Flashcards in Week 11: Pelvis and hip Deck (74):
5 Bones of the pelvic girdle
4 bony prominances of the pelvic girdle?
1. iliac crest
4. SIT (ischial tuberosity)
Which ligament is responsible for limiting sacral and pelvic motions?
short posterior SI ligament
What are the main differences between men and women pelvis?
men: more stable, more weight bearing, more prone to osteophytes
women: more flexible, more prone to SI dysfunction
Why is the pelvic ring important?
it is the connection between the sacrum and pelvis; it helps transfer weight
how many joints are in the pelvic girdle?
What is the SI joint?
transfer weight from spine to LE
What is nutation of the SI joint? Counter-nutation?
Nutation: anterior tilt of sacrum to ilium; PPT
Counter: posterior tilt of sacrum to ilium, APT
What is the open packed position of SI joint? Closed packed?
open: counter-nutation (Anterior tilt)
closed: nutation (posterior tilt)
What is the lumbosacral joint?
Connection between L5 and Sacral base
T/F with lumbar flexion, PPT always occurs?
No, at about 45* of flexion the ligaments are taut and vertebrae are stable and an APT occurs
APT and PPT occur in which plane?
Lateral Pelvic Tilt occurs in which plane?
Rotation occurs in which plane?
T/F: pelvic motion can be isolated?
With APT, what occurs at the pelvis, sacrum, hip, and lumbar spine?
Sacral counternutatoin (posterior tilt)
With PPT, what occurs at the pelvis, sacrum, hip, and lumbar spine
Sacral nutation (anterior tilt)
With elevation/lateral pelvic tilt, what occurs at the hip and lumbar regions?
ipsilateral hip hikes up and adducts
ipsilateral lumbar lateral flexion
What depression/lateral pelvic tilt, what occurs at the hip and lumbar regions?
ipsilateral hip depression and abduction
contralateral lumbar flexion
With anterior pelvic rotation, what occurs at the hip and trunk?
Anterior hip swing
posterior trunk rotation towards the planted leg
Internal rotation planted hip
With posterior pelvic rotation, what occurs at the hip and trunk?
Posterior swing hip
Anterior trunk rotation towards planted leg
External rotation planted hip
What is the angle of inclination for normal hip alignment? Which plane?
125* frontal plane
What is the femoral anteversion for normal hip alignment? Which plane?
12-15* transverse plane
How many DOF does the coxofemoral joint have?
ball and socket
tri-axial (3 DOF)
concave acetabulum with convex femoral head
Strongest hip ligament?
Iliofemoral L. or "Y" ligament
Weakest hip ligament?
3 hip ligaments
3 closed packed position for hip motions?
3 Resting position for hip motion?
3 areas of capsular restriction for hip motion?
Iliofemoral L. restricts which 2 hip motions?
This muscle is responsible for lateral flexion of the trunk (closed chain) and lateral tilt to elevate the pelvis (open chain)
Attachments of Quadratus Lumborum?
TP of lumbar and rib 12 to posterior aspect of iliac crest
4 main muscles involved in hip flexion?
Actions of Iliopsoas?
Innervation of Iliopsoas?
Actions of Rectus Femoris?
Innervation of Rectus Femoris?
Attachments of Rectus Femoris?
ASIS to tibial tuberosity
Passive insufficiency of the rectus femoris?
hip extension and knee flexion
Active insufficiency of the rectus femoris?
hip flexion and knee extension
Closed chain for hip extension? Open chain?
Closed chain for hip flexion? Open chain?
2 Muscle groups involved in hip extension?
hamstrings (semimembranosus, semitendinosus, biceps femoris)
Attachments of gluteus maximus?
sacrum to femur (GT)
Actions of gluteus maximus?
PT and contralateral rotates
Innervation of gluteus max?
inferior gluteal N.
3 muscles that make up the hamstring group?
Actions of the hamstring group?
flex the knee
Innervation of hamstring group
Active insufficiency of the hamstring group? Passive insufficiency?
Extend hip and flex the thigh
Flex hip and extend thigh
Open chain movement of hip abduction? Closed chain?
OC: hip abduction
CC: contralateral rotation; ipsilateral rotation
2 main muscles involved in hip abduction?
gluteus medius, gluteus minimus
Actions of gluteus medius and minimus
ipsilateral depression of pelvis
Innervation of the gluteus medius and minimus?
Superior gluteal N.
Attachments of gluteus medius and minimus?
external ilium to greater trochanter of the femur
Open chain movement of hip adduction? Closed chain?
OC: hip adductors
CC: ipsilateral elevation of pelvis
5 muscles of hip adduction
2 main muscles in hip ER?
Attachments of the Piriformis?
Sacrum to the greater trochanter of the femur
Actions of Piriformis?
Contralaterally rotates the pelvis
May Act As: IR at the thigh (if the thigh is first abducted >/ 60*)
Innervation of the piriformis?
Inferior Gluteal N.
What is a trendelenburg sign?
Weak gluteus medius
Muscles of hip IR
1.Tensor Fasciae Latae
3.Gluteal medius (anterior)
4.Contributions (SM and ST)
Actions of Tensor Fasciae Latae?
Abducts the thigh
Flexes the thigh
Anterior pelvic tilt
Innervation of TFL?
superior gluteal N.
Attachment of TFL?
ASIS to IT band
Piriformis tightness can result in what condition?
Tight TFL can put an individual at risk for what syndrome?
ITB friction or greater trochanter bursitis
Increased tension at the lateral femoral condyle that causes knee pain and tension at the greater trochanter is characteristic of?
ITB friction or greater trochanter bursitis
What is a coxa vara position?
angle is less than 120-125*
Clinical Impact: leg length discrepancy, weakness in hip abductors, early arthritis
What is coxa valga position?
Angle is greater than 125-135*
Clinical Impact: instability, subluxation, dysplasia, increased femoral anteversion, increase lumbar lordosis
What is the normal torsion for femoral anteversion?