extension/lordosis affect the sacrum?
It increases sacral nutation/flexion
How does lumbar flexion affect the sacrum?
It increases sacral counter-nutation/extension
With an anterior pelvic tilt, what muscles are strong but tight?
Hip flexors (iliosoas and rectus femoris) and back extensors (erector spinae)
With an anterior pelvic tilt, what muscles are stretched but weak?
Abdominals (rectus abdominis) and hamstrings and hip extensors (hamstrings and glute max)
sacral flexion = sacral _____
sacral extension = sacral _______
nutation
counter-nutation
When the trunk flexes what does the pelvis do? What does it do when the trunk extends?
Posterior tilt
Anterior tilt
When the trunk laterally flexes to the left what does the pelvis do?
Lateral tilt to the left
When the trunk rotates to the left what does the pelvis do?
rotates to the left
When the hip flexes bilaterally what does the pelvis do? What does it do when the hip extends bilaterally?
posterior tilt
anterior tilt
When the left leg flexes and the right leg extends at the hip what does the pelvis do?
The left side posteriorly tilts and outwardly rotates, while the right side anteriorly tilts and inwardly rotates
In order for there to be lateral pelvic tilt to the right what muscles have to contract?
left quadratus lumborum
right hip abductors
In order for there to be pelvic rotation to the right what muscles have to contract?
left lumbar rotators
left hip external rotators
right hip internal rotators
What does the trabecular system of he bony pelvis follow?
the weight-bearing Lines
With an lateral pelvic tilt to the left, what muscles are strong but tight?
right pelvis elevators and left hip abductors
With an lateral pelvic tilt to the left, what muscles are stretched but weak?
left pelvis elevators and right hip abductors
In standing when the right knee is flexed the pelvis drops to the ___ side
same
What is the purpose of the standing flexion test?
to assess sacroiliac joint dysfunction
What is a positive result for the standing flexion test?
If one PSIS moves further cranial than the other
When you receive a positive standing or seated flexion test for SIJ what side is affected?
The side with the higher PSIS is the affected side with less SI Joint motion causing movement of the ilium instead of movement at the SI joint.
What is the purpose of the Weber–Barstow Maneuver?
“resets” the pelvis and limbs prior to leg length testing
How is the Weber–Barstow Maneuver performed?
1) Examiner holds the feet of the patient and places the thumbs over the medial malleoli while providing slight traction on the legs
2) The patient is then asked flex both knees and hips to approximately 45°
3) The patient is then instructed to reset the pelvis by lifting the gluteals off of the table and then gently lowering himself or herself back down
What are the positive test implications of the Weber–Barstow Maneuver?
Femoral length difference (lateral view–increased anterior position)
Tibial length difference (front view–increased height difference)
How is Alli’s test performed?
1) The ASIS’s are aligned in the same frontal plane and transverse plane
2) The medial maleolli are placed together