Which ligament is classically tight on the side of the posterior ILA?
sacrotuberous (sacrum to isch tube)--they may only tell you this in the stem rather than which ILA is posterior. Remain calm.
What way does the sacrum move in the sphinx test?
anterior/flexion? the lumbar spine is extending
Which way does L5 rotate with respect to the sacrum in a torsion vs. a rotation?
sacral torsions have L5 rotating opposite and sacral rotations have L5 rotating in the same direction
Rate the muscle strenght of a person with weak movement without gravity
2 out of 5
Loss of function of the extensor hallucis longus may be from a lesion to this nerve root
loss of the anterior tibialis may be from a loss of this nerve root, what about named nerve?
L4; deep peroneal
Loss of function of the gastronemius may imply a lesion to this nerve root
LBP has a musculoskeletal etiology ____% of the time
Pain on a straight leg raise beyond 70 degrees implies a lesion where?
hip or joint
Pain on a straight leg raise between 35-70 degrees implies a lesion where?
If a person has a lesion to their right inferior gluteal nerve and is asked to stand on the right leg, what will happen to the left pelvis?
nothing, the gluteus medius is innervated by the superior gluteal nerve and so the Trendelenberg test is negative
What is the most common etiology of coccydynia? What is the treatment?
Regarding lumbarization of S1 and sacralization of L5 ,which is more common? What % of the population?
sacralization of L5 is more common and occurs in 3.5% of population
These 2 muscles form the pelvic diaphragm
levator ani, pubococcygeus
Which vertebral levels are the superior, middle, and inferior axes of sacral motion located?
All are located about S2
Which type of motion occurs about the middle transverse axis of S2
Which type of motion occurs about the inferior transverse axis of S2
dynamic i.e. walking
Which type of motion occurs around the superior transverse axis of S2
respiratory and cranial
A superior ASIS, inferior PSIS, and equal isch tubes with an ipsilaterally positive SF test implies this dysfunction
How do you set up a woman who had a hip replacement for Tx of her superior shear?
leg abducted with EXTERNAL rotation
What is the treatment sequence for pelvic dysfunction according to Mitchell?
Treat the non-neutral (type II) thoracic and lumbar dysfunctions, treat innominate and pubic shears, treat sacroiliac dysfunction, treat iliosacral dysfunction
A tenderpoint located 1/3 from the ASIS to the midline is for this muscle
What % of the population will experience LBP this year?
how do you tx acute injury to the low back
Where can pain be referred to in sacroiliitis?
the anterior hip
Sciatica commonly involves hypertonicity of this muscle
What usually causes lateral trochanteric bursitis?
Irritation of the bursa by the IT band
What is a good Tx for ligamentous laxity
LBP with contemporaneous upper extremity pain may indicate spasticity of a muscle innervated by this nerve
thoracodorsal nerve (latissimus dorsi)
What is the major etiology we should think of with lower extremity edema?
What is an important area to target if you suspect a muscular etiology for incontinent bowel?
Irritable bowel can be described as an imbalance between what?
sympathetic and parasympathetic nervous systems
Why would you target pelvic splanchnics for an ileus?
Assuming the parasympathetic nerves in S2-S4 where hypoactive and causing the ileus, treating this area could improve colonic motility
How would you go about treating a small bowel obstruction?
This one is a mess. If we go with Balmer's lecture then we wouldn?t bc obstruction = contraindication. If we go with O'donnel then we target pelvic splanchnics which makes no sense because the small bowel recieves parasympathetic input from the vagus. Good luck.
A UTI may have what structural dysfunction on palpatory exam?
An erectile dyfunction is caused by hypoactivity of this arm of the ANS and may be accompanied by this structural dysfunction
parasympathetics, pubic dysfunction
Which areas should you target in an osteopathic approach to prostatitis and BPH, why?
pelvic diaphragm to decrease congestion
If a male presents to you with trouble ejaculating what area should you target and why?
the pelvic diaphragm as blood flow is "key"
What may you suspect in a person who comes in with persistent dominant pelvic complaints?
What may happen to the AP curves in a pregnant woman?
Exacerbation of kyphosis and lordosis
What causes the ligamentous laxity of pregnancy?
Why are the lymphatic's effectivenesss decreased in pregnancy
because the diaphragm is messed up d/t the weird curvatures of the spine
Why is toxemia of pregnancy a relative contraindication for OMT?
it reduces the seizure threshold
When is the structural stage of pregnancy?
When is the congestive stage of pregnancy?
When is the preparatory stage of pregnancy?
Beyond 36 weeks, assess craniosacral rhythm
What structure acts as a ball-valve in pregnancy?
What hemodynamic change may occur in a supine pregnant woman
hypotension secondary to the ball valve obstruction of the IVC and subsequent decrease in venous return = stroke volume
How can you induce labor?
CV4, or pitocin like a normal person
What should you do prior to any lymphatic Tx?