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ANATOMY > HIP > Flashcards

HIP Flashcards

1
Q

HIP - ROM

A
  • Flexion - 80-90 (straight leg)
  • Flexion - 120 (bent leg)
  • Extension - 30
  • Internal rotation - 40
  • External rotation - 50
  • Abduction - 50
  • Adduction - 30
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2
Q

HIP - MYOTOMES

A
  • Hip flexion - L1, L2, L3 - femoral nerve
  • Knee extension - L3, L4 - femoral nerve
  • Knee flexion - L4, L5, S1, S2 - sciatic nerve
  • Ankle dorsiflexion - L4, L5 - deep peroneal nerve
  • Ankle inversion - L4, L5 - tibial nerve, deep peroneal nerve
  • Ankle eversion - L5, S1 - superior peroneal nerve
  • Big toe extension - L5, S1 - deep peroneal nerve
  • Big toe flexion - L5, S1 - tibial nerve
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3
Q

HIP - ORTHO TESTS - SCREENING

A
  • SCREENING - Heel walk, toe walk, Trendelenburg’s sign
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4
Q

HIP - ORTHO TEST - INSTABILITY

A
  • INSTABILITY - hip telescoping
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5
Q

HIP - ORTHO TEST - HIP DJD

A
  • HIP DJD - Scour, FABERE
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6
Q

HIP - ORTHO TEST - LUMBAR RADICULOPATHY

A
  • LUMBAR RADICULOPATHY - SLR, Braggard’s test
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7
Q

HIP - ORTHO TEST - HIP FLEXOR LENGTH

A
  • HIP FLEXOR LENGTH - Thomas test, Gaenslen’s test, Rectus femoris contracture test
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8
Q

HIP - ORTHO TEST - PIRIFORMIS SYNDROME

A
  • PIRIFORMIS SYNDROME - Sign of the buttock
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9
Q

HIP - JOINT TYPE

A

Synovial

  • Symphysis - pubic symphysis
  • Ball and socket - acetabulofemoral
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10
Q

HIP - ARTICULAR SURFACES

A
  • Acetabulofemoral - convex (head of femur) on concave (acetabulofemoral)
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11
Q

HIP - MAIN MUSCLE ACTIONS - FLEXION

A
  • FLEXION - iliopsoas, rectus femoris, sartorius
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12
Q

HIP - MAIN MUSCLE ACTIONS - EXTENSION

A
  • EXTENSION - gluteus maximus, hamstrings
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13
Q

HIP - MAIN MUSCLE ACTIONS - ABDUCTION

A
  • ABDUCTION - gluteus medius, gluteus minimus, tensor fasciae latae
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14
Q

HIP - MAIN MUSCLE ACTIONS - ADDUCTION

A
  • ADDUCTION - adductor Magnus, gracilis, adductor longus and brevis
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15
Q

HIP - MAIN MUSCLE ACTIONS - INTERNAL ROTATION

A
  • INTERNAL ROTATION - gluteus medius, gluteus minimus, tensor fasciae latae
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16
Q

HIP - MAIN MUSCLE ACTIONS - EXTERNAL ROTATION

A
  • EXTERNAL ROTATION - piriformis, quadrates femoris, superior and inferior gemellus, obturator internus and externus
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17
Q

HIP - RESTING POSITION

A

Acetabulofemoral: 30 abduction, 30 flexion, and slight external rotation

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18
Q

HIP - CLOSED PACKED POSITION

A

Acetabulofemoral: full extension, abduction and internal rotation

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19
Q

HIP - NORMAL END FEEL

A

FLEXION & ADDUCTION- elastic or tissue approximation

EXTENSION & ABDUCTION - elastic/firm

STRAIGHT LEG RAISE - elastic

INTERNAL/EXTERNAL ROTATION - elastic/firm

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20
Q

HIP - ABNORMAL END FEEL

A
  • Bony = osteoarthritis
  • Late myospasm = instability
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21
Q

HIP - HIP JOINT FORCES

A
  • Standing - 0.3x body weight
  • Standing on one leg - 2.5x body weight
  • Walking - 3x body weight
  • Running - >4.5x body weight
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22
Q

HIP - CONDITIONS - AVASCULAR NECROSIS

A

Hx - repetitive hip trauma, corticosteroids, alcohol, diabetes, sickle cell anaemia, atherosclerosis
S&S - pain/stiffness in hip joint, pain persists with rest, antalgic limp, limited ROM
DDx - osteoarthritis, osteoporosis, hip dislocation, femoral neck fracture

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23
Q

HIP - CONDITIONS - ACETABULAR LABRAL TEAR

A

Hx - prior trauma, deep hip/groin pain, worse with full hip flexion, possible locking
S&S - audible click with motion, pain with full passive hip flexion (bent knee)
DDx - internal or external snapping hip, DJD

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24
Q

HIP - CONDITIONS - HERNIA (INGUINAL OR FEMORAL)

A

Hx - M>F (9:1); prior heavy lifting with valsalva causes more pain
S&S - palpable protrusion worse with valsalva - Red flags: nausea, fever, vomiting, discolouration indicative of a strnagulated hernia = medical emergance
DDx - groin strain, testicular torsion

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25
Q

HIP - CONDITIONS - HIP DJD

A

Hx - groin pain worse with weight bearing or cold weather, morning stiffness
S&S - antalgic gait, +ve scour test, visible on x-rays (sclerosis, decreased joint space)
DDx - avascular necrosis

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26
Q

HIP - CONDITIONS - LEGG-CALVE PERTHES

A

Hx - pain in groin, medial thigh or knee (without knee pathology)
S&S - antalgic gait, decreased ROM, the hip may also refer pain down to the knee
DDx - osteoarthrosis, avascular necrosis (visible on x-ray)

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27
Q

HIP - CONDITIONS - MUSCLE STRAIN (HAMSTRING, QUADS, GROIN)

A

Hx - sudden onset of pain associated with muscle contraction
S&S - antalgic gait, local tenderness to palpation, decreased AROM
DDx - avulsion fracture

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28
Q

HIP - CONDITIONS - PIRIFORMIS SYNDROME

A

Hx - possible pain down back of leg, worse when sitting on hard surfaces
S&S - tender to palpation, +ve SLR, +ve sign of the buttock, +ve piriformis test
DDx - lumbar radiculopathy, disc herniation, lumbar sprain/strain, stenosisa

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29
Q

HIP - CONDITIONS - SEPTIC ARTHIRTIS

A

Hx - rapid onset of severe hip pain, prior infection possible (resp or other)
S&S - fever, mincing/painful gait, extremely limited ROM, puncture wound in skin
DDx - rheumatoid arthritis

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30
Q

HIP - CONDITIONS - SCFE

A

Hx - 10 - 16 years old, mild hip pain referral to medial thigh/knee; worse with activity
S&S - decreased abduction and internal rotation ROM; mild limp or awkward gait
DDx - visible on x-ray, groin strain, Legg-Calve-Perthes disease, septic arthritis

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31
Q

HIP - CONDITIONS - SNAPPING HIP

A

Hx - pt may feel repeatable ‘pop’ of ITB or direct trauma to greater trochanter
S&S - tender to palpation over greater trochanter, +ve Ober’s test
DDx - may causeteric bursitis

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32
Q

HIP - CONDITIONS - TROCHANTERIC BURSITIS

A

Hx - pt may feel ‘pop’ of ITB or direct trauma to greater trochanter
S&S - tender to palpation over greater trochanter, +ve Ober’s test
DDx - snapping hip

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33
Q

HIP - ORTHO TESTS - THOMAS TEST

A
  • Pt supine
  • Pt flexes one knee to chest while keeping the other leg straight
  • Examiner observes for straight leg elevation
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34
Q

HIP - ORTHO TEST - THOMAS TEST - POSITIVE TEST

A

Hip contracture, tight iliopsoas or rectus femoris

  • Elevation of the straight leg
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35
Q

HIP - ORTHO TEST - LABRAL TEAR TEST

A
  • Pt supine
  • 3 parts to test
    1. Examiner applies P-A force over distal thigh and asks pt to flex hipRectus femoris originates from the anterior acetabulum nd if the anterior labrum is torn the pull from the contraction may cause pain
    2. Pain in Gaenslen’s test position, examiner pushes hanging leg into extensionCompression of the posterior labrum may cause pain if damaged
    3. Pt knee bent, examiner flexes pt hip into full flexion and internal rotation with over pressureSN: 98SP: 8-25
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36
Q

HIP - ORTHO TEST - LABRAL TEAR TEST - POSITIVE TEST

A

Acetabular labral tear, Joint capsule impingement

  • Pain or apprehension
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37
Q

HIP - ORTHO TEST - OBER’S TEST

A
  • Pt sidelying with affected lower extremity up
  • Examiner stabilises pelvis with one hand and grasps ankle and flexes pt knee to 90, slightly abducts and extends hip
  • Examiner then proceeds to internally rotate the hip (lift the ankle up)
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38
Q

HIP - ORTHO TEST - OBER’S TEST - POSITIVE TEST

A

Trochanteric bursitis

  • Trochanteric pain

Hip joint pathology

  • Hip pain
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39
Q

HIP - ORTHO TEST - MODIFIED OBER’S TEST

A
  • Pt side lying with affected lower extremity up
  • Examiner stabilises the pt pelvis and adducts affected leg behind opposite leg
  • Examiner observes for pain, discomfort, ROM anf end feel
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40
Q

HIP - ORTHO TEST - MODIFIED OBER’S TEST - POSITIVE TEST

A

Hip joint pathology

  • Hip pain

Trochanteric bursitis

  • Trochanteric pain

ITB contracture

  • Decreased ROM
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41
Q

HIP - ORTHO TEST - FABERE TEST

A
  • Pt supine
  • Examiner instructs pt to cross legs into a figure 4 position (ankle placed above contralateral knee, ipsilateral knee flexed 90, ipsilateral hip abducted and externally rotated)
  • Examiner stabilises the pelvis and applies gentle downward pressure over the flexed knee
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42
Q

HIP - ORTHO TEST - FABERE TEST - POSITIVE TEST

A

Hip joint pathology, severe arthritis, sprain/strain, fracture, tight hip adductors

  • Pain
  • Inability to perform motion
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43
Q

HIP - ORTHO TEST - FABERE TEST - SN & SP

A

SN: 50

SP: 29

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44
Q

HIP - ORTHO TEST - FADIR TEST

A
  • Pt sidelying or supine
  • Hip neutral and knee flexed 60-90 degrees
  • Examiner stabilises hip and passively flexes hip to 60 and internally rotates femur
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45
Q

HIP - ORTHO TEST - FADIR TEST - POSITIVE TEST

A

Sciatic nerve compression, hip joint pathology, femoral acetabular impingement, hip fracture

  • Pain in sciatic/gluteal area
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46
Q

HIP - ORTHO TEST - FADIR TEST - SN & SP

A

SN: 88

SP: 83

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47
Q

HIP - ORTHO TEST - SCOUR TEST

A
  • Pt supine
  • Examiner flexes pt hip to 90 and flexes knee - 3 parts
    1. Take pt through PROM of hip (circumduction and rotation) without compression
    2. Examiner then applied mild axis compression over the femur and repeats
    3. If tolerated, examiner repeats the test with more pressure
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48
Q

HIP - ORTHO TEST - SCOUR TEST - POSITIVE TEST

A

Hip joint pathology, osteoarthritis, transient hip synovitis, capsulitis, labral tear, acetabular impingement syndrome, SCFE, fracture

  • Pain or crepitus
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49
Q

HIP - ORTHO TEST - SCOUR TEST - SN & SP

A

SN: 75-91

SP: 43

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50
Q

HIP - SNAPPING HIP SYNDROME

A
  • A palpable or audible snapping sensation that is heard during the movement of the hip joint.
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51
Q

HIP - SNAPPING HIP SYNDROME - CAUSE

A
  • Most commonly a result of overuse
  • External snapping hip syndrome most commonly is caused by the iliotibial band snapping over the greater trochanter of the femoral head during movements such as flexion, extension, and external or internal rotation.
  • Internal snapping hip is most commonly caused by the iliopsoas tendon snapping over underlying bony prominences, such as the iliopectinal eminence or the anterior aspect of the femoral head.
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52
Q

HIP - SNAPPING HIP SYNDROME - POPULATION AFFECTED

A
  • Slightly more common in women than men
    Heavy labour jobs, ballet dancers, weight lifters
    liotibial band tightness, shorter muscle or tendon lengths, muscle tightness
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53
Q

HIP - SNAPPING HIP SYNDROME - CLINICAL PRESENTATION

A
  • External SHS may also have coxa vara, fibrotic scar tissue, a prominent greater trochanter, smaller lateral pelvic width, or a past surgery for anterolateral knee instability.
  • Internal SHS Ps describe a painful sensation coming from deep within the anterior groin as they move their hip from flexion into extension or external rotation.
  • The snapping movement can produce an auditory clunk or click.
  • Pain
  • Inflammation
  • Feeling like hip is dislocation
  • Leg muscle weakness
  • Swelling
  • Difficulty standing up from a chair
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54
Q

HIP - ACQUIRED DISLOCATION OF THE HIP

A
  • Hip dislocation is the displacement of the femur head from the acetabulum
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55
Q

HIP - ACQUIRED DISLOCATION OF THE HIP - CAUSE

A
  • Majority from motor vehicle collisions - posterior dislocations
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56
Q

HIP - ACQUIRED DISLOCATION OF THE HIP - POPULATION AFFECTED

A
  • More common in elderly/females
  • Within 3 months of a hip replacement surgery
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57
Q

HIP - ACQUIRED DISLOCATION OF THE HIP - CLINICAL PRESENTATION

A
  • The hip will be shortenend, in external rotation, slight flexion and adduction in the more common posterior dislocations.
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58
Q

HIP - COXA VARA

A
  • Normal femoral neck-shaft is 160deg in adults – angle less than 120deg is called coxa vara. Can be either congenital (CCV) or acquired (ACV).
  • CCV due to defect of endochondral ossification in medial part of femoral neck
    When child starts to crawl or stand the femoral neck bends or develops a stress fracture
  • Infancy and early childhood (CCV)
  • ACV can develop at any age if the femoral neck gives way
  • Limb length discrepancy, Leg is short, thigh may be bowed
  • Prominent greater trochanter
  • Limitation of abduction and internal rotation of the hip
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59
Q

HIP - FEMORAL ANTEVERSION

A
  • The femur turns inwards causing the whole leg to turn in
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60
Q

HIP - FEMORAL ANTEVERSION - CAUSE

A
  • Excessive anteversion of the femoral neck, so that the internal rotation of the hip is increased and external rotation is diminished.
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61
Q

HIP - FEMORAL ANTEVERSION - POPULATION AFFECTED

A
  • Most evident in children 2-4
  • Twice as common in girls than boys
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62
Q

HIP - FEMORAL ANTEVERSION - CLINICAL PRESENTATION

A
  • When a child walks or runs, the feet turn inward instead of pointing straight ahead
  • Usually sit on floor with knees facing each other – should be advised to sit with knees facing outwards
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63
Q

HIP - PYOGENIC ARTHRITIS

A
  • Bacterial, viral or fungal infections - spreads through the bloodstream to a joint.
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64
Q

HIP - PYOGENIC ARTHRITIS - CAUSE

A
  • Lining of your joints has little ability to protect itself from infection. Your body’s reaction to the infection — including inflammation that can increase pressure and reduce blood flow within the joint — contributes to the damage.
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65
Q

HIP - PYOGENIC ARTHRITIS - RISK FACTORS

A
  • Children under 2
  • Complication of joint surgery
  • Diabetes mellitus
  • Immunodeficiency
  • Pre-existing joint disease, Rheumatoid arthritis
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66
Q

HIP - PYOGENIC ARTHRITIS - CLINICAL PRESENTATION

A
  • Child is in pain and ill
  • Hip movements resisted to total lack of ROM
  • Aspiring pus from joint
  • Severe joint pain, usually in just 1 joint, that started suddenly
  • Swelling around a joint
  • Skin around a joint has changed colour
  • Pt feels generally unwell and have a high temperature or feel hot and shivery
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67
Q

HIP - RHEUMATOID ARTHRITIS

A
  • Autoimmune disease.
  • This means your immune system attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.
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68
Q

HIP - RHEUMATOID ARTHRITIS - POPULATION AFFECTED

A
  • Women more likely to get it than men
  • Develops mainly 30-60
  • 16-40 diagnosed as early onset RA
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69
Q

HIP - RHEUMATOID ARTHRITIS - CLINICAL PRESENTATION

A
  • Usually, Pt has RA in many other joints
  • Groin pain comes on subtly
  • Limp common, may be as a result of knee or ankle RA too
  • Wasting of buttock or thigh muscles, limb usually held in external rotation and fixed flexion
  • Painful and restricted in all ROM
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70
Q

HIP - OSTEOARTHRITIS

A
  • Most common non-traumatic disorder of the hip in the middle and late age
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71
Q

HIP - OSTEOARTHRITIS - CAUSE

A
  • Usually no specific cause
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72
Q

HIP - OSTEOARTHRITIS - POPULATION AFFECTED

A
  • <50
  • In younger Ps (under 40) may appear as a sequel to childhood and adolescent disorders, such as coxa vera, perthes’ disease and Femoroacetabular impingement
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73
Q

HIP - OSTEOARTHRITIS - CLINICAL PRESENTATION

A
  • Typically occurs after periods of activity
  • Later becomes more constant and sometimes disturbs sleep
  • Stiffness most notable after waking up
  • Limp
  • Limited ROM
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74
Q

HIP - FEMOROACETABULAR IMPINGEMENT

A
  • Femoral head (ball of the hip) pinches up against the acetabulum (cup of the hip). When this happens, damage to the labrum (cartilage that surrounds the acetabulum) can occur, causing hip stiffness and pain, and can lead to arthritis.
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75
Q

HIP - FEMOROACETABULAR IMPINGEMENT - CAM

A
  • Cam – deformity at femoral head/neck junction, an unusual degree of bony thickening causes jamming of femoral neck against front of acetabulum and abrasion of articular cartilage
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76
Q

HIP FEMOROACETABULAR IMPINGEMENT - PINCER

A
  • Pincer – over-coverage of femoral head by anterior edge of acetabulum due to depth or retroversion of acetabular socket at a localised site. Hard acetabular margin abuts against the femoral head during movement causing degeneration of the acetabular labarum and adjacent articular cartilage
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77
Q

HIP - ILIOPECTINEAL BURSITIS

A
  • Largest bursa in the region of the hip joint
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78
Q

HIP - ILIOPECTINEAL BURSITIS - CAUSE

A
  • Trauma, osteoarthritis, rheumatoid arthritis, septic arthritis
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79
Q

HIP - ILIOPECTINEAL BURSITIS - CLINICAL PRESENTATION

A
  • Pt may have radicular pain and edema from groin to anterior thigh as enlargement of the bursa can irritate or entrap the femoral nerve and vein.
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80
Q

HIP - TROCHANTERIC BURSITIS

A
  • Inflammation of the bursa at the outside (lateral) point of the hip known as the greater trochanter
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81
Q

HIP - MERALGIA PARASTHETICA

A
  • Disorder characterised by tingling, numbness, and burning pain in the outer side of the thigh - may intensify after walking.
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82
Q

HIP - MERALGIA PARASTHETICA - CAUSE

A
  • Tight clothes, trauma
  • Compression of the lateral femoral cutaneous nerve, a sensory nerve to the skin, as it exits the pelvis.
  • Often under the inguinal ligament, which runs along your groin from your abdomen to your upper thigh.
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83
Q

HIP - MERALGIA PARASTHETICA - RISK FACTORS

A
  • Obesity or weight gain
  • Pregnancy
  • Local trauma
  • Diseases like diabetes
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84
Q

HIP - MERALGIA PARASTHETICA - CLINICAL PRESENTATION

A
  • Patients may complain ofpain, burning, numbness, muscle aches, coldness, lightning pain, or buzzing (like a cell phone) in their lateral or anterolateral thigh
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85
Q

HIP - PROTRUSIO ACETABULI

A
  • Condition of the hip where there is medial displacement of the femoral head into the pelvis and the medial aspect of the femoral head lies medial to the ilioischial line.
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86
Q

HIP - PERTHES DISEASE

A
  • Too little blood is supplied to the femoral head. Without enough blood, this bone becomes weak/dies off and fractures easily.
87
Q

HIP - PERTHES DISEASE - POPULATION AFFECTED

A
  • Childhood condition.
88
Q

HIP - PERTHES DISEASE - CLINICAL PRESENTATION

A
  • Complains of pain, starts to limp
  • pain in the groin, the thigh or the knee - particularly after physical activity.
  • They limp and have a restricted range of movement (stiffness) of the hip joint.
89
Q

HIP - SLIPPED UPPER FEMORAL EPIPHYSIS

A
  • Femoral head moves with respect to the rest of the femur.
  • The head of the femur stays in the cup of the hip joint while the rest of the femur is shifted.
  • If one side slips, 30% chance of other side slipping as well
90
Q

HIP - SLIPPED UPPER FEMORAL EPIPHYSIS - CAUSE

A
  • Trauma with an underlying abnormality
91
Q

HIP - SLIPPED UPPER FEMORAL EPIPHYSIS - RISK FACTORS

A
  • Obesity
  • Unusually tall/rapid growth
92
Q

HIP - THE IRRITABLE HIP

A
  • Most common cause acute hip pain in children
  • Hip joint becomes sore and inflamed.
93
Q

HIP - THE IRRITABLE HIP - POPULATION AFFECTED

A
  • 3-8 year olds, boys twice as likely to get it than girls
94
Q

HIP - THE IRRITABLE HIP - CLINICAL PRESENTATION

A
  • Pain around hip
  • Often intermittent limp following activity
  • Restriction of all movements with pain in all directions
  • Symptoms usually last for 2-3 weeks and then go spontaneously
  • Child may experience more than one episode
95
Q

HIP - AROM - FLEXION - MUSCLES ACTIVATED

A

Iliopsoas
Rectus femoris
Sartorius

96
Q

HIP - AROM - FLEXION - TISSUES STRETCHED

A

Gluteus maximus
Hamstrings
Sciatic nerve

97
Q

HIP - AROM - FLEXION - TISSUES COMPRESSED

A

Anterior hip muscles
Anterior joint capsule
Inguinal ligament
Femoral artery
Femoral nerve

98
Q

HIP - AROM - EXTENSION - MUSCLES ACTIVATED

A

Gluteus maximus
Hamstrings

99
Q

HIP - AROM - EXTENSION - TISSUES STRETCHED

A

Iliopsoas
Rectus femoris
Sartorius
Anterior iliofemoral ligament and joint capsule
Femoral nerve

100
Q

HIP - AROM - EXTENSION - TISSUES COMPRESSED

A

Posterior hip muscles
Posterior joint capsule

101
Q

HIP - AROM - ABDUCTION - MUSCLES ACTIVATED

A

Gluteus medius
Gluteus minimus
Tensor fascia latae

102
Q

HIP - AROM - ABDUCTION - TISSUES STRETCHED

A

Adductor Magnus
Gracilis
Adductor longus and brevis
Medial hip joint capsule

103
Q

HIP - AROM - ABDUCTION - TISSUES COMPRESSED

A

Lateral hip structures (joint capsule, lateral acetabular labrum)

104
Q

HIP - AROM - ADDUCTION - MUSCLES ACTIVATED

A

Adductor Magnus
Gracillis
Adductor brevis and longus

105
Q

HIP - AROM - ADDUCTION - TISSUES STRETCHED

A

Gluteus medius and minimus
Tensor fascia latae
Iliotibial band

106
Q

HIP - AROM - ADDUCTION - TISSUES COMPRESSED

A

Medial hip structures

107
Q

HIP - AROM - EXTERNAL ROTATION - MUSCLES ACTIVATED

A

Piriformis
Quadratus femoris
Superior and inferior gemellus
Obturator internus and externus

108
Q

HIP - AROM - EXTERNAL ROTATION - TISSUES STRETCHED

A

Tensor fascia latae
Gluteus medius and minimus
Anterior joint capsule

109
Q

HIP - AROM - EXTERNAL ROTATION - TISSUES COMPRESSED

A

Posterior hip structures

110
Q

HIP - AROM - INTERNAL ROTATION - MUSCLES ACTIVATED

A

Tensor fascia latae
Gluteus medius and minimus

111
Q

HIP - AROM - INTERNAL ROTATION - TISSUES STRETCHED

A

Piriformis
Quadratus femoris
Superior and inferior gemellus
Obturator interns and externus
Posterior joint capsule

112
Q

HIP - AROM - INTERNAL ROTATION - TISSUES COMPRESSED

A

Anterior joint capsule

113
Q

GLUTEUS MAXIMUS - ORIGIN

A

Posterior iliac crest
Sacrum
Coccyx
Sacrotuberous ligament

114
Q

GLUTEUS MAXIMUS - INSERTION

A

ITB
Gluteal tuberosity of femur

115
Q

GLUTEUS MAXIMUS - ACTION

A

Extension and lateral rotation of hip
Abduction of hip (upper 1/3)
Adduction of hip (lower 2/3)
Posterior pelvic tilt

116
Q

GLUTEUS MAXIMUS - INNERVATION

A

Inferior gluteal nerve (L5-S2)

117
Q

GLUTEUS MAXIMUS - TRIGGER POINT REFERRAL

A

Adjacent to sacrum - refers pain to gluteal cleft, gluteal fold and SIJ
Superior to ischial tuberosity - refers pain to entire buttock
Medial inferior fibres - refer pain to coccyx and gluteal cleft

118
Q

GLUTEUS MAXIMUS - STRETCH

A

Pull knee to chest

119
Q

GLUTEUS MAXIMUS - STRENGTHEN

A

Squat
Kick back
Lunge
Step up

120
Q

GLUTEUS MEDIUS - ORIGIN

A

Outer ilium (between anterior and posterior gluteal lines)

121
Q

GLUTEUS MEDIUS - INSERTION

A

Greater trochanter (superior and lateral surface)

122
Q

GLUTEUS MEDIUS - ACTION

A

Abduction of hip
Flexion and medial rotation of hip (anterior fibres)
Lateral rotation and extension of hip (posterior fibres)

123
Q

GLUTEUS MEDIUS - INNERVATION

A

Superior gluteal nerve (L4-S1)

124
Q

GLUTEUS MEDIUS - TRIGGER POINT REFERRAL

A

Near PSIS - refers pain to gluteal cleft, gluteal fold and SIJ
Mid iliac crest - refers pain to entire buttock and posterior proximal thigh
Lateral iliac crest - refer pain over sacrum, coccyx and gluteal cleft

125
Q

GLUTEUS MEDIUS - STRETCH

A

Place one leg in front of other and adduct anterior thigh

126
Q

GLUTEUS MEDIUS - STRENGTHEN

A

Resisted thigh abduction
Lunge
Side kicks

127
Q

GLUTEUS MINIMUS - ORIGIN

A

Outer ilium (between anterior and inferior gluteal lines)

128
Q

GLUTEUS MINIMUS - INSERTION

A

Greater trochanter (anterior surface)

129
Q

GLUTEUS MINIMUS - ACTION

A

Abduction of hip
Medial rotation and flexion of hip (anterior fibres)
Lateral rotation and extension (posterior fibres)

130
Q

GLUTEUS MINIMUS - INNERVATION

A

Superior gluteal nerve (L4-S1)

131
Q

GLUTEUS MINIMUS - TRIGGER POINT REFERRAL

A

Anterior muscle - refers pain down lateral leg, thigh and medial buttock
Posterior muscle - refers pain down the posterior leg, thigh and medial buttock

132
Q

GLUTEUS MINIMUS - STRETCH

A

Place one leg in front of other and adduct anterior thigh

133
Q

GLUTEUS MINIMUS - STRENGTHEN

A

Resisted thigh abduction
Lunge
Side kicks

134
Q

PIRIFORMIS - ORIGIN

A

Anterior sacrum

135
Q

PIRIFORMIS - INSERTION

A

Greater trochanter (superiomedial surface)

136
Q

PIRIFORMIS - ACTION

A

Lateral rotation of hip
Abduction of hip when thigh is flexed

137
Q

PIRIFORMIS - INNERVATION

A

Nerve to piriformis (L5-S2)

138
Q

PIRIFORMIS - TRIGGER POINT REFERRAL

A

Medial muscle - refers pain down posterior thigh and medial buttock
Lateral muscle - refers pain down posterior thigh and lateral buttock

139
Q

PIRIFORMIS - STRETCH

A

Cross ankle of other leg over thigh and pull knee to chest

140
Q

PIRIFORMIS - STRENGTHEN

A

Resisted thigh horizontal abduction with hip flexed

141
Q

SUPERIOR GEMELLUS - ORIGIN

A

Ischial spine

142
Q

INFERIOR GEMELLUS - ORIGIN

A

Ischial tuberosity

143
Q

SUPERIOR AND INFERIOR GEMELLUS - INSERTION

A

Greater trochanter

144
Q

SUPERIOR AND INFERIOR GEMELLUS - ACTION

A

External rotation of hip
Abduction of thigh when hip is flexed

145
Q

SUPERIOR AND INFERIOR GEMELLUS - INNERVATION

A

Nerve to obturator internus (L5-S2)

146
Q

SUPERIOR AND INFERIOR GEMELLUS - TRIGGER POINT REFERRAL

A

Gemellus superior - refers pain down posterior thigh and buttock
Gemellus inferior - refers pain down the buttock and upper posterior thigh

147
Q

SUPERIOR AND INFERIOR GEMELLUS - STRETCH

A

Cross ankle of other leg over thigh and pull knee to chest

148
Q

SUPERIOR AND INFERIOR GEMELLUS - STRENGTHEN

A

Resisted thigh horizontal abduction with hip flexed

149
Q

OBTURATOR INTERNUS - ORIGIN

A

Obturator foramen
Obturator membrane

150
Q

OBTURATOR INTERNUS - INSERTION

A

Greater trochanter

151
Q

OBTURATOR INTERNUS - ACTION

A

Lateral rotation od hip
Abduction of thigh when hip is flexed

152
Q

OBTURATOR INTERNUS - INNERVATION

A

Nerve to obturator internus (L5-S2)

153
Q

OBTURATOR EXTERNUS - ORIGIN

A

Obturator foramen
Obturator membrane

154
Q

OBTURATOR EXTERNUS - INSERTION

A

Trochanteric fossa of femur

155
Q

OBTURATOR EXTERNUS - ACTION

A

External rotation of hip

156
Q

OBTURATOR EXTERNUS - INNERVATION

A

Obturator nerve (L2-L4)

157
Q

QUADRATUS FEMORIS - ORIGIN

A

Ischial tiberosity

158
Q

QUADRATUS FEMORIS - INSERTION

A

Intertrochanteric crest of femur

159
Q

QUADRATUS FEMORIS - ACTION

A

External rotation of hip

160
Q

QUADRATUS FEMORIS - INNERVATION

A

Nerve to quadratus femoris (L4-S1)

161
Q

QUADRATUS FEMORIS - TRIGGER POINT REFERRAL

A

Medial muscle - refers pain down buttock and upper posterior thigh
Lateral muscle - refers pain near the gluteal fold and upper posterior thigh

162
Q

QUADRATUS FEMORIS - STRETCH

A

Cross ankle of other leg over thigh and pull knee to chest

163
Q

QUADRATUS FEMORIS - STRENGTHEN

A

Resisted thigh horizontal abduction with hip flexed

164
Q

PSOAS MAJOR AND MINOR - ORIGIN

A

TPs of L1-L5
Vertebral bodies of T12-L5
Intervening IVDs

165
Q

PSOAS MAJOR AND MINOR - INSERTION

A

Lesser trochanter of femur

166
Q

PSOAS MAJOR AND MINOR - ACTION

A

Flexion and external rotation of hip
Flexion and lateral flexion of spinal joints

167
Q

PSOAS MAJOR AND MINOR - INNERVATION

A

Lumbar plexus ventral rami (L1-L3)

168
Q

PSOAS MAJOR AND MINOR - TRIGGER POINT REFERRAL

A

Upper muscle - refers pain to posterior low back and upper medial buttock
Lower muscle - refers pain down anterior thigh and inguinal region

169
Q

PSOAS MAJOR AND MINOR - STRETCH

A

While kneeling extend hip and tilt pelvis posteriorly

170
Q

PSOAS MAJOR AND MINOR - STRENGTHEN

A

Resisted thigh flexion
Lying leg raise
Straight leg sit up

171
Q

ILIACUS - ORIGIN

A

Inner surface of iliac fossa
Sacral ala

172
Q

ILIACUS - INSERTION

A

Lesser trochanter of femur

173
Q

ILIACUS - ACTION

A

Flexion and external rotation of hip joint
Anterior pelvic tilt

174
Q

ILIACUS - INNERVATION

A

Femoral nerve (L2-L3)

175
Q

ILIACUS - TRIGGER POINT REFERRAL

A

Refer pain to the anterior thigh and inguinal region

176
Q

ILIACUS - STRETCH

A

While kneeling extend hip and tilt pelvis posteriorly

177
Q

ILIACUS - STRENGTHEN

A

Resisted thigh flexion
Lying leg raise
Straight leg sit up

178
Q

TENSOR FASCIA LATAE - ORIGIN

A

Anterior superior iliac spine (ASIS)
Anterior aspect of iliac crest

179
Q

TENSOR FASCIA LATAE - INSERTION

A

ITB

180
Q

TENSOR FASCIA LATAE - ACTION

A

Flexion, abduction and medial rotation of hip joint
Anterior pelvic tilt
Tenses ITB to support femur on tibia during standing

181
Q

TENSOR FASCIA LATAE - INNERVATION

A

Superior gluteal nerve (L4-S1)

182
Q

TENSOR FASCIA LATAE - TRIGGER POINT REFERRAL

A

Pain referred to hip joint and down the lateral thigh to the knee

183
Q

TENSOR FASCIA LATAE - STRETCH

A

Extend, adduct and medially rotate thigh

184
Q

TENSOR FASCIA LATAE - STRENGTHEN

A

Resisted abduction and flexion
Side lying leg raises
45 degree leg raises
Figure 8 in air with legs

185
Q

PECTINEUS - ORIGIN

A

Pectineal line of pubis

186
Q

PECTINEUS - INSERTION

A

Pectineal line of femur

187
Q

PECTINEUS - ACTION

A

Adduction and flexion of hip

188
Q

PECTINEUS - INNERVATION

A

Femoral nerve (L2-L3)
Obturator nerve (L2-L4)

189
Q

PECTINEUS - TRIGGER POINT REFERRAL

A

Pain is referred over the groin and anterior proximal thigh

190
Q

PECTINEUS - STRETCH

A

Lying supine, flex knees and touch soles of feet together and drop knees to the floor
Over pressure may be applied by hands

191
Q

PECTINEUS - STRENGTHEN

A

Resisted thigh adduction
Thigh master
Leg raise (inferior leg)

192
Q

ADDUCTOR LONGUS - ORIGIN

A

Anterior surface of pubis

193
Q

ADDUCTOR LONGUS - INSERTION

A

Medial lip of linea aspera (proximal 1/3)

194
Q

ADDUCTOR BREVIS - ORIGIN

A

Body and inferior ramus of pubis

195
Q

ADDUCTOR BREVIS - INSERTION

A

Medial lip of linea aspera (middle 1/3)

196
Q

ADDUCTOR LONGUS AND BREVIS - ACTION

A

Adduction and flexion of hip joint

197
Q

ADDUCTOR LONGUS AND BREVIS - INNERVATION

A

Obturator nerve (L2-L4)

198
Q

ADDUCTOR LONGUS AND BREVIS - TRIGGER POINT REFERRAL

A

Pain referred upward to the groin and down toward the medial knee and shin

199
Q

ADDUCTOR LONGUS AND BREVIS - STRETCH

A

Seated, flex knees and touch soles of feet together
Over pressure may be applied by elbows

200
Q

ADDUCTOR LONGUS AND BREVIS - STRENGTHEN

A

Resisted thigh adduction
Thigh master
Leg raise (inferior leg)

201
Q

ADDUCTOR MAGNUS - ORIGIN

A

Anterior head (adductor part) - inferior pubic ramus and ischial ramus
Posterior head (hamstring part) - ischial tuberosity

202
Q

ADDUCTOR MAGNUS - INSERTION

A

Anterior head - linea aspera
Posterior head - adductor tubercle of femur

203
Q

ADDUCTOR MAGNUS - ACTION

A

Adduction and extension of hip

204
Q

ADDUCTOR MAGNUS - INNERVATION

A

Anterior head - obturator nerve (L2-L4)
Posterior head - sciatic nerve, tibial division (L4-L5)

205
Q

ADDUCTOR MAGNUS - TRIGGER POINT REFERRAL

A

Pain referred upward to the groin and down the medial thigh

206
Q

ADDUCTOR MAGNUS - STRETCH

A

Seated, flex knees and touch soles of feet together
Over pressure may be applied by elbows

207
Q

ADDUCTOR MAGNUS - STRENGTHEN

A

Resisted thigh adduction
Thigh master
Leg raise (inferior leg)

208
Q

GRACILIS - ORIGIN

A

Body and inferior ramus of pubis

209
Q

GRACILIS - INSERTION

A

Proximal anterior medial tibis (pes anserine)

210
Q

GRACILIS - ACTION

A

Adduction and flexion of hip
Flexion and internal rotation of knee

211
Q

GRACILIS - INNERVATION

A

Obturator nerve (L2-L4)

212
Q

GRACILIS - TRIGGER POINT REFERRAL

A

Pain referred over the medial groin and thigh as far down as the knee
Pain often described as hot and stinging superficial pain

213
Q

GRACILIS - STRETCH

A

Standing, abduct both thighs as if attempting to do the splits

214
Q

GRACILIS - STRENGTHEN

A

Resisted thigh adduction
Thigh master
Leg raise (inferior leg)

ANATOMY (10 decks)

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