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OS2 Midterm > Sacrum > Flashcards

Sacrum Flashcards

(65 cards)

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1
Q

Where are the sacral base and apex?

A
  • sacral base - next to L5 (superior)

- sacral apex - next to the coccyx (inferior)

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2
Q

What does the inferior lateral angle of the sacrum signify?

A

where the sacrum angulates towards the apex

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3
Q

What does the sacrum articulate with?

A
  • L5 superiorly
  • coccyx inferiorly
  • innominate on either side through SI joints
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4
Q

Do males or female have more well developed SI joints after puberty?

A

males more well developed; females less developed allowing for mobility during childbirth

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5
Q

Long dorsal SI L. attachment

A

connects PSIS to lateral aspect of 3rd and 4th sacral segments

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6
Q

When does the long dorsal SI L become stretched?

A
  • when the sacrum is rotated posteriorly
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7
Q

Which muscle attaches to the sacrotuberous L.?

A

gluteus maximus M.

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8
Q

Which muscle connects the UE w/ the sacrum?

A

latissimus dorsi M.

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9
Q

What 3 muscles make up the elevator ani?

A
  • puborectalis M.
  • pubococcygeus M.
  • ilioccygeus M.
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10
Q

Name 6 muscles that make up the pelvic diaphragm

A
  • piriformis M.
  • ischiococcygeus M.
  • obturator internus M.
  • puborectalis M.
  • pubococcygeus M.
  • ileoccygeus M.
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11
Q

What is the form closure of the sacrum?

A

self-locking mechanism based on how the joints physically fit the pelvis and sacrum together

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12
Q

What is the force closure of the sacrum?

A

self-locking mechanism due to external forces compressing the sacrum to keep it in place (gravity, loading forces, muscles, fascia, and ligaments)

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13
Q

How are oblique axis named?

A

named according to the side of the body the superior end of the axis is located

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14
Q

What happens to the sacrum as the lumbar spine is flexed?

A

sacrum is extended

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15
Q

What happens to the sacrum as the lumbar spine is extended?

A

sacrum is flexed

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16
Q

What is another name for sacral extension? What happens to the sacrum in this motion?

A

counternutation - base moves posteriorly, apex moves anteriorly

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17
Q

What is another name for sacral flexion? What happens to the sacrum in this motion?

A

nutation - base moves anteriorly, apex moves posteriorly

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18
Q

What is lumbarization?

A

First sacral segment becomes an additional lumbar vertebrae

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19
Q

What is sacralization?

A

incomplete separation and differentiation of L5 - takes on characteristics of sacral vertebrae

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20
Q

Name 4 sacral static tests

A
  • sacral sulcus
  • L5 (rotation)
  • inferior lateral angle (ILA)
  • 4 digit examination
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21
Q

How do you find the sacral sulcus?

A

find the PSIS w/ thumbs -> move thumbs medially and inferiorly -> check for symmetry

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22
Q

How do you find the inferior lateral angle?

A
  • palpate w/ heel of hand midline down to where the sacrum drops anteriorly
  • place thumb near thenar eminence to feel ILA
  • place other thumb roughly symmetrical to the first
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23
Q

How do you perform a 4 point evaluation?

A
  • place index fingers in sacral sulci
  • place thumbs at ILAs
  • evaluate for symmetry
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24
Q

What type of testing is the seated forward bending test? What is its abbreviation?

A

lateralization - tells side of dysfunction - SeFBT

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25
With what type of dysfunction with the SeFBT be negative?
in bilateral dysfunctions
26
On what side will the SeFBT be positive in unilateral and torsion dysfunctions?
- unilateral: positive on side of dysfunction | - Torsion: positive on opposite side of axis (2nd letter of dx)
27
What are 2 sacral active motion tests and what do they examine?
- backward bending test (BBT) (sphinx) - respiratory motion - examine flexion and extension motion
28
What does a positive and negative BBT show?
negative BBT: flexed sacrum | positive BBT: extended sacrum
29
In which directions should the sacral base move during the respiratory motion test?
inhalation: base should move posteriorly exhalation: base should move anteriorly
30
Name 2 sacral passive motion tests and what they both show
- lumbar spring test (LS) - shows flexion/extension | - oblique axis passive motion - shows dysfunctional oblique axis
31
How do you perform a lumbar spring test? What does a positive test look like?
- pt lying prone - heel of your hand placed over spinous process of lumbar spine - push spine towards the table to extend it - Positive if the lumbar spine does not move well into extension
32
What do both positive and negative lumbar spring tests indicate?
- negative = flexed sacrum | - positive = extended sacrum
33
How do you perform an oblique axis passive motion test?
- pt is prone - place monitoring finger on sacral sulcus and heel of opposite hand on contralateral ILA - apply anterior pressure w/ heel of hand at ILA and monitor for posterior motion of opposite sulcus
34
At what level is the middle transverse axis located? What type of dysfunction will be found here?
S2 anteriorly; dysfunction will be bilateral
35
At what level is the inferior transverse axis?
S3
36
At what level is the superior transverse axis?
S2 posteriorly
37
On what side will there be a deep sacral sulcus along the left/right oblique axis?
opposite side of the posterior/caudal ILA
38
On what side will there be a deep sacral sulcus along the transverse axis?
same side as the posterior/caudal ILA
39
Along which axis are torsion, unilateral, and bilateral dx restricted?
- torsion: oblique axis - unilateral: vertical axis - bilateral: middle transverse axis
40
What type of torsions are held anteriorly and posteriorly?
- anterior = flexed | - posterior = extended
41
How do you a name sacral torsion dx?
- first part named for rotation of sacrum (direction its facing) - second part named for axis (left or right)
42
Difference in naming flexed/extended sacral torsions
- flexed will be the same letter (left on left/right on right) - extended will be opposite letter (left on right/right on left)
43
What will the SeFBT, BBT, and LS show with a L/L ST? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT positive on the right - LS and BBT negative (sacrum already stuck in flexion) - deep sacral sulcus on right - posterior ILA on left
44
What will the SeFBT, BBT, and LS show with a R/R ST? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT positive on the left - LS and BBT negative (sacrum already stuck in flexion) - deep sacral sulcus on the left - posterior ILA on the right
45
What will the SeFBT, BBT, and LS show with a L/R ST? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT positive on the left (side of dysfunction) - LS and BBT positive (sacrum stuck in extension, can't flex) - deep sacral sulcus on the right - posterior ILA on the left
46
What will the SeFBT, BBT, and LS show with a R/L ST? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT positive on the right - LS and BBT positive (sacrum stuck in extension, can't flex) - deep sacral sulcus on the left - posterior ILA on the right
47
What type of unilateral SDs are held anteriorly and posteriorly?
- anteriorly = flexed | - posteriorly = extended
48
On what side will the deep sacral sulcus be for unilateral SDs?
on the same side as the posterior ILA
49
What will the SeFBT, BBT, and LS show with a RSF (right sacrum flexed)? On which side will you find the deep sacral sulcus and posterior ILA?
- unilateral - SeFBT positive on the right - LS and BBT negative (sacrum already flexed) - deep sacral sulcus on the right - posterior ILA on the right
50
What will the SeFBT, BBT, and LS show with a LSF (left sacrum flexed)? On which side will you find the deep sacral sulcus and posterior ILA?
- unilateral - SeFBT positive on the left - LS and BBT negative (sacrum already flexed) - deep sacral sulcus on the left - posterior ILA on the left
51
What will the SeFBT, BBT, and LS show with a LSE (left sacrum extended)? On which side will you find the deep sacral sulcus and posterior ILA?
- unilateral - SeFBT positive on the left - LS and BBT positive (sacrum stuck in extension, can't flex) - deep sacral sulcus on the right - posterior ILA on the right
52
What will the SeFBT, BBT, and LS show with a RSE (right sacrum extended)? On which side will you find the deep sacral sulcus and posterior ILA?
- unilateral - SeFBT positive on the right - LS and BBT positive (sacrum stuck in extension, can't flex) - deep sacral sulcus on the left - posterior ILA on the left
53
What will the SeFBT show with a bilateral sacrum flexed? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT negative (no lateralization) | - bilateral deep sacral sulci and posterior ILA
54
What will the SeFBT show with a bilateral sacrum extended? On which side will you find the deep sacral sulcus and posterior ILA?
- SeFBT negative (no lateralization) | - bilateral shallow sacral sulci (no deep) and anterior ILA (no posterior)
55
What does it mean to say L5 is compensated or uncompensated?
- compensated if rotated in the opposite direction of the sacrum (balance) - uncompensated if rotated in the same direction as the sacrum (no balance)
56
What should be treated first if L5 is uncompensated?
L5 before the sacrum
57
What type of SD are L/L ST and R/R ST?
flexed
58
What type of SD are L/R ST and R/L ST?
extended
59
What does a flexed sacrum mean for L5 mechanics?
flexed sacrum means a neutral (Type 1) L5
60
What does an extended sacrum mean for L5 mechanics?
extended sacrum means a non-neutral (Type 2 flexed/extended) L5
61
In what direction should L5 be sidebent and rotated on the sacrum?
L5 should be rotated in opposite direction of sacrum (compensated) - L5 should be sidebent toward the oblique axis of the torsion (opposite of rotation)
62
What should L5 be if you have a R/R ST?
L5 should be rotated left and sidebent right
63
What should L5 be if you have a L/L ST?
L5 should be rotated right and sidebent left
64
What should L5 be if you have a L/R ST?
L5 should be rotated right and sidebent right
65
What should L5 be if you have a R/L ST?
L5 should be rotated left and sidebent left

OS2 Midterm (5 decks)

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