Podcast
Questions and Answers
What is the initial step in the procedure for treating pubic dysfunction?
What is the initial step in the procedure for treating pubic dysfunction?
- Place two fists side-by-side between the patient’s knees
- Hold the knees in adduction with both arms (correct)
- Instruct the patient to relax
- Patient adducts their hips while squeezing your forearm
How long should the patient maintain the contraction during the procedure?
How long should the patient maintain the contraction during the procedure?
- 5-10 seconds
- 3-5 seconds (correct)
- 1-2 seconds
- 10-15 seconds
What should be placed between the patient’s knees before they squeeze?
What should be placed between the patient’s knees before they squeeze?
- A pillow
- Your hand
- Your fist (correct)
- A chair
What is the role of tight flexors like quadriceps femoris?
What is the role of tight flexors like quadriceps femoris?
Which muscle group is responsible for posterior innominate rotation?
Which muscle group is responsible for posterior innominate rotation?
What should you do after the contraction and counterforce steps are repeated?
What should you do after the contraction and counterforce steps are repeated?
Which step involves using your forearm?
Which step involves using your forearm?
What should not be done during the initial steps of the procedure?
What should not be done during the initial steps of the procedure?
What action is performed to treat an anteriorly rotated innominate?
What action is performed to treat an anteriorly rotated innominate?
Which muscles provide the activating force for an anteriorly rotated innominate during treatment?
Which muscles provide the activating force for an anteriorly rotated innominate during treatment?
What is the initial position of the patient for treating an anteriorly rotated innominate?
What is the initial position of the patient for treating an anteriorly rotated innominate?
What is the goal of changing the origin and insertion of the muscle during treatment?
What is the goal of changing the origin and insertion of the muscle during treatment?
Which movement is performed to facilitate treatment for a posteriorly rotated innominate?
Which movement is performed to facilitate treatment for a posteriorly rotated innominate?
Which of the following muscles is mentioned as a hip flexor providing the activating force for a posteriorly rotated innominate?
Which of the following muscles is mentioned as a hip flexor providing the activating force for a posteriorly rotated innominate?
What position should the patient be in for the innominate outflare technique?
What position should the patient be in for the innominate outflare technique?
Which hand does the physician use to adduct the patient’s right knee in the innominate outflare?
Which hand does the physician use to adduct the patient’s right knee in the innominate outflare?
How long should the isometric contraction be maintained during the innominate outflare technique?
How long should the isometric contraction be maintained during the innominate outflare technique?
Which muscle is NOT a primary mover during the innominate outflare technique?
Which muscle is NOT a primary mover during the innominate outflare technique?
What is the initial action taken with the patient's right hip in the innominate outflare technique?
What is the initial action taken with the patient's right hip in the innominate outflare technique?
After maintaining the isometric contraction, what should the physician do next?
After maintaining the isometric contraction, what should the physician do next?
What is the purpose of re-assessing landmarks after the innominate outflare technique?
What is the purpose of re-assessing landmarks after the innominate outflare technique?
Where should the physician be positioned for the innominate outflare technique?
Where should the physician be positioned for the innominate outflare technique?
What action does the physician take first in the procedure?
What action does the physician take first in the procedure?
What type of contraction is performed during the procedure?
What type of contraction is performed during the procedure?
How many times should the physician repeat the contraction and relaxation steps?
How many times should the physician repeat the contraction and relaxation steps?
What is the primary muscle group activated in this procedure?
What is the primary muscle group activated in this procedure?
What should occur after the patient has completely relaxed?
What should occur after the patient has completely relaxed?
Which part of the patient's body does the physician focus on during the initial positioning?
Which part of the patient's body does the physician focus on during the initial positioning?
What position should the thumbs be in when assessing the ASIS for level?
What position should the thumbs be in when assessing the ASIS for level?
Which structure is used to determine potential lateralization of the iliac crest?
Which structure is used to determine potential lateralization of the iliac crest?
How is the lateralized side diagnosed in relation to the pubic ramus?
How is the lateralized side diagnosed in relation to the pubic ramus?
What is the purpose of testing the motion of the innominate bones?
What is the purpose of testing the motion of the innominate bones?
Where should the thumbs be placed when assessing the PSIS?
Where should the thumbs be placed when assessing the PSIS?
What measurement is taken for the transverse axis diagnosis?
What measurement is taken for the transverse axis diagnosis?
During the flaring test, where should the practitioner stand?
During the flaring test, where should the practitioner stand?
What is assessed when placing the fingers on the pubic ramus?
What is assessed when placing the fingers on the pubic ramus?
Study Notes
Anterior Pelvic Landmarks for Diagnosis
- Iliac Crest: Prominent ridge of the pelvis used as a reference point during assessments.
- ASIS (Anterior Superior Iliac Spine): Key landmark; tips of fingers placed here to check for lateralization.
- Pubic Symphysis: Joint where the left and right pubic bones meet; evaluated for level differences.
- Pubic Ramus: The horizontal part of the pubic bone; check for symmetry and positional discrepancies.
Diagnostic Techniques
- Pubic Ramus Level Check: Tips of second fingers placed on pubic ramus; assess for leveling and lateralization.
- ASIS Leveling Check: Thumbs placed under ASIS; check for symmetry and note which side is superior or inferior.
- Sacral Sulcus and PSIS Leveling Check: Thumbs placed under PSIS to assess for level and lateralization discrepancy.
Transverse Axis Assessment
- Reference point between ASIS; triangulate to umbilicus to compare distances.
- Determine if lateralized side is farther (outflare) or closer (inflare) than the umbilicus.
Motion Testing
- Conduct lateral force tests on ASIS while observing motion of innominates (hip bones).
- Right to left checks for right inflare and left outflare; left to right for left inflare and right outflare.
Muscle Energy Techniques (MET) for Pubic Dysfunction
- Focus on correcting superior shear, inferior shear, gapped, or compressed pubic dysfunction.
- Abduct/Adduction Technique: Patient resists adduction while therapist provides counterforce.
- Steps repeated with varying fist sizes (one or two) placed between knees to enhance the contraction.
Causes of Innominate Rotation
- Tight hip flexors (e.g., quadriceps) cause anterior rotation.
- Tight extensors (e.g., hamstrings) result in posterior rotation.
Treatment Principles for Innominate Rotation
- Anteriorly Rotated Innominate: Flex hip to rotate the innominate posteriorly; hip extensors activate.
- Posteriorly Rotated Innominate: Extend thigh to rotate it anteriorly; hip flexors provide the activating force.
Muscle Energy Technique for Anteriorly Rotated Innominate
- Objective: Patient supine with heel on shoulder; hip flexion testing barrier.
Muscle Energy Technique for Innominate Outflare
- Procedure: Patient flexes hip/knee; physician applies counterforce while patient attempts to abduct.
- Repeat to enhance the effect multiple times.
Muscle Energy Technique for Innominate Inflare
- Procedure: Patient flexes knee; physician applies counterforce as patient pushes against the external rotation.
- Multiple repetitions for effectiveness and assessment post-procedure.
Reassessment
- Continuous reassessment of landmarks post-treatment is vital for tracking progress and effectiveness of techniques.
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Description
This quiz focuses on the identification and assessment of anterior pelvic landmarks, including the iliac crest, ASIS, pubic symphysis, and pubic ramus. Participants will analyze the alignment and relative positioning of these landmarks for diagnostic purposes. It is essential for students in health and medical fields.