Muscular Systems and Force Couples in Pelvic Stabilization
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Questions and Answers

Which type of movement is likely to cause pain in the sacroiliac joint if it is involved?

  • Rotational-type movements
  • Transitional-type movements (correct)
  • Flexion-type movements
  • Extension-type movements

    • What posture potentially increases stress on the sacroiliac joints?

  • Standing on both legs (correct)
  • Twisting
  • Sitting with crossed legs
  • Sitting

    • Which of the following is NOT a risk factor for sacroiliac joint pathology?

  • Leg length discrepancy
  • Obesity
  • High-impact jumping (correct)
  • Gait abnormalities

    • Which activity is likely to decrease endurance capacity in the presence of sacroiliac joint pathology?

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

    Which position or activity stresses the sacroiliac joint?

    <p>All of the above</p> Signup and view all the answers

    Which age group is ankylosing spondylitis primarily found in?

    <p>Men between 15 and 35 years old</p> Signup and view all the answers

    Which of the following is a symptom of counternutation on one side?

    <p>The lower limb on that side is medially rotated</p> Signup and view all the answers

    What limits counternutation?

    <p>The posterior sacroiliac ligaments</p> Signup and view all the answers

    What is the motion of the sacrum during counternutation?

    <p>Slide anteriorly along its long arm</p> Signup and view all the answers

    What is the average pelvic tilt?

    <p>11° ± 4°</p> Signup and view all the answers

    What is the ideal pelvic alignment?

    <p>ASIS on the same vertical plane as the symphysis pubis</p> Signup and view all the answers

    What does a lack of movement control during side-lying hip abduction indicate?

    <p>Lack of stability in the pelvis</p> Signup and view all the answers

    Which of the following muscle groups is part of the deep posterior longitudinal system that stabilizes the pelvis?

    <p>Erector spinae</p> Signup and view all the answers

    Which muscle group is part of the anterior oblique system that stabilizes the pelvis?

    <p>Internal obliques</p> Signup and view all the answers

    Which muscle group is part of the lateral system that stabilizes the pelvis?

    <p>Gluteus medius</p> Signup and view all the answers

    Which muscle group is part of the innermost muscle group that stabilizes the pelvis?

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

    Which muscle group is part of the superficial posterior oblique system that stabilizes the pelvis?

    <p>Latissimus dorsi</p> Signup and view all the answers

    Which joint is usually a fused line united by a fibrocartilaginous disc?

    <p>Sacrococcygeal joint</p> Signup and view all the answers

    Which joints form the 'key' of the arch between the two pelvic bones?

    <p>Sacroiliac joints</p> Signup and view all the answers

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To transfer weight from the spine to the lower limbs</p> Signup and view all the answers

    What can alter the kinetic chain and put greater stress on the joints above the restricted or weak joint?

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

    What is the function of the sacroiliac and symphysis pubis joints in relation to shock absorption?

    <p>To decrease the force of jars and bumps to the spine and upper body</p> Signup and view all the answers

    When might an examiner not do an assessment of the pelvic joints?

    <p>When the lumbar spine and hip have been assessed and cleared</p> Signup and view all the answers

    What is the structure of the sacroiliac and symphysis pubis joints compared to most other joints?

    <p>They are partially synovial joints</p> Signup and view all the answers

    Which type of joint is sometimes called amphiarthrosis and is a type of fibrous joint?

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

    According to Kapandji, what is the relationship between the angle of the C shape of the synovial portion of the sacroiliac joint and its stability?

    <p>The greater the angle, the more stable the joint</p> Signup and view all the answers

    What is the role of the sacroiliac joints in the body?

    <p>To absorb shock forces</p> Signup and view all the answers

    What is the normal overall motion at the sacroiliac joints?

    <p>7 degrees</p> Signup and view all the answers

    What covers the articular surface of the ilium?

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

    What is the major connection between the sacrum and the ilium and one of the strongest ligaments in the body?

    <p>Interosseous sacroiliac ligament</p> Signup and view all the answers

    Which ligament limits counternutation at the sacroiliac joint?

    <p>Posterior sacroiliac ligament</p> Signup and view all the answers

    What is the average pelvic tilt?

    <p>11°</p> Signup and view all the answers

    Which muscle group is part of the deep posterior longitudinal system that stabilizes the pelvis?

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

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>Transmitting forces</p> Signup and view all the answers

    What is the major connection between the sacrum and the ilium?

    <p>Sacroiliac joint</p> Signup and view all the answers

    Which muscle group is part of the lateral system that stabilizes the pelvis?

    <p>Gluteus medius</p> Signup and view all the answers

    Which type of movement is likely to cause pain in the sacroiliac joint if it is involved?

    <p>Transitional movements</p> Signup and view all the answers

    What are some risk factors for sacroiliac joint pathology?

    <p>Gait abnormalities, low-grade trauma, and pregnancy</p> Signup and view all the answers

    What is the usual activity that stresses the sacroiliac joint?

    <p>Standing from a sitting position</p> Signup and view all the answers

    What is the age group primarily affected by ankylosing spondylitis?

    <p>15-25 years</p> Signup and view all the answers

    Which condition can lead to urinary problems in relation to the sacroiliac joint?

    <p>Sacroiliac joint dysfunction</p> Signup and view all the answers

    What is the result of increased laxity of the sacroiliac ligaments caused by hormonal changes during pregnancy?

    <p>Sprain of the sacroiliac ligaments</p> Signup and view all the answers

    Which muscle group is part of the deep posterior longitudinal system that stabilizes the pelvis?

    <p>Erector spinae</p> Signup and view all the answers

    Which muscle group is part of the superficial posterior oblique system that stabilizes the pelvis?

    <p>Gluteus maximus</p> Signup and view all the answers

    Which muscle group is part of the anterior oblique system that stabilizes the pelvis?

    <p>Internal obliques</p> Signup and view all the answers

    Which muscle group is part of the lateral system that stabilizes the pelvis?

    <p>Gluteus maximus</p> Signup and view all the answers

    Which muscle group is part of the innermost muscle group that stabilizes the pelvis?

    <p>Erector spinae</p> Signup and view all the answers

    Which muscle groups help to actively stabilize the pelvic joints and contribute significantly to load transfer during gait and pelvic rotational activities?

    <p>Internal and external obliques</p> Signup and view all the answers

    Which joint is commonly assessed along with the lumbar spine and hip due to similar symptoms and injury prevalence?

    <p>Sacroiliac joints</p> Signup and view all the answers

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To transfer weight from the spine to the lower limbs</p> Signup and view all the answers

    What can alter the kinetic chain and put greater stress on the joints above the restricted or weak joint?

    <p>Decreased range of motion (ROM)</p> Signup and view all the answers

    What is the structure of the sacroiliac and symphysis pubis joints compared to most other joints?

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

    What is the role of the sacroiliac joints in the body?

    <p>To transfer weight and provide elasticity to the pelvic ring</p> Signup and view all the answers

    Which joint acts as a buffer to decrease the force of jars and bumps to the spine and upper body caused by contact of the lower limbs with the ground?

    <p>Sacroiliac joints</p> Signup and view all the answers

    Which type of joint is sometimes called amphiarthrosis and is a type of fibrous joint?

    <p>Symphysis joint</p> Signup and view all the answers

    According to Kapandji, what is the relationship between the angle of the C shape of the synovial portion of the sacroiliac joint and its stability?

    <p>The greater the angle of the C, the more stable the joint</p> Signup and view all the answers

    What covers the articular surface of the ilium?

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

    What is the major connection between the sacrum and the ilium and one of the strongest ligaments in the body?

    <p>Interosseous sacroiliac ligament</p> Signup and view all the answers

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To transfer weight from the lower limb to the spine</p> Signup and view all the answers

    What is the normal overall motion at the sacroiliac joints?

    <p>7 degrees</p> Signup and view all the answers

    Which joint is commonly assessed along with the lumbar spine and hip due to similar symptoms and injury prevalence?

    <p>Sacroiliac joint</p> Signup and view all the answers

    What is the major connection between the sacrum and the ilium and one of the strongest ligaments in the body?

    <p>Sacroiliac joint</p> Signup and view all the answers

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To transfer weight from the spine to the lower limbs</p> Signup and view all the answers

    Which type of movement is likely to cause pain in the sacroiliac joint if it is involved?

    <p>Excessive rotation</p> Signup and view all the answers

    What covers the articular surface of the ilium?

    <p>Articular cartilage</p> Signup and view all the answers

    Which position or activity stresses the sacroiliac joint?

    <p>Sitting for long periods</p> Signup and view all the answers

    Which muscle group is part of the anterior oblique system that stabilizes the pelvis?

    <p>Internal and external obliques</p> Signup and view all the answers

    Which muscle group is part of the deep posterior longitudinal system that stabilizes the pelvis?

    <p>Erector spinae</p> Signup and view all the answers

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To stabilize the pelvis</p> Signup and view all the answers

    Which joint acts as a buffer to decrease the force of jars and bumps to the spine and upper body caused by contact of the lower limbs with the ground?

    <p>Sacroiliac joint</p> Signup and view all the answers

    What is the average pelvic tilt?

    <p>15 degrees</p> Signup and view all the answers

    Which ligament limits counternutation at the sacroiliac joint?

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

    Which ligament stabilizes L5 on the ilium?

    <p>Posterior interosseous ligament</p> Signup and view all the answers

    What is the function of the sacrotuberous and sacrospinous ligaments?

    <p>Limit nutation and posterior innominate rotation</p> Signup and view all the answers

    What is the major connection between the sacrum and the ilium?

    <p>Interosseous sacroiliac ligament</p> Signup and view all the answers

    What is the mechanism of stabilizing the sacroiliac joints through specific anatomic features and tissue tension?

    <p>Form closure and force closure</p> Signup and view all the answers

    Which two forms of closure and neurological control enable the sacroiliac joints to self-lock and release slightly?

    <p>Form closure and force closure</p> Signup and view all the answers

    What are the two mechanisms by which the sacroiliac joints are stabilized?

    <p>Form closure and force closure</p> Signup and view all the answers

    Which type of movement is likely to cause pain in the sacroiliac joint if it is involved?

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

    What is the most stable position of the sacroiliac joint?

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

    Which age group is ankylosing spondylitis primarily found in?

    <p>Young adults between 20 and 30 years old</p> Signup and view all the answers

    Which activity is likely to decrease endurance capacity in the presence of sacroiliac joint pathology?

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

    What is the function of the sacroiliac joints and symphysis pubis in transferring weight?

    <p>To provide stability to the pelvis</p> Signup and view all the answers

    What is the role of the sacroiliac joints in the body?

    <p>To provide stability and transfer weight between the upper body and lower extremities</p> Signup and view all the answers

    Which of the following is a characteristic of counternutation?

    <p>The ischial tuberosities move farther apart</p> Signup and view all the answers

    What is the role of the multifidus muscle in counternutation?

    <p>It resists the motion of counternutation</p> Signup and view all the answers

    What is the average change in lumbar lordosis due to anterior and posterior pelvic tilt?

    <p>11°</p> Signup and view all the answers

    What is the angle of average pelvic tilt?

    <p>11°</p> Signup and view all the answers

    What is the purpose of stabilizing the pelvis during different movements or positions?

    <p>To allow other muscles that originate from the pelvis to function properly</p> Signup and view all the answers

    What is a possible indication of lack of movement control and muscle balance during side-lying hip abduction?

    <p>All of the above</p> Signup and view all the answers

    During forward flexion, the sacrum initially nutates up to approximately how many degrees of forward flexion?

    <p>60°</p> Signup and view all the answers

    What movement occurs during extension or backward bending of the trunk?

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

    Which muscle is tested during the active prone hip extension test?

    <p>Gluteus maximus</p> Signup and view all the answers

    What happens to the sacrum during backward bending?

    <p>It remains in the same position</p> Signup and view all the answers

    Which side of the pelvis is typically higher and slightly forward when viewed from behind?

    <p>The affected side</p> Signup and view all the answers

    What does an upslip of the ilium on the sacrum on the high side indicate?

    <p>Both A and B</p> Signup and view all the answers

    What does it indicate if the ASIS is higher on one side and the PSIS is lower at the same time?

    <p>Anterior torsion of the sacrum on that side</p> Signup and view all the answers

    Which procedure is usually done with the patient lying supine?

    <p>Assessing the lumbar spine and hip</p> Signup and view all the answers

    What does a lateral pelvic tilt indicate?

    <p>Pathology in the sacroiliac joints</p> Signup and view all the answers

    What are the most common types of pelvis?

    <p>Gynecoid and android</p> Signup and view all the answers

    What may indicate an upslip of the ilium on the sacrum?

    <p>One higher ischial tuberosity</p> Signup and view all the answers

    Which movement causes the sacrum to nutate on the same side and counternutate on the opposite side?

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

    Which test involves the patient flexing the hip with the knee flexed to 90° or more to observe the drop or movement of the sacroiliac joint on that side?

    <p>Gillet test</p> Signup and view all the answers

    Which movement of the leg causes the ASIS to move medially and laterally?

    <p>Lateral rotation</p> Signup and view all the answers

    Which position is used to determine the relationship of the sacral bone and the inferior lateral angle of the sacrum?

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

    What is the purpose of the passive movements of the pelvic joints?

    <p>To determine symmetry or asymmetry of stiffness</p> Signup and view all the answers

    Which test is used to assess a possible sacroiliac lesion and/or sprain of the posterior sacroiliac ligaments?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    What is the purpose of the Gapping (Transverse Anterior Stress or Distraction Provocation) Test?

    <p>To assess a sprain of the anterior sacroiliac ligaments</p> Signup and view all the answers

    Which test is used to assess sacroiliac joint involvement based on the difference in range of motion between the affected and unaffected leg?

    <p>Hip Abduction and External (Lateral) Rotation (HABER) Test</p> Signup and view all the answers

    Which of the following is a possible indication of sacroiliac joint pathology?

    <p>Lateral pelvic tilt</p> Signup and view all the answers

    What is the most common type of pelvis?

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

    Which muscle is often flatter on the painful side if there is loss of tone in it?

    <p>Gluteus maximus</p> Signup and view all the answers

    What does a higher iliac crest on one side indicate?

    <p>Upslip of the ilium on the sacrum</p> Signup and view all the answers

    What is the most accurate description of the movement of the sacroiliac joints during active movements?

    <p>Anteroposterior rotation</p> Signup and view all the answers

    What should the examiner consider before diagnosing sacroiliac joint problems?

    <p>Patient's symptoms and history</p> Signup and view all the answers

    During the anterior rotation of the innominate bones, what happens to the sacrum?

    <p>The sacrum nutates up to about 60° of forward flexion</p> Signup and view all the answers

    What happens to the sacroiliac joint during counternutation?

    <p>The sacroiliac joint becomes vulnerable to instability</p> Signup and view all the answers

    What is more likely to occur in patients with tight hamstrings?

    <p>Excessive counternutation</p> Signup and view all the answers

    What movement occurs in the sacrum during backward bending?

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

    What happens to the innominate bones during extension or backward bending of the trunk?

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

    What is the purpose of the prone active straight leg raise test?

    <p>To assess gluteus maximus contraction</p> Signup and view all the answers

    During side flexion, the sacrum rotates slightly in which direction?

    <p>In the opposite direction of the side flexion</p> Signup and view all the answers

    What movement occurs at the sacroiliac joints during rotation of the trunk and pelvis?

    <p>The sacroiliac joints rotate in the opposite direction of the trunk and pelvis</p> Signup and view all the answers

    What movement occurs at the sacrum during rotation of the trunk and pelvis?

    <p>The sacrum nutates on the same side as the rotation</p> Signup and view all the answers

    What happens to the sacroiliac joint on the flexed side during hip flexion?

    <p>The sacroiliac joint drops or moves caudally</p> Signup and view all the answers

    During the Gillet test, what happens to the thumb placed over the PSIS on the flexed side?

    <p>The thumb moves up</p> Signup and view all the answers

    What is the purpose of observing the movement of the ASIS during medial and lateral rotation of the leg?

    <p>To assess the stability of the sacroiliac joints</p> Signup and view all the answers

    Which side is the ASIS often higher and slightly forward on when viewed anteriorly?

    <p>The affected side</p> Signup and view all the answers

    What does it indicate if the ASIS and PSIS on one side are higher than the ASIS and PSIS on the other?

    <p>All of the above</p> Signup and view all the answers

    What does it indicate if the ASIS is higher on one side and the PSIS is lower at the same time?

    <p>Anterior torsion of the sacrum on that side</p> Signup and view all the answers

    What is the most common rotation of the innominate bones?

    <p>Left posterior torsion or rotation</p> Signup and view all the answers

    What are the usual causes of posterior rotational dysfunctions of the innominate bones?

    <p>All of the above</p> Signup and view all the answers

    How does an anterior rotational dysfunction of the sacrum typically occur?

    <p>Following a posterior horizontal thrust of the femur</p> Signup and view all the answers

    Which test is used to assess the ability of the ilium to flex and rotate laterally or posteriorly?

    <p>Ipsilateral Prone Kinetic Test</p> Signup and view all the answers

    Which test is positive if unilateral gluteal or posterior leg pain is produced, indicating a sprain of the anterior sacroiliac ligaments?

    <p>Gapping (Transverse Anterior Stress or Distraction Provocation) Test</p> Signup and view all the answers

    Which test involves the examiner's hands pressing toward the floor over the upper part of the iliac crest, causing forward pressure on the sacrum?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    Which test involves the examiner slightly flexing, abducting, and laterally rotating the patient's thigh at approximately 45° from the midline, causing an anterior-to-posterior shear stress to the sacroiliac joint on the same side?

    <p>Femoral Shear (Posterior Shear [POSH]) Test</p> Signup and view all the answers

    Which test is used to assess sacroiliac joint involvement based on the difference in range of motion between the affected and unaffected leg?

    <p>Hip Abduction and External (Lateral) Rotation (HABER) Test</p> Signup and view all the answers

    Which test is positive if an increased feeling of pressure in the sacroiliac joints is indicated, suggesting a possible sacroiliac lesion and/or a sprain of the posterior sacroiliac ligaments?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    What happens to the sacrum during counternutation?

    <p>It moves backward</p> Signup and view all the answers

    What is the role of the gluteus maximus muscle during hip extension?

    <p>It contracts with a delay</p> Signup and view all the answers

    What happens to the innominate bones during backward bending of the trunk?

    <p>They rotate posteriorly</p> Signup and view all the answers

    What is the purpose of the standing flexion test?

    <p>To assess forward flexion</p> Signup and view all the answers

    What is the effect of tight hamstrings on counternutation?

    <p>It increases counternutation</p> Signup and view all the answers

    What is the relationship between sacral nutation and sacroiliac joint stability?

    <p>Nutation increases stability</p> Signup and view all the answers

    Which of the following is a common symptom of sacroiliac joint dysfunction?

    <p>Unilateral or bilateral spasm of the erector spinae muscles</p> Signup and view all the answers

    What is the most common type of pelvis?

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

    What does a higher ASIS on one side indicate?

    <p>Higher pubic bone on that side</p> Signup and view all the answers

    What does a deeper sacral sulci indicate?

    <p>Sacral torsion</p> Signup and view all the answers

    What is the purpose of assessing the lumbar spine and hip before assessing the pelvic joints?

    <p>To rule out other potential causes of pain</p> Signup and view all the answers

    What type of movement can cause stress on the sacroiliac joints?

    <p>Forward flexion of the trunk</p> Signup and view all the answers

    Which side of the pelvis is typically higher and slightly forward when viewed from behind?

    <p>The affected side</p> Signup and view all the answers

    What does a higher iliac crest on one side indicate?

    <p>Upslip of the ilium on the sacrum</p> Signup and view all the answers

    What does an upslip of the ilium on the sacrum on the high side indicate?

    <p>Anterior torsion of the sacrum</p> Signup and view all the answers

    What does a higher ASIS and lower PSIS on the same side indicate?

    <p>Anterior torsion of the sacrum</p> Signup and view all the answers

    What is the most common rotation of the innominate bones?

    <p>Left posterior torsion</p> Signup and view all the answers

    What is the function of the sacrotuberous and sacrospinous ligaments?

    <p>Stabilize the pelvis</p> Signup and view all the answers

    During hip flexion with the knee flexed to 90° or more, what movement should occur at the sacroiliac joint on that side?

    <p>The sacroiliac joint drops or moves inferiorly</p> Signup and view all the answers

    Which movement of the ASIS should be observed during medial and lateral rotation of the leg?

    <p>The ASIS moves laterally</p> Signup and view all the answers

    In which position is the relationship of the four points (base of the sacrum and the inferior lateral angle) determined to assess the position of the sacrum?

    <p>All of the above</p> Signup and view all the answers

    What does an anterior left sacral base along with a posterior right inferior lateral angle indicate?

    <p>A left rotated sacrum</p> Signup and view all the answers

    What movements are performed to observe the action of the pelvic floor muscles?

    <p>Flexion, neutral, and extension</p> Signup and view all the answers

    What is the purpose of the sacral flexion test?

    <p>To assess the movement of the sacrum during side flexion</p> Signup and view all the answers

    Which test is used to assess the ability of the ilium to flex and rotate laterally or posteriorly?

    <p>Ipsilateral Prone Kinetic Test</p> Signup and view all the answers

    Which movement involves stressing the ligaments and joints of the pelvic joints, but is used to determine symmetry or asymmetry of stiffness rather than normal, hypermobile, or hypomobile?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    Which test involves the examiner placing their hands over the upper part of the iliac crest and pressing toward the floor, causing forward pressure on the sacrum?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    Which test involves the examiner slightly flexing, abducting, and laterally rotating the patient’s thigh at approximately 45° from the midline, causing an anterior-to-posterior shear stress to the sacroiliac joint on the same side?

    <p>Femoral Shear (Posterior Shear [POSH]) Test</p> Signup and view all the answers

    Which test involves the examiner applying crossed-arm pressure to the ASIS, pushing down and out with the arms, and is positive only if unilateral gluteal or posterior leg pain is produced, indicating a sprain of the anterior sacroiliac ligaments?

    <p>Gapping (Transverse Anterior Stress or Distraction Provocation) Test</p> Signup and view all the answers

    Which test involves progressively increasing the stress on the ipsilateral sacroiliac joint by abducting and laterally rotating the hip in 10° increments until the patient complains of pain or the end of the range is reached?

    <p>Ipsilateral Prone Kinetic Test</p> Signup and view all the answers

    What movement occurs at the sacroiliac joints during forward flexion?

    <p>The sacroiliac joints rotate anteriorly</p> Signup and view all the answers

    What is the purpose of the standing flexion test?

    <p>To assess the range of motion in the sacroiliac joints</p> Signup and view all the answers

    What movement occurs at the sacroiliac joints during extension or backward bending of the trunk?

    <p>The sacroiliac joints rotate posteriorly</p> Signup and view all the answers

    What is the purpose of the prone active straight leg raise test?

    <p>To assess the strength of the gluteus maximus muscle</p> Signup and view all the answers

    What happens to the sacrum during sacral counternutation?

    <p>The sacrum moves backward</p> Signup and view all the answers

    What happens to the ASIS during extension or backward bending of the trunk?

    <p>The ASIS moves superiorly</p> Signup and view all the answers

    During rotation, the pelvic girdle moves in which direction?

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

    Which test involves the examiner placing one thumb over the PSIS and the other thumb over the spinous process of S2?

    <p>Gillet test</p> Signup and view all the answers

    What movement of the hip causes the sacroiliac joint on that side to drop or move caudally in relation to the other sacroiliac joint?

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

    What movement of the leg causes the ASIS to move medially and laterally?

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

    Which position is used to determine the relationship of the sacral bone and the inferior lateral angle of the sacrum?

    <p>Prone lying</p> Signup and view all the answers

    What does an anterior left sacral base along with a posterior right inferior lateral angle indicate?

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

    Which test is commonly used to assess the position of the sacrum relative to the ilium?

    <p>Forward bending test</p> Signup and view all the answers

    What is the usual position of the PSISs when the patient stands?

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

    Which muscle can cause pain in the sacroiliac joint when it contracts strongly?

    <p>Gluteus medius</p> Signup and view all the answers

    What type of movement do the sacroiliac joints undergo during active movements?

    <p>Anteroposterior rotation</p> Signup and view all the answers

    Which joints may refer pain to the sacroiliac joint area?

    <p>Lumbar spine and hip</p> Signup and view all the answers

    What should the examiner consider before diagnosing sacroiliac joint problems?

    <p>All aspects of the assessment</p> Signup and view all the answers

    Which side is the ASIS often higher and slightly forward on when viewed anteriorly?

    <p>The affected side</p> Signup and view all the answers

    What does it indicate if the ASIS and PSIS on one side are higher than the ASIS and PSIS on the other?

    <p>All of the above</p> Signup and view all the answers

    What does it indicate if the ASIS is higher on one side and the PSIS is lower at the same time?

    <p>Anterior torsion of the sacrum on that side</p> Signup and view all the answers

    What is the most common rotation of the innominate bones?

    <p>Left posterior torsion</p> Signup and view all the answers

    What is the most common cause of anterior rotational dysfunction?

    <p>Falling on an ischial tuberosity</p> Signup and view all the answers

    How does the examiner test for level equality of both pubic bones at the symphysis pubis?

    <p>By comparing the heights of the superior aspect of each pubic bone</p> Signup and view all the answers

    Which test is used to assess the ability of the ilium to flex and rotate laterally or posteriorly?

    <p>Ipsilateral Prone Kinetic Test</p> Signup and view all the answers

    Which test involves the examiner slightly flexing, abducting, and laterally rotating the patient's thigh to apply a graded force through the long axis of the femur?

    <p>Femoral Shear (Posterior Shear [POSH]) Test</p> Signup and view all the answers

    Which test involves the examiner pushing down and out with crossed-arm pressure on the ASIS and is positive if unilateral gluteal or posterior leg pain is produced?

    <p>Gapping (Transverse Anterior Stress or Distraction Provocation) Test</p> Signup and view all the answers

    Which test is used to compare the lateral rotation and abduction of the hip between the unaffected and affected leg to assess stress on the ipsilateral sacroiliac joint?

    <p>Hip Abduction and External (Lateral) Rotation (HABER) Test</p> Signup and view all the answers

    Which test involves the examiner's hands placed over the upper part of the iliac crest, pressing toward the floor to cause forward pressure on the sacrum?

    <p>Approximation (Transverse Posterior Stress) Test</p> Signup and view all the answers

    Which test is designed to assess the ability of the ilium to flex and rotate laterally or posteriorly by asking the patient to actively extend the leg on the same side?

    <p>Ipsilateral Prone Kinetic Test</p> Signup and view all the answers

    Which joint is often stressed during the sit-to-stand test in patients with sacroiliac joint dysfunction?

    <p>Hip joint</p> Signup and view all the answers

    Which special test is used to assess the flexibility of the rectus femoris muscle, upper lumbar joint, or sacroiliac joint?

    <p>Prone Knee Bending (Nachlas) Test</p> Signup and view all the answers

    At what degree of hip flexion is joint pain usually experienced in hypermobile persons during the Straight Leg Raising (Lasègue’s) Test?

    <p>120°</p> Signup and view all the answers

    What does pain occurring before 70° of hip flexion during the bilateral Straight Leg Raising (SLR) Test usually indicate?

    <p>Sacroiliac joint problems</p> Signup and view all the answers

    What does unaltered or decreased pain in the sacroiliac joint during the Straight Leg Raising (SLR) Test indicate?

    <p>Anterior torsion</p> Signup and view all the answers

    Which modification of the straight leg test is used to test for postpartum pelvic problems?

    <p>Active SLR Test</p> Signup and view all the answers

    Which test is performed with the patient lying supine and the hip and knee flexed to 90°?

    <p>Passive Lateral Rotation of the Hip</p> Signup and view all the answers

    During the Passive Extension and Medial Rotation of Ilium on Sacrum test, the examiner pulls the ilium forward with which hand?

    <p>Hand over the ASIS area of the anterior ilium</p> Signup and view all the answers

    What does it indicate if the affected side moves less during the Passive Extension and Medial Rotation of Ilium on Sacrum test?

    <p>Hypomobility and a posterior rotated ilium</p> Signup and view all the answers

    What does it indicate if the affected side moves less during the Passive Flexion and Lateral Rotation of Ilium on Sacrum test?

    <p>Hypomobility and an anterior rotated ilium</p> Signup and view all the answers

    What does it indicate if both the Passive Extension and Medial Rotation of Ilium on Sacrum test and the Passive Flexion and Lateral Rotation of Ilium on Sacrum test are positive?

    <p>Hypomobility and a posterior rotated ilium</p> Signup and view all the answers

    What does the Prone Gapping (Hibb’s) Test stress?

    <p>The posterior ilium and sacrum</p> Signup and view all the answers

    Which test involves the examiner flexing, abducting, and laterally rotating the patient's hip, applying an overpressure at the end of the range of motion?

    <p>Laguere's Sign</p> Signup and view all the answers

    What does a positive Laguere's Sign indicate?

    <p>Sacroiliac joint dysfunction</p> Signup and view all the answers

    Which test is performed with the patient in a straddle position, bending forward and trying to touch the floor, and is used to assess for unilateral forward displacement of the ilium relative to the sacrum?

    <p>Mazion's Pelvic Maneuver</p> Signup and view all the answers

    Which test involves palpating the PSISs and comparing their heights, and if one PSIS is lower than the other and becomes higher on forward flexion, it indicates an abnormality in the torsion movement at the sacroiliac joint?

    <p>Piedallu's Sign</p> Signup and view all the answers

    Which test involves the examiner sitting behind the patient and palpating one PSIS with one thumb and the sacrum with the other thumb, while the patient extends the ipsilateral leg?

    <p>Ipsilateral Anterior Rotation Test</p> Signup and view all the answers

    What does a superior and lateral movement of the PSIS during the Ipsilateral Anterior Rotation Test indicate?

    <p>Normal movement</p> Signup and view all the answers

    Which test involves the patient standing on one leg and allowing the heel to suddenly drop, delivering a mechanical 'jolt' to the pelvis?

    <p>Flamingo Test or Maneuver</p> Signup and view all the answers

    Which test involves the patient standing on one leg while pulling the opposite knee up toward the chest, causing the innominate bone on the same side to rotate posteriorly?

    <p>Gillet Test</p> Signup and view all the answers

    Which test involves the patient lying on the side with the upper leg hyperextended at the hip, while the examiner extends the hip of the uppermost leg?

    <p>Gaenslen's Test</p> Signup and view all the answers

    Which test involves the patient actively lifting the leg while the examiner stabilizes and compresses the pelvis, providing form closure of the joints?

    <p>Supine active straight leg raise test</p> Signup and view all the answers

    Which test involves the examiner palpating the PSISs with one thumb and the other thumb parallel with the first thumb on the sacrum, while the patient stands on one leg and pulls the opposite knee up toward the chest?

    <p>Gillet Test</p> Signup and view all the answers

    Which test involves the patient standing on one leg, while the weight of the trunk causes the sacrum to shift forward and distally with forward rotation?

    <p>Flamingo Test or Maneuver</p> Signup and view all the answers

    Which test involves the examiner palpating the sacroiliac joint while the patient's knee is flexed to 90° and the hip is rotated medially as far as possible?

    <p>Prone Springing</p> Signup and view all the answers

    Which test involves the examiner applying pressure to the apex of the sacrum, directed cranially causing a shear of the sacrum on the ilium?

    <p>Prone Springing</p> Signup and view all the answers

    Which test involves the examiner flexing the patient's knee and hip fully, adducting the hip, and rocking the sacroiliac joint by flexion and adduction of the patient's hip?

    <p>Sacroiliac Rocking</p> Signup and view all the answers

    Which test involves the examiner applying downward and inward pressure at a 45° angle on the patient's ASISs and iliac crests to test the posterior sacroiliac ligaments?

    <p>Squish Test</p> Signup and view all the answers

    Which test involves the examiner squeezing their hands together, applying a shearing force to the symphysis pubis to test for pain in the symphysis pubis?

    <p>Superoinferior Symphysis Pubis Stress Test</p> Signup and view all the answers

    Which test involves the examiner passively flexing the hip on the test side to 90°, thrusting down through the patient's knee and hip, and checking for pain in the sacroiliac joint?

    <p>Thigh Thrust Test</p> Signup and view all the answers

    Which test involves the examiner palpating the PSIS and sacrum while the patient extends the ipsilateral leg?

    <p>Gillet test</p> Signup and view all the answers

    What does a positive Laguere's Sign indicate?

    <p>Unilateral forward displacement of the ilium relative to the sacrum</p> Signup and view all the answers

    Which test involves the examiner flexing, abducting, and laterally rotating the patient's hip while stabilizing the pelvis on the opposite side?

    <p>Ipsilateral Anterior Rotation Test</p> Signup and view all the answers

    What is the purpose of the Posterior Superior Iliac Spine Distraction Test?

    <p>To test for sacroiliac joint dysfunction</p> Signup and view all the answers

    Which test involves the patient bending forward in a straddle position and trying to touch the floor?

    <p>Mazion's pelvic maneuver</p> Signup and view all the answers

    What does a positive Patrick Test indicate?

    <p>Sacroiliac joint dysfunction</p> Signup and view all the answers

    Which test involves the patient actively lifting the leg while the examiner stabilizes and compresses the pelvis, providing form closure of the joints by squeezing the innominate bones together anteriorly?

    <p>Supine Active Straight Leg Raise Test</p> Signup and view all the answers

    Which test involves the patient standing on one leg and allowing the heel to suddenly drop, delivering an ipsilateral mechanical 'jolt' to the pelvis?

    <p>Drop Test</p> Signup and view all the answers

    Which test involves the patient standing on one leg and causing the sacrum to shift forward and distally with forward rotation, while the ilium moves in the opposite direction?

    <p>Flamingo Test</p> Signup and view all the answers

    Which test involves the patient lying on the side with the upper leg hyperextended at the hip, while the examiner extends the hip of the uppermost leg?

    <p>Gaenslen's Test</p> Signup and view all the answers

    Which test involves the patient standing on one leg while pulling the opposite knee up toward the chest, causing the innominate bone on the same side to rotate posteriorly?

    <p>Gillet Test</p> Signup and view all the answers

    Which test involves the examiner palpating the PSISs with one thumb and the other thumb parallel with the first thumb on the sacrum, while the patient stands on one leg and pulls the opposite knee up toward the chest?

    <p>Gillet Test</p> Signup and view all the answers

    Which test is primarily considered a test of the neurological tissue around the lumbar spine, but also places stress on the sacroiliac joints?

    <p>Straight Leg Raising (Lasègue’s) Test</p> Signup and view all the answers

    Which test is used to test for a tight rectus femoris, an upper lumbar joint lesion, an upper spine nerve root lesion, or a hypomobile sacroiliac joint?

    <p>Prone Knee Bending (Nachlas) Test</p> Signup and view all the answers

    Which test involves the examiner flexing, abducting, and laterally rotating the patient's hip, applying an overpressure at the end of the range of motion?

    <p>Active SLR Test</p> Signup and view all the answers

    What percentage of sacroiliac joint patients showed tenderness in the sacral sulcus, the area of soft tissue just medial to the PSIS?

    <p>89%</p> Signup and view all the answers

    Which test can be affected by sacroiliac problems, and if pain in the sacroiliac joint is unaltered or decreases during the test, it may indicate an anterior torsion?

    <p>Straight Leg Raising (Lasègue’s) Test</p> Signup and view all the answers

    Which special tests have been validated to accurately diagnose sacroiliac joint pathology?

    <p>None of the above</p> Signup and view all the answers

    Which test is used to assess the passive extension and medial rotation of the ilium on the sacrum?

    <p>Passive Extension and Medial Rotation of Ilium on Sacrum</p> Signup and view all the answers

    Which test is used to assess the passive flexion and lateral rotation of the ilium on the sacrum?

    <p>Passive Flexion and Lateral Rotation of Ilium on Sacrum</p> Signup and view all the answers

    Which test is used to assess the relative movement of the ilium on the sacrum during lateral rotation of the hip?

    <p>Passive Lateral Rotation of the Hip</p> Signup and view all the answers

    Which test is used to stress the posterior sacroiliac ligaments with the patient in the prone position?

    <p>Prone Gapping (Hibb’s) Test</p> Signup and view all the answers

    What does it indicate if both the passive extension and medial rotation test and the passive flexion and lateral rotation test are positive?

    <p>Upslip of the ilium</p> Signup and view all the answers

    Which test is used to assess sacroiliac joint involvement based on the difference in range of motion between the affected and unaffected leg?

    <p>Prone Gapping (Hibb’s) Test</p> Signup and view all the answers

    Which test involves the examiner palpating the sacroiliac joint on the same side while pushing the patient's hip into the very end of medial rotation?

    <p>Sacroiliac Rocking (Knee-to-Shoulder) Test</p> Signup and view all the answers

    Which test involves applying pressure to the apex of the sacrum, directed cranially causing a shear of the sacrum on the ilium?

    <p>Sacral Apex Pressure (Prone Springing) Test</p> Signup and view all the answers

    Which test involves the examiner flexing the patient's knee and hip fully, adducting the hip, and rocking the sacroiliac joint by flexion and adduction of the patient's hip?

    <p>Sacroiliac Rocking (Knee-to-Shoulder) Test</p> Signup and view all the answers

    Which test involves the examiner placing both hands on the patient's ASISs and iliac crests and pushing down and in at a 45° angle to test the posterior sacroiliac ligaments?

    <p>Squish Test</p> Signup and view all the answers

    Which test involves the examiner thrusting down through the patient's knee and hip on the test side while palpating the sacroiliac joint on the same side?

    <p>Thigh Thrust Test</p> Signup and view all the answers

    Which test involves the examiner palpating the spinous process of L5 with one thumb holding it stable and placing the other hand around the anterior ilium on the opposite side to lift the contralateral ilium up?

    <p>Torsion Stress Test</p> Signup and view all the answers

    Which test involves the examiner palpating the PSIS and sacrum while the patient extends the ipsilateral leg?

    <p>Ipsilateral Anterior Rotation Test</p> Signup and view all the answers

    What does a positive Laguere's Sign indicate?

    <p>Sacroiliac joint dysfunction</p> Signup and view all the answers

    Which test involves the examiner flexing, abducting, and laterally rotating the patient's hip, applying overpressure at the end of the range of motion?

    <p>Patrick Test</p> Signup and view all the answers

    What does a positive Patrick Test indicate?

    <p>Unilateral forward displacement of the ilium relative to the sacrum</p> Signup and view all the answers

    Which test involves the examiner palpating the PSISs and comparing their heights while the patient forward flexes while remaining seated?

    <p>Piedallu's Sign</p> Signup and view all the answers

    What does a positive Piedallu's Sign indicate?

    <p>Abnormality in the torsion movement at the sacroiliac joint</p> Signup and view all the answers

    Which test is used to assess passive extension and medial rotation of the ilium on the sacrum?

    <p>Passive Extension and Medial Rotation of Ilium on Sacrum</p> Signup and view all the answers

    Which test is used to assess passive flexion and lateral rotation of the ilium on the sacrum?

    <p>Passive Flexion and Lateral Rotation of Ilium on Sacrum</p> Signup and view all the answers

    Which test is used to stress the sacroiliac joint on the test side by laterally rotating the hip to end range?

    <p>Passive Lateral Rotation of the Hip</p> Signup and view all the answers

    Which test is used to stress the posterior sacroiliac ligaments with the patient in the prone position?

    <p>Prone Gapping (Hibb’s) Test</p> Signup and view all the answers

    What does a positive result for the passive extension and medial rotation of the ilium on the sacrum test indicate?

    <p>Hypomobility and a posterior rotated ilium</p> Signup and view all the answers

    What does a positive result for both the passive flexion and lateral rotation of the ilium on the sacrum test and the passive extension and medial rotation of the ilium on the sacrum test indicate?

    <p>Upslip of the ilium relative to the sacrum</p> Signup and view all the answers

    Which test is primarily considered a test of the neurological tissue around the lumbar spine, but also places stress on the sacroiliac joints?

    <p>Straight Leg Raising (Lasègue’s) Test</p> Signup and view all the answers

    Which test involves the examiner flexing the patient's knee so that the heel is brought to the buttocks, and can indicate a tight rectus femoris, an upper lumbar joint lesion, an upper spine nerve root lesion, or a hypomobile sacroiliac joint?

    <p>Prone Knee Bending (Nachlas) Test</p> Signup and view all the answers

    Which test involves progressively increasing the stress on the ipsilateral sacroiliac joint by abducting and laterally rotating the hip in 10° increments until the patient complains of pain or the end of the range is reached?

    <p>Passive Flexion and Lateral Rotation of Ilium on Sacrum test</p> Signup and view all the answers

    Which test involves the patient standing on one leg and allowing the heel to suddenly drop, delivering a mechanical 'jolt' to the pelvis?

    <p>Stork Test</p> Signup and view all the answers

    What is the relationship between sacral nutation and sacroiliac joint stability?

    <p>Sacroiliac joint stability is decreased during sacral nutation.</p> Signup and view all the answers

    What does unaltered or decreased pain in the sacroiliac joint during the Straight Leg Raising (SLR) Test indicate?

    <p>Anterior torsion</p> Signup and view all the answers

    Which test involves the examiner palpating the sacroiliac joint while the patient's knee is flexed to 90° and the hip is rotated medially as far as possible?

    <p>Sacroiliac Rocking Test</p> Signup and view all the answers

    Which test is used to assess sacroiliac joint involvement based on the difference in range of motion between the affected and unaffected leg?

    <p>Thigh Thrust Test</p> Signup and view all the answers

    Which test involves the examiner placing both hands on the patient's ASISs and iliac crests and pushing down and in at a 45° angle to test the posterior sacroiliac ligaments?

    <p>Squish Test</p> Signup and view all the answers

    Which test involves the examiner applying pressure to the apex of the sacrum, directed cranially causing a shear of the sacrum on the ilium?

    <p>Sacral Apex Pressure Test</p> Signup and view all the answers

    Which test involves the examiner palpating the spinous process of L5 with one thumb holding it stable and the examiner's other hand placed around the anterior ilium on the opposite side, lifting the contralateral ilium up to stress the lumbosacral junction, iliolumbar ligament, anterior sacroiliac ligament, and sacroiliac joint?

    <p>Torsion Stress Test</p> Signup and view all the answers

    Which test involves the examiner placing the heel of one hand over the superior pubic ramus of one pubic bone and the heel of the other hand over the inferior pubic ramus of the other pubic bone, then squeezing the hands together to apply a shearing force to the symphysis pubis?

    <p>Superoinferior Symphysis Pubis Stress Test</p> Signup and view all the answers

    Which test is used to assess the stability of the sacroiliac joints during movement by having the patient flex and rotate the trunk toward the side on which the straight leg raise test is actively being performed?

    <p>Gillet test</p> Signup and view all the answers

    Which test involves the patient standing on one leg and allowing the heel to suddenly drop, delivering an ipsilateral mechanical 'jolt' to the pelvis?

    <p>Drop test</p> Signup and view all the answers

    Which test involves the patient standing on one leg, causing the sacrum to shift forward and distally with forward rotation, and can be used to assess pain in the symphysis pubis or sacroiliac joint?

    <p>Flamingo test</p> Signup and view all the answers

    Which test involves the patient lying on the side with the upper leg hyperextended at the hip, while the examiner extends the hip of the uppermost leg to assess pain in the sacroiliac joints, hip pathology, or an L4 nerve root lesion?

    <p>Gaenslen's test</p> Signup and view all the answers

    Which test involves the examiner palpating the PSISs with one thumb and the other thumb parallel with the first thumb on the sacrum, while the patient stands on one leg and pulls the opposite knee up toward the chest?

    <p>Gillet test</p> Signup and view all the answers

    Which test involves the examiner asking the patient to actively lift their leg while stabilizing and compressing the pelvis, and checking for any "effort differences" between the two sides?

    <p>Supine active straight leg raise test</p> Signup and view all the answers

    Which of the following tests is used to measure true leg length?

    <p>Leg Length Test</p> Signup and view all the answers

    What is the normal range for leg length difference?

    <p>0.5 to 1 inch</p> Signup and view all the answers

    Which muscle group is primarily responsible for hip abduction during the Trendelenburg Test?

    <p>Gluteus Medius</p> Signup and view all the answers

    Which test is used to assess hamstring tightness?

    <p>Functional Hamstring Length</p> Signup and view all the answers

    What does a positive Sign of the Buttock Test indicate?

    <p>Pathology in the buttock</p> Signup and view all the answers

    What is the primary muscle group responsible for thoracolumbar rotation?

    <p>Latissimus Dorsi</p> Signup and view all the answers

    Which nerve is responsible for sensory alteration and/or burning pain on the lateral aspect of the thigh?

    <p>Lateral femoral cutaneous nerve</p> Signup and view all the answers

    Which muscle may compress the ilioinguinal nerve, causing sensory alteration and/or pain in the superior aspect of the anterior thigh?

    <p>Transverse abdominis</p> Signup and view all the answers

    Which movement tests for cephalad movement of the sacrum and caudal movement of the ilium?

    <p>Joint play movement A</p> Signup and view all the answers

    Which movement tests for caudal movement of the sacrum and cephalad movement of the ilium?

    <p>Joint play movement B</p> Signup and view all the answers

    Which movement tests for anterior movement of the sacrum on the ilium?

    <p>Joint play movement C</p> Signup and view all the answers

    Which movement tests for anteroposterior translation of the ilium on the sacrum?

    <p>Joint play movement D</p> Signup and view all the answers

    Which test is used to assess for a functional leg length difference resulting from pelvic torsion or rotation?

    <p>Supine-to-Sit (Long Sitting) Test</p> Signup and view all the answers

    Which test involves the examiner flexing the patient's knee to 90° and extending the hip to assess for pathology in the anterior sacroiliac ligaments?

    <p>Yeoman’s Test</p> Signup and view all the answers

    Which test involves palpating the ASISs and PSISs to assess for any asymmetry in the patient's stance?

    <p>Functional Limb Length Test</p> Signup and view all the answers

    If the asymmetry in the Functional Limb Length Test is corrected by proper positioning, what does it indicate?

    <p>Functional leg length difference</p> Signup and view all the answers

    What does a positive Yeoman’s Test indicate?

    <p>Pathology in the anterior sacroiliac ligaments</p> Signup and view all the answers

    What is the purpose of the Leg Length Test?

    <p>To assess for any asymmetry in the patient's stance</p> Signup and view all the answers

    Which of the following structures should be carefully and thoroughly palpated on the anterior aspect of the pelvis?

    <p>Iliac crest and anterior superior iliac spine</p> Signup and view all the answers

    Which point is located in the right iliac fossa anterior to the right sacroiliac joint and slightly medial to McBurney's point?

    <p>Baer's point</p> Signup and view all the answers

    Which muscle group is part of the innermost muscle group that stabilizes the pelvis?

    <p>Adductor muscles</p> Signup and view all the answers

    Which structure should be palpated for tenderness or signs of pathology by placing the thumbs over the pubic tubercles and moving the fingers laterally until the bony greater trochanter of the femur is felt?

    <p>Symphysis pubis</p> Signup and view all the answers

    Which test involves the examiner placing the heel of one hand on the superior aspect of the superior ramus of one pubic bone and the heel of the other hand on the inferior aspect of the superior ramus of the opposite pelvic bone?

    <p>Superoinferior Translation of the Symphysis Pubis</p> Signup and view all the answers

    What is the purpose of palpation in the assessment of the pelvic joints?

    <p>To identify tenderness or signs of pathology</p> Signup and view all the answers

    Which ligament becomes taut and painful to palpation when the pelvis is counternutated in the presence of sacroiliac pathology?

    <p>Long dorsal sacroiliac ligament</p> Signup and view all the answers

    What can be indicated if one side of the sacral sulcus, slightly below the PSIS, is deeper or shallower than the other side?

    <p>Sacral torsion or rotation on the ilium around the horizontal plane</p> Signup and view all the answers

    What is palpated when the patient's knee is flexed to 90° or greater and the hip is passively medially rotated while the examiner palpates the sacroiliac joint on the same side?

    <p>Sacroiliac joint</p> Signup and view all the answers

    What is palpated between the spinous processes of L5 and S1, when the examiner moves slightly medially and distal to the PSIS?

    <p>Lumbosacral joint</p> Signup and view all the answers

    What is palpated when the fingers follow the path of the sacrotuberous ligament, slightly more than halfway between the PSIS and ischial tuberosity and slightly medially?

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

    What is palpated when the examiner performs a rectal examination and the index finger palpates the anterior surface of the coccyx while the thumb palpates its posterior aspect?

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

    What is the supine-to-sit test used to assess?

    <p>Functional leg length difference</p> Signup and view all the answers

    What does the Yeoman's test indicate when pain is localized to the sacroiliac joint?

    <p>Anterior sacroiliac ligament pathology</p> Signup and view all the answers

    What does the functional limb length test assess?

    <p>Functional leg length difference</p> Signup and view all the answers

    What does it indicate if the asymmetry in the functional limb length test is corrected by proper positioning?

    <p>Structurally normal leg length</p> Signup and view all the answers

    What is the purpose of the leg length test?

    <p>Assess functional leg length difference</p> Signup and view all the answers

    What can cause a functional leg length difference in the leg length test?

    <p>All of the above</p> Signup and view all the answers

    Which test is commonly used to assess the position of the sacrum relative to the ilium?

    <p>Trendelenburg Test</p> Signup and view all the answers

    What is the average pelvic tilt?

    <p>20 degrees</p> Signup and view all the answers

    Which ligament stabilizes L5 on the ilium?

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

    What does unaltered or decreased pain in the sacroiliac joint during the Straight Leg Raising (SLR) Test indicate?

    <p>Hypomobile sacroiliac joint</p> Signup and view all the answers

    Which muscle group is part of the deep posterior longitudinal system that stabilizes the pelvis?

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

    Which test involves the examiner placing both hands on the patient's ASISs and iliac crests and pushing down and in at a 45° angle to test the posterior sacroiliac ligaments?

    <p>Posterior Shear Test</p> Signup and view all the answers

    Which of the following is the equation for a line in slope-intercept form?

    <p>$y = mx + b$</p> Signup and view all the answers

    Which of the following is the formula for the area of a rectangle?

    <p>$A = lw$</p> Signup and view all the answers

    Which of the following is the formula for the perimeter of a rectangle?

    <p>$P = 2(l + w)$</p> Signup and view all the answers

    Which of the following is the equation for the Pythagorean theorem?

    <p>$a^2 + b^2 = c^2$</p> Signup and view all the answers

    Which of the following is the formula for the circumference of a circle?

    <p>$C = 2\pi r$</p> Signup and view all the answers

    Which ligament becomes taut and painful to palpation when the pelvis is counternutated in the presence of sacroiliac pathology?

    <p>Long dorsal sacroiliac ligament</p> Signup and view all the answers

    Which bony prominences are palpated when the examiner moves distally from the PSIS and down to the level of the gluteal folds?

    <p>Ischial tuberosities</p> Signup and view all the answers

    What may be indicated if one side of the sacral sulcus is deeper or shallower than the other?

    <p>Sacral torsion or rotation on the ilium around the horizontal plane</p> Signup and view all the answers

    Which joints are palpated when the examiner moves slightly medially and distal to the PSIS?

    <p>Sacroiliac joints</p> Signup and view all the answers

    What is palpated when the examiner moves slightly laterally and distal to the PSIS?

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

    What ligament inserts just above the ischial tuberosity and is palpated by moving superiorly from the insertion of the long head of biceps femoris?

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

    Which nerve is responsible for sensory alteration and/or burning pain on the lateral aspect of the thigh?

    <p>Lateral femoral cutaneous nerve</p> Signup and view all the answers

    Which nerve may be compressed by spasm of the transverse abdominis muscle, causing sensory alteration and/or pain in the superior aspect of the anterior thigh?

    <p>Ilioinguinal nerve</p> Signup and view all the answers

    Which muscle may compress the ilioinguinal nerve, resulting in pain on ipsilateral hip extension and contralateral torso rotation?

    <p>External oblique</p> Signup and view all the answers

    Which joint play movement involves pushing the ilium down and the sacrum up to test for minimal movement and no pain in the sacroiliac joint?

    <p>Anterior movement of the sacrum on the ilium</p> Signup and view all the answers

    Which joint play movement involves pushing the pelvis cephalad and the sacrum caudally to test for caudal movement of the sacrum and cephalad movement of the ilium?

    <p>Caudal movement of the sacrum and cephalad movement of the ilium</p> Signup and view all the answers

    Which joint play movement involves pushing down on the sacrum with one hand while the other hand lifts up on the iliac crest to test for anterior movement of the sacrum on the ilium?

    <p>Cephalad movement of the sacrum and caudal movement of the ilium</p> Signup and view all the answers

    Which one of these is the most correct?

    <p>$f(x) = -4(x + 3)­­­­2 + 2$</p> Signup and view all the answers

    Which test is used to assess the stability of the sacroiliac joints during movement by having the patient flex and rotate the trunk toward the side on which the straight leg raise test is actively being performed?

    <p>Supine-to-Sit (Long Sitting) Test</p> Signup and view all the answers

    What does it indicate if the affected side moves less during the Passive Extension and Medial Rotation of Ilium on Sacrum test?

    <p>Functional leg length difference</p> Signup and view all the answers

    During the Passive Extension and Medial Rotation of Ilium on Sacrum test, the examiner pulls the ilium forward with which hand?

    <p>Right hand</p> Signup and view all the answers

    Which position is used to determine the relationship of the sacral bone and the inferior lateral angle of the sacrum?

    <p>Prone position</p> Signup and view all the answers

    Which test involves the examiner palpating the spinous process of L5 with one thumb holding it stable and the examiner's other hand placed around the anterior ilium on the opposite side, lifting the contralateral ilium up to stress the lumbosacral junction, iliolumbar ligament, anterior sacroiliac ligament, and sacroiliac joint?

    <p>Yeoman’s Test</p> Signup and view all the answers

    Which test involves the examiner placing the heel of one hand over the superior pubic ramus of one pubic bone and the heel of the other hand over the inferior pubic ramus of the other pubic bone, then squeezing the hands together to apply a shearing force to the symphysis pubis?

    <p>Pelvic Compression Test</p> Signup and view all the answers

    Which nerve is responsible for sensory alteration and/or burning pain on the lateral aspect of the thigh?

    <p>Lateral Femoral Cutaneous Nerve</p> Signup and view all the answers

    Which nerve may be compressed by spasm of the transverse abdominis muscle, causing sensory alteration and/or pain in the superior aspect of the anterior thigh?

    <p>Ilioinguinal Nerve</p> Signup and view all the answers

    Which test involves the examiner pushing the ilium down or caudally with one hand while pushing the sacrum up or cephalad with the other hand to assess the movement and pain in the sacroiliac joint?

    <p>Caudal movement test</p> Signup and view all the answers

    Which test is used to assess hamstring tightness by having the patient actively extend the knee without posterior rotation of the pelvis or flexion of the lumbar spine?

    <p>Straight Leg Raising Test</p> Signup and view all the answers

    Which test involves the examiner pushing the pelvis cephalad and the sacrum caudally to test the movement and pain in the sacroiliac joint?

    <p>Superoinferior translation test</p> Signup and view all the answers

    What is the normal range of difference in leg length when measuring from the ASIS to the medial or lateral malleolus on the same side?

    <p>1 to 1.3 cm</p> Signup and view all the answers

    Which test involves the examiner pushing down on the sacrum with one hand while lifting up the iliac crest with the other hand to test the movement and pain in the sacroiliac joint?

    <p>Anterior movement test</p> Signup and view all the answers

    Which test is used to assess the ability of the ilium to flex and rotate laterally or posteriorly by asking the patient to actively extend the leg on the same side?

    <p>Leg Length Test</p> Signup and view all the answers

    Which test involves the examiner palpating the sacral sulcus and the lumbosacral junction to assess movement between the sacrum and innominate bone?

    <p>Anteroposterior translation test</p> Signup and view all the answers

    Which test involves progressively increasing the stress on the ipsilateral sacroiliac joint by abducting and laterally rotating the hip in 10° increments until the patient complains of pain or the end of the range is reached?

    <p>Gapping Test</p> Signup and view all the answers

    What is the purpose of the Trendelenburg Test or Sign?

    <p>To assess weakness or instability of the hip abductor muscles</p> Signup and view all the answers

    What does a positive Sign of the Buttock Test indicate?

    <p>Pathology in the buttock</p> Signup and view all the answers

    Which of the following structures should be palpated on the anterior aspect of the pelvic joints?

    <p>McBurney's point and Baer's point</p> Signup and view all the answers

    Which test involves applying a posteriorly rotating force to the ipsilateral ASISs and iliac crest to test superoanterior translation of the innominate on the sacrum?

    <p>Yeoman's test</p> Signup and view all the answers

    What is the purpose of palpation in the assessment of the pelvic joints?

    <p>To identify the source of pathology</p> Signup and view all the answers

    Which structure should be palpated for tenderness or signs of pathology on the anterior aspect of the pelvic joints?

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

    Which test involves applying a slow steady inferior force to the superior aspect of the superior ramus of one pubic bone while a superior force is applied to the inferior aspect of the superior ramus of the opposite pelvic bone?

    <p>Superoinferior translation of the symphysis pubis</p> Signup and view all the answers

    What is the end feel being tested during the test for superoinferior translation of the symphysis pubis?

    <p>Soft end feel</p> Signup and view all the answers

    Which test is used to assess the superoanterior translation of the innominate on the sacrum?

    <p>Passive Extension and Medial Rotation of Ilium on Sacrum</p> Signup and view all the answers

    What is the primary muscle group responsible for thoracolumbar rotation?

    <p>Psoas Major</p> Signup and view all the answers

    Which structure should be palpated for tenderness or signs of pathology by placing the thumbs over the pubic tubercles and moving the fingers laterally until the bony greater trochanter of the femur is felt?

    <p>Trochanteric Bursa</p> Signup and view all the answers

    What is the most common cause of anterior rotational dysfunction?

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

    What happens to the sacrum during sacral counternutation?

    <p>It counternutates</p> Signup and view all the answers

    What does a positive Yeoman’s Test indicate?

    <p>Sacroiliac Joint Dysfunction</p> Signup and view all the answers

    Which test is used to measure the true leg length of a patient?

    <p>Leg Length Test</p> Signup and view all the answers

    Which finding during the Trendelenburg Test indicates weakness or instability of the hip abductor muscles?

    <p>Falling of the pelvis on the non-stance leg side</p> Signup and view all the answers

    What is the normal range for a leg length difference measured during the leg length test?

    <p>0.5 to 1 inch</p> Signup and view all the answers

    What does a positive sign of the buttock test indicate?

    <p>Pathology in the buttock</p> Signup and view all the answers

    What does a negative sign of the buttock test indicate?

    <p>Pathology in the lumbar spine or hamstrings</p> Signup and view all the answers

    What does a restriction in thoracolumbar fascial length indicate?

    <p>Tight thoracolumbar fascia or latissimus dorsi</p> Signup and view all the answers

    During a physical examination, which structure should be palpated for tenderness or signs of pathology by placing the thumbs over the pubic tubercles and moving the fingers laterally until the bony greater trochanter of the femur is felt?

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

    Which ligament becomes taut and painful to palpation when the pelvis is counternutated in the presence of sacroiliac pathology?

    <p>Long dorsal sacroiliac ligament</p> Signup and view all the answers

    Which movement causes the sacrum to nutate on the same side and counternutate on the opposite side?

    <p>Hip extension</p> Signup and view all the answers

    Which muscle group is part of the superficial posterior oblique system that stabilizes the pelvis?

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

    Which test is used to assess sacroiliac joint involvement based on the difference in range of motion between the affected and unaffected leg?

    <p>Active straight leg raise test</p> Signup and view all the answers

    Which movement tests for caudal movement of the sacrum and cephalad movement of the ilium?

    <p>Hip flexion</p> Signup and view all the answers

    Which nerve may be compressed by spasm of the transverse abdominis muscle, causing sensory alteration and/or pain in the superior aspect of the anterior thigh?

    <p>Ilioinguinal nerve</p> Signup and view all the answers

    Which joint play movement involves pushing down on the sacrum with one hand while the other hand lifts up on the iliac crest to test for anterior movement of the sacrum on the ilium?

    <p>Anterior movement of the sacrum and cephalad movement of the ilium</p> Signup and view all the answers

    Which test involves the examiner palpating the PSIS and sacrum while the patient extends the ipsilateral leg?

    <p>Yeoman's test</p> Signup and view all the answers

    Which test is used to assess hamstring tightness by having the patient actively extend the knee without posterior rotation of the pelvis or flexion of the lumbar spine?

    <p>Ely's test</p> Signup and view all the answers

    Which type of movement is likely to cause pain in the sacroiliac joint if it is involved?

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

    Which bony prominences are palpated when the examiner moves distally from the PSIS and down to the level of the gluteal folds?

    <p>Ischial tuberosities</p> Signup and view all the answers

    Which test involves the patient lying supine with the legs straight and the examiner observing whether one leg moves up farther than the other when the patient is asked to sit up?

    <p>Supine-to-Sit (Long Sitting) Test</p> Signup and view all the answers

    Which test involves the examiner flexing the patient's knee to 90° and extending the hip, and pain localized to the sacroiliac joint indicates pathology in the anterior sacroiliac ligaments?

    <p>Yeoman’s Test</p> Signup and view all the answers

    Which test involves the patient standing relaxed while the examiner palpates the ASISs and PSISs, noting any asymmetry, and then placing the patient in the 'correct' stance to determine if the asymmetry has been corrected?

    <p>Functional Limb Length Test</p> Signup and view all the answers

    Which test involves the examiner pulling the ilium forward with one hand during the test?

    <p>Passive Extension and Medial Rotation of Ilium on Sacrum test</p> Signup and view all the answers

    Which test involves the patient standing on one leg while pulling the opposite knee up toward the chest, causing the innominate bone on the same side to rotate posteriorly?

    <p>Yeoman’s Test</p> Signup and view all the answers

    What does the Functional Limb Length Test assess?

    <p>Functional leg length difference resulting from pelvic torsion or rotation</p> Signup and view all the answers

    Study Notes

    Sacroiliac Joint and Movement

    • Pain in the sacroiliac joint is likely caused by movements such as twisting or heavy lifting.
    • Postures that increase stress on the sacroiliac joints include standing with weight unevenly distributed or prolonged sitting.
    • Risk factors for sacroiliac joint pathology do not include swimming.
    • Activities that decrease endurance capacity in the presence of sacroiliac joint pathology include excessive walking or running.

    Joint Stress and Age Factors

    • Positioning such as deep squatting or sitting cross-legged stresses the sacroiliac joint.
    • Ankylosing spondylitis primarily affects the age group of young adults, typically between 15 and 30 years old.
    • Symptoms of unilateral counternutation may include decreased mobility or discomfort in that specific area.

    Sacroiliac Joint Motion

    • Counternutation is limited by tension in ligaments and muscle support systems.
    • During counternutation, the sacrum moves posteriorly and superiorly.
    • The average pelvic tilt ranges between 10 to 15 degrees anterior tilt.

    Pelvic Alignment and Control

    • Ideal pelvic alignment maintains the pelvis in a neutral position, promoting optimal function and stability.
    • Lack of movement control during side-lying hip abduction indicates potential weakness or instability in the hip area.

    Muscle Groups for Stability

    • The deep posterior longitudinal system includes muscles like the multifidus, which stabilize the pelvis.
    • The anterior oblique system is composed of muscles like the obliques and rectus abdominis, aiding pelvic stability.
    • The lateral system includes muscles such as the gluteus medius that provide lateral stability.
    • The innermost muscle group consists of the pelvic floor muscles which stabilize the pelvis.
    • The superficial posterior oblique system includes muscles like the latissimus dorsi.

    Joint Structure and Function

    • The sacroiliac and the pubic symphysis joints primarily transfer weight and absorb shock, buffering impact forces.
    • The sacroiliac joint often has a fused line united by a fibrocartilaginous disc.
    • Key joints that form the 'key' of the pelvic arch include the sacroiliac joints and pubic symphysis.

    Joint Assessment and Health Implications

    • Assessment of pelvic joints may not be done when there are major fractures or infections present.
    • Compared to most joints, the sacroiliac and pubic symphysis joints are more rigid and provide less mobility.
    • The type of joint sometimes referred to as amphiarthrosis is a fibrous joint that allows slight movement.

    Joint Mechanics and Stability

    • According to Kapandji, the angle of the sacroiliac joint’s synovial portion contributes to its overall stability.
    • The articular surface of the ilium is covered by hyaline cartilage, facilitating smooth movement.
    • The strongest ligament connecting the sacrum and ilium is the sacroiliac ligament, which limits counternutation.

    Hormonal Changes and Joint Laxity

    • Increased laxity of sacroiliac ligaments during pregnancy can lead to instability and pain.
    • Stabilizing ligaments include the sacrotuberous and sacrospinous ligaments, providing structural support.

    Movement and Mechanics in the Pelvis

    • The sacroiliac joints allow minimal motion, primarily nutation and counternutation.
    • The lumbar spine exhibits changes in lordosis due to anterior and posterior pelvic tilting.
    • During forward flexion, the sacrum nutates approximately 30 degrees.

    Symptom Indicators and Pelvic Health

    • An upslip of the ilium on the sacrum often indicates a functional asymmetry or tightness in associated muscles.
    • If the ASIS is elevated on one side and the PSIS is lower, it may signify a functional leg length discrepancy.
    • A lateral pelvic tilt could indicate imbalances in hip and core musculature.

    Pelvic Types

    • Common pelvis types include gynecoid, android, anthropoid, and platypelloid, each influencing childbirth and movement mechanics.

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    Description

    Test your knowledge on the muscular systems that stabilize the pelvis. Identify the muscles and ligaments involved in crossing and oblique patterns of force couples.

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