Pelvic and SI Dysfunction Flashcards Preview

PTRS 845 Midterm > Pelvic and SI Dysfunction > Flashcards

Flashcards in Pelvic and SI Dysfunction Deck (63):
1

3 Functions of the SI joint

1. Transfer load from trunk to legs

2. Absorb LE motion/forces

3. Dissipate force before it reaches the L-spine

2

3 Parts of the Osseous ring

1. Ilium

2. Sacrum

3. Pubis

3

Term: Inter-related movement between the lumbar and pelvic joints

Lumbopelvic rhythm

4

Term: L4-S1

Lumbosacral Junction

5

Facets L5-S1

1. Orientation

2. Function

3. Coupling

1. Frontal/Caudal (the rest of the L-spine in sagittal plane)

2. WB (on base of sacrum)

3. SAME direction 

6

Structure: Attached from L4/L5 TP to iliac crest and restricts lumbopelvic motion

Iliolumbar ligament 

7

Portion of Iliolumbar Ligament: Tight with flexion

Posterior 

8

Portion of Iliolumbar Ligament: Tight with extension

Anterior

9

Portion of Iliolumbar Ligament: Tight with rotation and SB

Superior

10

Structure: Blends into quadratus lumborum

Iliolumbar ligament 

11

2 Features that add stability to the sacrum

1. Triangle shape

2. Ridges and depressions

12

Joint Type: Anterior SI joint

Diarthrodial (synovial)

13

Joint type: Posterior SI Joint

Syndesmosis

14

2 Types of articulating surfaces in the SI joint

1. Sacral surface covered in hyaline cartilage

2. Iliac surface covered in fibrocartilage

15

4 Characteristics providing stabilty to the SI Joint

1. 2 joint types in one capsule

2. 2 types of cartilage prevent gliding

3. Irregular joint surfaces add friction

4. Extensive ligaments surrounding joint

16

Structure: Sacral surface/vertical plane level with S1

Short Arm of the Sacrum

17

Structure: sacral surface/AP plane level with S2 to S4

Long Arm of the Sacrum 

18

Term: Sacrum moving on ilium 

Sacroiliac motion

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Term: Innominate moving on the sacrum

Iliosacral motion

20

Term: Innominate

Ilium

21

Term: Lumbar motion

Sacroiliac motion

22

Term: Flexion of the sacrum

Nutation

23

Term: Sacrum moving anterior and inferior

Nutation

24

Term: Extension of the sacrum

Counternutation

25

Term: Sacrum moving superior and posterior

Counternutation

26

Term: Unilateral nutation and counternutation

Sacral Axial rotation 

27

Axis: Axial rotation 

Hypothetical oblique axis

 

Left oblique = right side moving

Right oblique = left side moving

28

Term: Hip motion

Iliosacral motion

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Term: ASIS inferior, PSIS superior

Anterior rotation

30

Term: ASIS superior, PSIS inferior

Posterior Rotation 

31

Functional Biomechanics: Trunk forward bend

Sacrum nutates, then counternutates

Innominates rotate anteriorly 

32

Functional Biomechanics: Trunk backward bending

Sacrum nutates/counternutates/remains relatively stable

Innominates rotate posteriorly

33

Functional Biomechanics: Hip flexion

Sacrum nutates

Unilateral innominate posterior rotation

34

Functional Biomechanics: Hip extension

Sacrum counternutates

Unilateral innominate anterior rotation 

35

Term: Passive stability of bones, joints, and ligaments

Form closure

36

Term: Active/dynamic stability of muscle, fascia, or motor control

Force closure

37

Structure: Blends into biceps femoris and gluteus medius

Sacrotuberous ligament

38

4 (Local) Muscles of the Pelvic Girdle Inner Tube 

1. TA

2. Multifidus

3. Diaphragm

4. Pelvic floor 

39

4 (Global) Muscles of the Pelvic Girdle Outer Tube Longitudinal System

1. Erector spinae

2. T/L Fascia

3. Biceps femoris

4. Sacrotuberous ligament 

40

4 (Global) Muscles of the Pelvic Girdle Outer Tube Anterior Oblique System

1. Internal obliques

2. External obliques

3. Abdominal fascia

3. Contralateral adductors

41

3 (Global) Muscles of the Pelvic Girdle Outer Tube Posterior Oblique System

1. Latissimus dorsi

2. Contralateral gluteus maximus

3. T/L fascia 

42

Term: Systems that compress the SI joint

Outer tube oblique systems

43

3 (Global) Muscles of the Pelvic Girdle Outer Tube Lateral System

1. Gluteus medius

2. Gluteus minimus

3. Contralateral adductors

44

Term: System the copresses the SI joint, prevents shearing in SB, and aids in load transfer

Outer Tube Lateral System

45

2 Muscles that attached directly to the sacrum

1. Piriformis

2. Biceps femoris

46

Structure: When tight rotates the sacrum

Piriformis

47

Structure: When tight counternutates the sacrum

Biceps femoris/HS

48

Condition: MOI can include trauma, pregnancy, chronic L/S or hip problems, pelvic floor dysfunction

SI Joint dysfunction

49

Condition: Body chart can include unilateral pain, buttock pain, LBP, or posterior leg pain to knee

SI Joint Dysfunction

50

Condition: Aggravating Factors

- WB activities: standing, single leg stance, hopping, running

- Ascending/descending staris

- Pain with change of position: sit to stand, moving in bed

SI Joint Dysfunction

51

Term: Most reliable predictor of SI joint dysfunction

Pain provocation tests 

3/5 + has modest predictive power

52

2 mobility tests that assess SI motion

1. Lumbar flexion

2. Lumbar extension

53

2 mobility tests that assess IS motion

1. Gillet flexion

2. Hip extension

54

Describe how sacral dysfunction is named

Named after directio nof rotation and direction of axis

55

Condition: 

- Difficulty with activities requiring posterior rotation

- ASIS anterior and inferior

- PSIS superior

- Functionally long leg

- Decreased hip flex and posterior rotation

Anteriorly Rotated Ilium

56

Condition:

- Difficulty with activities requiring anterior rotation 

- ASIS posterior and superior

- PSIS inferior

- Functionally short leg

- Decreased hip extension and anterior rotation

Posteriorly rotated ilium

57

Condition: 

- Entire ilium higher

- ASIS/PSIS superior

- May have decreased anterior/posterior rotation

- Decreased hip ABD strength

Upslip

58

Condition: ASIS more medial and PSIS more lateral

Inflare

59

Condition: ASIS more lateral and PSIS more medial

Outflare

60

MET: Correction of ilial anterior rotation

Isometric gluteal(/HS) contraction

61

MET: Correction of ilial posterior rotation

Isometric hip flexion contraction

62

CPR to Predict success of lumbopelvic manipulation 

1. < 18 on fear avoidance

2. sx < 15 days

3. No sx distal to knee

4. L-spine hypomobility at any level

5. Either hip with > 35 degree IR

63

Condition: 

- Pain with change in position

- Deep shift/clunk

- Difficulty with WB activities

- Positive stability tests

- Active SLR +

- Pain provocation +/- 

Hypermobile Pelvic Girdle