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Anatomy LE > Hip and pelvis > Flashcards

Hip and pelvis Flashcards

1
Q

ball and socket joint of the hip allows for what movement

A

3 DF

Flex and extension
abd and add
ER and IR

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2
Q

fovea

A

attachment for the ligamentum teres

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3
Q

two planes for the femoral neck

A

angle of inclination
torsional angle

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4
Q

what plane angle of inclination

A

frontal

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5
Q

normal angle of inclination

A

120 - 125

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6
Q

coxa valga

A

greater the 125

not stable - too mobile

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7
Q

coxa vara

A

less than 120

not mobile enough

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8
Q

torsional angle plane

A

transverse plane

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9
Q

normal torsional angle

A

8-14 degrees ant from neutral reference

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10
Q

anterversion

A

increased torsional angle

femoral head settles into joint

feet turned inwards

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11
Q

retroversion

A

decrease in torsional angle

joint is not stable enough

feet turn outwards

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12
Q

angle of inclination and torsional at birth

A

All these angles start higher at birth and get lower w/ age

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13
Q

arcuate bundles

A

Primarily handles tensile stress, follows the path of Femoral neck

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14
Q

Supporting Bundle

A

Primarily handles compressive loads
head of the femur

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15
Q

Trochanteric Bundle

A

A secondary accommodator of compressive loads

between the trochanters

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16
Q

Accessory Bundle

A

where we have lots of attachments

on the greater trochanter

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17
Q

Zone of Weakness

A

Common site of femoral neck fractures, there is not a lot of pressure

in the middle of the neck

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18
Q

what way does the ace face

A

ALI

anterior
lateral
inferior

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19
Q

Acetabular Notch

A

the inferior interruption of the acetabulum

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20
Q

is the femoral head completely covered by the ace

A

no
- the femoral head and the acetabulum​ are both oriented anteriorly

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21
Q

center edge angle

A

the amount of overhang​ of the ace over the femoral head
normal: 30 - 40

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22
Q

Acetabular Fossa

A

The central, deepest portion of the acetabulum

Not covered by articular cartilage

Contains fibroelastic fat pad

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23
Q

Transverse Ligament

A

Spans the acetabular notch, completes the circle with the labrum

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24
Q

articular cart innervation and blood vessels

A

avascular and minimally innervated

no healing or pain

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25
Q

Femoral Articular Cartilage

A

Thickest superiorly-posteriorly
Thinnest inferior

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26
Q

Fovea Capitis- Articular Cartilage

A

area devoid of articular cartilage

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27
Q

Acetabular Articular Cartilage

A

Horseshoe shaped lining of the periphery of the acetabulum

Thickest superiorly

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28
Q

Acetabular Labrum

A

Horseshoe shaped fibrocartilage ring attached to periphery of the acetabulum

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29
Q

Acetabular Labrum Internal Surface

A

Attached to acetabular rim and transverse acetabular ligament

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30
Q

Acetabular Labrum Central Surface

A

Lined by articular cartilage continuous with that of the acetabulum

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31
Q

Acetabular Labrum Peripheral Surface

A

Attaches to joint capsule at the base

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32
Q

role of the labrum

A

helps provide more joint stability - more overhang

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33
Q

labrum and stress

A

spreads the impact of force of a larger area of the joint surface

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34
Q

what make hip joint suction effect

A

labrum and joint capsule

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35
Q

BV of labrum

A

poor - therefore bad healing

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36
Q

joint capsule

A

Dense, relatively inelastic, fibrous capsule

2/3 of the femoral neck is intracapsular

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37
Q

proximal and distal parts of hip joint capsule

A

Proximal: Acetabular rim
Distal: Base of femoral neck

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38
Q

most important capsule fiber

A

Circular deep fibers (zona orbicularis),

Forms a collar around the femoral neck

Provide the stability to the joint

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39
Q

Ligamentous Reinforcement of the hip joint

A

Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament

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40
Q

Anterior Ligaments

A

Iliofemoral Ligament

Pubofemoral Ligament

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41
Q

Iliofemoral Ligament position

A

AIIS –> intertrochanteric line

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42
Q

primary role of Iliofemoral Ligament

A

Limits hip extension & external rotation

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43
Q

Iliofemoral Ligament 2ndary function

A

Inferior band can limit abduction;

superior band can limit adduction

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44
Q

what is the strongest ligament in the hip

A

Iliofemoral Ligament

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45
Q

Pubofemoral Ligament local

A

Runs from pubic ramus to the intertrochanteric fossa

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46
Q

Pubofemoral Ligament primary function

A

Limits abduction

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47
Q

Pubofemoral Ligament Secondary function

A

Limits extension and possibly external rotation

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48
Q

Ischiofemoral Ligament local

A

ischium posterior surface of acetabulum to the medial surface of the greater trochanter

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49
Q

Primary Ischiofemoral Ligament

A

Limits internal rotation

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50
Q

Secondary Ischiofemoral Ligament

A

: Limits extension and adduction

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51
Q

Ligamentum Teres local

A

Attaches to the fovea of the femoral head

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52
Q

Ligamentum Teres function

A

ligament may help stabilize the hip joint in hypermobile individuals

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53
Q

Factors Enhancing hip Stability

A

Atmospheric pressure (vacuum effect of joint)
Gravity (in standing position)
Ace compressing on the femur
Capsule and ligaments*
Acetabular labrum*

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54
Q

Bursae

A

Fluid-filled structures that function to reduce friction between tissues of the body

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55
Q

Primary bursae of hip/pelvic region

A

Iliopsoas/iliopectineal
Trochanetric
Ischial

56
Q

Ignore

A

Bursae

57
Q

bursitis

A

when the bursae become inflammed and painful

58
Q

Iliopsoas/ Iliopectineal bursea location

A

Deep to the iliopsoas on the floor of the femoral triangle, just anterior to the hip joint

59
Q

Trochanteric bursea

A

Superficial, between the greater trochanter and iliotibial band

60
Q

Ischial bursa​

A

Overlies the ischial tuberosity just covered by edge of the gluteus maximus

61
Q

loos packed position​ for the hip joint/open packed

A

30 degrees flexion, 30 degrees abduction, & slight external rotation

62
Q

what do we look at in Loose-Packed Position

A

often preferred position to apply joint distraction or initially apply joint mobilization techniques when delivering manual therapy

63
Q

Closed-Packed Position for the hip joint

A

Extension with slight abduction and internal rotation (other sources suggest external rotation)

64
Q

Closed-Packed Position meaning

A

This is the position of maximal ligamentous tension

65
Q

is the closed packed position the position of maximal articular congruency

A

no, Quadruped is

66
Q

Quadruped

A

90 degrees flexion
Slight abduction
External Rotation

Position of maximal concordance/congruency

67
Q

Non Weight Bearing Arthrokinematics

A

Roll and glide occur in opposite directions

68
Q

Weight Bearing Arthrokinematics

A

Roll and glide will occur in the same direction

69
Q

rolling movement compared to glide

A

Because of the inherent stability of the hip joint (deep socket), rolling movement is proportionately greater than glide

70
Q

Femoral head roll is close to a

A

spin

71
Q

External Rotation NWB

A

Roll: posterior
Glide: anterior

72
Q

Internal Rotation NMB

A

Roll: anterior
Glide: posterior

73
Q

Forward Flexion WB

A

Roll: anterior & inferior
Glide: anterior & inferior

74
Q

Standing Extension

A

Roll: posterior & superior
Glide: posterior & superior

75
Q

where do we Apply manual glide on the hip

A

medial and inferior direction

76
Q

Ambulation swing phase

A

non weight bearing

77
Q

Ambulation stance phase

A

WB

78
Q

what plane is ambulation in

A

sagittal

79
Q

Single Limb Stance center of mass

A

body lies posterior and medial to the hip joint

80
Q

Single Limb Stance center of mass results on the hip

A

this creates a rotatory moment about the hip into adduction and some extension

To provide normal stability; the hip abductors must overcome this moment - abductors must contract with considerable force to achieve this

81
Q

Single Limb Stance abductor response

A

The abductor muscle group contraction force creates a joint reaction force at the hip that is up to 3x an individual’s bodyweight

82
Q

painful hip in single limb stance

A

the body will attempt to decrease this force via decreasing the need for the abductors to contract.

83
Q

Trendelenburg Sign in single leg stance

A

in a single limb stance, the pelvis drops to the opposite side of the stance leg; observed with abductor weakness or inhibition

This may also be accomplished by shifting the weight over the stance limb (compensation)

84
Q

Sagittal Plane gait mechanics

A

Flexed at heel strike
Extends through stance phase
Begins flexing again as heel raises off ground
Flexes through swing phase

85
Q

Frontal Plane gait mechanics

A

Neutral to slight adduction at heel strike

Abducts to neutral or slight abduction throughout stance phase

Abducts through swing phase (begins after contralateral heel strike)

not as much movement in this plane - a wide deviation in movement can be observed in normal gait

86
Q

transverse plane gait mechanics

A

Neutral before heel strike

Rapid but not extreme internal rotation in early stance

Slow external rotation throughout stance to neutral at heel lift

87
Q

is normal gait the same for everyone

A

no normal gait is varible

88
Q

three joint of the Innominate

A

Left and right sacroiliac joints

The pubic symphysis

89
Q

Innominate function

A

Transmit forces between the lower extremities and the spine

90
Q

The boney architecture of the pelvis favors

A

stability

91
Q

Sacrum made out of

A

Consists of five fused vertebrae

Contains 4 pairs of sacral foramina

92
Q

Sacrum location

A

Located in a wedge-like fashion between the innominates

93
Q

Lateral surfaces of sacrum articulate with

A

the ilia (forming the sacroiliac joints)

94
Q

Base of sacrum articulates with

A

L5

95
Q

Apex of sacrum articulates with

A

the coccyx

96
Q

Sacroiliac Joints - joint type

A

Planar synovial joints

97
Q

Pubic Symphysis location

A

Anterior midline joint

98
Q

connection in the pubic symphysis

A

Connected by fibrocartilage disc structure with additional ligamentous reinforcement

99
Q

Sacral hiatus is the access for what

A

the epidural space used for caudal nerve blocks

100
Q

why do we mainly see differnce in male and female pelvis

A

(XX)female give brith

101
Q

gender difference pubic arch

A

50-80 degrees (m)
> 90 degrees (f)

102
Q

Gender difference hip height

A

Taller (m)
Shorter (f)

103
Q

Concavity gender differnce

A

Conical (m)
Cylindrical (f)

104
Q

gender differnce Sacrum

A

Longer/narrower (m)
Shorter/wider (f)

105
Q

gender differnce Sacral concavity

A

Shallower (m)
Deeper (f)

106
Q

Gender difference Sciatic notch

A

Narrower (m)
Wider (f)

107
Q

Gender difference Acetabular distance

A

Narrower (m)
Wider (f)

108
Q

Iliolumbar Ligament location

A

Runs from the transverse process of L4 and L5 attaching distally to the iliac crest, anterior sacrum, and sacroiliac joint region

109
Q

Iliolumbar Ligament function

A

Provides stability to the lumbrosacral junction via resisting posterior rotation of innominate and forward glide of L5 on the sacrum

110
Q

Sacrotuberous Ligament location

A

Travels from the ischial tuberosity to the inferior portion of the sacrum

111
Q

Sacrotuberous Ligament function

A

Provides resistance to posterior rotation of the innominate and sacral nutation

112
Q

Muscular Involvement of sacrotuberous ligament

A

This ligament serves as an origin for fibers of the gluteus maximus and the hamstrings

113
Q

Sacrospinous Ligament location

A

Connects the ischial spine and the anterior and lateral borders of the sacrum

114
Q

Sacrospinous Ligament function

A

Functions to resist posterior rotation of the innominate and sacral nutation

115
Q

Sciatic Foramina formed by

A

Formed in part by the sacrospinous and sacrotuberous ligaments

116
Q

Greater Sciatic Foramen:

A

Bounded anterior and superior by the greater sciatic notch, posterior by the sacrotuberous ligament, and inferiorly by the sacrospinous ligament

Partially filled by the piriformis muscle and nerves of the sacral plexus

117
Q

Lesser Sciatic Foramen

A

Bounded anterior by the body of the ischium, superior by the sacrospinous ligament, and posterior by the sacrotuberous ligament

118
Q

Anterior Sacroiliac Ligament

A

Thickens the anterior sacroiliac joint capsule

Has a contribution from the iliopsoas muscle

Relatively strong at the level of the SI joint; but thin and relatively weak elsewhere

Susceptible to tearing from traum

119
Q

Interosseous Ligament

A

Spans the syndesmotic portion of the sacroiliac joint

Extremely Strong; resists separation of the joint surfaces

120
Q

Posterior Sacroiliac Ligament location

A

Located in depression between sacrum and ilium

121
Q

Posterior Sacroiliac Ligament superior portion/short band

A

Oriented horizontally

Attachments to 1st and 2nd sacral tubercles and the tuberosity of the ilium

122
Q

Posterior Sacroiliac Ligament inferior portion/long band

A

Oriented obliquely

Attachments to 3rd and 4th tubercles of the sacrum and the PSIS

Blends with the sacrotuberous ligament inferiorly, and with the fibers of the mutifidus and erector spinae aponeurosis medially

Functions to resist counternutation of the sacrum and anterior innominate rotation

123
Q

what happens to the ligaments during pregnecy

A

Ligaments more relaxed during pregnancy

This allows more movement through sacroiliac and symphysis joints

Hypermobility after child birth is common for 5-6 weeks

124
Q

movement of the pelvis complex

A

Iliosacral Movement:
Sacroiliac Movement

125
Q

Iliosacral Movement

A

Innominate moving on fixed sacrum

Occurs primarily in the sagittal plane

126
Q

Sacroiliac Movement

A

Sacrum rotating within fixed/stable innominate

Movement described to occur about variable axes and is debatable

127
Q

Anterior Rotation - Iliosacral Movement

A

ASIS moves inferior
PSIS moves superior

128
Q

Posterior Rotation - Iliosacral Movement

A

ASIS moves superior
PSIS moves inferior

129
Q

Nutation - Sacroiliac Movement

A

flexion

Sacral base moves anterior/inferior

anterior

130
Q

counternutation - Sacroiliac Movement

A

extension

Sacral base moves posterior/superior

posterior

131
Q

The muscle most commonly considered in SI joint movement is

A

the piriformis

attaches to the front of the sacrum

132
Q

What is the primary casue of movement in the sacroiliac joint

A

The effects of the spine and gravity are more commonly the cause of movement

133
Q

Iliopsoas/Rectus Femoris influence on the si joint

A

May cause anterior rotation of the innominate

134
Q

Hamstring Group influence on the si joint

A

May cause posterior rotation of the innominate

135
Q

Gluteus Maximus influence on thr si joint

A

Contraction of this muscle may cause posterior rotation of the innominate secondary to attachments to the long posterior and sacrotuberous ligaments

136
Q

piriformis

A

unilateral contraction of tightness has the potential to cause torsion of the sacrum

137
Q

muscle plus tightness in the SI

A

test for muscle tightness may prove useful if you think the problem is coming from the SI joint

contraction of certain muscle can be used to reach positional faults by creating movement in a specific direction

Anatomy LE (13 decks)

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