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APK 3220c Biomechanical Basis of Movement > Hip Joint Complex > Flashcards

Hip Joint Complex Flashcards

1
Q

Max Bony Congruence

A

• Flexion, abduction, and external rotation (frog legged
position)
• Not position of highest stability

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2
Q

Most Stable Position

A
  • Extension, slight abduction, Internal Rotation

* Extension further tightens capsular ligaments

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3
Q

Least Stable Position

A

Flexion with Adduction

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4
Q

Ischiofemoral

A

Taught with hip Extension

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5
Q

Iliofemoral

A

Fan shaped ligament resembles inverted

Y, strongest ligament at the hip. Checks hyperextension

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6
Q

Pubofemoral

A

Taught in hip abduction and in extension. With the iliofemoral ligament it form a Z on the anterior capsule

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7
Q

Femoral Neck

A

Angulates superiorly, anteriorly, and medially

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8
Q

Angle of Wiberg/Center Edge Angle

A

Angle drawn between vertical and a line drawn from the center of the femoral to the bony edge/rim of the acetabulum; normally 35-38 degrees; smaller Angle of Wilberg increases risk of dislocation due to smaller load bearing surface

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9
Q

Smaller Angle of Wiberg

A

Increased likelihood for superior dislocation; smaller load-bearing surface

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10
Q

Inclination Angle

A

Neck to shaft angle; Superior/inferior inclination; Angle varies from individual to individual; Decreases with age for both genders; smaller angle for females (more cantilevered neck)

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11
Q

Angle of Anteversion/Torsion

A

Anterior/posterior angulation; formed by the intersection of the long axis of the femoral head
and the transverse axis of the femoral condyles; measures medial torsion from proximal to distal end

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12
Q

Normal Inclination Angle

A

125⁰

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13
Q

Coxa Valga- Pathologically Larger Inclination Angle

A

> 125⁰; Larger/Steeper Inclination Angle; Causes higher than normal Joint Reaction Forces

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14
Q

Coxa Vara- Pathologically Smaller Inclination Angle

A

<125⁰; Increases moment arm for abductor muscles, so need less muscle force, but creates greater bending and shear stress in the femoral neck and reduces ROM.

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15
Q

Normal Hip Angle of Anteversion

A

15-20⁰

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16
Q

Anteversion (pathologically high angle)

A

Toe in; Coxa valga; >20⁰; internal rotation during gait; causes adductor moments at the knee and ankle, also may cause posterior positioning of GRF
during propulsion effectively reducing the lever arm of
the triceps surae; decreases propulsion you get from the triceps surae

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17
Q

Retroversion (pathologically low angle)

A

Toe out; <20⁰; external rotation during gait (duck-footed walk); may cause posterior positioning of GRF
during propulsion effectively reducing the lever arm of
the triceps surae.

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18
Q

Posterior Pelvic Tilt

A

Brings pubis up; leads to hip extension and lumbar flexion; often occurs at the deepest part of an individual’s squat

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19
Q

Anterior Pelvic Tilt

A

Brings anterior superior iliac spine (ASIS) anterior and inferior; leads to hip flexion and lumbar
extension

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20
Q

Hip Flexion

A

Primary: Iliopsoas
Secondary: Rectus Femoris, Tensor Fascia Latae, Sartorius
Dependent on Hip Position: Pectineus, Adductor longus, Adductor magnus, Gracilis, Gluteus Minimus (anterior fiber)

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21
Q

Hip Extension

A

Primary: Gluteus Maximus
Secondary: (Hamstrings) Semitendinosus, Semimembranosus, Long Head of Biceps Femoris
Dependent on Hip Position: Gluteus medius (posterior fibers), Adductor magnus (posterior fibers), piriformis

22
Q

Abduction

A

Limited by gracilis
Primary: Gluteus medius
Secondary: Gluteus minimus, Tensor fascia latae
Dependent on Hip Position: Piriformis (when Hip is flexed), Sartorius, Rectus Femoris, Superior Fibers of Gluteus Maximus

23
Q

Adduction

A

Limited by Tensor Fascia Latae (and associated IT band)
Primary: Adductor magnus
Secondary: Pectineus, Adductor Longus, Adductor Brevis, Gracilis, Obturator Externus

24
Q

Medial Rotation

A

42⁰-50⁰; usually measured with hip at 90⁰

25
Q

Lateral Rotation

A

42⁰-50⁰; usually measured with hip at 90⁰

26
Q

Medial Rotation

A

Anterior Roll and Posterior Gliding

27
Q

Lateral Rotation

A

Posterior Roll and Anterior Gliding

28
Q

Lateral Rotation

A

Primary: Gluteus maximus, piriformis
Secondary: Quadratus femoris, obturator internus and externus, Gemellus superior and inferior, sartorius
Depending on hip position: Gluteus medius (posterior fibers); long head of biceps femoris

29
Q

Medial Rotation

A

NO MUSCLE HAS A PRIMARY ROLE OF MEDIAL ROTATION
Secondary: Tensor Fascia Latae, Gluteus minimus, Gluteus medius (anterior fibers)
Dependent on Hip position: Pectineus, Adductor longus and brevis, adductor magnus (posterior fibers), semimembranosus, semitendinosus

30
Q

Flexion

A

Spin

31
Q

Extension

A

Spin

32
Q

Abduction

A

Superior Roll and Inferior Glide

33
Q

Adduction

A

Inferior Roll and Superior Glide

34
Q

Medial Rotation

A

Anterior Roll and Posterior Glide

35
Q

Lateral Rotation

A

Posterior Roll and Anterior Glide

36
Q

Angulation of the Femur

A

Femoral neck angulates so that the head most

commonly faces medially, superiorly, and anteriorly.

37
Q

Right Hip/Pelvic Drop

A

Lateral flexion of lumbar spine towards left, left hip joint adducts

38
Q

Anterior Pelvic Tilt

A

Right hip: Flexion
Left Hip:
Lumbar spine: Flexion Extension

39
Q

Posterior Pelvic Tilt

A

Right Hip: Extension
Left Hip: Extension
Lumbar spine: Flexion

40
Q

Left Forward Rotation

Right Foot Planted

A

Right Hip: Medial Rotation
Left Hip: Open chain
Lumbar Spine: Left Rotation

41
Q

Left Backward Rotation

Right Foot Planted

A

Right Hip: Lateral Rotation
Left Hip: Open chain
Lumbar Spine: Right Rotation

42
Q

Pelvifemoral rhythm

A

like scapulohumeral rhythm of the shoulder. To maximize the apparent range of motion of the distal segment (in this case the head) multiple joints
are used in concert; not pathologic but rather characteristic of normal functional human movement. Caution is only warranted with injuries and heavy loaded human movement.

E.g., touching your toes, roundhouse kick (rhythm allows end effector- toes- to reach higher target)
E.g., Posterior Pelvic tilt at deepest part of squat (achieve apparent ROM of hip flexion)

43
Q

Lateral trunk lean towards the side of pain or weakness

A

Helps by:
• Reduces the moment arm of the force of gravity which reduces the required muscle force needed to maintain equilibrium

• Reduces necessary torque generated by the
abductor muscles (gluteus medius)

• Reduces the overall joint reaction force at the hip

44
Q

Cane in Contralateral Hand

A

• Reduces weight of Head, Arms, Torso (HAT), but also provides a counter torque to
the torque of gravity thus reducing need for abductor muscle force.
• Canes considered to relieve hip of up to 60% of its load in stance

45
Q

Cane in Ipsilateral Hand

A

• Still some benefit from alleviating some of the body weight through the cane
• But in theory the force of the cane on the hand causes a torque about the affected
hip in the same direction at the torque due to gravity
• Overall exacerbates the problem

46
Q

Arthrokinematics during Flexion/Extension of the Hip

A

Pure Spin

47
Q

Arthrokinematics During Adduction of the Hip

A

Inferior Roll and Superior Gliding; Femoral head glides within acetabulum in opposite direction of distal femur

48
Q

Arthrokinematics During Abduction of the Hip

A

Superior Roll and Inferior Gliding; Femoral head glides within acetabulum in opposite direction of distal femur

49
Q

Arthrokinematics During medial Rotation of the Hip

A

Anterior Roll and Posterior Gliding

50
Q

Arthrokinematics During Lateral Rotation of the Hip

A

Posterior Roll and Anterior Gliding

APK 3220c Biomechanical Basis of Movement (8 decks)

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