Lecture #12 - Sacroiliac Pathologies and Palpation Techniques
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Questions and Answers

What are the two main types of sacral torsions?

Forward and backward.

List three classifications of sacroiliac dysfunctions.

Forward/backward sacral torsions, flexed/extended sacrum, anterior/posterior sacrum.

Which structures are palpated and compared bilaterally in the case of sacral torsion?

Sacral sulci and inferior lateral angles (ILA).

Identify the acronym SSSIPP and its relevance in sacroiliac pathology assessment.

<p>SSSIPP stands for sacral base, sacral sulci, sacrotuberous ligaments, inferior lateral angles, PSIS, and piriformis.</p> Signup and view all the answers

What terminology refers to the direction the anterior portion of the sacrum is looking towards during oblique axis rotations?

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

What is classified as a dysfunction of the movement between the sacrum and ilium?

<p>Sacroiliac pathology.</p> Signup and view all the answers

In sacral torsion, what is the main axis around which the torque occurs?

<p>An oblique axis.</p> Signup and view all the answers

What are the physiological types of dysfunctions that can occur in sacroiliac pathology?

<p>Forward and backward sacral torsions.</p> Signup and view all the answers

Which two structures are primarily assessed during the palpation for sacral torsion?

<p>Sacral sulci and inferior lateral angles (ILA).</p> Signup and view all the answers

In oblique axis rotations, what does 'L on R' signify regarding the sacrum's orientation?

<p>'L on R' indicates the sacrum is facing left while being positioned on a right oblique axis.</p> Signup and view all the answers

Explain the significance of the sacral base in assessing sacroiliac pathologies.

<p>The sacral base serves as a crucial landmark, indicating the alignment and mobility of the sacrum relative to the ilium.</p> Signup and view all the answers

Differentiate between forward and backward sacral torsions in terms of their orientation.

<p>Forward sacral torsions are characterized by the anterior portion of the sacrum facing forward, while backward sacral torsions have the anterior portion facing backward.</p> Signup and view all the answers

List and describe the role of the sacrotuberous ligament in sacroiliac assessment.

<p>The sacrotuberous ligament helps stabilize the sacrum and contribues to identifying pelvic dysfunction.</p> Signup and view all the answers

What is the importance of comparing the sacral sulci during palpation for sacral torsion?

<p>Comparing the sacral sulci bilaterally helps determine sacral torsion presence and its direction.</p> Signup and view all the answers

Discuss the clinical relevance of palpating the hamstrings in the context of sacroiliac pathologies.

<p>Palpating the hamstrings aids in assessing the tension patterns related to sacral dysfunction and pelvic stability.</p> Signup and view all the answers

What are the implications of a fixated sacrum in terms of sacroiliac dysfunction?

<p>A fixated sacrum can lead to restrictions in movement, affecting both stability and mobility of the pelvis, causing pain and dysfunction.</p> Signup and view all the answers

Describe the significance of palpating the inferior lateral angles (ILA) in sacral torsion assessment.

<p>Palpating the ILA allows for assessment of asymmetries and contributes to determining the type of sacral torsion present.</p> Signup and view all the answers

What role do the gluteal muscles play in relation to sacroiliac dysfunction?

<p>The gluteal muscles support pelvic stability and can contribute to pain if dysfunctional or tight, impacting sacroiliac mechanics.</p> Signup and view all the answers

Explain the concept of the oblique axis in relation to sacral movements.

<p>The oblique axis refers to the diagonal axis around which the sacrum rotates during dysfunction, influencing both forward and backward torsions.</p> Signup and view all the answers

How do pathological/non-physiological sacral dysfunctions differ from physiological dysfunctions?

<p>Pathological/non-physiological dysfunctions arise from underlying structural issues, while physiological dysfunctions typically result from normal variations in sacral movement.</p> Signup and view all the answers

What implications do forward and backward sacral torsions have for treatment strategies in a clinical setting?

<p>Forward and backward sacral torsions require different manual therapy approaches, as the mechanics of the dysfunction influence the direction of treatment.</p> Signup and view all the answers

How would palpating the sacral base contribute to diagnosing sacroiliac pathologies?

<p>Palpating the sacral base allows practitioners to assess the position and mobility of the sacrum, indicating potential dysfunctions.</p> Signup and view all the answers

Explain the role of the inferior lateral angles (ILA) in the assessment of sacral torsion.

<p>Evaluating the ILA helps in determining the symmetry and motion of the sacrum, critical for identifying torsional dysregulation.</p> Signup and view all the answers

What challenges may arise from a fixated sacrum during a restriction assessment?

<p>A fixated sacrum can complicate the identification of associated dysfunctions and obscure the normal biomechanical patterns.</p> Signup and view all the answers

Discuss how the quadratus lumborum's involvement is essential in evaluating sacroiliac joints.

<p>The quadratus lumborum affects pelvic stability and movement, which can directly influence sacroiliac joint function.</p> Signup and view all the answers

Which of the following options represents the main types of sacral dysfunctions?

<p>Physiological dysfunctions</p> Signup and view all the answers

A sacral somatic dysfunction includes only pathological dysfunctions.

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

Name one of the structures palpated for sacroiliac pathology that starts with the letter 'S'.

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

The two types of sacral torsions are _______ and _______.

<p>forward, backward</p> Signup and view all the answers

Match the following oblique axis rotations with their descriptions:

<p>L on L = Facing left on a left oblique axis R on L = Facing right on a left oblique axis R on R = Facing right on a right oblique axis L on R = Facing left on a right oblique axis</p> Signup and view all the answers

Which of the following are included in the six most relevant structures to palpate for a sacroiliac pathology? (Select all that apply)

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

A sacral somatic dysfunction can only be classified as pathological.

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

What is the main difference between forward and backward sacral torsions?

<p>The orientation of the sacrum: forward torsions involve the sacrum facing forward, while backward torsions involve the sacrum facing backward.</p> Signup and view all the answers

The two types of dysfunctions in sacroiliac pathology are __________ and __________.

<p>physiological, pathological/non-physiological</p> Signup and view all the answers

Match the following structures with their roles in assessing sacroiliac pathology:

<p>Sacral base = Main area to palpate for dysfunction Piriformis = Key muscle in sacral movement Gluteal muscles = Support pelvis and hip movement Hamstrings = Assist in stabilizing the pelvis</p> Signup and view all the answers

What describes the fixation of the sacrum during motion?

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

The inferior lateral angles (ILA) are significant structures to palpate for sacral torsion assessment.

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

What are the two primary types of dysfunction in sacroiliac pathology?

<p>Physiological dysfunctions and pathological/non-physiological dysfunctions</p> Signup and view all the answers

The two types of sacral torsions are __________ and __________.

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

Match the following sacral torsion structures with their functions in assessment:

<p>Gluteal muscles = Support pelvic stability Sacrotuberous ligaments = Provide structural support Piriformis = Assist in hip rotation Hamstrings = Aid in knee flexion</p> Signup and view all the answers

Which of the following structures is NOT included in the six most relevant structures for palpating sacroiliac pathology?

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

Forward sacral torsion is characterized by the sacrum facing towards the left oblique axis.

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

Name one of the five somewhat relevant structures to palpate in sacroiliac pathology assessment.

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

The two types of dysfunctions in sacroiliac pathology are _______ and _______.

<p>physiological, pathological</p> Signup and view all the answers

Match the following types of oblique axis rotations with their descriptions:

<p>L on L = Facing the left but on a left oblique axis R on L = Facing the right but on a left oblique axis R on R = Facing the right but on a right oblique axis L on R = Facing the left but on a right oblique axis</p> Signup and view all the answers

Which of the following is a physiological dysfunction in sacroiliac pathology?

<p>L on R oblique axis</p> Signup and view all the answers

Forward and backward sacral torsions refer to the orientation of the sacrum in relation to the ilium.

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

Name two structures that are most relevant to palpate for sacroiliac pathology.

<p>Sacral base, sacral sulci</p> Signup and view all the answers

Match the following terminology with their corresponding descriptions in sacroiliac assessment:

<p>PSIS = Posterior superior iliac spine, an important landmark for palpation Piriformis = Muscle involved in hip rotation and stability Sacrotuberous ligaments = Ligaments that connect the sacrum to the ischium Gluteal muscles = Muscles responsible for hip extension and stability</p> Signup and view all the answers

Study Notes

Sacroiliac Pathologies

  • Sacroiliac pathology refers to a dysfunction in the movement of the sacrum on the ilium, classified as a sacral somatic dysfunction.
  • The sacrum can become fixated during its movement.
  • Dysfunctions can be physiological (normal) or pathological (abnormal).
  • Further classifications include forward/backward sacral torsions, and flexion/extension of the sacrum, and anterior/posterior positioning.

Palpation Structures (SSSIPP & HHILS)

  • Key structures for palpation in sacroiliac pathology include:
    • Sacral base
    • Sacral sulci
    • Sacrotuberous ligaments
    • Inferior lateral angles (ILA)
    • Posterior superior iliac spine (PSIS)
    • Piriformis muscle
  • Other somewhat relevant structures include:
    • Hamstrings
    • Hip flexors
    • Ilia
    • Lumbosacral joint
    • Sacroiliac joints

Sacral Torsion

  • Sacral torsion is a dysfunction around an oblique axis with torque between the sacrum and innominates.
  • Two types of sacral torsions are forward and backward.
  • For sacral torsion, bilateral comparisons are made of:
    • Sacral sulci
    • Inferior lateral angles (ILA).

Palpation for Sacral Torsion

  • 7 primary palpatory structures include:
    • Gluteal muscles
    • Quadratus lumborum
    • Abdominal muscles
    • Sacrotuberous ligaments
    • Inguinal ligaments
    • Greater trochanters
    • Hamstrings

Oblique Axis Rotations

  • Four types of oblique axis rotations exist:
    • Left on Left (L on L)
    • Right on Left (R on L)
    • Right on Right (R on R)
    • Left on Right (L on R)
  • Note the direction the anterior sacral portion faces.

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Description

Explore the intricacies of sacroiliac pathologies, including sacral somatic dysfunction and the structures involved in palpation. This quiz covers both physiological and pathological dysfunctions, sacral torsion, and key anatomical landmarks. Test your understanding of sacroiliac joint mechanics and palpation methods used in assessment.

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