Innominates

Question 1

What muscles participate in hip adduction? How do you evaluate them?

Answer 1

Gracilis
Adductor longus
Adductor magnus
Adductor brevis
Pectineus

Evaluate with hip abduction

Question 2

What are the origins and insertions of Pectineus?

Answer 2

Origin: Superior ramus of the pubis

Insertion: Pectineal line of femur

Question 3

What are the origins and insertions of gracilis?

Answer 3

Origin: Inferior ramus of the pubis

Insertion: Proximal and medial surface of the tibia (Pes Anserine)

Question 4

What is the common origin of the adductor muscles?

Answer 4

Body and inferior ramus of pubis

Question 5

What is the insertion of adductor brevis?

Answer 5

Proximal part of linea aspera

Question 6

What is the insertion of adductor longus?

Answer 6

Middle 1/3 of linea aspera

Question 7

What is the insertion of adductor magnus?

Answer 7

Linea aspera and adductor tubercle of femur

Question 8

What are the hip abductors and internal rotators? How do you evaluate them?

Answer 8

Gluteus Medius and Minimus

Tensor Fasciae Latae

Evaluate with hip adduction and external rotation

Question 9

What is the origin and insertion of the gluteus medius and minimus?

Answer 9

Origin: lateral surface fo ilium

Insertion: Greater trochanter of femur

Question 10

What are the hip external rotators and how do you evaluate them?

Answer 10

Piriformis

Gluteus maximus

Evaluate with hip internal rotation

Question 11

What are the hip extensors and how do you evaluate them?

Answer 11

Gluteus maximus
Hamstrings - Biceps femoris (long and short head), semitendinosus, and semimembranosus

Evaluate with hip flexion

Question 12

What are the hip flexor muscles and how do you evaluate them?

Answer 12

Psoas major
Illiacus major
Rectus femoris major
Sartorius minor
Tensor fascia latae minor

Evaluate with hip extension

Question 13

When you are walking and your leg is forward, what is the innominate doing?

Answer 13

Innominate is in posterior rotation on same side as leading leg

Question 14

The sacrum and lumbar spine move in _____ directions

Answer 14

Opposite

Question 14

When you are walking and your leg is behind, what is the innominate doing?

Answer 14

The innominate on the side of the leading leg is in anterior rotation

Question 15

Innominate Inflare

Answer 15

ASIS is closer to midline

Question 16

Innominate Outflare

Answer 16

ASIS is farther from midline

Question 17

Upslip

Answer 17

Superior translation of innominate on sacrum

Question 18

Downslip

Answer 18

Inferior translation of innominate on sacrum

Question 19

Pubic tubercle high on side of positive test

Answer 19

Superior pubic shear

Question 20

Pubic tubercle low on side of positive test

Answer 20

Inferior pubic shear

Question 21

Positive Standing Flexion Test

Answer 21

Side that PSIS moves farther

Question 22

Positive ASIS Compression Test

Answer 22

Side that is less compressible

Question 23

What is counterstrain in regards to the patients movement and whether we are engaging with barrier?

Answer 23

Indirect

Passive

Question 24

What is muscle energy in regards to the patients movement and whether we are engaging with barrier?

Answer 24

Direct and active Isometric and isolytic

Question 25

Internal rotation of the hip

Answer 25

Thigh points medial

Question 26

External rotation of the hip

Answer 26

Thigh points laterally

Question 27

What is occurring with the ASIS and PSIS in anterior rotation?

Answer 27

On same side ASIS is inferior PSIS is superior

Question 28

What is occurring with the ASIS and PSIS in posterior rotation?

Answer 28

On same side ASIS is superior PSIS is inferior

Question 29

What is occurring with the ASIS and PSIS in superior shear?

Answer 29

ASIS and PSIS are superior on same side

Question 30

What is occurring with the ASIS and PSIS in inferior shear?

Answer 30

ASIS and PSIS are inferior on same side

Question 31

What is occurring with the ASIS and PSIS in inflare?

Answer 31

ASIS is more medial and PSIS more lateral on same side

Question 32

What is occurring with the ASIS and PSIS in outflare?

Answer 32

ASIS is more lateral and PSIS is more medial

Question 33

What does the structural exam include for diagnosis of innominate rotations?

Answer 33

One landmark - left and right ASIS position 2 tests - Standing Flexion Test/ASIS compression test and Innominate rotation test

Question 34

If innominate rotation does not match ASIS position, what should you look for?

Answer 34

Upslipped innominate

Question 35

What is the treatments for anterior rotation?

Answer 35

HVLA - flex hip 30 degrees and abduct leg; direct treatment Muscle Energy - use hip extensors to bring hip into flexion; direct treatment

Question 36

What are the treatments for posterior rotation?

Answer 36

HVLA - Hip on table, abduct leg (30 degrees); direct treatment Muscle Energy - Use hip flexors; direct treatment