Keys to Dx

Question 1

What muscle is used to treat rib 1 exhalation dysfunction?

Answer 1

ant/med scalene

Question 2

What muscle is used to treat rib 2 exhalation dysfunction?

Answer 2

post scalene

Question 3

What muscle is used to treat ribs 3-5 exhalation dysfunction?

Answer 3

pectoralis minor

Question 4

What muscle is used to treat ribs 6-8 exhalation dysfunction?

Answer 4

serratus anterior

Question 5

What muscle is used to treat ribs 9-10 exhalation dysfunction?

Answer 5

latissimus dorsi

Question 6

What muscle is used to treat ribs 11-12 exhalation dysfunction?

Answer 6

quadratus lumborum

Question 7

How do we treat ribs 1-10 inhalation dysfunction? ribs 11-12?

Answer 7

1. depress key rib with exhalation

2. quadratrus lumborum

Question 8

Steps in Rib DX

Answer 8

1. Screening view of ribs
   a. Tenderness
   b. Static Asymmetry (place hands on ribs, and note if either side is superior/inferior, anterior/posterior)
   c. TTA
2. Motion testing (with hands on ribs, have pt breath and check to see if one side or both moves better into exhalation or inhalation)
   a. Asymmetry
   b. Restriction of motion

Question 9

How do you test bucket handle motion? pump handle?

Answer 9

1. Move ribs side to side starting from bottom ribs up to axilla
2. Check motion along the costal cartilages

Question 10

What is the first step in innominate dx?

Answer 10

Standing Flexion test OR ASIS compression test

1. hook up under PSISs, and have pt. bend forward to see which PSIS moves first +farther/superior
2. Alternating posterior compression; + sign is when they don’t move as far posteriorly

Question 11

What is something you need to do before you check the innominate when you have your pt lie supine?

Answer 11

reset the hips

*important for dx and re-asses

Question 12

What are the steps, in order, of dx-ing an innominate?

Answer 12

1. Lumbar flexion test OR ASIS compression test
2. Evaluate for rotations and/or shears
   a. PSIS height
   b. ASIS height
   c. Iliac crest height
   d. Medial malleoli height
3. Evaluate for inflates or outflares
   a. ASIS to midline
4. Evaluate for pubic dysfunction
   a. Pubic tubercles

Question 13

If the distance from ASIS to midline is longer on the left than the right, what do you have?

Answer 13

a left outflare

*distance shrinks –> inflare

Question 14

For an anterior innominate rotation, you’d have what for the following:

1. Standing flexion/ASIS compression
2. PSIS heights
3. ASIS heights
4. Medial malleoli
5. Iliac crests

Answer 14

1. positive on side of dysfunction
2. superior on side of dysfunction
3. inferior on side of dysfunction
4. inferior on side of dysfunction
5. even

Question 15

For a posterior innominate rotation, you’d have what for the following:

1. Standing flexion/ASIS compression
2. PSIS heights
3. ASIS heights
4. Medial malleoli
5. Iliac crests

Answer 15

1. positive on side of dysfunction
2. inferior on side of dysfunction
3. superior on side of dysfunction
4. superior on side of dysfunction
5. even

Question 16

For a superior innominate shear, you’d have what for the following:

1. Standing flexion/ASIS compression
2. PSIS heights
3. ASIS heights
4. Medial malleoli
5. Iliac crests
6. Pubic tubercle heights

Answer 16

1. positive on side of dysfunction
2. superior on side of dysfunction
3. superior on side of dysfunction
4. superior on side of dysfunction
5. superior on side of dysfunction
6. superior on side of dysfunction

Question 17

For an inferior innominate shear, you’d have what for the following:

1. Standing flexion/ASIS compression
2. PSIS heights
3. ASIS heights
4. Medial malleoli
5. Iliac crests

Answer 17

1. positive on side of dysfunction
2. inferior on side of dysfunction
3. inferior on side of dysfunction
4. inferior on side of dysfunction
5. inferior on side of dysfunction
6. inferior on side of dysfunction

Question 18

For an inflare of the innominate, you’d have what for the following:

1. Standing flexion/ASIS compression
2. ASIS to midline

Answer 18

1. positive on side of dysfunction

2. shorter distance on side of dysfunction

Question 19

For an outflare of the innominate, you’d have what for the following:

1. Standing flexion/ASIS compression
2. ASIS to midline

Answer 19

1. positive on side of dysfunction

2. longer distance on side of dysfunction

Question 20

For a superior pubic shear of the innominate, you’d have what for the following:

1. Standing flexion/ASIS compression
2. Pubic Tubercle

Answer 20

1. positive on side of dysfunction

2. superior on side of dysfunction

Question 21

For an inferior pubic shear of the innominate, you’d have what for the following:

1. Standing flexion/ASIS compression
2. Pubic Tubercle

Answer 21

1. positive on side of dysfunction

2. inferior on side of dysfunction

Question 22

Inhalation + sacrum

Answer 22

base moves posteriorly; apex moves anteriorly

aka: sacral extension

Question 23

Exhalation + sacrum

Answer 23

apex moves posteriorly; base moves anteriorly

aka: sacral flexion

Question 24

How do you determine the sacral axis?

Answer 24

if the left or right sacral sulcus is locked, that’s the side of the axis

*locked on right, right axis

Question 25

How do you determine forward or backward torsion?

Answer 25

for forward, the letters will match (R on R), and backwards they won't (L on R) *pretend the sacrum is looking, and that tells you direction

Question 26

What's something to remember to do on a seated flexion test? what is it used for?

Answer 26

PUT THEIR FEET ON THE GROUND to tell you which side is the problem of the sacrum

Question 27

For a forward torsion

Answer 27

anterior ILA and posterior sacral sulcus are on opposite sides, and not on the axis side

Question 28

For a backward torsion,

Answer 28

deep sacral sulcus, and anterior ILA is still opposite the anterior ILA, but are on the axis line

Question 29

If you see that your deep sacral sulcus, and your posterior ILA are opposite, you have a ...

Answer 29

torsion

Question 30

What is the motto for the sacrum treatments?

Answer 30

push down whatever is sticking up at you

Question 31

How do you open the front of the SI joint? the back?

Answer 31

1. externally rotate | 2. internally rotate

Question 32

For torsion treatment, how do you end it?

Answer 32

YOU move them back to the table --> if the pt. does they'll mess up their sacrum again