Final Exam SI Joint Flashcards by B Burr

What 3 structures fuse at the acetabulum to form each innominate?

Ilium
Ischium
Pubic Bone

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Each of the 2 innominates articulates with the __, forming the ___, and with each other at the __ __

sacrum
SI joint
Symphisis pubis

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The sacrum is a __ and __ bone located between the 2 innominates

strong

triangular

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Sacrum provides stability and transmits the weight of the body from the mobile __ __ to the __ region

vertebral column

pelvic

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The iliac joint surfaces are formed from __

fibrocartilage

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The sacral surfaces are formed from __ __

hyaline cartilage

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The hyaline cartilage is __-__x thicker than the fibrocartilage

3-5

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The SI joint is a __ articulation, or __

synovial

Diarthrosis

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The Anterior Sacral Ligament (ASL) is an __-__ thickening of the __ __

anterior-inferior

fibrous capsule

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The Anterior Sacral ligament is relatively __ and __ compared to the rest of the SI ligaments

weak

thin

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Anterior Sacral Ligament extends between the __ and __ borders of the __ Auricular surface and the __ border of the __ auricular surface

anterior 
inferior
Iliac
Anterior
Sacral

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Interosseous ligament is a __ ligament located __ to the __ __ ligament

short
deep
dorsal SI

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Interosseous ligament forms the major connection between the __ and the __, filling the irregular space __-__ to the joint:Between the __ sacral crest, and the __ __

sacrum
innominate
posterior-superior
lateral
iliac tuberosity

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The dorsal S/I ligament (__ligament) connects the ___ (and a small part of the iliac crest) with the lateral crest of __ and __

long
PSIS
S3
S4

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Dorsal SI ligament is a __ and __ ligament

tough

strong

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Sacral __ (anterior motion) of the sacrum appears to __ the Dorsal SI ligament whereas __ (posterior motion) __ the ligament

Nutation
slacken
counternutation
tauten

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The sacrospinous ligament is made of __ large fibrous bands, broadly attached by its base to the __, the lateral __, and partly blended with the __ __ ligament - deep to the __ ligament

3
PSIS
sacrum
sacroiliac
sacrotuberous

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Sacrospinous ligament stabilizes against __ of the __

nutation

sacrum

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Sacrospinous ligament counteracts against __ and __ migration of the __ __ during __ __

dorsal
cranial
sacral apex
weight bearing

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Sacrotuberous ligament extends from __ __ to lateral margins of __, __, and __- lower borders of the ligament continuous with the __ __ tendon

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ischial tuberosity
ilium
sacrum
coccyx
biceps femoris

Sacrotuberous Ligament counteracts against __ of the __

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nutation

sacrum

Pubic Symphisis is classified as a symphisis as it has no __ tissue and contains a __ __

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synovial

fibrocartilagenous disc

Bone surfaces of pubic symphisis are covered with __ __, but are kept apart by the presence of the __

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hyaline cartilage

disc

__ muscles attach directly to the sacrum and/or innominate. These muscles primarily function to __ the SI joint rather than to __ it

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35
stabilize
move

Piriformis primarily functions to produce __ __ and __ of the __

external rotation | abduction

Piriformis is also though to function as an __ __ and __ of the hip if the hip joint is flexed beyond __ degrees.

internal rotator abductor 90

The piriformis is capable of restricting __ __ motion

SI joint

The term "Pelvic Floor Muscles" primarily refers to the __ __, a muscle group composed of the _(3)_

Levator Ani Pubococcygeus Puborectalis Iliococcygeus

Levator Ani muscles join the __ muscles to complete the __ __

coccygeus | pelvic floor

Pelvic floor muscles work in a coordinated manner to increase __ __ pressure, provide __ support during defecation, inhibit __ activity, help to support the pelvic __, and assist in __ stability

``` intra-abdominal rectal bladder organs lumbopelvic ```

Anterior part of SI joint likely receives innervation from the __ rami of __-__ roots

posterior | L2-S2

The pelvic area must function to absorb the majority of the lower extremity __, while still permitting __ to occur

rotation | motion

It is likely that the movement of the pelvis is in the nature of deformations and slight __ motions areound a number of undefined __, with the joints of the pelvic ring deforming in response to body __ and __ reaction forces.

gliding axes weight ground

Note : There is very little agreement, either among disciplines, or even within disciplines about the biomechanics of the pelvic complex. The results from the numerous studies on mobility of the sacroiliac joint have led to a variety of different hypotheses and models of pelvic mechanics over the years

Just Sayin.

In the osteopathic model, the __ rotates around 2 __ axes. The Innominates are capable of rotating __ and __

sacrum oblique anteriorly posteriorly

In the chiropractic model, as one innominate flexes, the ipsilateral sacral base moves __ and __, and as the other innominate extends, the sacral base on that side moves __ and __

anterior inferior posterior superior

In the biomechanical model, when the sacrum nutates, or __, relative to the innominate, a __ glide occurs between the two L-shaped articular surfaces of the __ joint. The shorter of the 2 lengths, level with __, lies in a __ plane. The longer length, spanning __-__, lies in an __ plane

``` flexes linear SI S1 vertical S2-4 A-P ```

• Under the premise that a relationship between pelvic asymmetry and low back pain exists, orthopedic, osteopathic, and physical therapy texts promote the use of __ provoking (symptom-based) tests and __ (mechanical-based) tests that include __ (positional) and __ (motion or functional) tests

pain biomechanical static dynamic

PT with history SIJ dysfunction may present with a history of __ pain awakening the patient from sleep upon __ in bed

sharp | turning

PT with history SIJ dysfunction may present with pain from __, ascending or descending __, __ from __ position, or hopping or standing on involved leg.

walking stairs standing sitting

PT with history SIJ dysfunction may present with positive ___ at, or near, the end of range, pain, and sometimes limitation on __ and __ side bending of the trunk

SLR extension ipsilateral

Given the number of ___ in the vicinity of the S/I joint, a thorough systems review is needed to rule out a __ source for the symptoms

organs | visceral

*Note: • An examination of posture is performed to check for the presence of asymmetry • However, as pelvic landmark asymmetry is probably the norm, ‘positive findings’ are to be expected

``` ░☆░☆░ ░☆░☆░ ░☆░☆ ░☆░☆ ☆┏┓┏┓☆╭━━┓☆╭━━╮ ☆┃┃┃┃☆┃╭━┛☆┃╭╮┃ ☆┃┃┃┃☆┃╰━╮☆┃┗┛┃ ☆┃┃┃┃☆╰━╮┃☆┃┏┓┃ ☆┃╰╯┃☆┏━╯┃☆┃┃┃┃ ☆╰━━╯☆┗━━╯☆┗┛┗┛☆ ░☆░☆░ ░☆░☆░ ░☆░☆░ ░☆░ ```

An altered positional relationship within the pelvic girdle should only be considered positive if a mobility restriction of the __ and/or __ __ is also found

Si joint | pubic symphisis

Weight bearing and non-weight bearing kinetic tests are designed to assess the __ occurring at the __ during patient generated movements. The tests assess the mobility of the __ and the ability of the sacrum to __ (ipsilateral test), and to __ __ (contralateral test)

``` osteokinematics SIjoint innominate nutate side bend ```

Si joint stress tests are believed to be sensitive for severe __ or __ __ tears

arthritis | ventral ligament

What are the SI joint stress tests?

Gaenslen's Lewin-Gaenslen's Hibb's Fabere

Acute Phase Intervention goals

• Decrease pain, inflammation, and muscle spasm • Increase weight bearing tolerance, where appropriate • Promote healing of tissues through sufficient stabilization (may require belt) • Increase pain-free range of S/I joint motion • Regain soft tissue extensibility around the pelvic region • Regain neuromuscular control • Allow progression to the functional stage

Functional Phase Intervention goals

To significantly reduce or to completely resolve the patient’s pain • To restore full and pain-free S/I joint range of motion • To integrate the lower kinetic chains into the rehabilitation • Complete restoration of gait, where appropriate • The restoration of pelvic and lower quadrant strength and neuromuscular control

Final Exam SI Joint Flashcards

(49 cards)