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Pt with R leg pain. Burning sensation radiating down the right posterior thigh. Began while
gardening earlier that day. No recent trauma and sx worse with ambulation. Osteopathic
structural exam reveals TP halfway between the ILA of the sacrum and G trochanter in the R
gluteal region. TP most likely due to spasm of what muscle? correct answers Piriformis
What nerve is compressed in Piriformis syndrome? correct answers Sciatic nerve
Pt has burning sensation, numbness, or tingling down the back of thigh. correct answers
Piriformis syndrome.
Where is the TP of piriformis musckle located? correct answers Midway between the ILA of the
sarcum and the G trochanter of the femur
Name the origin and insertion of the biceps femoris? correct answers O: Ischial tuberosity
I: Fibular head
What muscle has TP posterior thigh just lateral to the midline? correct answers Biceps femoris
Name origin and insertion of the iliopsoas? correct answers O: lumbar spine and iliac fossa and
inserts on the lesser trochanter
TP located medial to the ASIS correct answers Iliopsoas
If there is spasm of the iliopsoas what can become secondary hypertonic? correct answers
Contralateral piriformis
What TP is associated with ipsilateral forward sacral torsion? correct answers Gluteus medius
,What position do you put a pt for counterstrain of the piriformis muscle? correct answers Prone
with flexion, abduction, and ext rotation of the right lower extremity
What motion does the piriformis do? correct answers Ext rotation the flexed hip and abduct the
LE
What is the general technique for CS? correct answers Indirect and passive technique. Think of
action of muscle. Position pt in same motion of the action of that muscle.
28 yo F with heel pain. Hx reveals the pain started after she began wearing high heels in attempts
to be more attractive. Hx reveals the pain is worse in the morning after sitting for long periods of
time at work. Which of the following is the most appropriate recommendation? correct answers
Insert arch supports
28 yo F with heel pain. Hx reveals the pain started after she began wearing high heels in attempts
to be more attractive. Hx reveals the pain is worse in the morning after sitting for long periods of
time at work. What is the most likely dx? correct answers Plantar fasciitis
What is Plantar fasciitis? correct answers Microtears in the plantar fascia leading to
inflammation.
Pain worse in the morning when the pt takes first step--> dorsiflexion required to step after hours
of sleeping with foot in a relatively platar flexed positon, stretching the plantar flascia
Primary tx for plantar fasciaiits? correct answers Arch supports
initial treatment--> Daily icing, Anti-inflamm meds, and stretching.
What should be avoided for plantar fasciitis? correct answers AVOID flat shoes and barefoot
walking
Structural exam:
, Standing flexion test is negative
Seated flexion + right
Sacral sulcus deep on left
ILA inferior and posterior on R
Backward bending test is positive
Dx? correct answers Right on left sacral torsion
What does the seated flexion test check? correct answers isolates movement of sacrum between
the innominates--> Preventing the practitioner from misdx as innominate dysfunction
3 components of sacral dx? correct answers Seated flexion test
Depth of sacral sulci
Piosition of ILAs
Name Dx:
+ seated flexion on left
Deep sacral sulcus on left
Negative backward bending test and inferior posterior ILA on left correct answers Left unilat
sacral flexion
Name dx:
+ seated flexion test on left
Negative backward bending test
Deep sacral sulcus on the left
inferior posterior ILA on the right correct answers Right on right sacral torsion
Inferior ASIS and superior PSIS on the side of standing flexion test. Dx? correct answers
Anterior rotated innominate
Pt with R leg pain. Burning sensation radiating down the right posterior thigh. Began while
gardening earlier that day. No recent trauma and sx worse with ambulation. Osteopathic
structural exam reveals TP halfway between the ILA of the sacrum and G trochanter in the R
gluteal region. TP most likely due to spasm of what muscle? correct answers Piriformis
What nerve is compressed in Piriformis syndrome? correct answers Sciatic nerve
Pt has burning sensation, numbness, or tingling down the back of thigh. correct answers
Piriformis syndrome.
Where is the TP of piriformis musckle located? correct answers Midway between the ILA of the
sarcum and the G trochanter of the femur
Name the origin and insertion of the biceps femoris? correct answers O: Ischial tuberosity
I: Fibular head
What muscle has TP posterior thigh just lateral to the midline? correct answers Biceps femoris
Name origin and insertion of the iliopsoas? correct answers O: lumbar spine and iliac fossa and
inserts on the lesser trochanter
TP located medial to the ASIS correct answers Iliopsoas
If there is spasm of the iliopsoas what can become secondary hypertonic? correct answers
Contralateral piriformis
What TP is associated with ipsilateral forward sacral torsion? correct answers Gluteus medius
,What position do you put a pt for counterstrain of the piriformis muscle? correct answers Prone
with flexion, abduction, and ext rotation of the right lower extremity
What motion does the piriformis do? correct answers Ext rotation the flexed hip and abduct the
LE
What is the general technique for CS? correct answers Indirect and passive technique. Think of
action of muscle. Position pt in same motion of the action of that muscle.
28 yo F with heel pain. Hx reveals the pain started after she began wearing high heels in attempts
to be more attractive. Hx reveals the pain is worse in the morning after sitting for long periods of
time at work. Which of the following is the most appropriate recommendation? correct answers
Insert arch supports
28 yo F with heel pain. Hx reveals the pain started after she began wearing high heels in attempts
to be more attractive. Hx reveals the pain is worse in the morning after sitting for long periods of
time at work. What is the most likely dx? correct answers Plantar fasciitis
What is Plantar fasciitis? correct answers Microtears in the plantar fascia leading to
inflammation.
Pain worse in the morning when the pt takes first step--> dorsiflexion required to step after hours
of sleeping with foot in a relatively platar flexed positon, stretching the plantar flascia
Primary tx for plantar fasciaiits? correct answers Arch supports
initial treatment--> Daily icing, Anti-inflamm meds, and stretching.
What should be avoided for plantar fasciitis? correct answers AVOID flat shoes and barefoot
walking
Structural exam:
, Standing flexion test is negative
Seated flexion + right
Sacral sulcus deep on left
ILA inferior and posterior on R
Backward bending test is positive
Dx? correct answers Right on left sacral torsion
What does the seated flexion test check? correct answers isolates movement of sacrum between
the innominates--> Preventing the practitioner from misdx as innominate dysfunction
3 components of sacral dx? correct answers Seated flexion test
Depth of sacral sulci
Piosition of ILAs
Name Dx:
+ seated flexion on left
Deep sacral sulcus on left
Negative backward bending test and inferior posterior ILA on left correct answers Left unilat
sacral flexion
Name dx:
+ seated flexion test on left
Negative backward bending test
Deep sacral sulcus on the left
inferior posterior ILA on the right correct answers Right on right sacral torsion
Inferior ASIS and superior PSIS on the side of standing flexion test. Dx? correct answers
Anterior rotated innominate
