1

Question 1

Flexors pull pelvis which direction? Extensors?

Answer 1

Flexors: anteriorly

Extensors: posteriorly

Question 2

Major hip flexors

Answer 2

Iliacus and Psoas

Question 3

What nerve pierces the piriformis?

Answer 3

Sciatic n.

Question 4

Contraction of the piriformis may cause what?

Answer 4

Sciatica

Question 5

Function of the piriformis

Answer 5

Abductor when hip is FLEXED
External rotator when hip is EXTENDED

*ONLY rotator that connects directly to sacrum

Question 6

How to determine LATERALITY?

Answer 6

Pelvic Compression

Standing Flexion

Question 7

Positive side for Standing Flexion test?

Answer 7

Innominate will lock out and move most CEPHALAD

Question 8

Pubic shears are often seen with what?

Answer 8

Rotations

Upslips

Question 9

What is Lumbarization of the sacrum?

Answer 9

When S1 and S2 do NOT fuse

Question 10

Sacrum has how many vertebrae?

Answer 10

5

S1-S5

Question 11

Where are sacral epidural nerve blocks performed?

Answer 11

Sacral hiatus

Question 12

How many vertebrae make up the Coccyx?

Answer 12

4

C1-C4

*Lowest part of spinal cord

Question 13

What are the 3 true pelvic ligaments?

Answer 13

Posterior sacroiliac ligaments: PSIS to 3rd/4th sacral segments

Interosseous sacroiliac ligaments: from medial sacral crest to iliac tuberosities

Anterior sacroiliac ligaments: attach from 3rd sacral segment to preauricular surface of ilium

Question 14

What do the Sacrospinous and Sacrotuberous ligaments do?

Answer 14

Prevent apex of sacrum from moving posteriorly and superiorly (like the attic door movement…going up)

*Opposite=Iliolumbar ligament–stabilizes posterior motion..attaches 4th/5th lumbar vertebra to iliac crests

Question 15

What does the sacrospinous ligament attach?

Answer 15

Attaches sacrum to ischial spine

*Creates greater and lesser sciatic foramen

Question 16

Ileum vs ischium

Answer 16

Ileum=top part

Ischium=lower part

Question 17

Cranial and Sacral dura attachment

Answer 17

Cranial dura: C1-C2

Sacral: S2

Question 18

Force closure vs Form closure

Answer 18

Force closure: muscles holding object by pressure on sides

Form closure: roman arch. (Sacrum=keystone between iliums)

Question 19

3 transverse axes of motion on sacrum

Answer 19

Superior (S1): “respiratory”. At level of articular process of S2. Inhalation: base goes posterior, apex-anterior..”Think of sacral base as moving back to let in air”

Middle (S2): “Postural” or “Sacroiliac”. Flexion/extension in sitting/standing. Level of S2 body. Flexion: base goes anterior

Inferior (S3 axis): “Iliosacral”. axis for rotation of iliums on sacrum…at inferior pole of lower sacral articulation

Question 20

Cranial motions

Answer 20

Sacral base goes posteriorly and apex anteriorly during CRANIAL FLEXION

Base anterior and apex posteriorly during CRANIOSACRAL EXTENSION
(opp. of sacrum movements)

Craniosacral flexion/extension is VERY different than postural flexion/extension

W/ flexion, SBS moves up

Question 21

Nutation vs Counternutation

Answer 21

Nutation: Nodding forward (base goes anterior)

Counternutation: (base goes posterior). Occurs w/ craniosacral/SBS flexion

Question 22

Dynamic motion occurs around what axes?

Answer 22

Oblique

Question 23

Where to place hands during 4-pt passive test

Answer 23

Contact each sacral sulci and ILA

Put force around oblique axis…looking for ease of motion

Question 24

Where to put palms during Side Bending

Answer 24

Palms on ILA’s…give cephalad force

Question 25

Fred Mitchell Sr.: described muscle energy in 1958. Held 5 day tutorial. Son later published his manual. JAOA article by Dr. Vick- evaluated reported injuries from manipulation. Risk=1 in million S. Haldeman: unpredictability of Cerebral Vascular Ischemia..more common injuries from tennis etc

Answer 25

True

Question 26

Golgi Tendon Reflex

Answer 26

They are stretched whenever muscles contract They detect degree of skeletal muscle tension and send this info to CNS...synapse w/ inhibitory interneurons...cause reflex relaxation of the muscle Purpose: prevent tissue disruption SUDDEN STRETCH activates golgi tendon organ.

Question 27

Spinal somatic dysfunction involves: Vertebral segment *segment above and below the disc between the 2

Answer 27

True

Question 28

Where does dura attach?

Answer 28

Superior transverse axis (S2) (Foramen magnum, C1, C2, S2) Motion from SBS is transferred through the dura to the sacrum *dura is like a string...it's attached at the foramen magnum in your skull and to your S2 articular processes on your sacrum. The string pulls on the sacrum, moving it forward or backward-opposite of cranial movement.

Question 29

Sacroilial motions are for what? *So sitting on butt, you're having the sacrum move ON the ilium...so the seated flexion test is measuring sacral movement and blocking out ilium

Answer 29

The flexion tests

Question 30

How to treat Forward Torsion (L on L, R on R)

Answer 30

Modified Sims position, Axis side down, feet together and hanging off table as you hug the table

Question 31

How to treat Backward Torsion (L on R, R on L)

Answer 31

Lateral recumbent, Axis side down, one foot off the table and the other on the table, as you hug the table

Question 32

How to treat Unilateral Sacral Extension

Answer 32

Sphinx position, anterior/inferior force on sacral sulcus

Question 33

How to treat Unilateral Sacral Flexion

Answer 33

Prone, anterior/superior force on ILA Doctor on SIDE OF DYSFUNCTION

Question 34

Seated flexion and pelvic compression being positive on OPPOSITE sides is a clue....only happens in TORSIONS

Answer 34

True

Question 35

Sacral sulci become MORE SYMMETRIC in the Sphinx test=anterior torsion or unilateral flexion

Answer 35

True

Question 36

2 muscle groups of pelvis

Answer 36

Levator ani Coxxygius