Sacrum Lab Flashcards
What is the respiratory effect of inhalation upon the sacrum?
- abdominal cavity contents increase in AP diameter as diaphragm flattens
- lumbar lordotic curve decreases (flattens out)
- sacral base moves posteriorly
- sacral apex moves anteriorly
What is the respiratory effect of exhalation upon the sacrum?
- abdominal cavity contents decrease in AP diameter as diaphragm domes
- lumbar lordotic curve increases
- sacral base moves anteriorly
- sacral apex moves posteriorly
Lumbar Spring Test
- 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
Lumbar Spring Interpretation: Negative
Negative: flexed
- left/right unilateral flexion
- R/R sacral torsion
- L/L sacral torsion
- bilateral flexion
Lumbar Spring Interpretation: Positive
Postive: Extended
- left/right unilateral extension
- R/L sacral torsion
- L/R sacral torsion
- bilateral extension
Backward Bending Sphinx Test
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)
Positive sphinx test
inequity between right and left increases (worsens) = posterior/backward
left/right unilateral extension
L/R sacral torsion
R/L sacral torsion
Negative sphinx test
sacral sulci and ILAs even out during the exam = anterior/forward
Left/right unilateral flexion
L/L sacral torsion
R/R sacral torsion
What could a deep on right sacral sulcus indicate?
right unilateral flexion
left unilateral extension
L/L sacral torsion
L/R sacral torsion
What could a deep left sacral sulcus indicate?
left unilateral flexion
right unilateral extended
R/R sacral torsion
R/L sacral torsion
What could a posterior/inferior ILA on the right indicate?
right unilateral flexion
left unilateral extended
R/L sacral torsion
R/R sacral torsion
What could a posterior/inferior ILA on the left indicate?
left unilateral flexion
right unilateral extension
L/R sacral torsion
L/L sacral torsion
Where do you gap the SI joint to facilitate extension?
posterior via internal rotation
Where do you gap the SI joint to facilitate flexion?
anterior via external rotation
Bilaterally extended sacrum findings
bilaterally positive lateralization = false negative bilateral posterior sacral sulci bilateral anterior/superior ILA \+ LS false - BBT
Bilaterally extended sacrum MET/ART
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
Bilaterally flexed sacrum findings
bilaterally positive = false negative lateralization bilateral anterior sacral sulci bilateral posterior/inferior ILA - LS test - BBT
Bilaterally flexed sacrum ME/ART
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
Unilateral Flexed Sacrum findings (left)
\+ left lateralization Left deep sacral sulcus Lest posterior/inferior ILA - LS - BBT
Unilaterally Flexed Sacrum ME/ART
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
Unilaterally Extended Sacrum Findings (left)
+ Left Lateralization test
Right deep sacral sulcus (left posterior sacral sulcus)
Right posterior/inferior ILA (left anterior/superior ILA)
+ LS test
+ BBT
Unilaterally Extended Sacrum ME/ART
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
Which unilateral SD do you encourage exhalation and resist inhalation?
Unilateral extended (when inhale, sacrum is extending)
Which unilateral SD do you encourage inhalation and resist exhalation?
Unilateral Flexed (when exhale, sacrum is flexing)
