DIAG 2730 Final Exam Review - Condensed

DIAG 2730 Final Exam Review - Condensed - The articulating...

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The articulating surfaces of the sacroiliac joint differ The iliac joint surfaces are formed from fibrocartilage The sacral surfaces are formed from hyaline cartilage. The hyaline cartilage is 3-5x thicker than the fibrocartilage S/I joint = a synovial articulation, or diarthrosis normal adaptations The anterior sacral ligament (ASL) Relatively weak and thin compared to the rest of the S/I ligaments short ligament located deep to the dorsal S/I ligament Forms the major connection between the sacrum and the innominate, filling the irregular space posterior- superior to the joint between the lateral sacral crest, and the iliac tuberosity The dorsal S/I ligament (long ligament) connects the PSIS with the lateral crest of the S3 + S4 Tough and strong ligament Sacral nutation (anterior motion) of the sacrum appears to slacken this ligament Counternutation (posterior motion) tautens the ligament The sacrotuberous ligament Stabilizes against nutation (forward rotation) of the sacrum Counteracts against nutation of the sacrum 35 muscles attach directly to the sacrum and/or innominate These muscles primarily function to stabilize the S/I joint rather than to move it The piriformis muscle Primarily functions to produces external rotation and abduction of the femur Also thought to function as an internal rotator and abductor of the hip if the hip joint is flexed beyond 90° Capable of restricting S/I joint motion “Pelvic floor muscles” The pelvic floor muscles work in a coordinated manner to increase intra-abdominal pressure, provide rectal support during defecation, inhibit bladder activity, help to support the pelvic organs, and assist in lumbopelvic stability Neurology The anterior portion S/I joint receives innervation from the posterior rami of the L2-S2 roots Osteopathic model The sacrum rotates around two oblique axes The innominates are capable of rotating anteriorly and posterior Chiropractic model As one innominate flexes, the ipsilateral sacral base moves anterior and inferior, and as the other innominate extends, the sacral base on that side moves posterior and superior Biomechanical model When the sacrum nutates, or flexes, relative to the innominate, a linear glide occurs between the two L-shaped articular surfaces of the sacroiliac joint. The shorter of the two lengths, level with S 1, lies in a vertical plane The longer length, spanning S 2-4, lies in an A-P plane Examination a relationship between pelvic asymmetry and low back pain exists, orthopedic, osteopathic, and physical therapy texts promote the use of pain provocation (symptom-based) tests and biomechanical (mechanical-based) tests that include static (positional) and dynamic (motion or functional) tests
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History SIJ dysfunction Patient presents with: A history of sharp pain awakening the patient from sleep upon turning in bed (if pin-point pain = SIJ) Pain with walking , ascending or descending stairs , standing from a sitting position, or with hopping or standing on the involved leg
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DIAG 2730 Final Exam Review - Condensed - The articulating...

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