OS midterm Spring 2020 > Sacral Lecture > Flashcards

Sacral Lecture Flashcards

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1
Q

Review the diagnosis slides on slide 3 and 4

A

:)

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2
Q

What are the 4 points of static testing?

A
  1. Sacral sulcus 2. L5 (rotation) 3. Inferior lateral angle 4. 4 digit examination
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3
Q

How would you palpate for the sacral sulcus?

A
  1. Palpate the Posterior Superior Iliac Spine (PSIS) with thumbs 2. Move thumbs medially and inferiorly 3. Check for symmetry (Deep or Shallow Sacral Sulcus)
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4
Q

How do you test for L5 rotation?

A

1.Palpate Lumbar Spine at the level of L5 2.Check for symmetry (L5 Rotation)

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5
Q

How do you palpate for the inferior lateral angle?

A
  1. Palpate with the heel of the hand in midline down sacrum until it drops anteriorly 2. Place one thumb near the thenar eminence to feel the inferior lateral angle of the sacrum 3. Place the other thumb roughly symmetrical to the first 4. Adjust slightly to find the inferior lateral angle 5. Compare each side for posterior/anterior and cephalad/caudal (inferior/superior)
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6
Q

Describe the 4 digit evaluation

A
  1. place fingers int eh sacral sulk 2. place thumbs on the ILAs 3. evaluate for symmetry
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7
Q

Review the documentation part 1 portion to see her diagrams that she had laid out

A

IT doesn’t make a lot of since to make it into a flashie

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8
Q

What are the steps of sacral testing?

A
  1. static testing 2. motion testing 3. diagnosis
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9
Q

What are the 3 aspects involved in static testing?

A
  1. lateralization 2. active motion 3. passive motion
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10
Q

how do you test for lateralization?

A

seating forward bending test

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11
Q

How do you test for active motion?

A

Backward bending test Respiratory motion test

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12
Q

How do you test for passive motion?

A

Lumbosacral spring test Oblique axis passive motion

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13
Q

What is the function of the lateralization test?

A

Tells the side of the dysfunction

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14
Q

A _______ seated forward bending test results in a positive test on the side of the dysfunction

A

unilateral

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15
Q

A _______ seated forward bending test results in a positive test on the opposite side of the axis

A

Torsion

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16
Q

Describe the seated forward bending test steps

A
  1. The patient is seated on a stool or treatment table with both feet flat on the floor. 2. Thephysician’s eyes at the level of the patient’s PSISs. 3.The physician’s thumbs are placed on the inferior aspect of the patient’s PSISs, and a firm pressure is directed on the PSISs. 4. The patient is instructed to forward bend as far as possible within a pain-free range. 5. The test is positive on the side where the thumb (PSIS) moves more cephalad at the end range of motion. A positive seated flexion test identifies the side of sacroiliac dysfunction (motion of the sacrum on the ilium), not the specific type of dysfunction.
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17
Q

What is the function of the active motion tests?

A

The examine the flexion and extension motion

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18
Q

A negative BBT indicates a ________ sacrum

A

flexed

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19
Q

A positive BBT indicates a ______ sacrum

A

extended

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20
Q

The bilateral sacral base should move ______ during inhalation and ______ during exhalation

A

posteriorly anteriorly

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21
Q

What is the function of the lumbar spring?

A

Defines flexion and extension

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22
Q

What is the function of the oblique axis passive motion

A

Defines the dysfunctional oblique axis

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23
Q

A negative lumbar spring is a ______ sacrum

A

flexed

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24
Q

A positive lumbar spring is an _______ sacrum

25
Review the sacral axis
....
26
Define torsion 1. Which axis is involved? 2. Where might the restriction be?
restricted along an oblique axis may be restricted in flexion or extension
27
Define a unilateral diagnosis 1. Which axis is involved? 2. Where might the restriction be?
Restricted along an Vertical Axis May be restricted in Flexion or Extension
28
What axis is shown here? What motion is it involved in?
* Superior Transverse Axis (S2 posteriorly) * Respiratory and Craniosacral Motion
29
What axis is shown here? What motion is it involved in? What happens if there is a dysfunction?
• Middle Transverse Axis(S2 anteriorly) * Postural Motion * Dysfunction along this axis will have bilateral findings
30
What axis is shown? What motions does this contribute to?
* Inferior Transverse Axis (S3) * Innominate rotation
31
Which axis is shown? What dysfunctions occur here?
• Left Oblique Axis Named for the superior portion of the axis Dysfunction along this axis will have a deep sacral sulcus on the opposite side of the posterior/caudal ILA
32
Which axis is shown? What dysfunctions occur here?
Right Oblique Axis Named for the superior portion of the axis Dysfunction along this axis will have a deep sacral sulcus on the opposite side of the posterior/caudal ILA
33
What axis is shown here? What dysfunction is typically seen here
* Vertical Axis * Dysfunction along this axis will have a deep sacral sulcus on the same side as the posterior/caudal ILA
34
A torsion can be restricted anteriorly or posteriorly... What does it look like for each?
* Held Anteriorly: Flexed or forward torsions * Held Posteriorly: Extended or backward torsions
35
How are torsions named?
1. for the rotation of the sacrum 2. acis that is involved
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A \_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_ can be classified as a left on left sacral torsion or a right on right sacral torsion
Flexed/ Forward
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A \_\_\_\_\_\_\_/\_\_\_\_\_\_\_\_ can be classified as a left on RIGHT sacral torsion or a right on LEFT sacral torsion
Extended/bakwards
40
Describe a left rotation on a left axis sacral torsion 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
FLEXED Deep sacral sulcus on the right Posterior/caudal ILA on the left setaing forward beding test positive on the right BBT negative Lumbar spring negative
41
42
Describe a right rotation on a right axis sacral torsion 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
FLEXED Deep sacral sulcus on the left Posterior/caudal ILA on the right seated forward bending test positive on the left BBT negative Lumbar spring negative
43
Describe a left rotation on a right axis sacral torsion 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
EXTENDED Deep sacral sulcus on the RIGHT Posterior/caudal ILA on the LEFT Seated forward bending is positive on the left BBT is positve Lumbar spring positive
44
Describe a right rotation on a left axis sacral torsion 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
EXTENDED Deep sacral sulcus on the LEFT Posterior/caudal ILA on the RIGHT Seated forward bending test positive on the RIGHT BBT positive Positive lumbar spring
45
Describe a right sacrum flexed 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
* Flexed * BBT Negative (gets better) * Lumbar spring negative (ease of spring) * Deep sacral sulcus on the right * Posterior/Caudal ILA on the right * Seated forward bending test positive on the right
46
Describe a left sacrum flexed 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
Flexed * BBT Negative (gets better) * Lumbar spring negative (ease of spring) * Deep sacral sulcus on the left * Posterior/Caudal ILA on the left * Seated forward bending test positive on the left
47
Describe a left sacrum extended 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
* Extended * BBT Positive (gets worse or stays the same) * Lumbar spring Positive (difficulty of spring) * Deep sacral sulcus on the right * Posterior/Caudal ILA on the right * Seated forward bending test positive on the left
48
Describe a right sacrum extended 1. positioning 2. where is the deep sacral sulcus 3. where would you expect the IL to be 4. What tests would be positive?
* Extended * BBT Positive (gets worse or stays the same) * Lumbar Spring Positive (difficulty of spring) * Deep sacral sulcus on the left * Posterior/Caudal ILA on the left * Seated forward bending test positive on the right
49
Describe a bilateral sacrum extended in terms of the 1. deep sacral sulcus 2. bilateral posterior/caudal ILA 3. negative seated forward bending test (no lateralization)
* Bilateral shallow sacral sulcus * Bilateral anterior/cephalad ILA * Negative Seated forward bending test
50
Describe a bilateral sacrum flexed in terms of the 1. deep sacral sulcus 2. bilateral posterior/caudal ILA 3. negative seated forward bending test (no lateralization)
* Bilateral deep sacral sulcus * Bilateral posterior/caudal ILA * Negative Seated forward bending test * No lateralization
51
L5 should be rotated in the _____ direction of the sacrum for balance
opposite
52
L5 Sidebends _______ the oblique axis of a torsion
toward
53
A flexed sacrum means a _______ L5 (Type 1)
neutral
54
An extended sacrum means a ________ L5 (type 2)
non-neutral
55
Rotation of the sacrum shoud be in the ______ direction of L5
Opposite
56
L5 beinds toward the _______ \_\_\_\_\_\_\_ _____ \_\_\_\_\_\_\_
oblique axis of a torsion
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58
Review the last few slides in this lecture because wow this was a freaking doozie
its so many pictures
OS midterm Spring 2020
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