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OTM Sacrum Exam With Accurate Answers 100% Verified
Midterm Breakdown for Sacrum - ANSWER 9 questions on sacrum: 1- Dx, 1- Tx for Dx, 1- Motion testing, 1- ME, 3- Tx unspecified, 2- Direct Midterm = 23 questions. [9 on sacrum] + [13 on cervical]. One question unaccounted for. Tenderpoints not on test. Dx reveals a Left on Left Sacral rotation. What would LVMA Tx look like? - ANSWER Pt. prone, Dr. on R side. Dr. guides flexed knees to side, while chest remains on table. Monitor motion at LS junction, Flex knees to 90. Introduce L5 rotation by pulling up. Let legs drop over fulcrum= SB. Push down on Legs (springing).
Dx for Sacrum Rotated Left on Left Oblique Axis - ANSWER R base anterior & deep, motion (+). L ILA is posterior, motion (-)
Motion at L base and R ILA is (+/-).
- BBT negative
- lumbar-sacral spring test is negative
Patient presents with sacral pain. Dx indicates a Left on Left Sacral rotation. What would M.E. Tx look like? - ANSWER Pt. prone, Dr. on R side. Dr. guides flexed knees to side, chest remains on table. Monitor motion at LS junction, Flex knees to 90. Introduce rotation on L5 by pulling up. Push down on Legs and do ME.
Dx is a Left on Left Sacral rotation. What would Respiratory Tx be? -ANSWER Pt. prone, Dr. on R side. Dr. moves flexed knees to side, while chest remains on table. Watch the motion at LS junction, Flex knees to 90. Introduce rotation on L5 by pulling up. Pt. inhale/exhale deeply. On Exhalation Pt. reaches hands and feet to floor. Repeat x3.
Tx Sacrum Left on a Left Oblique Axis BLT - ANSWER - fingers 2 & 3, push R base anterior
- test resp. phases, hold breath as long as possible in phase
What is the purpose of sidebending to the left or placing patient with left axis of rotation down? - ANSWER Lock the axis in. Subsequent (seated) slump/arch is to facilitate opposite rotation.
Patient presents with L on L sacral rotation. Describe seated M.E. Tx you might use? - ANSWER Pt. straddles table. Dr. L thumb monitors L ILA. Pt. slumps forward. Dr. guides Pt. into L rotation and L Sidebending. M.E.
- "bend to the R" while physician offers isometric counterforce
Dx Right rotation on Left oblique axis - ANSWER -R base posterior, sulcus shallow, motion (-)
- left ILA anterior/motion (+)
- backward bending test positive (gets worse)
- motion testing at left base and right ILA both (+/-)
Tx Sacrum Right on Left Oblique Axis BLT - ANSWER - thenar eminence to lift left ILA anterior
- test resp. phases, hold breath as long as possible in phase
You diagnose your patient with a Right rotation on Left Oblique Axis. Describe a Direct, LVMA Tx you could use? - ANSWER Patient on Left side, Dr. in front. Pt. L shoulder forward for rotation at L/S jxn. Pt. knees/hips flexed & drop off edge. Dr. R hand monitors R-SB & rolls UP shoulder forward.
Pt takes deep breath, on exhalation Dr. rolls further and springs legs.
Patient has Left rotation on a Right Oblique Axis. Describe a seated, direct Tx you could use? - ANSWER Pt. straddles table near end. Thumb on L-SB. Dr. Sidebends pt. to Right, then Extension and L-rotation. (Dr. R arm on L shoulder) Do M.E.
- patient "gently bend to the right"
Patient has a Right rotation on a Left Oblique Axis. Describe an indirect Tx you could use? - ANSWER Pt. supine, Dr. on R side. Dr. R hand with fingers at sacral base and palm cupping sacral apex. Left hand bridge ASIS's to gap SI joint. R hand lifts up on L ILA. Test respiratory BLT. patient holds breath
Dx for Left Unilateral Sacral Flexion: - ANSWER - Lateralization test positive on left
- Left sacral base anterior/motion +
- Left ILA posterior & inferior/motion -
Patient with Positive Lateralization test on the Right, Anterior Right SB, and Posterior Right ILA. Left SB and ILA and +/-. Patient has Hx of knee surgery. What is the Dx? What is a Prone Tx you could use for it? - ANSWER Dx: Right Unilateral Sacral Flexion
landmarks show +/- motion. Dx: _______, and a M.E. Tx you could use for it. ANSWER Dx: Right posterior Sacral Margin Tx: Seated M.E. Patient straddles table. Typical ME, but NO SB.
Left Sacral Margin Posterior Dx - ANSWER -Left sacral base posterior, motion (-)
- left ILA posterior/motion (-)
- motion of right ILA and base is (+)
Tx Sacral Margin Posterior BLT - ANSWER -sit on same side of posterior margin
- thenar eminence to push up on anterior margin of sacrum
- test resp. phases, hold breath as long as possible in phase
Patient with Posterior SB and ILA on the Left side, and restricted motion. Right landmarks show +/- motion. What is the Dx, and what is a Supine Tx you could use for it? - ANSWER Dx: Left Posterior Sacral Margin Tx: Supine HVLA. Dr. Opp. Dys. Legs bent away (V towards Dr.) Pt Hands behind neck. One hand through Pt. contralateral arm and across chest, other on ASIS. Roll and push.
Tx for Left Sacral Margin Posterior: Seated Muscle Energy - ANSWER - patient straddles end of table
- patient's left hand grabs head, right hand grabs elbow
- physician's left thenar eminence on left sacral base
- physician induces rotation to the right NO SIDEBENDING
- patient attempts to resist by rotating to the left
- three times, then carry to barrier
Dx for Bilateral Sacral Flexion - ANSWER - L & R Bases anterior, motion (+)
- L & R ILA's posterior, motion (-)
Your post-partum has Bilateral Anterior SBs and Posterior ILAs. What do you Dx and what is one Tx you could use to rectify this? - ANSWER Dx: Bilateral Sacral Flexion Tx: Supine, Direct ME. i.e. Hands on LS junction, Knee bend and push.
Tx Bilateral Sacral Flexion BLT - ANSWER - Lift sacral bases anterior to the point of BLT
- test resp. phases, hold breath as long as possible in phase
Dx for Bilateral Sacral Extension - ANSWER - L and R sacral bases posterior, motion (-)
- L and R ILA's anterior, motion (+)
Your patient has bilateral posterior SBs and Anterior ILAs. What is your Dx and what is one Tx you could use? - ANSWER Dx: Bilateral Sacral Extension Tx: Prone, LVMA. Patient in Sphinx pose. Patient exhales as you push on SBs. Balance with other arm on thigh.
what Dx have a neutral BBT? - ANSWER B/L Sacral Flexion, B/L Sacral Extension
With a (-) BBT, what are the possible sacral rotations on an oblique axes? - ANSWER L on L, R on R. same oblique axis what other Dx can you have with a (-) BBT? - ANSWER Unilateral Sacral Flexion Dx: L on L
what is the Dx for a compensated L5? - ANSWER L5 is N RrSl =rotated R, sidebent L
Dx: L on L, L5 N RrSl
You flex the patients hips to 90 & his chest stays on the table. What happens to L spine, L5, sacral base, and axis? - ANSWER L spine = flexed. L5 rotates left, sidebends left. Right sacral base moves posterior, Axis= still left oblique
if your patient is L on L, what happens if you sidebend to the right? - ANSWER sacrum becomes: L on R.
because sidebending engages axis
Dx: L on L
Tx: Seated, direct, ME phyio response tech.
what does "slumping forward" do to the left ILA? what is the Dx during Tx? - ANSWER brings left ILA anterior. rotation becomes R on L axis.
Dx: L on L Tx: Seated, direct, ME phyio response tech.
why do you have the patient rotate to the left? - ANSWER Decreases L5- sacral torsion. Right sacral base moves posterior.
Dx: R on L, L5 N RlSr
You flex the patients hips less than 90 & his chest is up, off of the table. What happens to L spine, L5, sacral base, and axis? - ANSWER L spine = extended. L5 rotates right, sidebends left. Right sacral base moves anterior, Axis= left oblique
Patient is supine and you're going to do BLT. State whether you put your thenar eminence on the sacral base or ILA when setting up your Tx for the following Dx:
- L on L
- R on R
- R on L
- L on R - ANSWER 1. L on L = SB
- R on R = SB
- R on L= ILA
