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Intro to Biomechanics > Pelvis, Hip, and Knee > Flashcards

Pelvis, Hip, and Knee Flashcards

(107 cards)

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1
Q

Lumbosacral joint

A
  • Connected by a large intervertebral disc
  • Transfers weight, along with the ilium
  • Iliolumbar ligament
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2
Q

Posterior strength of lumbosacral joint comes from

A
  • Interosseous

- Dorsal sacroiliac ligaments

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3
Q

Lumbosacral joint/ilium weight transfer

A
  • While walking, transferred to the femur

- While sitting, transferred to the ischial tuberosities

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4
Q

Iliolumbar ligament

A
  • Ventral and dorsal portion

- Restrains movement at the lumbosacral and sacroiliac joint

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5
Q

Pelvis in open kinetic chain

A
  • The thigh moves on the hip joint
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6
Q

Pelvis in closed kinetic chain

A
  • The hip joint moves on the thigh
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7
Q

Pelvis is made up of

A
  • Sacrum
  • Coccyx
  • Pubis
  • (Two os coxae = ishium, ilium and pubis)
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8
Q

Male pelvis

A
  • Longer and more curved sacrum

- Narrow sub-pubic arch

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9
Q

Female pelvis

A
  • Wider and broader

- Less prominent ischial spines

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10
Q

Sacroiliac joint

A
  • Synarthrodial joint
  • Allows little to no movement in adulthood
  • Helps absorb the weight bearing load from the legs
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11
Q

Sacroiliac joint stability provided by

A
  • Interosseous sacroiliac ligament (prevents anterior inferior ovemet of the sacrum)
  • Posterior sacroiliac ligament
  • Sacrotuberous ligament
  • Sacrospinous ligament
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12
Q

Sacroiliac joint movement

A
  • Anterior-posterior (sagittal plane)

- Movement limited to 2 to 4 mm due to architecture and ligamentous support

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13
Q

Pubic symphysis

A
  • Cartilagenous synarthrodial joint
  • Fibrocartilagenous interpubic disc
  • Small amount of translation and rotation
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14
Q

Pubic symphysis resists

A
  • Traction force inferiorly
  • Compressive forces superiorly
  • Shearing and compressive forces during stance
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15
Q

Pubic symphysis rotation

A
  • Will rotate in tandem with the sacroiliac joint

- Can move ~2 mm with 1 degree rotation

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16
Q

Pubic symphysis support

A
  • Supported by 4 ligaments

- Superior, inferior (arcuate), anterior and posterior pubic ligaments

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17
Q

Hip joint

A
  • A ball and socket synovial joint
  • Has three degrees of freedom
  • Motion in all three cardinal planes
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18
Q

Hip joint stability provided by

A
  • Anatomic shape

- Soft tissue attachments

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19
Q

Ischial component of acetabular fossa

A
  • ~>2/5 total surface

- Lower and side boundaries

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20
Q

Ilial component of acetabular fossa

A
  • ~<2/5 total surface

- Upper boundary

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21
Q

Pubis component of acetabular fossa

A
  • Remainder of fossa that is not ischial or ilial
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22
Q

Parts of the acetabular fossa

A
  • Hemispherical shape
  • Sides lined with articular cartilage
  • Acetabular notch (inferior, horse-shoe shaped)
  • Acetabular labrum (upper, thick rim that deepens the fossa)
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23
Q

Acetabular fossa alignment

A
  • Forward (30-40° from the frontal plane)
  • Lateral
  • Downward (30-40° (20-30°) from horizontal or transverse plane, roof overhangs head of femur)
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24
Q

Acetabular fossa function

A
  • Allows for stability medially, superiorly and posteriorly
  • Roof receives greatest pressure
  • Difficult to dislocate
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25
Acetabular labrum
- Fibro-cartilaginous rim attached to the margin of the acetabulum - Deepens the acetabular cavity
26
Characteristics of acetabular labrum
- Horse-shoe shaped - Ends contacted at the acetabular notch via transverse ligament - Thicker posteriorly - Wider and thinner anteriorly
27
Three extracapsular hip ligaments
- Iliofemoral - Ischofemoral - Pubofemoral
28
Iliofemoral ligament
- Y-shaped - Strongest ligament in the body - Tighter when hip is extended
29
Iliofemoral ligament extends from
- AIIS to intertrochanteric line
30
Iliofemoral ligament function
- Prevents hip hyperextension during standing
31
Pubofemoral ligament extends from
- Superior pubic rami to the intertrochanteric line
32
Pubofemoral ligament function
- Triangular shape - Reinforces the joint anteriorly and inferiorly - Prevents excessive abduction and extension
33
Ischiofemoral ligament extends from
- Body of ischium to the greater trochanter
34
Ischiofemoral ligament function
- Spiral orientation - Prevents hyperextension - Supports head of femur in acetabulum
35
Ligamentum teres extends from
- Ischial and pubic sides of acetabular fossa to the fovea capitus of the femur - Encloses a branch of the obturator artery
36
Ligamentum teres function
- Stabilizes the hip in flexion | - Particularly in squatting position
37
Head of femur supported by
- Femoral neck (obliquely set) | - Angulation within frontal plane
38
Angle of femoral inclination
- Average adult = 128°
39
Angle of antetorsion
- Deviated 10-30° from the frontal plane
40
Femur sagittal plane contour
- Mild forward curvature | - Aided by pull of hamstrings
41
Femur frontal plane curvature
- Outward curvature of the head, neck and upper shaft | - Tensor fascia lata and vastus lateralis aid valgus curve of distal femur
42
Bending of the femur
- Only biarticular muscles can bend the femur
43
Factors that provide hip stability
- Shape of acetabular fossa - Extracapsular ligaments - Intracapsular ligaments
44
Hip joint frontal or lateral axis
- Projects to body's surface near greater trochanter | - Flexion and extension of hip
45
Hip joint sagittal or anterior-posterior axis
- At groin, midpoint of inguinal line | - Abduction and adduction of hip
46
Hip joint vertical (mechanical) axis
- Line that connects femur's points of contact with acetabulum and tibia  - Internal and external rotation of hip
47
Hip joint has 3 degrees of freedom
- Sagittal plane - Frontal plane - Transverse plane
48
Hip sagittal plane degree of freedom
- Flexion: 120 - 140 degrees | - Extension: 15 - 20 degrees
49
Hip frontal plane degree of freedom
- Abduction: 45 - 50 degrees | - Adduction: 20 - 30 degrees
50
Hip transverse plane degree of freedom
- Internal rotation: 45 degrees | - External rotation: 45 degrees
51
Transverse plane motion at hip
- Internal and external rotation - Each more distal limb segment rotates in the same direction as the pelvis - But, each distal segment rotates more than its proximal segment
52
Infant hip transverse plane range of motion
- 2-3:1 external to internal - Total range up to 155° - Decreases to 90° by age six
53
Adult hip transverse plane range of motion
- 1:1 external to internal | Total range ~90°
54
Geriatric hip transverse plane range of motion
- 2:1 external to internal - Concomitant increased angle of gait - Total range may be < 90°
55
1st element of gait
- Pelvic Rotation (transverse plane)
56
Ligamentous causes of femoral anteversion/retroversion
- Pubofemoral ligament - Iliofemoral ligament - Ligamentum teres - Intrauterine position?
57
Muscular etiologies of femoral anteversion/retroversion
- Tight medial hamstrings | - Tight adductor muscles
58
Sagittal plane motion at hip
- Allows forward movement of leg - Hip flexion and extension - Moves from flexed to full extension in midstance - Begins flexing during early propulsion
59
Frontal plane motion at hip
- Very slight movement during gait - Abduction and adduction - During gait, 5° drop on non-weight bearing side - Mild abduction during early swing
60
2nd element of gait
- Pelvic list (frontal plane)
61
Angle of femoral inclination (Mickulicz angle)
- Relationship of the long axis of the head and neck to the long axis of the femoral shaft
62
Normal values of angle of femoral inclination (Mickulicz angle)
- Birth: 35 - 150° | - Adult: 120 - 132°
63
Hip positions in the stance phase of gait
- Heel strike: extended - Loading response: mild flexion - Midstance: extended - Heel lift: extended - Toe off: staring to flex
64
Hip positions in the swing phase of gait
- Early swing: flexed - Midswing: flexed - Terminal swing: extending
65
3rd element of gait
- Knee joint extension/flexion
66
Knee joint
- Complex hinge joint - Endures the heaviest stresses of any joint - Two degrees of freedom
67
Knee joint in extension
- Stabilizer | - Shock absorber
68
Knee joint in flexion
- Great mobility - Helps foot to adapt to ground - Shortens the limb - Develops kinetic energy for running
69
Knee joint components
- Distal Femur - Proximal Tibia (transfers weight across the knee and to the ankle) - Patella
70
Knee joint horizontal frontal plane axis
- Runs through femoral condyles | - Sagittal plane motion (flexion and extension)
71
Knee joint vertical axis
- Transverse plane motion | - Movement in the final degrees of knee extension
72
Knee joint horizontal sagittal plane axis
- Potential frontal plane motion | - Generally pathologic
73
Bony features of distal femur (knee joint)
- Lateral and medial condyles - Lateral and medial epicondyles - Intercondylar notch - Intercondylar (trochlear) groove - Lateral and medial patellar facets - Popliteal surface
74
Knee joint articular facets
- Two facets between femur and tibia - One two-sided facet between patella and femur - Medial and Lateral condyles are not symmetrical
75
Bony features of proximal tibia and fibula (knee joint)
- Head of fibula - Medial and lateral condyles - Intercondylar eminence (with tubercles) - Anterior intercondylar area - Posterior intercondlar area - Tibial tuberosity - Soleal line
76
Tibial plateau
- Medial facet - Lateral facet - Peripheral portions
77
Medial tibial facet
- Oval and concave
78
Lateral tibial facet
- Nearly circular - Concave side to side - Convex from posterior
79
Tibia peripheral portions
- Fibrocartilagenous minisci
80
Menisci properties
- Semi-lunar - Poor vascular supply - Disperse friction - Shock absorbers
81
Medial meniscus
- Well attached | - Injured slightly more often
82
Lateral meniscus
- More mobile
83
Bony features of the patella
- Base - Apex - Anaterior surface - Posterior articular surface - Vertical ridge - Lateral, medial and odd facet
84
Patella
- Patella = “small plate” in Latin - Embedded within the quadriceps tendon - Functions as a pulley - Largest sesamoid in body
85
Patella is tethered by
- Patellar retinaculum - Anchored inferiorly by patellar tendon - Acts as a pulley to redirect the force of quadriceps contraction
86
Patella function
- It glides in the intercondylar notch | - This adjusts the oblique pull of the quadriceps
87
Lateral facet of posterior patella
- Broader and deeper - Roughly 2/3 of patella - Sagittal convexity - Coronal concavity
88
Medial facet of posterior patella
- Narrower and shallower | - Smaller and slightly convex
89
Patellar movement in knee extension
- Inferior portion of patella has greatest contact with femur
90
Patellar movement in knee flexion
- Superior portion makes greatest contact with femur
91
Medial collateral ligament attachments
- Originates on medial epicondyle of femur - Attaches to medial condyle of tibia - Attached to joint capsule and medial meniscus
92
Medial collateral ligament fibers
- Anterior: tight with knee flexion | - Posterior: tighter with knee extension, shorter and more oblique
93
Lateral collateral ligament attachments
- Originates on lateral epicondyle of femur | - Attaches to fibula
94
Lateral collateral ligament fibers
- Tight only | - Knee joint extension beyond 150°
95
Anterior cruciate ligament function
- Resists excess sagittal plane movement - Tight in full extension - Resists anterior movement of tibia - Tightens again with knee in full flexion
96
Anterior cruciate ligament attachments
- Anterior intercondylar area of tibia | - Medial posterior aspect of lateral femoral condyle
97
Posterior cruciate ligament function
- Resists excess sagittal plane movement | - Tightens with > 30° flexion
98
Posterior cruciate ligament attachments
- Posterior intercondylar area of tibia | - Lateral anterior aspect of the medial femoral condyle
99
Knee joint axis
- Moving axis, possesses two degrees of freedom - Predominant motion: sagittal plane - At end of knee extension: transverse plane motion to lock the knee
100
Knee joint sagittal plane range of motion
- Extension: to vertical; up 5° beyond vertical | - 130 - 135° flexion; limited by soft tissue impingement
101
Knee joint transverse plane range of motion
- Occurs during last 20° of knee extension - When knee is flexed: up to 40°motion is available - Locking mechanism of knee joint
102
Knee joint flexion in closed kinetic chain
- Femur rotates slightly lateral (relaxes LCL) - Menisci pulled posteriorly - PCL tightens - Femur “rocks” on tibial plateau - Tibia moves posteriorly
103
Knee joint flexion in CKC during gait cycle occurs during
- During propulsion after heel off but before toe off | - Limb is beginning to shorten for swing
104
Knee joint extension in closed kinetic chain
- Femoral condyles “roll” on tibial plateau - Femur rotates slightly medial and posterior - Medial condyle slides slightly posterior - Collaterals pulled tight - Tibia moves anteriorly - ACL pulled tight
105
Locking mechanism of knee
- Occurs due to the shape and convexity of medial femoral condyle - Facilitated by the quadriceps - Lateral condyle begins internal rotation - It occurs within the last 20° of knee extension
106
Unlocking of the knee
- The popliteus is the “key” to unlocking the knee | - It initiates lateral rotation of the femur to promote flexion
107
Knee frontal plane deviations
- Genu valgus (knock kneed) | - Genu varum (bow legged)

Intro to Biomechanics (8 decks)

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