Hip Flashcards by Siva Pye

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Gluteus Maximus
Gluteus Medius
Gluteus Minimus
TFL
Rectus Femoris
Gluteus Maximus
Gluteus Medius
Gluteus Maximus
Adductor Longus
Semimembranosus
Biceps Femoris (long head) and Semitendinosus

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Coxa vara is hip bend ______ and ____ 125°

inward; <

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Coxa valga is hip bend _____ and ___ 125°

outward; >

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Anteversion has more ____ than _____

IR; ER

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Retroversion has more ____ than ______

ER; IR

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Angle of inclination can alter the _______ @ the acetabulum and is involved with _____/______

CP is typically coxa _____

articulation

OA; dislocation

valga

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Top pic: Normal

Coxa Vara

Coxa Valga

2nd pic: Coxa valga; Coxa vara

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Normal Anteversion

Excessive Anteversion

Excessive Retroversion

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The ______ is a deep, cuplike socket

acetabulum

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The acetabular notch has a ____-____° opening

60-70

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________ ________ : floor of fossa, has no cartilage, no contact, filled with fat/blood vessels/ synovial membrane/lig

acetabular fossa

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Femoral head normally contacts only along the ______ _______

lunate surface

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The _______ _________ is covered in articular cartilage, thickest along the antsup region matching area of highest joint force with walking

lunate surface

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Forces ____% swing to _____% BW at mid stance

13; 300

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In midstance, the _____ widens, lunate _____, ______ contact area, _______ pressure

notch
deforms
increase
decrease

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Know these

a. ischiofemoral
b. ligamentum teres
c. iliofemoral
d. lesser
e. transverse acetabular
f. ischial ramus
g. pubis
h. ligamentum teres cut
i. acetabular fossa
j. lunate surface
k. acetabular labrum
l. iliofemoral

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The acetabular labrum is a strong, _______ ring with a ____________ rim

flexible; fibrocartilage

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The acetabular labrum provides mechanical _______ ‘grip’ and _______ the socket

stability; deepens

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The acetabular labrum has a mechanical seal keeps negative _______, is _______ sealed

This causes reduced ________/contact stress and improved _______ to the joint

pressure; fluid

friction; lubrication

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The acetabular labrum is poorly _______ but well _________

Focuses on pain and ________

vascularized; innervated

proprioception

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Capsule with synovial membrane:

Iliofemoral/pubofemoral/ischiofemoral ligaments reinforce external ________, _________, gluteus ________, _________ __________

capsule; iliocapsularis; minimus; rectus femoris

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This ligament is thick, strong upside down “Y” med. and lat; AIIS/ rim of acetabulum to intertronchanteric line; full hip ext and also full EROT elongates it?

Iliofemoral

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This ligament is taught in hip abd/ext and a bit of ERot?

Pubofemoral

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This ligament is posterior, spirals, taught in IROT and ABD?

Ischiofemoral

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know these

a. iliofemoral b. ischiofemoral c. iliacus d. psoas e. pubofemoral f. obturator externus g. iliopsoas tendon

know these

a. ischial spine b. inferior pubi ramus c. ischial tuberosity d. ilium e. greater trochanter f. ischiofemoral g. protrusion of synovial membrane h. lesser trochanter

_____-on-______: femur on about fixed pelvis

femoral-on-pelvic

____- on- ________: rotation of the pelvis on fixed femurs

pelvic-on-femoral

T/F: FOP and POF occur often simultaneously

know this

sagittal

know this

horizontal

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frontal

hip flexion is _____-_____ degrees

120-140

with hip flexion and LE extended. it is ____-_____ degrees (hamstring tension)

70-80

hip extension is ____-_____ degrees

18-30

Abduction is ____-_____ degrees Limited by _______ and _______ muscles

40-55 pubofemoral adductor

Adduction is _____-______ degrees Limited by ____, _______, and ________

20-25 abd; piriformis; ITB

IR is ____-_____ degrees

30-45

ER is _____-______ degrees

32-50

know this

Muscular function: FLEXION 6 main hip flexors?

Iliopsoas Sartorius TFL RF Adductor Longus Pectineus

The ________ and _______ ________ large, long Iliacus – iliacus fossa/over SIJ Psoas major – TP T12/discs (blend with diaphragm) Blend anterior to femoral head before attachment to lesser trochanter “internal snapping hip” – distal abrasion @iliopubic eminence region

Iliopsoas and psoas minor

The _______ is Prominent femoral-on-hip flexor and flexor of trunk/pelvis over fixed thighs Swing phase of walk/run Frontal plane stability of lumbar spine bilat contraction

Iliopsoas

The _______ ________ is Directly anterior to major Present in 60-65% T12/L1 bodies to medial to acetabulum and iliac fascia May help stabilize the position of the underlying psoas major (prevent ‘bowstringing’)

psoas minor

The __________ muscle: Longest muscle in the body ASIS to medial proximal tibia @ pes anserine Tailor’s muscle Hip flexion/ER/abd

Sartorius

The ______ muscle Ilium to IT Band (short) Flexor/abd of hip IRot only from Erot

TFL

The ______ _______ of the thigh: max and TFL attachments it circles the thigh Forms fascial sheets of intermuscular septa (attach at linea aspera) ITB forms as thickened deeper portion

fascia lata

TFL innervation: ______ _______ nerve (L4-S1)

Superior gluteal

ITB innervation: _______ and _______ ______ nerve (L4-S1) (L5-S2)

superior inferior gluteal

________ _______ Between sartorius and TFL AIIS and superior rim of acetabulum/capsule to tibia @ 1/3 of isometric torque at hip Primary knee extensor

Rectus Femoris

Rectus femoris innervation?

Femorak nerve

The _______ _________ contributes to the flexion of the extended thigh, as well as the extension of the flexed thigh.

adductor longus

The _______ muscle assists in hip adduction and flexion

pectineus

With normal activation of abdominal muscles, the pelvis is stabilized and prevented from _______ ________ by strong inferior pull of ______ ______ muscles

anterior tilting hip flexor

With reduced activation of ______ _______ (core) contraction of the hip flexor muscles causes a marked ________ tilt of pelvis

rectus abdominis anterior

Adductor muscles: 1. Adductor ________ 2. Adductor ________ 3. Adductor ________ 4. _________ 5. _________

Longus Brevis Magnus Gracilis Pectineus

3 layers of hip adductors Superficial: _________, adductor ________, _______ Middle layer: adductor ______ Deep: adductor ______- horizontal and oblique (60% of mass)

pectineus longus gracilis brevis magnus

_______ muscles attach: Pubis to linea aspera Pubis to medial tibia (gracilis) Pubis/IT to linea aspera

adductor

Adductor muscles produce forces in all ____ plane primarily _____ and ______

3 sagittal; frontal

______ adduction on both R and L _________ activation L ______ ________ to help control velocity and extent of drop oof the adducting ____ hip

Eccentric Concentric gluteus medius L

Weakness of _________ may place valgus strain on LE and risk ACL (specifically gluteus medius)

ABDors

Adductor _______- posterior fibers powerful extensors of the hip – any position When hip is near full flexion, adductors assist with _______ When hip is near full extension, adductors assit with ________

Magnus extension flexors

Adductor Magnus is important in high-power ______ motions…sprinting, cycling, deep squat, running up a _____ – susceptible to injury/soreness with running/jumping/changing directions.

cycling hill

Internal Rotators (secondary) ant fibers of ______ ____/____ ______ adductor _____/______ _________

glute med/min TFL longus/brevis pectinous

___-____ degrees hip flexion the internal rotators increase in _____ due to angle change; piriformis even becomes internal rotator past _____ deg

60; 90 torque 60

Internal rotator in gait: during stance they rotate the ______ on ______

pelvis femur

Hip EXTENSORS: Primary: Gluteus _______, _______, posterior head of adductor _______ Secondary: middle and posterior fibers of glute _____ and anterior fibers of adductor _______ > ____ degree flexion most adductors assist with _______

maximus hamstrings magnus med magnus 70

Gluteus maximus innervated by _______ _______ nerve (L5-S2) Hamstrings: ______ nerve (L5-S2) Posterior head of adductor magnus: _______ nerve (L2-4)

Inferior gluteal sciatic obturator

_______ _______ attaches Ilium/sacrum/coccyx/ST and posterior SIJ ligs/TL fascia to IT Band/TFL and gluteal tuberosity on femur. is a ______ and _______ rotator __________ SIJ / Lumbar region secondary to legs/fascial attachments

Gluteus maximus extensor; external stabilizes

________ attach to IT to tibia and fibula Extend ____ and flex _______

hamstrings hip; knee

Abductors Primary: ______ _______ ilium to gtr trochanter, largest @ 60-65% of abductors, excellent leverage, ant/middle/posterior portions ______ ________- deep and anterior to medius, ilium to gtr trochanter, blends with capsule hip joint (may prevent impingement) ________ _______ _______

gluteus medius gluteus minimus TFL

External rotators: Primary- ______ _______ Secondary- posterior fibers of ______ ______ and ________ obturator _______ sartorius long head of _____ ______

Max gluteus min/med externs

What are the 6 ER of the HIP?

1. Obturator Internus 2. Sup Gemelli 3. Inf gemmeli 4. piriformis 5. quadratus femoris 6. obturator externus

GTPS: Can be a primary cause of _____ ______ pain, common > 40 F; “rotator cuff syndrome of the hip” Ache, tender near ______ ______ Weak hip _____ possible ________ gait P! with _______ on one leg, climbing ____/_____, prolonged ______

lateral greater trochanter ABD Trendeleburg standing hills stairs walking

With GTPS: there will be ______ stress; also _______ (______ of gait and with ______ muscle)

tension compression midstance TFL

_________ sign: weak hip ‘falls’ into pelvic-on-femoral adduction; can be masked by trunk side lean (reduces external torque)

Trendelenburg

With tredelenburg giat, there could be damage to ______ _____ nerve

sup gluteal

Changing of piriformis with hip flexion Hip EXT: line of force _______ rotates the hip; the muscle's line of pull is ______ to vertical axis Hip FLX: line of force shifts to _______ side with a ________ axis; this now turns into a ______ rotator of hip

externally posterior opposite longitudinal internally

Usage of cane: ___________ force= (cane and hip abd) = clockwise forces (BW) Reduces compressive forces in _______ hand Reduces _____ by reducing activation of hip ______

counterclockwise opposite JRF abductors

Usage of cane: _________ forces (hip abd) = clockwise forces (BW and contralateral weight held) With compromised hip- ideal not to carry any ______ load, if so then it can add _______ load

counterclockwise external ipsilateral