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Spine & Hip Kines > Hip/Upper Leg > Flashcards

Hip/Upper Leg Flashcards

1
Q

Hip Joint (basic info)

A

Ball & Socket joint, triaxial, more stable than most B&S joints b/c deep fossa (acetabulum) and labrum, pelvic bone very stable

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2
Q

Angle of Inclination

A

Angle from line of head and neck to line that bisects femoral shaft, usually 125, coxavalga >125, coxavara <125, prone to femoral neck Fx, develope as we become weight bearing

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3
Q

Angle of tortion

A

rotation of distal part of femur relative to proximal part (femoral condyles usually rotated 15’ internally relative to head and neck), grows as we grow

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4
Q

Retroversion of Femur

A

Angle of Tortion>15’, people will need to laterally (externally) rotate in order to centralize femoral head

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5
Q

Anteversion of Hip

A

Angle of Tortion >15’, people will need to medially rotate in order to centralize femoral head

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6
Q

3 ligaments of hip joint

A

iliofemoral, pubofemoral, isciofemoral

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7
Q

iliofemoral ligament attachments and importance

A

“Y” ligament, from AIIS to trochanteric line, restricts femoral extension and posterior pelvic tilt

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8
Q

pubofemoral ligament attachments and importance

A

pubis to trochanteric fossa, medial to lateral, prevents hyperextension and ABduction, split really stretches

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9
Q

isciofemoral ligament attachments and importance

A

from posterior acetabulum up and over to base of greater trochanter, checks extension and pelvic tilt as well as prevents hyper-internal rotation, W Seat stretches

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10
Q

Muscles that anteriorly tilt pelvis

A

erector spinae and hip flexors (when leg is fixed), tight hip

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11
Q

Muscles that posteriorly tilt pelvis

A

abdominals and hip extensors

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12
Q

Tight hamstrings will tilt the pelvis ____.

A

posteriorly, decreasing lordosis

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13
Q

Tight hip flexors will tilt the pelvis ____.

A

anteriorly, increasing lordosis

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14
Q

Lumbo-pelvic rhythm

A

3/4 spinal flexion, 1/4 anterior pelvic tilt

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15
Q

Abdominals work synergistically with ___ during a crunch. Why?

A

Hip flexors, in order to anchor the pelvis and prevent posterior pelvic tilt so that the abdominals will shorten… if pelvis tilts they won’t generate as much tension

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16
Q

Clinical implications of weak abdominals (effect on pelvis)

A

Anterior pelvic tilt

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17
Q

Clinical implications of tight back extensors (effect on pelvis)

A

Anterior pelvic tilt

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18
Q

Back extensors work synergistically with ___ during extension. WHy?

A

Hip extensors (hamstrings) , in order to stabilize pelvis and prevent anterior pelvic tilting and excessive shortening of muscles

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19
Q

Pelvic motion associated with hip flexion

A

anterior tilt

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20
Q

pelvic motion associated with hip extension

A

posterior tilt

21
Q

pelvic motion associated with hip ABduction

A

ipsilateral tilt

22
Q

pelvic motion associated with hip ADduction

A

contralateral tilt

23
Q

pelvic motion associated with hip external rotation

A

contralateral rotation

24
Q

pelvic motion associated with hip internal rotation

A

ipsilateral rotation

25
Q

Sartorius: attachments, actions,

A

ASIS to pes anserine, acts as a hip flexor (ant pelvic tilt), ABductor (ipsilateral pelvic tilt), can externally rotate hip (or contra laterally rotate pelvic closed-chain)

26
Q

Iliopsoas:attachments and actions

A

Psoas Maj: L1-L5, Iliacus: internal iliac crest, all to lesser trochanter, primary hip flexor (ant pel tilt), also ext rotator (contralat pel rot), spinal flexor (legs stabilized), to test, bring knee to chest while seated

27
Q

Rectus Femoris: attachments and action, act/pass insufficientcy

A

AIIS to superior patella to tibial tubercle by way of infrapatellar tendon, hip flexor and knee extensor, active insuf: hip flex and knee ext, passive insuf: hip ext, knee flex

28
Q

Tensor Fascia Lata: attachments and action

A

form behind ASIS to IT band, hip flexor (ant tilt), ABduct (ipsilateral tilt), internal rot (ipsilateral rot), to test: side-lying, leg flexed to 45’, ABduct

29
Q

How do hip ADductors contribute to to flexion

A

all except ADductor magnus contribute to hip flexion, strongest when hip is extended due to line of pull, can be used to substitute for flexors by externally rotating hip to move leg forward

30
Q

Glut. Max: attachments and actions

A

sacrum, coccyx, sacrotuberous ligament to the gluteal tuberosity and IT band, is primary extensor (post tilt), external rotator (contra rot), upper fibers ABduct, lower fibers ADduct

31
Q

Hamstrings: attachments and actions, passive/active insufficientcy

A

Biceps fem: ischial tub> fib head (can do some ext rotation), Semitendinosis: ischial tuberosity> pes anserine, Semimembrenosis: ischial tuberosity> med tib condyle (medials can int rotate), all extend hip and can adduct a little
passive insuf: hip flex/knee ext, active insuf: hip ext knee flex

32
Q

MMT for Hip ABductors

A

Glut Med, some sartorius, TFL, upper Glut Max, piriformis, Gamelli (short adductrs better when hip flexed), palpate external iliac blade, pt is side lying, stabilize pelvis in unilateral stance to prevent contralateral tilt

33
Q

Hip ADductors

A

Pectineus, AD longus, AD brevis, Gracilis, and AD magnus, act as stabilizers, anterior Addductors can assist in flexion, Magnus in extension, important to stretch on people who are debilitated

34
Q

External Rotators

A

Piriformis, Gamelli, obturator internis, Quadratus Femoris all insert to greater trochaner, can create a little ABduction (when hip flexed except obt intern), contralaterally rotate pelvis so help eccentrically control ipsilateral rotation in gait

35
Q

Internal Rotators

A

Glut Min, TFL

36
Q

HIP Flexion (ROM, goniometry)

A

0-120’, pivot: greater trochanter, static: mix-axillary line, moving: lateral femoral condyle,
pt in supine, ask to bring knee to chest, careful not to post pelvic tilt

37
Q

Hip ABduction (ROM, goniometry)

A

0-45’, pivot: ASIS, static arm: line w/opp ASIS, moving arm: mid-line of thigh in line w/patella
pt in supine, support leg if going off table, beware of int/ext rotation & stabilize other leg, stop when pelvis moves

38
Q

Hip ADduction (ROM, goniometry)

A

0-20’, pivot: ASIS, static arm: line w/opp ASIS, moving arm: mid-line of thigh in line w/patella
pt in supine, support leg if going off table, beware of int/ext rotation & stabilize other leg, stop when pelvis moves

39
Q

Hip Ext Rotation (ROM, goniometry)

A

0-50’, Supine, flex hip and knee to 90’, pivot: patella, static arm: in line w/ASISs, moving arm: tibial crest

40
Q

Hip Int Rotation (ROM, goniometry)

A

0-40’, Supine, flex hip and knee to 90’, pivot: patella, static arm: in line w/ASISs, moving arm: tibial crest

41
Q

Hip Extension (ROM, goniometry)

A

0-20’, pt prone, stabilize pelvis, pivot: greater trochanter, static: mid-axillary line, moving: lat femoral condyle, grab under pt’s thigh (knee supported and not in full ext) and gently lift

42
Q

Iliopsoas MMT

A

femoral nerve L2-L4, have pt seated and raise knee (marching) and try to depress thigh, palpate: deep in ingiunal ligament, grav elim: side-lying, sub: pelvic tilt, sartorius, leaning back

43
Q

Sartorius MMT

A 
femoral nerve (L2-L3), sartorius flexes, ABducts, and ext rotates, pt is seated and brings leg up as if to cross over other leg, use two hands to try to push thigh down, int rotate, and ADduct, 
grav elim: supine w/tested leg sliding on opp shin
44
Q

External Rotation MMT (Gamelli, Obt Int, Obt Ext, Quad Fem)

A

Gam Sup & Obt Int: Nerve to Obt Int, Gam Inf &Qud Fem: Nerve to QF, Obt Int: Obt Nerve… seated with hips and knee flexed, externally rotate by trying to elevate medial aspect of foot w/o ABduction, palpate post to greater trochanter, apply resistance to medial tibial border
Grav elim: supine, rotate straight leg from int to ext

45
Q

Internal Rotation (Glut Min, TFL)`

A

Sup Gluteal Nerve (L4-S1), seated with hips and knee flexed, internally rotate by trying to elevate lateral aspect of foot without ADducting thigh, aply resistance to lateral tibial border
Grav elim: supine, externally rotate straight leg and have pt internally rotate

46
Q

Hip ABduction MMT

A

Glut Med (Sup Gluteal L4-S1), pt is side-lying, bend bottom knee, ensure pelvis stays neutral (not flex)and lift top leg, palpate ext iliac blade, apply pressure on distal femur,
grav elim: supine
sub: TFL, hip hike, obliques

47
Q

TFL (Abduction & Flexion) MMT

A

Sup Glut Nerve (L4-S1), pt is side-lying bottom knee bent, and hip flexed to 45’, ensuring pelvis is stabile, lift leg, palpate near greater trochanter

48
Q

Hip ADduction MMT

A

Pect: Femoral, all Adductors: Obturator, AD magnus also Sciatic, pt is side-lying top knee/hip flexed and foot on met in front of body or cradled, lift lower leg and apply pressure on distal femur
grav elim: supine on powder/sliding board
subs: any rotation

49
Q

Hip Extension MMT (Hamstrings and Glut Max)

A

Hamstrings: SciaticL5-S2, Glut Max: Inf Glut Nerve L5-S2, pt is prone (if really tights flexors can stand)have pt lift leg/thigh off mat, may bend knee to reduce hamstring, can int/ext rotate to tease out med/lat hams
grav elim: side-lying

Spine & Hip Kines (2 decks)

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