Topic #11 - Iliosacral Pathologies

The sacrum.

They are not the same; iliosacral pathologies specifically refer to the ilium's movement dysfunction relative to the sacrum.

Anterior/posterior innominate rotations, superior/inferior innominate shears, and inflared/outflared innominate.

<p>Yes, they can occur but they would be separate from one another, possibly involving different dysfunctions on each side.</p> Signup and view all the answers

<p>It is merely a finding and not a diagnosis; it indicates a restriction that needs to be addressed.</p> Signup and view all the answers

<p>The pubis is often viewed as a separate dysfunction within the context of iliosacral pathologies.</p> Signup and view all the answers

<p>Muscle energy techniques have been adopted into osteopathic practice to address iliosacral dysfunction.</p> Signup and view all the answers

<p>The possibility of having one iliosacral pathology on one side and a different one on the other side complicates assessments.</p> Signup and view all the answers

<p>They are highly interrelated, often presenting simultaneously.</p> Signup and view all the answers

<p>A lumbosacral dysfunction is likely to be present.</p> Signup and view all the answers

<p>Upslip.</p> Signup and view all the answers

<p>The ASIS would be lower on the same side.</p> Signup and view all the answers

<p>It can drive the innominate bone superiorly, resulting in an upslip.</p> Signup and view all the answers

<p>Shortened hamstrings on one or both sides can lead to this rotation.</p> Signup and view all the answers

<p>The right sacral sulcus would likely be shallower.</p> Signup and view all the answers

<p>ASIS, MM, IT, and PSIS.</p> Signup and view all the answers

<p>It moves more freely towards the head and is limited towards the feet.</p> Signup and view all the answers

<p>Re-assess the condition.</p> Signup and view all the answers

<p>It may help self-correct the position towards neutrality.</p> Signup and view all the answers

<p>Motion assessment.</p> Signup and view all the answers

<p>The PSIS would be closer to the midline of the body.</p> Signup and view all the answers

<p>Grasp the ankles and provide slight bilateral traction.</p> Signup and view all the answers

<p>Asymmetrical muscular imbalances usually complicate these diagnoses.</p> Signup and view all the answers

<p>Inferior-superior, medial-lateral, and anterior-posterior.</p> Signup and view all the answers

<p>It moves freely upwards and is restricted downwards.</p> Signup and view all the answers

<p>It would be lax on the affected side.</p> Signup and view all the answers

<p>Strength-length discrepancies and neuromuscular recruitment.</p> Signup and view all the answers

<p>Tissue texture abnormalities, ligamentous tension, and tenderness.</p> Signup and view all the answers

<p>Not well, as dysfunction may reoccur with subsequent visits.</p> Signup and view all the answers

<p>Pubic dysfunction.</p> Signup and view all the answers

<p>The standing flexion test and relevant landmarks.</p> Signup and view all the answers

<p>Re-evaluate whether it is a right down slip or a left up-slip.</p> Signup and view all the answers

<p>It moves more freely down towards the feet.</p> Signup and view all the answers

<p>The plane of movement must be considered.</p> Signup and view all the answers

<p>It causes depth changes in the ASIS, PSIS, and pubic tubercle.</p> Signup and view all the answers

<p>Flares occur in medial and lateral directions, with a potential deep and superficial component.</p> Signup and view all the answers

<p>An upslip is more common due to the mechanism of injury.</p> Signup and view all the answers

<p>ASIS, PSIS, and MM.</p> Signup and view all the answers

<p>Flares are the rarest type of dysfunction.</p> Signup and view all the answers

<p>Hamstring length can impact the assessment.</p> Signup and view all the answers

<p>Before performing the standing flexion test.</p> Signup and view all the answers

<p>Posture and pelvic angles in standing.</p> Signup and view all the answers

<p>A flare may often be misidentified as a rotation.</p> Signup and view all the answers

<p>Explain the procedure, demonstrate it, and obtain consent.</p> Signup and view all the answers

<p>The pubic tubercles located on the lateral border of the pubis.</p> Signup and view all the answers

<p>Place your thumbs parallel to the pubis and adjust them for a midline reference from the umbilicus.</p> Signup and view all the answers

<p>Superior-inferior and anterior-posterior discrepancies.</p> Signup and view all the answers

<p>Instruct them to move everything out of the way to facilitate examination.</p> Signup and view all the answers

<p>It's a technique where one stands on one leg, using trunk movement to reach, and can help in accessing structures when you're short.</p> Signup and view all the answers

<p>A standing flexion test.</p> Signup and view all the answers

<p>The ASIS (anterior superior iliac spine).</p> Signup and view all the answers

<p>The positioning of the malleoli should be observed.</p> Signup and view all the answers

<p>It may indicate adaptations of the lumbar spine due to sacral or sacroiliac pathology.</p> Signup and view all the answers

<p>To ensure that the discrepancies are documented accurately according to the patient's condition.</p> Signup and view all the answers

<p>To position her hands on the medial aspect of the ASIS while maintaining a reference line from the umbilicus.</p> Signup and view all the answers

<p>Avoid recording the superior side instead of the affected side.</p> Signup and view all the answers

<p>You can assess the PSIS from underneath the patient, ensuring not to be on top.</p> Signup and view all the answers

<p>One side may present a distinct iliosacral pathology, making the assessment of the pelvis challenging due to the bilateral differences.</p> Signup and view all the answers

<p>It should be regarded as a finding rather than a definitive diagnosis, indicating the presence of dysfunction that requires treatment.</p> Signup and view all the answers

<p>These techniques are primarily taught within osteopathic training and may not be part of the standard curriculum in physiotherapy schools.</p> Signup and view all the answers

<p>It would likely be lax on the affected side.</p> Signup and view all the answers

<p>Recognizing the pubis as an independent factor allows for a more comprehensive assessment and targeted treatment strategy.</p> Signup and view all the answers

<p>By assessing for tenderness and observing the tension in the ligaments.</p> Signup and view all the answers

<p>They can lead to compensatory patterns, resulting in altered gait mechanics and increased risk of further musculoskeletal problems.</p> Signup and view all the answers

<p>It would feel tight and tender.</p> Signup and view all the answers

<p>Symptoms often serve as findings within evaluations rather than standalone diagnoses, complicating their interpretation.</p> Signup and view all the answers

<p>The ilium would be restricted in upward movement and move freely downward.</p> Signup and view all the answers

<p>The presence of multiple dysfunctional changes within the pelvis can obscure clear diagnostic classifications.</p> Signup and view all the answers

<p>The ilium moves around the sacrum as a fixed point, allowing coordinated motion essential for optimal lower body function.</p> Signup and view all the answers

<p>By evaluating movement restrictions of the ilium relative to the sacrum.</p> Signup and view all the answers

<p>The PSIS is generally expected to be higher than the ASIS in a normal pelvis.</p> Signup and view all the answers

<p>Strength-length discrepancies through muscle testing and functional assessments.</p> Signup and view all the answers

<p>The dysfunction is likely to reoccur, necessitating a more comprehensive approach.</p> Signup and view all the answers

<p>The ASIS, PSIS, and MM.</p> Signup and view all the answers

<p>It moves more freely downward towards the feet.</p> Signup and view all the answers

<p>You should consider that it might actually be a left up-slip instead of a right down-slip.</p> Signup and view all the answers

<p>If the mechanism of injury (MOI) does not suggest such a condition, doubt may arise.</p> Signup and view all the answers

<p>Flares occur in medial and lateral contexts, with a possible deep and superficial component.</p> Signup and view all the answers

<p>Their depth affects the plane of movement and can influence examination findings.</p> Signup and view all the answers

<p>Patients are likely to present with shear injuries.</p> Signup and view all the answers

<p>A rotation is often misidentified as a flare due to its mediolateral component.</p> Signup and view all the answers

<p>Hamstring length can impact assessment outcomes and may need to be evaluated beforehand.</p> Signup and view all the answers

<p>The ASIS moves closer to the midline during an inflare.</p> Signup and view all the answers

<p>The interrelation between iliosacral and sacroiliac pathologies can complicate assessment.</p> Signup and view all the answers

<p>Rotations, particularly right anterior or left posterior rotations, are the most common.</p> Signup and view all the answers

<p>The ischial tuberosity would have depth changes, affecting its alignment.</p> Signup and view all the answers

<p>The posture and angles of the pelvis are assessed for alignment and dysfunction.</p> Signup and view all the answers

<p>A short hip flexor on one side can pull the innominate bone into an anterior rotation.</p> Signup and view all the answers

<p>The ilium moves more freely toward the head and is limited when pushed toward the feet.</p> Signup and view all the answers

<p>The iliac crest would be higher on the affected side.</p> Signup and view all the answers

<p>The right sacral sulcus would likely be deeper.</p> Signup and view all the answers

<p>The ASIS on the affected side would be lower compared to the unaffected side.</p> Signup and view all the answers

<p>The innominate bone moves inferiorly and is restricted in upward movement.</p> Signup and view all the answers

<p>A limitation or pain in the lower back region is to be expected.</p> Signup and view all the answers

<p>Shortened hip adductors may pull the innominate into an inflare position.</p> Signup and view all the answers

<p>The PSIS on the affected side would be lower compared to the unaffected side.</p> Signup and view all the answers

<p>ASIS, PSIS, iliac tubercle, and the middle of the sacrum are assessed.</p> Signup and view all the answers

<p>Performing motion tests to assess joint mobility can confirm the pathology.</p> Signup and view all the answers

<p>Trauma can cause shearing of the innominate bone, creating an upslip.</p> Signup and view all the answers

<p>Weight-bearing can provide sufficient traction to mobilize back to a neutral position.</p> Signup and view all the answers

<p>They should be instructed to move everything out of the way.</p> Signup and view all the answers

<p>It could indicate a superior innominate shear on the affected side.</p> Signup and view all the answers

<p>The pubic tubercles located at the lateral border of the pubis.</p> Signup and view all the answers

<p>She uses the PIP joint of her index finger on the medial aspect of the ASIS.</p> Signup and view all the answers

<p>Superior-inferior and anterior-posterior discrepancies.</p> Signup and view all the answers

<p>It suggests that the discrepancy corrects when the patient sits up.</p> Signup and view all the answers

<p>The up-down discrepancies in relation to the affected side.</p> Signup and view all the answers

<p>Conduct a standing flexion test and identify the affected side.</p> Signup and view all the answers

<p>An imaginary line drawn from the umbilicus down to the midline.</p> Signup and view all the answers

<p>Recording the superior side instead of noting the affected side.</p> Signup and view all the answers

<p>The iliac crest.</p> Signup and view all the answers

<p>Investigate adaptations of the L spine or a potential sacroiliac pathology.</p> Signup and view all the answers

<p>It indicates potential innominate dysfunctions.</p> Signup and view all the answers

<p>The supine-to-sit test.</p> Signup and view all the answers

<p>Perform a Golfer's reach by standing on one leg and moving forward.</p> Signup and view all the answers

<p>They may present as distinct conditions on each side, complicating the evaluation process.</p> Signup and view all the answers

<p>Assessments reveal findings, while diagnoses interpret those findings in the context of treatment.</p> Signup and view all the answers

<p>It's viewed as a finding rather than a pathology, similar to strength findings in muscle assessments.</p> Signup and view all the answers

<p>It includes anterior/posterior innominate rotations, superior/inferior innominate shears, and inflared/outflared innominates.</p> Signup and view all the answers

<p>Multi-axial assessments consider various movement restrictions, complicating diagnosis and treatment.</p> Signup and view all the answers

<p>It's often assessed separately but is integral to understanding overall pelvic mechanics.</p> Signup and view all the answers

<p>Findings can suggest multiple underlying issues, requiring further investigation to determine appropriate treatment.</p> Signup and view all the answers

<p>It indicates a dysfunction that needs to be treated rather than simply identified.</p> Signup and view all the answers

<p>Inferior-superior, medial-lateral, anterior-posterior.</p> Signup and view all the answers

<p>The ilium would move freely upwards and be restricted downwards.</p> Signup and view all the answers

<p>It would not address the root causes, resulting in the dysfunction recurring.</p> Signup and view all the answers

<p>The sacrotuberous ligament would be taught/tight.</p> Signup and view all the answers

<p>The inguinal ligament.</p> Signup and view all the answers

<p>Related joint play assessment.</p> Signup and view all the answers

<p>Look for tenderness and texture abnormalities indicating upslip or downslip.</p> Signup and view all the answers

<p>Ligamentous tension and tenderness in associated structures.</p> Signup and view all the answers

<p>Iliosacral pathologies are commonly present along with sacroiliac pathologies.</p> Signup and view all the answers

<p>An 'upslip' refers to a superior movement of the innominate bone.</p> Signup and view all the answers

<p>A short hip flexor can pull the innominate into an anterior rotation.</p> Signup and view all the answers

<p>The right sacral sulcus would likely appear shallower.</p> Signup and view all the answers

<p>It indicates that the sulcus is deeper on the side experiencing the posterior rotation.</p> Signup and view all the answers

<p>ASIS, PSIS, iliac crest, and pubic tubercle are the key landmarks assessed.</p> Signup and view all the answers

<p>It moves more freely when pushed towards the head and is limited when pushed downwards.</p> Signup and view all the answers

<p>Traction forces, such as those experienced during sports or getting stuck, can cause a downslip.</p> Signup and view all the answers

<p>The ASIS is lower on the side experiencing the inferior innominate shear.</p> Signup and view all the answers

<p>Muscle imbalances, such as shortened muscles on one side, are crucial for assessment.</p> Signup and view all the answers

<p>It may self-correct during activities like walking or weight-bearing due to natural mobilization.</p> Signup and view all the answers

<p>Lumbosacral dysfunction can be inferred from asymmetries in landmark levels and movement restrictions.</p> Signup and view all the answers

<p>Joint motion assessment can confirm findings from bony landmark evaluations.</p> Signup and view all the answers

<p>The anterior aspect would appear more lateral, such as a higher ASIS on the affected side.</p> Signup and view all the answers

<p>Muscle imbalances can create complex rotation dysfunctions, making assessment more challenging.</p> Signup and view all the answers

<p>Treat it for a down slip.</p> Signup and view all the answers

<p>It may indicate a misdiagnosis, possibly a left up-slip instead of a right down slip.</p> Signup and view all the answers

<p>The rotational discrepancies between ASIS, PSIS, and MM.</p> Signup and view all the answers

<p>Flares occur in medial-lateral context with deep and superficial components.</p> Signup and view all the answers

<p>A rotation, due to its mediolateral component.</p> Signup and view all the answers

<p>Shears are most commonly associated with trauma.</p> Signup and view all the answers

<p>It suggests a lack of correlation between the symptom and underlying cause.</p> Signup and view all the answers

<p>There is often a combination of multiple pathologies affecting both regions.</p> Signup and view all the answers

<p>It causes changes in depth positioning of landmarks like ASIS and PSIS.</p> Signup and view all the answers

<p>The innominate will be stuck in a superior position.</p> Signup and view all the answers

<p>Hamstring length should be assessed first.</p> Signup and view all the answers

<p>Posture and pelvic angles in standing.</p> Signup and view all the answers

<p>You could use your thumbs to feel for differences in distance from the midline when in a supine position.</p> Signup and view all the answers

<p>The supine-to-sit test should be performed to assess leg length discrepancies.</p> Signup and view all the answers

<p>Ask the patient to perform a sit-up to re-check the positioning of the malleoli.</p> Signup and view all the answers

<p>It may suggest an upslip with a posterior rotation on the affected side.</p> Signup and view all the answers

<p>The iliac crests are typically not palpated in a supine position but are important for assessing positional faults.</p> Signup and view all the answers

<p>A Golfer's reach involves standing on one leg and using trunk extension to reach under the patient for palpation.</p> Signup and view all the answers

<p>It often indicates adaptations in the lumbar spine related to sacral or sacroiliac pathology.</p> Signup and view all the answers

<p>The ASIS can present differences superiorly and inferiorly, creating complexities in evaluation.</p> Signup and view all the answers

<p>The ASIS, pubis, and ischial tuberosities are primary landmarks for these assessments.</p> Signup and view all the answers

<p>Establish up-down discrepancies and follow the landmarks for depth assessment.</p> Signup and view all the answers

<p>The presence of bony anomalies can mislead evaluations, suggesting pathologies that don't exist.</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Inguinal ligament</p> Signup and view all the answers

<p>upwards</p> Signup and view all the answers

<p>ASIS = Inferior-superior Ischial tuberosity = Anterior-posterior Pubic tubercle = Inferior-superior PSIS = Medial-lateral</p> Signup and view all the answers

<p>Observing the ilium's movement on the sacrum (B)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Ligamentous tension and tenderness</p> Signup and view all the answers

<p>Trauma from falling on one side (B)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Deeper sacral sulcus on the right side</p> Signup and view all the answers

<p>anterior</p> Signup and view all the answers

<p>Upslip = Superior movement of the innominate bone Downslip = Inferior movement of the innominate bone Anterior rotation = Forward rotation of the innominate bone Posterior rotation = Backward rotation of the innominate bone</p> Signup and view all the answers

<p>More freedom of movement towards the head (B)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>Getting a foot stuck in sand or concrete</p> Signup and view all the answers

<p>hip flexors</p> Signup and view all the answers

<p>It can help self-correct the position (A)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>ASIS and PSIS</p> Signup and view all the answers

<p>shallow</p> Signup and view all the answers

<p>Moves more freely (A)</p> Signup and view all the answers

<p>Movement of the ilium on the sacrum (A)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Iliosacral pathology</p> Signup and view all the answers

<p>sacrum</p> Signup and view all the answers

<p>Anterior innominate rotation = Front of ilium moves upward Superior innominate shear = Movement of the ilium upwards Inflared innominate = Ilial bone angles inward</p> Signup and view all the answers

<p>They can have different types on each side (B)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Muscle energy</p> Signup and view all the answers

<p>Perform a standing flexion test (D)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Pubic tubercles</p> Signup and view all the answers

<p>PIP</p> Signup and view all the answers

<p>ASIS = Medial-lateral PSIS = Superior-inferior Ischial tuberosity = Up-down Pubis = Anterior-posterior</p> Signup and view all the answers

<p>Discrepancy upon sit-up (A)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Tenderness</p> Signup and view all the answers

<p>perpendicular</p> Signup and view all the answers

<p>Recording the superior side (C)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>Golfer's reach</p> Signup and view all the answers

<p>innominate bones</p> Signup and view all the answers

<p>Thumbs on ASIS = Check medial-lateral discrepancies Thumbs on pubis = Assess tenderness Fingers on ischial tuberosity = Evaluate up-down discrepancies PIP joint on ASIS = Determine angle of alignment</p> Signup and view all the answers

<p>Flares (A)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>Reassess the standing flexion test.</p> Signup and view all the answers

<p>MM</p> Signup and view all the answers

<p>Upslip = Innominates stuck up Downslip = Innominates stuck down Rotation = Typical dysfunctions associated with trauma Flare = Least likely to occur</p> Signup and view all the answers

<p>They create rotation discrepancies. (D)</p> Signup and view all the answers

<p>True (A)</p> Signup and view all the answers

<p>Superior or inferior innominate shear.</p> Signup and view all the answers

<p>medial, lateral</p> Signup and view all the answers

<p>Before the standing flexion test (C)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>Hamstring length.</p> Signup and view all the answers

<p>further away</p> Signup and view all the answers

<p>A rotation (C)</p> Signup and view all the answers

<p>Rotation = Common due to leg dominance Upslip = Innominate moves up Downslip = Innominate moves down Flare = Rarely occurs in isolation</p> Signup and view all the answers

<p>Iliosacral dysfunction alters the movement dynamics, leading to compensatory movements or restrictions in adjacent joints.</p> Signup and view all the answers

<p>Iliosacral pathologies specifically refer to the dysfunction of the ilium on the sacrum, while pelvic dysfunction encompasses a broader range of issues including pubic symphysis dysfunction.</p> Signup and view all the answers

<p>Differing iliosacral pathologies can occur due to unilateral trauma or muscle imbalances affecting one side more than the other.</p> Signup and view all the answers

<p>The pubis may present as a separate dysfunction and can influence overall pelvic alignment and function.</p> Signup and view all the answers

<p>It indicates a finding that warrants treatment rather than serving as a standalone diagnosis.</p> Signup and view all the answers

<p>Variability in symptoms, potential for bilateral conditions, and concurrent dysfunctions complicate diagnosis and treatment strategies.</p> Signup and view all the answers

<p>Anterior innominate rotations tilt the pelvis forward, whereas posterior rotations tilt it backward, impacting leg length and gait.</p> Signup and view all the answers

<p>The sacrum acts as the fixed point around which the ilium moves during normal biomechanics.</p> Signup and view all the answers

<p>The sacrotuberous ligament would be taught/tight on the affected side.</p> Signup and view all the answers

<p>The PSIS are located posteriorly and superiorly compared to the ASIS in a normal pelvis.</p> Signup and view all the answers

<p>An upslip would allow for free movement of the ilium upwards and restricted movement downwards.</p> Signup and view all the answers

<p>The inguinal ligament on the affected side is likely to be tight and tender.</p> Signup and view all the answers

<p>TTAs involve assessing ligamentous tension and tenderness in related structures.</p> Signup and view all the answers

<p>Muscle imbalances can indicate strength-length discrepancies and neuromuscular control issues.</p> Signup and view all the answers

<p>The quadratus lumborum is particularly relevant for assessing upslips or downslips.</p> Signup and view all the answers

<p>Manual therapy may not resolve the underlying dysfunction, which often reoccurs.</p> Signup and view all the answers

<p>The standing flexion test and its landmarks should be re-assessed.</p> Signup and view all the answers

<p>It moves more freely downward towards the feet.</p> Signup and view all the answers

<p>A potential lumbosacral dysfunction.</p> Signup and view all the answers

<p>The plane of movement due to their depth and rotational discrepancies requires consideration.</p> Signup and view all the answers

<p>Because the presence of certain injury mechanisms may better indicate the type of dysfunction present.</p> Signup and view all the answers

<p>During an inferior innominate shear.</p> Signup and view all the answers

<p>The sulcus would likely present as shallower.</p> Signup and view all the answers

<p>Flares occur medially and laterally, potentially also having deep and superficial components.</p> Signup and view all the answers

<p>Rotations, specifically a right anterior or left posterior rotation.</p> Signup and view all the answers

<p>It moves more freely superiorly and is restricted inferiorly.</p> Signup and view all the answers

<p>The ASIS moves closer to the midline while the PSIS moves further away.</p> Signup and view all the answers

<p>Trauma such as falling and landing on one side.</p> Signup and view all the answers

<p>The ASIS, PSIS, and MM are the three most useful bony landmarks.</p> Signup and view all the answers

<p>The right sacral sulcus would be more posterior or shallow.</p> Signup and view all the answers

<p>ASIS, MM, IT, and PSIS.</p> Signup and view all the answers

<p>A rotation is often misidentified as a flare due to overlooking the mediolateral component.</p> Signup and view all the answers

<p>The complexity arising from muscle imbalances.</p> Signup and view all the answers

<p>Hamstring and hip flexor lengths can significantly impact the assessment.</p> Signup and view all the answers

<p>It indicates that the innominate bone is locked in an elevated position.</p> Signup and view all the answers

<p>An upslip allows for more lateral movement of the innominate.</p> Signup and view all the answers

<p>Identifying hamstring length issues aids in avoiding confounding results of the test.</p> Signup and view all the answers

<p>That the ilium moves more freely towards the head but is limited towards the feet.</p> Signup and view all the answers

<p>The pubic tubercle forms a small joint while the ischial tuberosity is larger but deeper.</p> Signup and view all the answers

<p>It could lead to an anterior innominate rotation.</p> Signup and view all the answers

<p>The joint glides of the ilium on the sacrum would be limited when pushing towards the head.</p> Signup and view all the answers

<p>The right leg often serves as the dominant leg for many individuals.</p> Signup and view all the answers

<p>A right posterior rotation.</p> Signup and view all the answers

<p>It would be higher on the affected side.</p> Signup and view all the answers

<p>Getting a foot stuck in sand while moving forward.</p> Signup and view all the answers

<p>Explain what you're doing, demonstrate the process, and obtain consent.</p> Signup and view all the answers

<p>You are checking for superior-inferior discrepancies at the pubic tubercles.</p> Signup and view all the answers

<p>Use an imaginary line from the umbilicus to determine the midline and check thumb positions.</p> Signup and view all the answers

<p>It can indicate a functional leg-length discrepancy or adaptations of the lumbar spine.</p> Signup and view all the answers

<p>ASIS, PSIS, ischial tuberosities, and pubic tubercles.</p> Signup and view all the answers

<p>The iliac crests may help identify positional faults, even if they are not typically assessed supine.</p> Signup and view all the answers

<p>You should come underneath the patient rather than positioning yourself directly on top.</p> Signup and view all the answers

<p>The common mistake is recording the superior side instead of the affected side.</p> Signup and view all the answers

<p>It allows individuals to reach further by leveraging one leg while maintaining balance.</p> Signup and view all the answers

<p>Make note of the differences, as they can indicate potential innominate dysfunction.</p> Signup and view all the answers

<p>Palpating depth helps establish up-down discrepancies and overall pelvic alignment.</p> Signup and view all the answers

<p>It helps rule out bony anomalies and determines appropriate interventions.</p> Signup and view all the answers

<p>It may indicate an upslip with a posterior rotation on the affected side.</p> Signup and view all the answers

<p>It helps identify tenderness and discrepancies related to pubic dysfunction.</p> Signup and view all the answers

<p>Re-assessing the individual's condition if there's no improvement could be necessary.</p> Signup and view all the answers

A dysfunction in the movement of the ilium on the sacrum, considered an innominate somatic dysfunction.

The normal movement of the ilium around the fixed sacrum in the pelvis.

A dysfunction in the pelvis identified by osteopathic practitioners, often linked with iliosacral dysfunction.

Types of innominate somatic dysfunction where the innominate bone (ilium) rotates forward or backward.

Types of innominate somatic dysfunction where the innominate bone shifts superiorly or inferiorly.

They are NOT the same; iliosacral refers to the movement of the ilium on the sacrum, while sacroiliac refers to any pathology specifically located in the sacroiliac joint itself.

Multiple separate iliosacral pathologies can exist on both sides of the pelvis.

An iliosacral finding describes a restriction or dysfunction, while being treated, rather than simply designating a condition.

Iliosacral and sacroiliac pathologies are closely related. A sacroiliac issue often involves an iliosacral problem too, frequently accompanied by lumbosacral dysfunction.

Abnormal movement of the innominate bone (hip bone) in relation to the sacrum or other bones. This can result from trauma, MVA or muscle imbalances.

When the innominate bone shifts upward on one side, creating an 'upslip'.

When the innominate bone shifts downward (inferior), creating a 'downslip'.

Rotational movement of the innominate bone around an axis. Anterior rotation moves the front part of the bone outwards, and posterior inwards.

Grooves on the sacrum's surface. The depth of these sulci can indicate the presence of innominate rotation.

Key bony features (ASIS, pubis, iliac crest, PSIS, and MM) used to evaluate innominate alignment.

Movement or assessments of joint mobility, specifically, how the ilium (hip bone) moves on the sacrum.

Weight-bearing activities might naturally correct or reduce an innominate downslip.

Following initial assessment, re-evaluate joint function to confirm or refine findings.

Trauma (falls, MVA), leg traction, or muscle imbalances can cause innominate shear.

Shortened hip flexors or hamstrings can contribute to innominate rotations.

Evaluating joint movement helps confirm suspected innominate alignment issues.

The height of the iliac crest (top of the hip bone) relative to the other side can indicate an innominate shift.

The front of the innominate bone moves more laterally.

The back of the innominate bone moves more medially.

An iliosacral dysfunction where the innominate bone shifts superiorly (upward) on the sacrum.

An iliosacral dysfunction where the innominate bone shifts inferiorly (downward) on the sacrum.

An iliosacral dysfunction where the innominate bone moves toward the midline and deeper.

An iliosacral dysfunction where the innominate bone moves away from the midline and becomes more superficial.

Iliosacral dysfunctions characterized by a superior or inferior shift of the innominate bone, often associated with trauma.

Iliosacral dysfunctions where the innominate bone rotates either anteriorly or posteriorly, more common than shears.

Right anterior rotations are often more common due to the right leg being the dominant leg for most people.

When evaluating an iliosacral dysfunction, you should assess for both iliosacral and sacroiliac pathologies as they can influence each other.

Flares are less common and can often be misidentified as rotations, as they share a mediolateral component.

Hamstring length can influence iliosacral assessments; consider assessing hamstring length before conducting a standing flexion test.

Observing posture and pelvic angles in standing can provide information about potential iliosacral dysfunction.

When assessing iliosacral dysfunction, consider the positioning of bony landmarks like the ASIS, PSIS, and MM to identify rotations or shears.

Consider the three-dimensional aspects of iliosacral dysfunction, including anterior/posterior and deep/superficial positioning of landmarks.

A technique where the practitioner helps the patient stand at their feet, grasp their ankles and apply slight bilateral traction to the legs to try to level the pelvis.

These structures are landmarks used to assess the pelvis from the anterior side, including the ASIS (anterior superior iliac spine), the pubic tubercle, and the medial malleoli.

These structures are landmarks used to assess the pelvis from the posterior side, including the PSIS (posterior superior iliac spine) and the ischial tuberosity.

Beyond movement assessment, assessing related joint play and muscle imbalances can shed light on iliosacral dysfunction. This includes examining the sacrum's movement on the ilium, muscle strength and length discrepancies, and core muscle control.

Manual therapy might not effectively address long-standing iliosacral dysfunction. The dysfunction may reappear upon the next visit, indicating a deeper-rooted issue.

In an upslip, the sacro tuberous ligament on the affected side is expected to be lax. This ligament runs between the sacrum and the ischial tuberosity.

In a downslip, the sacro tuberous ligament on the affected side is expected to be tight or taut. This ligament runs between the sacrum and the ischial tuberosity.

Palpating various pelvic structures, like the sacro tuberous ligament, inguinal ligament, and gluteal muscles, can reveal tissue texture abnormalities (TTAs) indicating tenderness or tightness in ligamentous structures.

Recording the superior side instead of the affected side.

1. Explain what you're doing. 2. Demonstrate the technique (like on YouTube). 3. Get consent from the patient.

To determine the presence and type of innominate dysfunctions.

Looking for a difference in the distance from the midline to the ASIS on each side.

Comparing the height of the pubic bone on both sides.

Checking the height of the medial malleoli, often done after leg-length discrepancy tests.

Comparing the height of the PSIS on both sides, typically palpated from underneath.

Comparing the depth or position of the PSIS on both sides, typically palpated by rolling upwards.

Comparing the height of the ischial tuberosities on both sides, typically palpated from underneath.

Comparing the depth of the ischial tuberosity on both sides, typically palpated by following the curve.

Combine landmark palpation, standing flexion test, and assess for an affected side.

The patient has a functional leg-length discrepancy.

A technique used to reach the ischial tuberosities, especially for short practitioners.

1. ASIS higher on one side with no PSIS difference. 2. ASIS way higher on one side with a slight difference on the other. 3. ASIS way higher, PSIS the same or barely higher - possible upslip with posterior rotation.

To assess for a combination of pathologies and to understand the big picture of pelvic dysfunction.

A finding describes a restriction, while a diagnosis labels a condition. It's treated, not just a label.

Iliosacral refers to the movement of the ilium on the sacrum, while sacroiliac deals with pathologies in the sacroiliac joint itself.

Iliosacral and sacroiliac pathologies are often interconnected; a problem in one can influence the other.

A restriction in the normal movement of the ilium on the sacrum.

Innominate dysfunctions include shears (superior/inferior) and rotations (anterior/posterior), affecting the position of the ilium.

Upslip is a superior shift of the ilium, while downslip is an inferior shift.

Anterior rotation brings the front of the ilium forward, while posterior rotation brings the back of the ilium backward.

The depth of the sacral sulci can indicate the presence of innominate rotation.

Trauma, muscle imbalances, and leg traction can contribute to iliosacral dysfunction.

After initial assessment, re-evaluate joint function to confirm or refine findings.

Joint glides can help confirm suspected iliosacral alignment issues.

Comparing the height of the iliac crests on each side can reveal a superior or inferior shear.

Consider the anterior-posterior and deep-superficial aspects of iliosacral dysfunction.

An iliosacral dysfunction where the ilium rotates either anteriorly or posteriorly around the sacrum.

An iliosacral dysfunction where the ilium moves laterally away from the midline or medially towards the midline.

A test used to assess iliosacral dysfunction, where the patient flexes forward from a standing position while the practitioner observes movement of the ilium.

Considering all axes of movement (anterior-posterior, superior-inferior, medial-lateral) when assessing iliosacral dysfunction.

Shortened hamstrings can impact the findings of iliosacral assessments. Assess hamstring length before iliosacral assessment.

Iliosacral and sacroiliac pathologies are frequently co-existing. Assessment should include both.

Anterior rotations are the most common iliosacral dysfunction, particularly on the right side due to dominant leg usage.

The order of assessment may vary based on clinical judgment and the patient's presentation. Hamstring length may be assessed first, followed by posture and pelvic angles.

Shearing dysfunctions are more likely to be associated with trauma, while rotations can occur with or without trauma.

Multiple iliosacral dysfunctions can exist simultaneously, often accompanied by sacroiliac and lumbosacral dysfunctions.

Treating long-standing iliosacral dysfunction can be challenging and may require addressing underlying causes.

The bony bumps on the lateral borders of the pubis, palpated during the supine pelvic examination.

Comparing the distance of the ASIS from the midline on each side to check for discrepancies, best visualized using an imaginary line from the umbilicus.

Assessing the height of the medial malleoli to determine if they are level, typically done after leg-length discrepancy tests.

Identifying and comparing specific landmarks, like ASIS, pubis, PSIS, and ischial tuberosities, to assess pelvic alignment.

Assessing if a leg-length discrepancy corrects itself when transitioning from supine to sitting.

Mistaking the superior side for the affected side during landmarking.

Dysfunctions of the innominate bone (ilium), involving rotations and shears, detected through landmarking.

A technique to reach the ischial tuberosities when the practitioner is short, involves standing on one leg and extending the other.

Before examining pelvic landmarks, explain the procedure, demonstrate the technique, and obtain patient consent.