Hip Flashcards
Know this
Gluteus Maximus
Gluteus Medius
Gluteus Minimus
TFL
Rectus Femoris
Gluteus Maximus
Gluteus Medius
Gluteus Maximus
Adductor Longus
Semimembranosus
Biceps Femoris (long head) and Semitendinosus
Coxa vara is hip bend ______ and ____ 125°
inward; <
Coxa valga is hip bend _____ and ___ 125°
outward; >
Anteversion has more ____ than _____
IR; ER
Retroversion has more ____ than ______
ER; IR
Angle of inclination can alter the _______ @ the acetabulum and is involved with _____/______
CP is typically coxa _____
articulation
OA; dislocation
valga
Know this
Top pic: Normal
Coxa Vara
Coxa Valga
2nd pic: Coxa valga; Coxa vara
Normal Anteversion
Excessive Anteversion
Excessive Retroversion
The ______ is a deep, cuplike socket
acetabulum
The acetabular notch has a ____-____° opening
60-70
________ ________ : floor of fossa, has no cartilage, no contact, filled with fat/blood vessels/ synovial membrane/lig
acetabular fossa
Femoral head normally contacts only along the ______ _______
lunate surface
The _______ _________ is covered in articular cartilage, thickest along the antsup region matching area of highest joint force with walking
lunate surface
Forces ____% swing to _____% BW at mid stance
13; 300
In midstance, the _____ widens, lunate _____, ______ contact area, _______ pressure
notch
deforms
increase
decrease
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
The acetabular labrum is a strong, _______ ring with a ____________ rim
flexible; fibrocartilage
The acetabular labrum provides mechanical _______ ‘grip’ and _______ the socket
stability; deepens
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
The acetabular labrum is poorly _______ but well _________
Focuses on pain and ________
vascularized; innervated
proprioception
Capsule with synovial membrane:
Iliofemoral/pubofemoral/ischiofemoral ligaments reinforce external ________, _________, gluteus ________, _________ __________
capsule; iliocapsularis; minimus; rectus femoris
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
This ligament is taught in hip abd/ext and a bit of ERot?
Pubofemoral
This ligament is posterior, spirals, taught in IROT and ABD?
Ischiofemoral
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
T
know this
sagittal
know this
horizontal
know this
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
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 _______ muscleassists 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:
- Adductor ________
- Adductor ________
- Adductor ________
- _________
- _________
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?
- Obturator Internus
- Sup Gemelli
- Inf gemmeli
- piriformis
- quadratus femoris
- 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