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OMM > Spring 2020 Pelvis and Sacrum Lab Exam > Flashcards

Spring 2020 Pelvis and Sacrum Lab Exam Flashcards

1
Q

Identify the appropriate order of treatment of pelvic somatic dysfunction

A
  1. LIPLSIP
  2. Legs
  3. Inonominate shears (up/down)
  4. Pubic shears (up/down)
  5. Lumbar dysfunction
  6. Sacrum
  7. Ilial rotation (flares)
  8. Psoas
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2
Q

The standing flexion test and ASIS compression tests are used for what? The seated flexion test, sphinx test and spring test are used for what?

A

Standing flexion: Iliosacral

Seated flexion: Sacrum

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3
Q

True/False: When working on the pelvis, make sure to ALWAYS “reset” the pelvis prior to evaluating the landmarks

A

True

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4
Q

What are the landmarks of the pelvis?

A
  • ASIS height
  • ASIS distance from midline
  • PSIS height
  • Pubic tubercle height
  • Medial malleolar height
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5
Q

Pelvis: What is the diagnosis?

  1. Positive Standing Flexion on the Right Side
  2. Superior ASIS on R. side
  3. Superior PSIS on R. side
  4. Superior Iliac Crest on R. side
  5. Superior Pube on R. side
  6. ASIS equidistant to midline
  7. Malleolus superior on the R.
A

Right Superior Shear

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6
Q

Pelvis: A positive standing flexion test indicates which iliosacral joint (R or L) is restricted from normal motion.

When performing the standing flexion test (1st thing to do), where do you put your thumbs?

A
  • hook underneath the PSIS
  • patient bends forward

*the side the move is the positive (dysfunctional) side

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7
Q

Pelvis: List the steps involved in Pelvis diagnosis

A
  1. Positive Standing Flexion Test

OR ASIS Compression Test (palms on ASIS; compress each side – resistance = bad side)

  1. Evaluate the following landmarks:
    - Iliac Crest (Superior/Inferior/Even; Right or Left)
    - ASIS (Superior/Inferior/Even; Right or Left)
    - Pubic tubercle (Superior/Inferior/Even; Right or Left)
    - ASIS to midline distance (Greater, Lesser, Even; Right or Left)
  2. Diagnosis
    - Side of dysfunction
    - dysfunctional bone (ilia vs. pubic)
    - type of problem (shear, rotation or flare)
    - position (superior, inferior, medial or lateral)
  3. Treat
    - -Localize motion, monitor motion
    - -etc.
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8
Q

Pelvis: List the steps involved in treating a Superior Ilial Shear

A
  1. Patient supine
  2. Abduct leg 5-10 degrees
  3. Internally rotate leg
  4. Gentle traction/HVLA
  5. Reset pelvis; check findings
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9
Q

Pelvis: List the steps involved in an inferior Ilial shear

A
  1. Stand on dysfunctional leg and jump up and down
    Repeat 2-3x
    Recheck

*Rare

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10
Q

Pelvis: For a right ilial anterior rotation, you would expect to see the following:

  1. Inferior ASIS
  2. Superior PSIS
  3. Inferior Malleolus

(same would be seen on the left side)

How do you treat ilial anterior (innominate) rotation?

A
  1. Patient on back
  2. Flex hip and knee to 1st restrictive barrier
  3. stabilize sacral base with fingertips
  4. Patient pushes knee towards me (extend knee)
  5. Isometric pause
  6. Flex hip further into the barrier; Repeat ME
  7. Reset pelvis and re-check

*page 8 in manual

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11
Q

Pelvis: For a posterior innominate (ilial) rotation you would see the following:

  1. Superior ASIS
  2. Inferior PSIS
  3. Superior Malleolus (shorter leg)

*Same would be seen either R or L

How would you treat a posterior innominate rotation?

A
  1. Patient lies on back
  2. Drops leg off the side of the table
  3. Stabilize opposite ASIS; Other hand rests above Knee
  4. Patient pushes to ceiling
    * *Muscle Energy
  5. Reset and Re-check
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12
Q

Pelvis: How would you treat an ilial outflare (ASIS is lateral to center)?

A
  1. Patient on back
  2. Somatic leg bent (flexed) 90 degrees over other leg (straight)
  3. Lateral traction to PSIS
  4. Patient pushes laterally
    * Repeat 3-5 times

*Page 9 in handbook

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13
Q

Pelvis: How would you treat an ilial inflare (ASIS is lateral to center)?

A
  1. Patient on back
  2. Set dysfunctional knee indian style
  3. Opposite hand stabilizes ASIS
  4. patient tries to bring knee back in
    * *Muscle Energy 3-5 times
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14
Q

Pelvis: How would you treat a Superior Pubic Shear?

*Note: only the pubis is affected, everything else is normal.

A
  1. Patient on back - near edge of table
  2. Hip off side
  3. Stabilize opposite ASIS
  4. Flex and adduct hip (bring up and in)
    * uscle energy
  5. Reset pelvis and recheck
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15
Q

Pelvis: How would you treat an inferior pubic shear?

A
  1. Patient on back
  2. Flex knee up and internally rotate
  3. Stabilize ischial tuberosty
  4. Patient tries to straighten leg
    * ME
  5. Flex and internally rotate hip more etc.
  6. Reset pelvis and check findings
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16
Q

Sacrum: List the steps involved in sacrum diagnosis

A
  1. Positive seated flexion test (which one moves is dysfunction)
    - -thumbs under PSIS
  2. Deep Sacral Sulcus
  3. Which side is ILA posterior/caudad?
  4. Check L5. Is it compensated?
    (Transverse process will be more posterior on the same side as the deep sacral sulcus – if sulcus is deep on right, transverse process posterior on the right)
  5. Backward bending test
    - -if it gets better (negative) = flexion (same letter)
    - -if it gets worse (positive) = extension
17
Q

Sacrum: True/False: For forward torsions, the backwards bend test gets better because it is a flexed torsion. Thys, letters are the same and treatment involves feet together, (chest) facing the leather.

A

True

NOTE: opposite letters will not have the feet together, and the chest faces the ceiling

18
Q

Sacrum: Describe Treatment of Unilateral Sacral Flexion

A
  1. Patient prone (on belly)
  2. Monitor sacral sulcus, abduct leg (15 degrees) and internal rotation slightly
  3. Place heel on hand on ypsilateral base of sacrum
  4. Apply anterior and cephalad force (during inhalation)
    (resist with exhalation)
  5. Recheck
19
Q

Describe how you would treat a Unilateral Sacral Extension

A
  1. Patient prone (on belly)
  2. Monitor sacral sulcus, abduct leg (15 degrees) and internal rotation slightly
  3. Place heel on hand on ypsilateral base of sacrum
  4. Apply anterior and caudad force (during exhalation)
    (resist with inhalation)

x5

  1. Recheck

NOTE: Extension – enc. during Exhalation

OMM (11 decks)

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