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LOWER EXTREMITY > Pelvis - ANATOMY AND KINESIOLOGYpart1 > Flashcards

Pelvis - ANATOMY AND KINESIOLOGYpart1 Flashcards

1
Q

PLANES OF MOTION drive

A
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2
Q

Frontal/Coronal

Axis
Movement

A

Z or Horizontal Axis,
A-P Axis

Abduction, adduction /
Inversion, Eversion
* Thumb flexion,
extension

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3
Q

Sagittal

Axis
Movement

A

X or Transverse Axis,
Coronal Axis

Flexion, extension/
Plantarflexion,
Dorsiflexion
* Thumb Abd & Add

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4
Q

Horizontal/Transverse

Axis
Movement

A

Y or Vertical Axis,
Longitudinal Axis

IR, ER

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5
Q

Fibrous Joints
(Synarthroses)

A

Movement minimal to none
sutures, syndesmosis and gomphosis

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6
Q

Type 0f joint

Movement is minimal to none

A

Fibrous Joints
(Synarthroses)

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7
Q

SUTURE
SYNDESMOSIS (Tibia &fibula)
GOMPHOSIS (tooth)

A

Fibrous Joints
(Synarthroses)

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8
Q

Hyaline/fibrocartilage
connects one bone
to another

A

Cartilaginous Joints
(Amphiarthroses)

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9
Q

Type of Joint:

Slightly movable joints

A

Cartilaginous Joints
(Amphiarthroses)

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10
Q

Type of joint

SYNCHONDROSIS (sternum)
SYMPHYSIS

A

Cartilaginous Joints
(Amphiarthroses)

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11
Q

5 distinguishing characteristics:
1. Joint cavity
2. Articular cartilage
3. Synovial membrane
4. Synovial fluid
5. Fibrous capsule

A

Synovial Joints (Diarthroses)

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12
Q

Type of joint:

Free movement

A

Synovial Joints (Diarthroses)

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13
Q

Uniaxial
Biaxial
Multi-axial

A

Synovial Joints (Diarthroses)

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14
Q

Synovial Joints (Diarthroses)

5 distinguishing characteristics:
1. J
2. A
3. S
4. S
5. F

A
  1. Joint cavity
  2. Articular cartilage
  3. Synovial membrane
  4. Synovial fluid
  5. Fibrous capsule
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15
Q

Type of endfeel

Elbow extension

A

Bone to bone (Hard)

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16
Q

Type of endfeel

Knee flexion

A

Soft tissue approximation
(Soft)

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17
Q

Type of endfeel

Ankle dorsiflexion

A

Tissue stretch

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18
Q

Type of abnormal endfeel

Protective spasm after injury

A

Early muscle spasm

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19
Q

Type of abnormal endfeel

Spasm due to instability

A

Late muscle spasm

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20
Q

Type of abnormal endfeel

Tight muscle

A

“Mushy” tissue stretch

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21
Q

Type of abnormal endfeel

UMNL

A

Spasticity

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22
Q

Type of abnormal endfeel

Frozen shoulder

A

Hard capsular

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23
Q

Type of abnormal endfeel

Synovitis

A

Soft capsular

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24
Q

Type of abnormal endfeel

Osteophyte formation

A

Bone to bone

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25
Q

Type of abnormal endfeel

Acute subacromial bursitis

A

Empty

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26
Q

Type of abnormal endfeel

Meniscus tear

A

Springy block

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27
Q

The patient performs the action of the
supraspinatus. The axis of the said motion is at the?

A

Frontal/Coronal plane

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28
Q

Your patient tries to perform heel raises but was only able to lift at a few mm from the floor. Accurate muscle grade?

A

3 minus

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29
Q

PROM assessment of the knee towards
extension. Approximating the end range you felt a springy block that limited you to bring the knee towards extension.

A

Meniscus tear

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30
Q

Pelvis landmark:

ASIS:

AIIS:

PSIS: vs ASIS

A

ASIS: pelvic position, Leg length, q-angle
- Sartorius, inguinal lig, TFL (SIT)

AIIS: O- straight of Rectus femoris

PSIS: vs ASIS - To know the pelvic position. Psis higher than asis

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31
Q

Deep Posterior Longitudinal
System:

  1. ____
  2. ____
  3. ____
A
  1. Erector Spinae
  2. Thoracolumbar Fascia
  3. Hamstring
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32
Q

Iliac Crest

G med: O- ____
TFL: O- ____

A

G med: O- post/outer surface of the ilium
TFL: O- Ant aspect

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33
Q

Pelvis :
- w____
- s____
- m____

Formed by:
- ____
- ____
- ____

A

Pelvis :
- weightbearing
- shock absorption
- mobility

Ilium, ischium and Pubis bone

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34
Q

Iliac fossa:

medial aspect ; O: ____
Gluteal lines: ____

A

medial aspect ; O: Iliacus
Gluteal lines: outer surface

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35
Q

Ischium:
ischial tub: ____
- prox attachment ____and portion of ____

A

ischial tub: wt bearing when sitting
- prox attachment hams and portion of Adductor Magnus

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36
Q
  • smallest of the innominate bones
  • body, inf and sup rami
A

Pubis

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37
Q

Pelvic tilt:

Inc angle : ____
Dec angle: ____

A

Inc angle : Inc APT
Dec angle: PPT

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38
Q

Pelvic Inclination:
Inc: ____
dec: ____

Neutral Position:

  • __SIS > __SIS ( ___ FB)
    -Lumbar spine: Neutral ; N lordosis
  • Hip neutral
    N Pelvic tilt: ave- _degrees
A

Inc: APT
dec: PPT

Neutral Position:
- least amt of stress

  • PSIS > ASIS ( 1-2 FB)
    -Lumbar spine: Neutral ; N lordosis
  • Hip neutral
    N Pelvic tilt: ave- 11 degrees
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39
Q

N pelvic inclination:
____ brunstrom
____- magee

A

50-60 bruns
30 - magee

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40
Q

APT/ Ant Innom Rot ( AIR)

  • Inclined ____
  • ____Up, ____down
  • Lumbar spine: ____ lordosis
  • hip jt: ____
A
  • Inclined fwd
  • PSIS Up, ASIS down
  • Lumbar spine: inc lordosis
  • hip jt: flexion
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41
Q

Posterior Pelvic Tilt/ PIR
- Inclined ____
- ____Up; ____down
- Lumbar spine: ____-> dec lordosis
- hip jt: ____

A
  • Inclined bwd
  • ASIS Up; PSIS down
  • Lumbar spine: flexion-> dec lordosis
  • hip jt: extension
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42
Q

Hip Hiking:
- elev of the ____side of pelvis
- Hiking of R pelvis around L hip jt = L hip abduction

A

Hip Hiking:
- elev of the opp side of pelvis
- Hiking of R pelvis around L hip jt = L hip abduction

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43
Q

Pelvic Drop:
- drop of the ____pevis
- Dropping on R pelvis around the left jt= L joint Adduction

A

Pelvic Drop:
- drop of the opp pevis
- Dropping on R pelvis around the left jt= L joint Adduction

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44
Q

PELVIC MOTION to hip mvmts

Anterior pelvic tilt - ____
Posterior pelvic tilt - ____

Lateral pelvic tilt(Pelvic drop – RLE stance) - ____
Lateral pelvic tilt(Pelvic hike – RLE stance) - ____

Forward rotation(RLE stance) - ____
Backward rotation(RLE stance) - ____

A

Anterior pelvic tilt - Hip flexion
Posterior pelvic tilt - Hip extension

Lateral pelvic tilt (Pelvic drop – RLE stance) - Right hip adduction
Lateral pelvic tilt(Pelvic hike – RLE stance) - Right hip abduction

Forward rotation(RLE stance) - Right hip medial rotation
Backward rotation(RLE stance) - Right hip lateral rotation

45
Q

HIP to innominate rotation

Flexion
Extension
Medial rotation
Lateral rotation
Abduction
Adduction

A

INNOMINATE

Flexion - Posterior rotation

Extension - Anterior rotation

Medial rotation - Inflare (medial rotation)

Lateral rotation - Outflare (lateral rotation)

Abduction - Superior glide

Adduction - Inferior glide

46
Q

ANTERIOR PELVIC TILT

L.A.C.E.

Strong muscles:
Weak muscles:

A

Lordosis
Anterior pelvic tilt
Counternutation
Extension of back

  • Strong muscles: Hip flexors &
    lumbar extensors
  • Weak muscles: Hip extensors
    & abdominals
47
Q

POSTERIOR PELVIC TILT

Kyphosis
Posterior pelvic tilt
Nutation
Flexion of back

Strong muscles: ____
Weak muscles: ____

A

Kyphosis
Posterior pelvic tilt
Nutation
Flexion of back

Strong muscles: Hip extensors &
abdominals
Weak muscles: Hip flexors &
lumbar extensors

48
Q

Pelvic Rot: ____degrees

A

Pelvic Rot: 8 degrees

49
Q

Lower Crossed Syndrome:
Shortened: ____
Lengthened: ____

  • Hams - tight d/t ____
A

Shortened: iliopsosas & erectors
Lengthened: G max and Abs
* Hams - tight d/t attempt to PPT

50
Q

(L) HIP HIKE

ipsi and contralateral

A

Right abduction
Left Adduction

51
Q

(L) pelvic drop

right and left?

A

Right Adduction
Left Abduction

52
Q

(L) pelvic drop bilateral

A

Right Adduction
Left Abduction

53
Q

Pelvic rotation of left forward

A

Right Medial rotation

54
Q

hip flexion c knee extension muscles involved mm?:

Abdominals: PPT - stabilize pelvis

if weak ABS: ____

A

rec fem, APT

Abdominals: PPT - stabilize pelvis

if weak ABS: inc lordosis

55
Q

AIR

L
S
S

ASIS: ____
PSIS: ____

A

Supine/Standing

Long sitting/Standing with trunk flexion

Sitting with reaching toes

ASIS: INF
PSIS: SUP

56
Q

Posterior Innominate Rotation

S
L
L

ASIS: SUP
PSIS: INF

A

Supine/Standing

Long sitting/Standing with trunk flexion

Sitting with reaching the toes

ASIS: SUP
PSIS: INF

57
Q

Landmarks to get the leg length

*True leg length: ____

*Functional : ____

A

*True leg length: ASIS to med /lat malleoli

*Functional : Xiphisternum/ umbilicus to med malleoli

58
Q

PELVIC DYSFUNCTION

Anterior Innominate Rotation

Tight?
Stretch?
Strengthen?

A

Tight iliopsoas muscle

Stretch Iliopsoas

Strengthen the gluteus maximus

59
Q

PELVIC DYSFUNCTION

Posterior Innominate Rotation

caused by?
Stretch?
Strengthen?

A

Caused by hamstring muscle

Stretch hamstring

Strengthen the quads muscle
(concentric contraction)

60
Q

Case 1:

(R) PSIS higher
(R) ASIS lower

(R) LE longer in supine

A

(R) AIR

ALSU

61
Q

Case 2:

(L) PSIS lower
(L) ASIS higher

(L) LE longer in long sitting

A

(L) PIR

62
Q

Case 3:

(R) PSIS higher
(L) ASIS higher

(R) LE shorter when trying to reach the toes

A

(R) AIR

63
Q

Case 4:

(L) PSIS higher
(L) ASIS higher

(R) LE longer in supine

A

(L) UPSLIP

kase same side umangat

64
Q

Upslip:
- sup subluxation of innominate on the sacrum
- Upslip limb: ____
- sup positioning of ASIS, PSIS, Iliac crest , pubic tubercle and ischial tub
- tight ____

Tx: ____, ____

A

Upslip:
- sup subluxation of innominate on the sacrum
- Upslip limb: shorter
- sup positioning of ASIS, PSIS, Iliac crest , pubic tubercle and ischial tub
- tight Quadratus Lumborum
Tx: jt mobilization, distraction forces

65
Q

SACROILIAC JOINT

PRIMARY LIGAMENTS
1.
2.
3.

SECONDARY LIGAMENTS
1.
2.

Function of ligaments?

A

PRIMARY LIGAMENTS
1. Anterior sacroiliac
2. Posterior sacroiliac
3. Interosseous

SECONDARY LIGAMENTS
1. Sacrotuberous
2. Sacrospinous

For stability and prevents rotation

66
Q

Sacrum:
- base- sup: ______
- apex: inf , ______
Inf lat angle: ______- point where the lower portion of sacrum curves med

A
  • base- sup: ______
  • apex: inf , ______
    Inf lat angle: ______- point where the lower portion of sacrum curves med
  • base- sup: Sacral Promontory
  • apex: inf , coccyx
    Inf lat angle: ILA - point where the lower portion of sacrum curves med
67
Q

SI Jt:
- transfer of wt from ______ to ______
- S ______
- Relative ______- young;
______as age progresses

A
  • transfer of wt from spine to LE
  • Shock absorber
  • Relative mobile- young; stiffen as age progresses
68
Q

SACROILIAC JOINT

Resting position: ______
Close pack: ______
Open pack: ______
Capsular pattern: Pain when joints are ______

A

Resting position: Neutral
Close pack: Nutation
Open pack: Counternutation
Capsular pattern: Pain when joints are stressed

69
Q

SACRAL MOVEMENT <drive></drive>

x2

A

SACRAL MOVEMENT <drive></drive>

x2

70
Q

LUMBO-PELVIC RHYTHM <drive></drive>

A

LUMBO-PELVIC RHYTHM <drive></drive>

71
Q

Sacrum

Nutation
Short part: ______
Long part: ______
Sacrum: ______
Pelvis : ______

Counternutation
Long arm: ______
Short arm: ______
Sacrum: ______
Pelvis: ______

A

Nutation
Short part: down
Long part: post
Sacrum: Ant torsion
Pelvis : PPT

Counternutation
Long arm: slide ant
Short arm: Sup
Sacrum: Backward torsion
Pelvis: APT

72
Q

Lumbopelvic rhythm:
a.) Head and trunK fwd
b.) ____dg - nutate ( PPT)
c.) ____deg - counternutation (APT)
= reach more
** Hams and gluts - eccentric contraction to control

A

Head and trunK fwd
45 dg - nutate ( PPT)
60 deg - counternutation (APT)
= reach more
** Hams and gluts - eccentric contraction to control

73
Q

PELVIC MOTIONS WITH
LUMBAR SPINE MOVEMENT <drive></drive>

A

PELVIC MOTIONS WITH
LUMBAR SPINE MOVEMENT <drive></drive>

74
Q

Naming sacral torsion:

______ on ______

  1. By the direction that the front of the sacrum
    faces
  2. By the axis of the movement

If same ang letters: Forward torsion (nutation)
if diff letters: Bwd torsion (counternutation)

A

Naming sacral torsion:

______ on ______

  1. By the direction that the front of the sacrum
    faces
  2. By the axis of the movement

If same ang letters: Forward torsion (nutation)
if diff letters: Bwd torsion (counternutation)

75
Q

SACRAL MOVEMENTS

L on L

A

R SB deeper , L ILA more prominent

76
Q

SACRAL MOVEMENTS

R on L:

A

R SB more palpable, L ILA deeper

77
Q

SACRAL MOVEMENTS

R on R

A

L SB deeper, R ILA more post

78
Q

SACRAL MOVEMENTS

L on R

A

L SB more palpable, R ILA deeper

79
Q

FWD torsion: Nutation

PPT

tight : ____
Weak: ____

A

tight : G max
Weak: iliopsosas

80
Q

BWD Torsion:

Counternutation
- APT
Tight mm: Iliopsoas
weak : G max

A

Tight mm: ____
weak : ____

81
Q

Sphinx position: Prone to
POE

  • ____
    (Asymmetrical) BACKWARD torsion
  • ____
    FORWARD
    torsion

Extension of the spine-> APT =
counternutation

A

Sulcus deeper/prominent
(Asymmetrical) BACKWARD torsion
Sulcus symmetrical FORWARD
torsion

Extension of the spine-> APT =
counternutation

82
Q

Sphinx position:

Ex:
Prone: L SB is deeper than R
POE: L SB is level c R SB

A
  • inc symmetry - ant torsion of sacrum/ nutate
  • R axis
83
Q

Sphinx position:

Prone: L SB is deeper than R
POE: L SB is even deeper than the R

A

(non moving landmark)
- dec symmetry - post torsion ( counternutate)
- L axis

84
Q

Superficial Posterior
Oblique System:

  1. ____
  2. ____
  3. ____
A
  1. Latissimus Dorsi
  2. Gluteus Maximus
  3. Thoracolumbar Fascia
85
Q

Innermost Muscle group:
- actively ____ pelvic jts, lumbar spine
- ____ mm

A
  • actively stabilizing pelvic jts, lumbar spine
  • true core mm
86
Q

Anterior Oblique System:

  1. ____and ____
  2. ____
  3. ____
A
  1. Internal and External
    Obliques
  2. Contralateral Adductors
  3. Abdominal Fascia
87
Q

Lateral Muscle System:

  1. ____
  2. ____
A
  1. Gluteus Medius
  2. Contralateral Adductors
88
Q

Innermost Muscle Group:

  1. ____
  2. ____
  3. ____
A
  1. Transverse Abdominis
  2. Multifidus
  3. Pelvic floor muscles
89
Q

Cartilaginous joint; has a fibrocartilaginous
interpubic disc

A

Symphysis Pubis

90
Q

Cartilaginous joint between apex of the sacrum
and base of coccyx

A

Sacrococcygeal Joint

91
Q

TEST FOR SACROILIAC JOINT
INVOLVEMENT

1.
2.
3.
4.
5.
6.
7.

A
  1. APPROXIMATION TEST
  2. GAPPING TEST (Transverse Anterior
    Stress or Distraction Provocation)
  3. SACRAL APEX PRESSURE TEST/AKA PRONE SPRINGING TEST / CRANIAL SHEAR / MIDLINE SACRAL THRUST / SACRAL THRUST
  4. THIGH THRUST TEST

AKA OOSTAGARD, 4P, SACROTUBEROUS STRESS,
OR POSTERIOR PELVIC PAIN PROVOCATION TEST
5. GAENLEN’S TEST
6. SACROILIAC ROCKING TEST aka Knee to
Shoulder or Sacrotuberous Test
7. SLR (LASEGUE’S TEST)

92
Q

APPROXIMATION TEST

Procedure:
(+):
Indication:

A
  • Side-lying
  • Downward pressure
    over iliac crest
  • (+) increase pressure
    felt on SI joint
    indicates SPRAIN of
    POSTERIOR SI JOINT
    LIGAMENT
93
Q

GAPPING TEST (Transverse Anterior
Stress or Distraction Provocation)

Procedure:
(+):
Indication:

A
  • Supine (pushes down &
    outward)
  • (+) unilateral gluteal
    pain/posterior leg pain
    indicates SPRAIN OF THE
    ANTERIOR SACROILIAC
    LIGAMENT
94
Q

SACRAL APEX PRESSURE TEST

AKA PRONE SPRINGING TEST / CRANIAL SHEAR / MIDLINE

SACRAL THRUST / SACRAL THRUST

Procedure:
(+):
Indication:

A
  • Prone
    -Base of his or her hand
    at the apex of the
    patient’s sacrum ->
    pressure
  • (+) pain over the joint
    indicate a SACROILIAC
    JOINT PROBLEM
95
Q

THIGH THRUST TEST

AKA OOSTAGARD, 4P, SACROTUBEROUS STRESS,
OR POSTERIOR PELVIC PAIN PROVOCATION TEST

Procedure:
(+):
Indication:

A
  • Supine,90 deg of hip
    flex
  • Palpate SI joint, thrust
    down
  • (+) pain on SI joint
96
Q

GAENLEN’S TEST <drive></drive>

A
97
Q

SACROILIAC ROCKING TEST aka Knee to
Shoulder or Sacrotuberous Test

Procedure:
(+):
Indication:

A
  • Supine
  • Flex the knee and
    hip fully then
    adduct
  • (+) Pain in SI joint
98
Q

SLR (LASEGUE’S TEST)

Procedure:
(+):
Indication:

<drive>
</drive>

A
  • Patient in supine, passive hip
    flexion with knee extended
  • (+) SI joint pathology

Confirmed with unilateral SLR
– pain is elicited >70 degrees hip
flexion

Confirmed with bilateral SLR
– (+) pain < 70 degrees of hip
flexion

99
Q

SLR (LASEGUE’S TEST)

  • ____ patients
  • Compare active SLR only
    vs active SLR with
    compression (squeezing
    innominate bones together)
    (+):
    Indication:
A
  • Postpartum patients
  • Compare active SLR only
    vs active SLR with
    compression (squeezing
    innominate bones together)
  • (+) Easier to SLR / pain
    decreases with compression
    indicates SI JT PROBLEM
  • SI belt
100
Q

Test for Hamstring
tightness

1.
2.

A
  1. Tripod Sign
  2. 90-90 SLR
101
Q

Tripod Sign

Procedure:
(+):
Indication:

A
  • Sitting dangling
  • Passive extension of each knee
  • (+) patient extends the trunk or
    patient leans backward
102
Q

90-90 SLR

Procedure:
(+):
Indication:

A
  • 90 hip flex, 90 deg knee flexion
  • Actively extend each knee
  • N: within 20 deg of full extension
  • (+) <125 deg angle between tibia and
    femur
103
Q

STANDING FLEXION..

Procedure:
(+):
Indication:

A
  • Palpate PSIS (sacrum / SI jt)
  • Ask pt to bend forward
  • N: pelvis -> APT -> PSIS up
  • (+) PSIS moves upward less
    than the other -> HYPOMOBILE
    ILIUM ON THE SACRUM
104
Q

FLAMINGO TEST

Procedure:
(+):
Indication:

A
  • aka One leg standing
  • (+) pain on SI joint or Symphysis
    pubis
  • Inc stress: hop on leg
  • Stress Xray position: symphysis pubis
105
Q

GILLET’S TEST (ipsilateral
posterior rotation test)

Procedure:
(+):
Indication:

A
  • palpate: PSIS & sacrum
  • One leg stance, ask patient to
    flex other knee
  • N: PIR -> PSIS down
  • (+) PSIS moves minimally or up =
    hypomobility or block
106
Q

IPSILATERAL ANTERIOR
ROTATION TEST

Procedure:
(+):
Indication:

A
  • Palpate: PSIS, sacrum (SI jt)
  • Ask step back - hip extends
  • N: AIR -> PSIS up (sup and lat)
  • (+) no identified movement of
    PSIS = SI JOINT PROBLEM
107
Q

GOLDTHWAIT’S TEST <drive></drive>

A

GOLDTHWAIT’S TEST <drive></drive>

108
Q

Patrick’s Test (FABER, “Figure-4”
or Jansen’s Test) <drive></drive>

A

Patrick’s Test (FABER, “Figure-4”
or Jansen’s Test) <drive></drive>

109
Q

PIEDALLU’S SIGN

Procedure:
(+):
Indication:

A
  • Sit on stable and firm surface
    (stab. Pelvis)
    Palpate: PSIS
    Active forward flexion
    N: sacrum - ant, pelvis - no
    movement
    (+) PSIS move up - ant rot of pelvis
    -> SI JOINT -HYPOMOBILITY

LOWER EXTREMITY (3 decks)

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