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OS II Midterm > Sacrum Lab > Flashcards

Sacrum Lab Flashcards

1
Q

What is the respiratory effect of inhalation upon the sacrum?

A
  • abdominal cavity contents increase in AP diameter as diaphragm flattens
  • lumbar lordotic curve decreases (flattens out)
  • sacral base moves posteriorly
  • sacral apex moves anteriorly
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2
Q

What is the respiratory effect of exhalation upon the sacrum?

A
  • abdominal cavity contents decrease in AP diameter as diaphragm domes
  • lumbar lordotic curve increases
  • sacral base moves anteriorly
  • sacral apex moves posteriorly
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3
Q

Lumbar Spring Test

A
  • pt prone, use one or both palms to firmly push the lumbosacral junction in an anterior direction several times
  • negative test = ease of springing; preference for anterior/forward sacral base motion
  • positive test = resistance to springing; preference for posterior sacral base motion
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4
Q

Lumbar Spring Interpretation: Negative

A

Negative: flexed

  • left/right unilateral flexion
  • R/R sacral torsion
  • L/L sacral torsion
  • bilateral flexion
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5
Q

Lumbar Spring Interpretation: Positive

A

Postive: Extended

  • left/right unilateral extension
  • R/L sacral torsion
  • L/R sacral torsion
  • bilateral extension
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6
Q

Backward Bending Sphinx Test

A

1) pt prone
2) physician determines static position of and monitors bilateral sacral sulci and/or ILAs
3) pt instructed to push up on their elbows in extended position (sacral base should move anteriorly and ILAs should move posteriorly)

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7
Q

Positive sphinx test

A

inequity between right and left increases (worsens) = posterior/backward

left/right unilateral extension
L/R sacral torsion
R/L sacral torsion

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8
Q

Negative sphinx test

A

sacral sulci and ILAs even out during the exam = anterior/forward

Left/right unilateral flexion
L/L sacral torsion
R/R sacral torsion

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9
Q

What could a deep on right sacral sulcus indicate?

A

right unilateral flexion
left unilateral extension
L/L sacral torsion
L/R sacral torsion

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10
Q

What could a deep left sacral sulcus indicate?

A

left unilateral flexion
right unilateral extended
R/R sacral torsion
R/L sacral torsion

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11
Q

What could a posterior/inferior ILA on the right indicate?

A

right unilateral flexion
left unilateral extended
R/L sacral torsion
R/R sacral torsion

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12
Q

What could a posterior/inferior ILA on the left indicate?

A

left unilateral flexion
right unilateral extension
L/R sacral torsion
L/L sacral torsion

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13
Q

Where do you gap the SI joint to facilitate extension?

A

posterior via internal rotation

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14
Q

Where do you gap the SI joint to facilitate flexion?

A

anterior via external rotation

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15
Q

Bilaterally extended sacrum findings

A 
bilaterally positive lateralization = false negative
bilateral posterior sacral sulci
bilateral anterior/superior ILA
\+ LS
false - BBT
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16
Q

Bilaterally extended sacrum MET/ART

A

Setup: each SI individually and monitor
Abduct leg until motion felt
Externally rotate patient’s legs
Gap anterior aspect of the SI joints
Place heel of the hand on the sacral base
Instruct pt to assume prone TV watching position
MET: with heel of hand apply anterior/inferior force to engage RB, have pt breathe deeply and encourage motion associated with exhalation and resist posterior/superior motion associated with inhalation
ART: apply a springing motion with heel of hand in anterior/inferior direction until motion improves

17
Q

Bilaterally flexed sacrum findings

A 
bilaterally positive = false negative lateralization
bilateral anterior sacral sulci
bilateral posterior/inferior ILA
- LS test
- BBT
18
Q

Bilaterally flexed sacrum ME/ART

A

Setup: each SI individually, monitor
Abduct leg until motion felt
Internally rotate to gap posterior aspect
place heel of hand across apex of sacrum
ME: with heel of hand apply anterior/superior force to engage the RB, have pt breathe deeply and encourage anterior/superior motion associated with inhalation and resist posterior/inferior motion associated with exhalation
ART: apply springing motion with heel of hand in anterior/superior direction until motion improves

19
Q

Unilateral Flexed Sacrum findings (left)

A 
\+ left lateralization 
Left deep sacral sulcus
Lest posterior/inferior ILA
- LS
- BBT
20
Q

Unilaterally Flexed Sacrum ME/ART

A

Setup: monitor SI joint, abduct leg until motion felt, internally rotate leg to gap posterior aspect of SI joint
ME: with heel of hand apply anterior/superior force to engage barrier; encourage anterior/superior motion associated with inhalation and resist posterior/inferior motion associated with exhalation
ART: apply springing motion with the heel of hand in anterior/superior direction until motion improves

21
Q

Unilaterally Extended Sacrum Findings (left)

A

+ Left Lateralization test
Right deep sacral sulcus (left posterior sacral sulcus)
Right posterior/inferior ILA (left anterior/superior ILA)
+ LS test
+ BBT

22
Q

Unilaterally Extended Sacrum ME/ART

A

Setup: monitor SI joint, abduct leg until motion felt, externally rotate leg to gap anterior aspect of SI joint, place heel on sacral base of affect side, instruct pt to assume prone TV watching position
ME: apply anterior/inferior force to engage restrictive barrier; encourage anterior/inferior motion with exhalation, resist posterior/superior motion with inhalation
ART: apply springing motion with heel of hand in anterior/inferior direction until motion improves

23
Q

Which unilateral SD do you encourage exhalation and resist inhalation?

A

Unilateral extended (when inhale, sacrum is extending)

24
Q

Which unilateral SD do you encourage inhalation and resist exhalation?

A

Unilateral Flexed (when exhale, sacrum is flexing)

25
Q

What is the SI Rocking Oblique Axis Test used to confirm?

A

torsion; axis determined by side around which there is greatest motion

26
Q

How to test SI rocking oblique axis

A

place thumb over posterior aspect of left ILA and other thumb over right sacral base, apply anterior pressure alternating between the two thumb pads to assess motion (then switch sides)

27
Q

Left Oblique Axis interpretations

A

Right on Left sacral torsions

Left on Left sacral torsions

28
Q

Right Oblique Axis interpretations

A

Right on Right sacral torsions

Left on Right sacral torsions

29
Q

Forward Sacral Torsion findings (left on left)

A 
\+ right lateralization test
Right anterior sacral sulci
Left posterior/inferior ILA
- LS
- BBT
Compensated L5: N Rr Sl
30
Q

Forward Sacral Torsion ME/ART (modified sims position)

A

1) pt lateral recumbent, axis side down
2) pt’s chest toward the table (“forward”)
3) physician monitors L5-S1 interspaces and flexes pt’s hips and knees until motion is felt at monitoring hand (90 degrees)
4) with caudal hand, lower pt’s ankles towards floor until reaching sidebending restrictive barrier
ME: instruct pt to lift feet towards ceiling for 3-5 seconds, then proceed with ME treatment
ART: use springing towards the floor technique to repetitively engage and treat the RB until TART changes maximally improve

31
Q

Backward Sacral Torsion findings (left on right)

A

+ left lateralization test
Right deep sacral sulcus (left posterior sacral sulcus)
Left posterior/inferior ILA (right anterior/inferior ILA)
+ LS
+ BBT
Compensated L5: F/E Rr Sr

32
Q

Backward Sacral Torsion ME/ART (lateral recumbent position)

A

1) pt lie lateral recumbent, axis side down
2) have pt drop top shoulder posteriorly so their back is toward the table
3) physician monitors L5-S1 interspace, flex top hip and knee to 90 degrees and add hip flexion/extension to localize
4) apply gentle force on pt’s knee towards the floor (adducting top hip), until motion felt at L5-S1 and restrictive barrier engaged
ME: instruct patient to lift knee toward ceiling for 3-5 seconds, then proceed with ME treatment
ART: use springing towards the floor technique to repetitively engage and treat restrictive barrier until TART changes improved

33
Q

Which sacral SD will look like a right unilateral flexion?

A

left unilateral extension

34
Q

Which sacral SD will look like a left unilateral flexion?

A

right unilateral extension

35
Q

Which sacral SD will look like a right on right torsion?

A

right on left torsion (turned the same way)

36
Q

Which sacral SD will look like a left on left torsion?

A

left on right torsion (turned the same way)

OS II Midterm (14 decks)

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