Lab 4

Question 2

If you suspect a patient has a LBP+SI joint problem, what should you do first

Answer 2

First perform lumbar spine exam

never preform only an SIJ exam

Question 3

Pain with transitional movements is a common sign of what

Answer 3

SIJ problems

Question 4

If a patient clearly has neurological symptoms and has back pain, should you still do a scanning exam?

Answer 4

yes because you need to know to what extent the neurological system is involved

Question 5

Pt has pain w/ coughing/sneezing and symptoms decrease with walking

Answer 5

lumbar disc pathology

Question 6

Pt has pain with flexion or extension and pain with Posterior-anterior joint glides

Answer 6

Lumbar joint pathology

Question 7

If a patient has these symptoms what joint is likely the issue ?
Pt has Trendelenburg sign

Pain and decreased ability to squat

positive sign of buttock

Answer 7

Hip joint problem

Question 8

Is someone has these symptoms what is the likely pathogenesis ?

Inc pain with coughing and sneezing

Dec in Sx with walking

Answer 8

Lumbar Disc pathology

Question 9

If someone has these symptoms what is the likely pathogenesis ?

Pain does not inc with coughing or sneezing
Inc pain with extension or flexion
Pain with PA joint glides

Answer 9

Lumbar spine joint pathology

Question 10

What are the 4 reasons to preform a full SIJ exam?
MEMORIZE THESE

Answer 10

Fortin’s sign

Positive SI joint test (gapping or compression)

Tenderness at posterior SI ligaments

Pain/weakness w/ single leg stance
ONLY NEED ONE POSITIVE

Question 11

How is the fortin’s sign evaluated?

Answer 11

Pain localized w/ 1 finger point

area is 1cm near PSIS

patient consistently points to same spot in 2 trials

Question 12

The SIJ gapping test should _______ symptoms

the SIJ compression test should _______ symptoms

Answer 12

Recreate symptoms for both
For the gapping technique, the patient should feel the approximation in the posterior side

Question 13

Sacral Thrust test

Answer 13

Pt is prone

Up to 6 thrusts applied straight down to inferior aspect of sacrum (S3)

Positive test - recreation of symptoms

Question 14

FABER/ Patrick Test

Answer 14

AKA
Flexion Abduction and ER

if patient feels symptoms then that is a positive

if not then you have to apply downward pressure on the FABER leg and the contralateral ASIS

Question 15

Gaeslen’s test

Answer 15

Pt is in Thomas test position.
Pt pushes one hip further into flexion and the other further into extension.

The test hip is the one with the leg in extension

Positive test- reproduction of symptoms at SI joint or pubic symphysis

Question 16

If you’re examining R sided SIJ pain, and one of the 5 tests comes back positive on the L side, can this contribute to the CPR?

Answer 16

Yes, positive test on either side can contribute to CPG

Question 17

Where does your hand need to be placed for the Thigh Thrust test?

Answer 17

Place hand beneath patient’s sacrum, NOT their SIJ

positive test is reproduction of symptoms

Stand on the IPSILATERAL side of the sacrum that you are interested in testing

Question 18

What tests are a part of the positive SIJ dysfunction CPR?

MEMORIZE

Answer 18

Compression

Distraction

Sacral Thrust

Gaeslen Test

Thigh Thrust

3 or more out of these have to be positive

Question 19

What tests are a part of the NEGATIVE SIJ dysfunction CPR

MEMORIZE

Answer 19

Compression

Distraction

FABER

Gaeslen

Thigh Thrust

fewer than 3 of these positive than these indicate no SI issue

Question 20

How many tests have to be true for the Positive SIJ CPR?

Answer 20

3 or more

Question 21

How many tests need to be true for the negative SIJ CPR?

Answer 21

3 or less

Question 22

Name the secondary SI joint stress tests
There are 6 of em

Answer 22

Pubic stress test
Buttock Test
Thigh hip thrust
FABER/Patrick
Gaenslens Test
Sacral Thrust test

Question 23

Where do you push for the pubic stress test

What kind of SIJ pain is it for?

Answer 23

Pubic rami

Anterior SIJ pain

Question 24

What is sign of buttock

Answer 24

Pain w/ passive SLR

THEN Pain with passive hip flexion with knee bent to same ROM

Indicates neoplasm, Fracture, Infection, Septic arthritis

Question 25

Where should you place your fingers to check the alignment of the ASIS?

Answer 25

Inferior to ASIS

Question 26

What is the advantage of the seated flexion test?

Answer 26

Rules out leg length discrepancy or hamstring length

Question 27

For the seated and standing flexion tests, which side is hypomobile?

Answer 27

The side the moves more with flexion because it's stuck and moving with the spine, cant move independently like it's suppose to

Question 28

When using the longsitting test what will a longer limb appear as what about a shorter limb?

Answer 28

Longer Limb- Posterior innominate Shorter limb- Anterior innominate

Question 29

What is the landmark to compare leg length with the long sitting test

Answer 29

medial malleoli

Question 30

Which leg are you testing with Gillet's (stork) test?

Answer 30

The SLS leg

Question 31

What is assessed during Gillet's (Stork) test

Answer 31

Assessing whether or not the PSIS of the elevated leg moves INFERIOR to the sacrum, if it does not then it is a positive test also a positive test if it reproduces pain

Question 32

What are the 3 steps of the active SLR test can you do them out of order?

Answer 32

1. Raise leg, see if pain happens 2. Apply compression and raise leg, see if pain happens 3. activate abdominals and raise leg, see if pain happens note: You must preform the steps in order

Question 33

Which part of the active SLR tests for form closure problems?

Answer 33

Part 1 and 2: If they have less pain with manual compression a compression belt may be indicated as treatment

Question 34

What part of the active SLR test tests for force closure?

Answer 34

Part 3: If activating their abdominals makes the pain less

Question 35

How do you interpret the active SLR if both part 2 and part 3 makes the pain better

Answer 35

Combination of force and form closure issues

Question 36

Review last 9 slides of Lab 4 to learn the manipulations we didn't cover in lab