KINES: Pelvis and Hip Flashcards
what type of joint is the hip joint
diarthrodial, ball and socket
other name for hip joint
enarthrodial or universal joint
how many degrees of freedom in hip joint
3
when does full ossification of pelvis happen
20-25 yo
main function of hip joint
more for stability in WB compared to mobility
deepens the concavity of acetabulum
labrum
what completes the acetabular notch
transverse acetabular ligament
small opening on femoral head
fovea capitis - attachment of ligamentum teres
orientation of acetabular head
anterior, lateral, inferior
orientation of femoral head
superior, anterior, medial
joint stability depends on
joint congruence
negative atmospheric pressure
joint capsule
what forms the congruency of the hip joint
femoral head w the acetabulum w labrum making it more congruent
potential site for instability in hip joint
anterior - bc both face anterior
true physiological pos of hip
FABER
flexion - 90 deg
slight abd
slight ER
yields greatest stability of jip
bony CPP
bony CPP of hip
extension
slight abd
medial rot
OPP of hip
30 deg flexion
30 deg abd
slight lateral rot
in OPP what happens to femoral head
shifts anteriorly - decreasing congruence
is the cross sitting position stable
OPP so ligaments are actually slacked/loose
how does negative atmos psi contribute to congruency
creates a suction through the enclosure of capsule and ligaments
when is the joint capsule taut
at ligamentous CPP
what is ligamentous CPP
extension
abd
ER
when is joint capsule laxed
at OPP
where is the joint capsule thick and thin
anterosuperiorly - thick bc need i prevent anterior instability
posteroinferiorly - thin
significance of zona orbicularis
encircles neck and provides more stabilization during distraction
secondary blood supply of femoral head
ligamentum teres
site of the femoral head w/o hyaline cartilage
fovea capitis bc dun ligamentum teres
primary blood supply of femoral head
medial circumflex artery
where is ligamentum teres derived
from obturator artery, only present in matured bone
where is medial femoral circumflex derived
branch of profunda femoris of femoral artery
normal value of center edge angle
25-40 degrees
other name from center edge angle
vertical center anterior angle
angle of wiberg
whre is center edge angle measured
betw vertical line though center of femoral head and outer edge of acetabular roof
what happens if CE angle is less than 25 deg
hip dysplasia
lower angle = unstable
what happens if CE angle is more than 40 deg
coxa profunda or pwd din acetabular protrusio
increase angle - reduces mobility
what is coxa profunda
deep acetabular socket = LOM
what is acetabular protrusio
femoral head projects to medial = LOM
whres is acetabular anteversion measured
line from anterior and posterior edge of acetabulum and a line moving forward
normal value of acetabular anteversion
20 degrees
what happens in increased acetabular anteversion
acetabulum faces too forward = instability
what happens in decreased acetabular anteversion
retroversion = increased coverage = LOM
how is angle of inclination measured
meeting the axis of femoral shaft and axis of femoral head and neck
normal value of angle of inclination
120-125 deg
value of angle of inclination at birth
150 deg
what happens in decrease angle of inclination
COXA VARA
greater stabilization but greater risk for femoral neck fractures
increases moment arm and torque of gluteus medius
what happens in increased angle of inclination
COXA VALGA
very unstable = head can easily go out
decrease moment arm of gluteus medius
where is angle of torsion formed
long axis of the femoral head and neck and line drawn through ends of femoral condyles
torsion and twisting of bone
normal value of angle of torsion
15-20 deg
lower for males
increased angle of torsion
anteversion or antetorsion
decreased stability = both anteriorly facing
can also affect ankle and knee since CKC
decreased angle of torsion
retroversion or retrotersion
increased congruence = LOM
primary ligaments of hip
iliofemoral lgiameny - Y ligament
pubofemoral ligament - Z ligament
ischiofemoral ligament - spiral
attachment of iliofemoral ligament
from AIIS to superior and inferior intertrochanteric line
which band of the Y ligament is stronger
superior
function of superior and inferior bands of Y ligament
sup - resists add
inf - resists abd
together - prevents hyperextension and ER
some fibers behind - IR
attachement of pubofemoral ligament
pubic ramus to intertorchanteric line
function of pubofemoral ligament
prevents ER and hyperextension since nasa ant
excessive abd since found below
attachment of ischiofemoral ligament
from posterior acetabular rim and labrum and spirals around femoral neck tas attach sa intertrochanteric line
function of ischiofemoral ligament
prevents too much IR and abd and spiral prevents hyperextension
primary flexor and extensor when knee is flexed
flex - iliopsoas
ext - gluts max
primary flexor and extensor when knee is extended
flexion - rectus femoris
ext - hamstring
primary abductor and adductor when knee is flexed
abd - gluts medius
add - short adductors
primary abductor and adductor when knee is extended
abd - gluts max, TFL and IT band
add - gracilis
CKC movement of hip in sagittal
anterior and posterior pelvic tilt
CKC movement of hip in coronal
pelvic hike and pelvic drop
lateral pelvic shift
explain concept of pelvic hike and drop
R pelvic hike = L hip abd
R pelvic drop - L hip add
explain lateral pelvic shift
simultaneous hip add and abd
R lateral pelvic shift - R add L abd
CKC movement of hip in transverse
L forward step = L IR and R ER
happens in walking alternate lang
lumbopelvic rhythm for forward bending
lumbar - anterior pelvic tilt - hip flexion
lumbopelvic rhythm for post bending
hip ext - posterior pelvic tilt - lumbar ext
function of primary agonists of hip flexion
hip flexion
primary agonist muscles of hip flexion
iliopsoas
rectus fem
TFL
sartorius
function of secondary agonist of hip flexion
40-50 deg flexion
secondary agonist muscles of hip flexion
pectineus
adductor long
adductor mag
gracilis
primary agonist for hip extension
gluts max
hamstrings
secondary agonist for hip extension
gluts medius
adductor mag - hamsting portion
piriformis
short adductors of the hip
add long, brev, mag
pectinues
gracilis
primary hip abductors
rotator cuff of hip
gluts med
gluts min
secondary hip abductors
gluts max
sartorius
TFL
primary hip ER
red carpet
obturator internus and externus
gemellus sup and inf
quadratus fem
piriformis
secondary hip ER
gluts max, med, min
primary hip IR
WALA
secondary hip IR
gluts med and min
TFL
short adductors - controversial
explain gait and ambulation in sagittal
stance - starts as flexion
move forward - movers until hyperextension
tas mag moce back sa stance tas cycle lng
explain gait and ambulation in frontal
pelvic hike and drop in walking
midstance - only one LE is bending contralateral pelvis drop = glut med should contract
explain gait and ambulation in transverse
LE steps forward = left pelvis anterior rotate tas posterior on right
ant = ER
post = IR
relate movement of pelvis to lumbar spine
anterior tilt = lordosis
posterior tilt or swayback - flattening of lumbar spine
what is erect bilateral stance
hip in slight hyperextension = posterior tilt = LOG posterior to axis
how much weight is carried in bilateral
2/3 of hat
explain from erect bilateral to shift to R
R hip add tas L abd
muscles on R will eccentrically control you from falling on that side
shifted to R to neutral
contraction of R abd and L add concentrically
how much weight carried in unilateral stance
5/6 of hat
relate weak hip abd un unilateral stance
if weak pelvic drop will happen = compensatory lean to decrease moment arm/torque
explain ipsilateral cane
on side of cane gluts med contracts which prevents dropping of pelvis = pangit kase ma ccompress padin yung hip e ayaw o nga yun
explain contralateral use of cane
contralateral latissimus dorsi assists hip abd producing counter torque = replaces fucntion of gluts med on affectied side
prescribed
