hip & pelvis Flashcards
what 3 joints make up the pelvic girdle?
- hip joint – movable (acetabular femoral joint)
- sacroiliac joint – immovable, not palpable, center level w/ s2, iliac crests @ L4/5
- pubic symphysis – immovable
what type of joint is the hip joint?
ball & socket joint
congruous
when observed from the spin, the lumbar portion of the spine normally exhibits a slight ________ curve
lordosis curve
absence of the normal lordosis may suggest?
paravertebral muscle spasms
what may be the cause of hyperlordotic/kyphotic lumbar spine?
- hyperlordosis may be caused by flexion deformity of the hip
- anterior abdominal muscles may be weak
what can the gluetal fold symmetry indicate?
- raise with hip extension
- lower with hip flexion
- asymmetry:
— congenital dislocation
— muscular atrophy
— pelvic obliquity
— leg length discrepancy
what is it called if the iliac crests are not level?
pelvic obliquity
which structure in the hip & pelvis serves as a point of origin or insertion for a variety of muscles?
iliac crest
what is the widest point on the iliac crest?
iliac tubercle
where is the greater trochanter located?
- anterior & lateral portion covered by tensor fascia lata & gluteus medius
- level w/ the pubic tubercles
what is the name of the structures which are on the same level as the top of the greater trochanters?
pubic tubercles
what tests increase intrathecal pressure?
- milgram’s test
– pt. supine, raise lets 2-3” off table & hold 30 sec
+ inability to perform test and/or low back indicates weak abdominal muscles or space occupying lesion. - valsalva’s maneuver
_ instruct pt. to take a deep breath, hold, and bear down as if you’re having a difficult bowel mvmt
+ radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)
what are the tests for the sacroiliac joint?
- pelvic rock test aka “iliac compression test”
+ pain in either sacroiliac joint indicates sacroiliac joint lesion - gaenslen’s test
+ pain on the affected sacroiliac joint stressed into extension indicates general sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the sacroiliac joint - patrick or fabere’s test
+ pain in the hip region indicates hip joint pathology
Is SI joint pathology common?
no, when found is usually in conjunction with either a severe or massive trauma involving the pelvis or infectious disease (e.g. tuberculosis)
what other areas can refer pain to the lumbar spine?
hip, rectum, and pelvis
what is the location of the PSIS?
directly underneath the visible dimples just above the buttocks
where is the ischial tuberosity located, and how do you find it?
– level with the lesser trochanter of femur
– level with the gluteal fold
what is the patient position for palpation of the ischial tuberosity?
patient is on their side with hip flexed
an imaginary line drawn between the PSIS’s crosses which structure?
S2
A line drawn across the top of the iliac crest crosses the spine between which spinour processes?
L4/L5
How many clinical zones are there in the examination of the hip and pelvic region?
5
name the 5 clinical zones
- femoral trianble
- greater trochanter
- sciatic nerve
- iliac crest
- hip and pelvic muscles
what are the borders of the femoral triangle?
superior - inguinal ligamnet (ASIS to pubic tubercle)
medial - adductor longus m.
lateral - sartorius m.
floor - adductor longus, pectineus, iliopsoas m.
which structure is located between the ASIS’s and the pubic tubercles?
inguinal ligament
