MT Flashcards
1
Q
importance of pelvis
A
middle center of mass
locomotion
stability of masses above/below
base of vertebral column
2
Q
function of pelvis w/ GI/GU
A
acts as a bowl supporting most of the systems
3
Q
pelvis lymphatic/vascular importance
A
contains all vascular/lymphatic contents for below structures
4
Q
important areas of pelvis for LE circulation
A
pelvic diaphragm and inguinal area
5
Q
pelvis main functions
A
- biomechanical function/balance
- reproduction
- elimination
- vascular/lymphatics for the region and LE
6
Q
basic anatomy of the innominate
A
composed of the ilium, pubis, and ischium
7
Q
acetabulum structure
A
composed of 3 different ossifaciton centers (3 areas of innominate)
8
Q
true vs accessory ligaments
A
true - bone to bone
accessory - attach at another ligament, tendon, or fascia
9
Q
ligament functions
A
- limit movement
- permit motion
- elastic quality
- limit movement as part of reflex response
10
Q
anterior pelvic ligaments
A
sacrospinous - sacrum to ischial spine
iliolumbar - from ilia to L5
anterior sacroiliac - covers sacroiliac joint
inguinal L - ASIS to superior pubic rami
11
Q
posterior pelvic ligaments
A
sacrotuberous - sacrum to ischial tuberosity
posterior ascroiliac - covers sacroiliac joint
12
Q
attachment of Gmax/biceps femoris
A
sacrotuberous L
13
Q
attachement of coccygeus M
A
sacrospinous L
14
Q
iliolumbar L function
A
stabilization of L5, prevents excessive anterior/rotary motion
15
Q
origin of IOM and TAM
A
inguinal L
16
Q
L preventing anterior displacement of sacrum
A
anterior sacroiliac L (thicker than PSL for this reason)
17
Q
L filling irregular space posteriosuperior to sacroiliac joint
A
interosseous sacroiliac L
18
Q
attachment points of PSL
A
3rd/4th sacral segments to PSIS and posteiror iliac crest
19
Q
attachment points of ASL
A
3rd sacral segment to lateral pre-auricular sulcus
20
Q
attachment points of inguinal L
A
pubic tubercle to ASIS
21
Q
attachment points of sacrospinous L
A
ischial spine to lateral sacrum/sacrotuberous L
22
Q
attachment points of sacrotuberous L
A
lower sacral tubercles to ischial tuberosity
23
Q
Ls associated w/ pubic symphysis
A
superior pubic L (above) and inferior pubic L (below)
24
Q
innominate w/ heel strike
A
right heel strike = right innominate rotates posterior due to iliopsoas contraction
25
innominate w/ toe off
right toe off = right innominate rotates anterior w/ iliopsoas relaxation and gmax/hamstring contraction
26
major/minor hip flexors
major = iliacus, psoas
minor = rectus femoris, sartorius
27
hip extensors
Gmax, hamstrings (biceps femoris, semitendonosis, semimembranosis)
28
hamstring tension effect on innominate
posterior rotation
29
rectus femoris, iliacus, or adductor tension effect on innominate
anterior rotation
30
major/minor hip adductors
major = ad magnus/brevis/longus
minor = gracilis, pectineus
31
hip abductors
Gmed, Gmin, TFL
32
trendelenburg sign
drop of pelvis when lifting leg opposite to a weak Gmed
+ sign = abductor strenght not adequate
33
causes of trendelenburg gait
weak abductor (Gmed/Gmin) or superior gluteal N (L5) issues
34
hip external rotators
piriformis, obturator externus/internus, superior/inferior gemilli, quadratus femoris
35
only hip rotator connected to sacrum
piriformis
36
quadratus lumborum effect on Ns
may product Sx of groin pull/hernia by irritating the ilioinguinal and iliohypogastric Ns as they pass anterior to it (L1)
37
greater and lesser sciatic formaen are created by
sacrospinous L
38
gravitational line
- auditory meatus
- acromion process
- greater trochanter
- L3 body
- anterior 1/3 of sacrum
- lateral condyle of knee
- lateral malleolus
39
innominate shear
superior/inferior motion of one innominate
40
innominate flare
flares out/in as measured by distance of ASIS to midline on both sides
41
lateralization tests
used to determine which side SD is on
standing flexion test and ASIS compression test
42
rib articulations w/ spine
articulates w/ superior costal facet of its own vertebra
articulates w/ inferior costal facet of above vertebra
43
rib tubercle articulation
articulates w/ transverse process of its own vertebra
44
joints of ribs
costochondral and sternocostal
45
rib articulation exceptions
1/10/11/12 - articulate only w/ their own vertebra
11/12 - dont have tubercles, dont articulate w/ TPs
46
atypical/typical ribs
1, 2, 11, 12 (sometimes 10) are atypical
3-9 (sometimes 10) are typical (have all landmarks)
47
true/false ribs
true = 1-7; cartilage attaches to sternum
false = 8-12;
- 8-10 cartilage attaches to above ribs
- 11-12 are floating
48
rib at sternal angle (Louis)
rib 2 costal cartilage
49
Ms of 1st/2nd ribs
i get up at 1 AM 2 P
Anterior scalene/Middle scalene - elevate 1
Posterior scalene - elevates 2
50
pec minor action and correlation w/ ribs
stabilizes scapula drawing it inferior/anterior; inserts of ribs 3/4/5
51
serratus anterior action and correlation w/ ribs
protracts scapula, ribs 2-8 insertion
52
lat action and correlation w/ ribs
extends/adducts/med rotates humerus, lower 4 ribs origin
53
quadratus lumborum action and correlation w/ ribs
fixes 12th rib in inhalation (insertion)
54
external intercostals
from spine -> costal cartilage
elevates during forced inspriation
55
internal intercostals
from rib angle -> sternum
depresses ribs
56
innermost intercostals
from rib angle -> costal cartilage
depresses ribs
57
origin of diaphragm
xiphoid process, lower 6 ribs, L1-L3
58
vessels/nerves b/w ribs
VAN (vein most superior) b/w ribs found in b/w internal and innermost Ms
59
bucket handle rib motion
ribs
superior/lateral motion, increase transverse diameter (AP axis)
ribs 1-2, 8-10
60
pump handle rib motion
ribs
superior/anterior motion, increase AP diameter (transverse axis)
ribs 3-7
61
caliper/pincer rib motion
ribs
downward/posterior in inspiration, upward/anterior in expiration
ribs 11/12
62
torsional rib movement of rib
due to rotation of thoracic spine
T6 RL -> L 6th rib turns externally, R 6th rib internally; L 6th sharp/flat anteriorly, R 6th accentuated
63
non-physiologic movement of rib
due to trauma -> ant/post subluxation
64
inhalation SD
inhalation more free, exhalation restricted
exhalation SD opposite
65
ribs in inhalation/exhalation SDs
inhalation SD = ribs 1-4 held up (key rib = 4)
exhalation SD = ribs 3-8 held down (key rib = 3)
66
key ribs
BITE (bottom inhalation, top exhalation)
key rib maintains the group, treat key rib first
67
ribs 11-12 inhalation SD cause
quadratus lumborum
68
rib 1 ex SD cause
ant/med scalene Ms
69
rib 2 ex SD cause
post scalene
70
ribs 3-5 ex SD cause
pec minor
71
ribs 6-8 ex SD cause
serratus anterior
72
ribs 9-10 ex SD cause
lat
73
ribs 11-12 ex SD cause
quadratus lumborum
74
major cause of rib dysfunction
thoracic scoliosis/kyphosis
rib asymmetries (excavatum/carinatum)
osteoporosis/osteoarthritis (anteriorly depress ribs)
COPD
M strain
trauma
slumping (depression, desk work, etc)
75
SI joint after puberty
males: well developed and strong
females: less developed for childbirth
76
males SI joint degeneration
begin in sacral side in 4th-5th decade of life
77
SI joint type
diarthrodial joint - contains synovial fluid
is unique b/c 1 side is hyaline cartilage and other is fibrocartilage (sacral hyaline, iliac fibro)
78
SI ligaments
posterior - thicker, blends w/ STL and thoracolumbar fascia
anterior - blends w/ iliolumbar L
79
long dorsal SI ligament
stretches w/ pregnancy/aging, connects to PSIS
80
form/force closure of the sacrum
form - due to how the joints fit together
force - due to gravity/loading forces/Ms/etc
81
axes of the sacrum
Superior Transverse (respiratory) - parallel and through S2
Middle Transverse (postural) - through S2 parallel to the ground not the vertebrae
Inferior Transverse (pelvic) - through S3 upwards
82
lumbar/sacrum relationship
lumbar flexion -> sacral extension
lumbar extension -> sacral flexion
83
sacrum movement relationship w/ base/apex
extension -> base posterior, apex anterior
flexion -> base anterior, apex posterior
84
Tender vs Trigger points
Tender - in Ms/Ts/Ls/fascia, twitch response not present
Trigger - in Ms, has radiating pain pattern, present in a taut band of tissue, elicits twitch response
85
Tender vs Trigger points Tx
tender - spontaneous release by positioning (counterstrain)
trigger - spray and stretch
86
nociceptive model of counterstrain
tissue is strained recruiting nociceptors within that tissue -> reflexive contraction occurs within tissue -> contraction becomes the new neutral
87
proprioceptive model of counterstrain
muscle is strained (w/o nocicpetor recruitment) -> antagonist M shortens via antagonist gamma neuron system -> antagonist contraction new neutral
seen in whiplash: posterior neck Ms strained, so anterior shorten in new neutral
88
nociceptive/proprioceptive models similarity
constriction -> decreased circulation causing localized edema and back up of products of metabolism
89
4 phases of counterstrain
- relaxation
- reset of spindle fibers/nociceptors
- washout
- slow return to neutral
90
counterstrain vs MET targets
counterstrain - muscle spindle fibers
MET - golgi tendon organs
91
washout in counterstrain
washing out of waste products
begins 10-15 seconds, peaks at 1 min
92
time for counterstrain holding
90 seconds for most
120 seconds for ribs
93
anatomical reasoning for tender point
where motor N pierces investing fascia and enters M
94
position of comfort
70% of tenderness alleviated
95
position of optimal comfort
100% of tenderness alleviated
96
maverick
tender point that does not respond to typical positioning, usually requires opposite position from standard
97
counterstrain founder
Lawrence Jones 1955/1980 published
98
sacral Dx
review notes and sacral review ppt
99
L5 movement w/ sacral torsion
rotates opposite = compensated
rotates same = uncompensated
SB towards the axis
flexed sacrum -> neutral L5 (T1)
extended sacrum -> flexed/extended L5 (T2)
100
Ms elevating ribs 1/2
woke up at 1am 2P
1 - anterior and middle scalenes
2 - posterior scalenes
101
pec Ms contraction leads to what rib SD
contraction -> inhalation SD
this is why exhalation dysfunctions contract it
102
M elevating ribs 3-5
pec minor
103
M elevating ribs 6-8
serratus anterior
104
M elevating ribs 9-10
lat
105
M elevating ribs 11-12
quadratus lumborum
