Term
| In standing, should the normal sacrum be slightly nutated, counternutated, or neutral? |
|
Definition
|
|
Term
| How does the SI joint in men and heavier individuals compare to the SI joint in women and lighter weight individuals? |
|
Definition
| It is more irregular in men and heavier people, which means it is more stable. |
|
|
Term
| What makes the SI joint stable? |
|
Definition
| Its wedge shape, and the ligaments that hold the joint in place. |
|
|
Term
| What is the importance of the shape of the sacrum when evaluating joint play? |
|
Definition
| It’s a wedge shape medial to lateral, as well as anterior to posterior, so you need to make sure you’re following the joint plane to get accurate joint play results. |
|
|
Term
| What happens to the sacrum during fwd flexion? |
|
Definition
|
|
Term
| During what movements of the sacrum and innominate will the sacrospinous ligament be tight? |
|
Definition
| In nutation of the sacrum, or counternutation of the innominate. |
|
|
Term
| When a pt presents with restriction in both the lower lumbar, and SI joints, which do you address first? |
|
Definition
|
|
Term
| In the standing forward flexion test, what is a positive result? |
|
Definition
| The side that moves first and furthest. |
|
|
Term
| When doing the gilette/stork test, which side is positive? |
|
Definition
| The side that has no difference between sacrum and innominate movement is stuck. If it’s normal, the innominate should move more, placing the PSIS back and down in relation to the sacrum. |
|
|
Term
| What is the “brim” of the pelvis? |
|
Definition
| The A-P diameter – symphesis pubis to the front of the center of the sacrum. |
|
|
Term
| What is the “outlet” of the pelvis? |
|
Definition
| The tip of the coccyx to the ischial tuberosity. |
|
|
Term
| What happens to the size of the brim when the sacrum is nutated? |
|
Definition
|
|
Term
| In what situation is it normal for the outlet to increase in size? |
|
Definition
|
|
Term
| Before the baby settles, what position is it best for the mother to lie in? Why? |
|
Definition
| In supine w/ legs extended, because it results in an anterior rotation of the innominate, which is a relative counternutation of the sacrum. It increases the brim diameter to allow the baby to settle. |
|
|
Term
| When the baby enters the vaginal canal, what position is it best for the mother to be in? Why? |
|
Definition
| With the hips flexed, because it leads to a relative nutation of the sacrum to increase the size of the outlet diameter and allow for the baby’s passage through the pelvic girdle. |
|
|
Term
| Should the SI joint move, or be stable? |
|
Definition
| It should move. That’s normal. We don’t know on what axis, or exactly how much it moves, but we do know that it is normal for it to be mobile to a certain extent. |
|
|
Term
| How is the axis for sacral torsion named? |
|
Definition
| It’s named by the direction the top pole is going. See pg P11 for pictures |
|
|
Term
| If you have left on left torsion, what direction is the R superior corner of the sacrum facing, and what direction is the L inferior corner tipped? |
|
Definition
| R superior = tipped forward, L inferior = tipped posteriorly. |
|
|
Term
| If on palpation you feel that the R sulcus is deeper and the L ILA is more posterior, what is the name of the sacral torsion? |
|
Definition
| Left on left sacral torsion. |
|
|
Term
| If on palpation the L ILA is deeper and the R sulcus is shallow, what is the name of the sacral torsion? |
|
Definition
| Right on Right sacral torsion. |
|
|
Term
| If on palpation the L sulcus is shallow and the R ILA is deeper, what is the name of the sacral torsion? |
|
Definition
|
|
Term
| If a pt has a longer L leg in sitting, and a longer R leg in supine, is the L innominate nutated or counternutated in relation to the R? |
|
Definition
| Counternutated. See pg P13 for more info |
|
|
Term
| If the innominate is posteriorly rotated (counternutated) what happens to the acetabulum? Does it result in a functionally shorter or longer leg on the side of rotation? |
|
Definition
| It moves cranially, resulting in a functionally shorter leg on the affected side. |
|
|
Term
| What happens to the lumbar spine when there is posterior rotation of the R innominate? |
|
Definition
| Lumbar spine side bents to the left and rotates to the right. |
|
|
Term
| What ligaments are stretched with posterior innominate rotation? |
|
Definition
| Sacrospinous and sacrotuberous ligaments. |
|
|
Term
| When there is posterior rotation of the innominate, what happens to the hip joint? |
|
Definition
| It externally rotates because the acetabulum has moved anterlaterally. |
|
|
Term
| If the R innominate is posteriorly rotated, to which direction with the coccyx deviate? |
|
Definition
|
|
Term
| What happens to the abdominal muscles with anterior innominate rotation? |
|
Definition
| They get lax because they are stretched out over time. |
|
|
Term
| What happens to the abdominal muscles with posterior innominate rotation? |
|
Definition
| They tighten because they are put in a shortened position over time. |
|
|
Term
| What are the osteo and arthro kinematic motions of the sacrum in back extension? |
|
Definition
| Arthrokinematic: sacral nutation. Osteokinematic: sacral counternutation. |
|
|
Term
| With back flexion, what are the osteo and arthrokinematic motions of the sacrum? |
|
Definition
| Initially, the sacrum nutates arthro and osteokinematically. At the end, it counternutates arthrokinematically and nutates osteokinematically. |
|
|
Term
| Order the following abdominal groups in importance to L spine: internal obliques, external obliques and transverse abdominals. |
|
Definition
| Transverse, then internal, then external. |
|
|
Term
| Which muscles of the abdomen are most important to the L spine stabilization? |
|
Definition
|
|
Term
| What groups of abdominal muscles are most important for facilitation of pelvic floor control? (2) |
|
Definition
| Internal and external obliques |
|
|
Term
| How do the iliopsoas muscles affect the SI joint? |
|
Definition
| When tight, they pull on the Lspine and affect illiacus – lumbar alignment. |
|
|
Term
| How can adductors affect pelvis? |
|
Definition
| They attach to the ischial and pubic ramii. |
|
|
Term
| What happens to the pubic symphesis if you place a ball between the knees and ask the pt to squeeze the ball? |
|
Definition
| It pulls apart because the insertion of the adductors can’t move, forcing movement of the adductor origin |
|
|
Term
| How does isometric contraction of the adductor muscles affect the SI joint? |
|
Definition
|
|
Term
| What affect does tight gluteal muscles have on SI joint in the closed kinetic chain (ie: standing)? |
|
Definition
| Activation of them in CKC results in a gapping of the SI joint. |
|
|
Term
| What is the indication for a pt with SI hypermobility when performing glut exercises? Why? |
|
Definition
| They should wear an SI belt, or have SI stabilization of some kind, because glut exercises will gap the SI joint leading to further instability. |
|
|
Term
| What ligament will be affected if tone is increased in the gluteus maximus? |
|
Definition
| Sacrotuberous ligament will become tighter. |
|
|
Term
| What muscles do the anterior pelvic floor muscles work with to stabilize the LB? |
|
Definition
|
|
Term
| What muscles do the posterior pelvic floor muscles work with to stabilize the SI joint? |
|
Definition
|
|
Term
| What are the primary posterior supporters of the LB? |
|
Definition
|
|
Term
| How can a sprained ankle lead to LBP? |
|
Definition
| Inversion sprain lowered fibular head pulls on biceps femoris attached to LB via lumbar fascia pain in low back. |
|
|
Term
| When falling on one buttock, what will most likely happen to the innominate that is landed on? |
|
Definition
| It will rotate posteriorly |
|
|
Term
| Why can skiing result in anterior rotation of the innominate? |
|
Definition
| When falling forward with one leg going out to the side, the innominate can get pulled. |
|
|
Term
| What is a common mechanism of trauma to the SI joint when playing golf? |
|
Definition
| If the heel isn’t lifted on follow through, it puts and anterior force on the innominate. |
|
|
