Hip, Pelvis and Spine

Question 1

how many vertebrae do we have

Answer 1

cervical: 7
thoracic: 12
lumbar: 5
sacral : 5
coccygeal: 4

Question 2

where do the nerves that control the legs and feet exit the spinal cord, and what are the 3 main nerves

Answer 2

• at the lumbar and sacral plexi
• sciatic
• femoral
• obturator

Question 3

in what plane is scoliosis a deformation

Answer 3

frontal plane
(or functional due to leg / foot problem)

Question 4

where might a limb length difference be compensated (5)

Answer 4

• spine
• pelvis
• hip
• knee
• ankle/foot

Question 5

what effect will a limb length difference have on the following structures:
* long leg/ short leg
* ankle
* knee
* spinal

Answer 5

• long leg/ short leg: pronation/supination
• ankle: early heel lift
• knee: long leg - hyperextension or flexion, genu valgum/varum
• spinal: short side will drop at SI joint, resulting in numerous compensation mechanisms

Question 6

in what plane is lordosis and kyphosis a deformity of

Answer 6

sagittal plane

Question 7

what damage can happen with lordosis and kyphosis (4)

Answer 7

1. stretching of ligament
2. crushing / herniation of discs
3. erosion of vertebrae
4. pelvic instability

Question 8

what is nutation and counter nutation

Answer 8

• nutation: sacrum moves down and forwards, increasing stability of the SI joint
• counter nutation: opposite, improves flexibility

Question 9

in gait, what plane does the hip move in primarily

Answer 9

sagittal plane, with some motion in transverse and frontal planes

Question 10

what is the normal hip angle between the neck and shaft of the femur, in the frontal plane, for an adult and a newborn

Answer 10

• adult: 125° to 130°
• paediatric: 135° to 140° at birth
• too much or too little is known as coxa varum and valgum

Question 11

muscles can be prime movers or postural stabilisers - what does that mean

Answer 11

• prime movers moves body parts
• postural stabilisers keep things stable

Question 12

postural stability is ESSENTIAL for efficient gait - where are they

Answer 12

lumbar spine, pelvis and hips

Question 13

what muscles are commonly weak (in gait)

Answer 13

• gluteus medius
• abdominal (esp transverse abdominis)

Question 14

which muscles are commonly tight

Answer 14

• quadratus lumborum
• erector spinae
• gluteus maximus
• iliopsoas
• prirformis
• hams and quads
• gastrocs
• ADductors and TFL

Question 15

which muscle is possibly the most important postural stabiliser

Answer 15

transverse abdominis

Question 16

what does the transverse abdominis do (3)

Answer 16

1. creates a rigid cylinder of muscle
2. braces spine and pelvis
3. increases pressure in abdomen to pusj against abnormal movements

Question 17

what happens if the gluteus medius is weak

Answer 17

1. contra-lateral pelvic drop
2. results in internal femoral, thus knee, rotation
3. therefore, tibia interanallu rotates
4. causes increased STJ pronation