Innominate/Pube Txt

Question 1

Dx- right anterior innominate

Answer 1

rotate innominate posterior

Question 2

Dx- left posterior innominate

Answer 2

rotate innominate anterior

Question 3

Dx- left superior innominate shear

Answer 3

pull the innominate inferior, leg tug, rotate foot medial

Question 4

Dx- right innominate outflare

Answer 4

inflare the innominate- bend at the knee, push the knee medial

Question 5

Dx- right innominate inflare

Answer 5

outflare the innominate- bend the knee, push the knee lateral

Question 6

Dx- bilat pubic compression

Answer 6

decompress the pubes using hip adductors- preparatory phase is squeezing the knees together while the pt pulls them apart, direct method phase is pushing the knees apart while the pt pushes them together

Question 7

Dx- left inferior pubic shear

Answer 7

posteriorly rotate the innominate while gapping the pubes- bend the knee and rotate up

Question 8

Dx- right superior pubic shear

Answer 8

anteriorly rotate the innominate while gapping the pubes- push the leg down off the table

Question 9

Dx- anterior pubic shear right (BLT)

Answer 9

carry left pubes posteriorly to point of balance, carry right ASIS laterally which outflares the right innominate, bringing the right pubes further anterior

Question 10

L1 tenderpoint is where?

Answer 10

ASIS

Question 11

L2, 3, and 4 tenderpoints are where?

Answer 11

AIIS

2 is medial, 3 is lateral, 4 in inferior

Question 12

L5 tenderpoint is where?

Answer 12

pubic tubercle

Question 13

AL1 is found on medial aspect of the ASIS, you will push medial to lateral. What is the treatment?

Answer 13

supine, Dr on side of dysfunction, lumbar flexion with sidebending torso toward and rotating torso away by flexing hips and knees and pulling hips and legs towards point
FStRa

Question 14

AL5 found on anterior pubic rami 1cm lateral to pubic symphysis, you will push anterior to posterior. What is the treatment?

Answer 14

supine, Dr on side of dysfunction, lumbar flexion with sidebending torso away and rotating torso away by flexing hips and knees and pulling hips towards you while swinging hips and feet away from you
FSaRa

Question 15

Which is more common with postural dysfunction? AL1 or AL5?

Answer 15

AL1

AL5 is more common with pubic somatic dysfunction and may also occur with bladder dysfunction

Question 16

What will be weak and tight with lower cross syndrome?

erector spinae?
gluteal?
abdominals?
iliopsoas?

Answer 16

tight erector spinae
weak gluteal
weak abdominal
tight iliopsoas

Question 17

AL2- medial AIIS, push medial to lateral
AL3- lateral AIIS, push lateral to medial
AL4- inferior AIIS, push inferior to superior

Treatment?

Answer 17

supine, standing on OPPOSITE side of dysfunction, lumbar flexion with sidebending torso away and rotating torso towards by flexing hips and knees and pulling hips and legs towards you
FSaRt

Question 18

AL2-4 is common with ____ dysfunction- people who _____.

Answer 18

postural, sit a lot

Question 19

What is found deep in anterior pelvis, 2/3 of distance from ASIS to midline? What is the treatment for this?

Answer 19

Psoas
supine, standing on side of dysfunction, marked bilat hip flexion and external rotation with knees bilat flexed with ankles crosses

Question 20

What is found deep in iliac fossa, 1/3 of distance from ASIS to midline? What is the treatment?

Answer 20

Iliacus
supine, standing on side of dysfunction, marked bilat hip flexion and external rotation with knees bilat flexed and ankles crossed

Question 21

What is found on lateral aspect of pubic tubercle at attachment of Inguinal ligament and pectineus muscle? You will push anterolateral to posteromedial. What is the treatment?

Answer 21

Inguinal (pectineus)
supine, standing on side of dysfunction, bilat hip and knee flexion, contralateral knee crossed over ipsilateral knee, ipsilateral hip adduction and internal rotation produced by pulling ipsilateral foot towards you

Question 22

What is found on the superior surface of iliopectineal eminence associated with the attachment of psoas minor? You will push anterosuperior to posteroinferior. What is the treatment?

Answer 22

Low ilium
supine, standing on side of dysfunction, marked ipsilateral hip flexion to about 100º (bend the knee and push it toward head)

Question 23

Posterior lumbar tender points on the spinous process treatment?

Answer 23

pure extension

Question 24

Posterior lumbar tender points on the transverse process treatment?

Answer 24

ESaRt- stand on same side, slide your knee under their thigh

Question 25

Where is the upper pole L5? Lower pole L5?

Answer 25

superior to PSIS, inferior to PSIS

Question 26

Upper pole of L5 is found on the superomedial aspect of PSIS. What is the treatment?

Answer 26

prone, extend ipsilateral trunk by rotating pelvis towards point OR by extending ipsilateral hip with slight adduction, creating slight extension and sidebending away from point ESaRt

Question 27

Lower pole L5 is found on the inferior aspect of the PSIS. What is the treatment?

Answer 27

prone, ipsilateral hip flexion (90˚) with internal rotation and slight adduction F IR Add (flexion, internal rotation, adduction) the foot will be toward the Dr, not the bed

Question 28

Piriformis- found in the belly of the piriformis muscle midway between ILA and greater trochanter. What is the treatment?

Answer 28

prone, seated on side of dysfunction, ipsilateral hip flexion to about 120˚ with some abduction and external rotation the foot will be toward the table

Question 29

High ilium sacroiliac is found 2-3 cm lateral to PSIS at attachment of gluteus maximus. You will push lateral to medial. Treatment?

Answer 29

prone, standing on side of dysfunction, ipsilateral hip extension with slight abduction you will grab the ankle and pick up the leg while pointing the toes away from the bed toward you

Question 30

Lateral PL3 and PL4 (gluteus medius) Lat PL3 is on the iliac crest in superomedial gluteus medius muscle about halfway between PSIS and posterior edge of tensor fascia lata at the level of the PSIS Lat PL4 is on the iliac crest in superolateral gluteus medius at the posterior border of the tensor fascia lata Treatment?

Answer 30

prone, extend ipsilateral hip with abduction and external rotation E ER Abd (extend, external rotation, abduction) you will grab the knee and pull the leg up with the toes pointing away from the table and toward you

Question 31

Mid pole sacroiliac found 10cm inferior and slightly lateral to PSIS at the level of the ILA. You will push anteromedial toward the ILA. Treatment?

Answer 31

prone, standing on side of dysfunction, ipsilateral hip abduction with slight flexion or extension as needed pts knee bend with knee toward Dr, push ankle into table

Question 32

High ilium flareout found on lateral aspect of coccyx at attachment of coccygeus muscle. You will push posterolateral to anteromedial at 45˚. Treatment?

Answer 32

prone, standing on side of dysfunction, ipsilateral hip extension and adduction, may need slight external rotation you will cross the pts legs and push up on top leg (leg closest to you) at the knee

Question 33

MPSI/gluteus is common with what?

Answer 33

sacral shears, USF, USE

Question 34

HIPO/coccygeus is common with what?

Answer 34

coccydynia (pain in coccyx) and pelvic floor dysfunction