COM OS II Flashcards
hip flexors
iliacus psoas major, minor sartorius gracilis adductor longus/brevis pectineus rectus femoris
medial hip extensors
semitendinosus
semimembranosus
gracilic
sartorius
lateral hip extensors
biceps femoris
glut max
adductor magnus
what muscles insert on tuberosity of the ischium?
biceps femoris
semimembranosus
semitendinosus
glut max
hip extensor
adductor longus
gracilis and pectineus
medial adductors
adductor longus, brevis, adductor magnus
pectinius
gracilis
adductor groups attach to
all attach to the pubic ramus and the mediar and/or posterior femur
function of all is ADduction
ABductors
gluteus medius
gluteus minimus
tensor fascia lata
glut medius
attaches to ilium and lesser trochanter
glut min
attaches to ilium and lesser trochanter
external rotators
piriformis obturator internus obturator externus gemellus superior gemellus inferior quadratus femoris
muscle that causes sciatica in 10-12% of the population
periformis, sciatic nerve pierces periformis
periformis as abductor and rotator
abduct when hips is flexed
but
external rotators when hip is extended
the ONLY rotator to connect directly to sacrum
Anterior Innominate rotation: position of the ASIS and the PSIS
ASIS rotates inferiorly and PSIS rotates superiorly
Superior Innominate shear
ASIS goes superior, PSIS goes superior
“inflare”
ASIS is pushed more medially
“outflare”
ASIS is pushed more laterally
Pubic shear
r or l pubis goes up, the other goes down.
the “major hip flexors”
iliopsoas
the “lesser” hip flexors
sartorius and rectus femoris
Innominate testing: static anterior landmark assessment
Anteriorly: greater trochanters, pubic symphysis, iliac crest, ASIS
Posteriorly: PSIS
Internal/external leg roll
medial malleolus
Innominate testing: dynamic testing
AP compression
lateral to medial compression
flexion testing (standing and seated)
a patient with a positive standing flexion sign and a positive seated flexion sign indicates a problem with the
sacrum
a patient with a positive standing flexion sign and a negative seated flexion sign have a problem in the
innominate
a patient with a negative standing flexion sign and a positive seated flexion sign indicate a problem in the
sacrum
side with the + standing flexion test indicates the rest of the exam is performed on the
the same side
if a standing flexion test indicates the PSIS on the R side is dysfunctional, what other land marks are assessed?
the sacral sulcus and the ASIS
standing flexion test
patient stand, doc behind patient with eyes at level of PSIS
contacts the inferior aspect of the PSIS
on the dysfunctional side the SI locks prematurely, and the PSIS will elevate first and usually the fatherest. this is the side of the “positive test”
the ilium is dysfunctional in relation to the sacrum
+ standing flexion test
ASIS superior
PSIS inferior
sulcus deep
leg length shorter
posterior innominate rotation
+ standing flexion test
ASIS superior
sulcus equal
leg length shorter
superior innominate shear
+ standing flexion test
ASIS is inferior
PSIS is inferior
sulcus equal
leg length longer
inferior innominate shear
+ standing flexion test
ASIS inferior
PSIS superior
sulcus shallow
leg length longer
Anterior innominate rotation
