Flashcards in Pelvic Exam Deck (13)
How is the iliolumbar ligament palpated?
- Roll off posterior edge of iliac crest
- Find L4/ L5 interspace
- Move down to L5, and palpate back towards the iliac crest
- Palpate rope like ligament
How can the PSIS be distinguished from fatty deposits in the low back?
- Pt standing
- Pt flexes hip causing anterior pelvic rotation
- PSIS will slip under the palpation finger
- Fatty nodules will not move
How is the sacral sulcus palpated?
- Drop medially and inferiorly from the PSIS into the deep sacral sulcus.
How is the inferor lateral angle of the sacrum palpated?
- Palpate along the sacral sulci
- When the innominate turns continue downwards and feel for the angle
How is the piriformis palpated?
- Make a T of the greater trochanter, ichial tuberosity, and coccyx.
- Piriformis will be the base of the T
How are the ischial tuberosities palpated?
- Ask for consent first
- Find gluteal fold
- Fall off the fold
- Come superiorly
- Palpate into tuberosities
What 2 impairments may be palpated at the ischial tuberosities during palpation?
- Ischial bursitis
- Hamstring inflammation/ irritation
How are the pubic tubercles palpated?
- Obtain consent
- Palm the abdomen
- Walk the hand down
- Find it, and feel it with the thumbs
- Can have female patient find it themselves and use their thumbs as dummy thumbs
- May palpate the pubic symphysis for pain
How can the ASIS be palpated more consistently?
- Move the thumb directly under the ASIS
In what positions should the pelvic landmarks be palpated?
What 10 landmarks should be palpated during the pelvic exam?
- Iliac crest
- Ilio-lumbar ligament
- Sacral sulcus
- Sacral inferior lateral angles
- Ischial tuberosities
- Pubic tubercles/ pubic symphysis
What is the 4 (or 5) item test cluster for SIJ dysfunction?
- Thigh thrust
- Sacral thrust
- Gaenslen's (?)