``` "Thigh bone" Longest and strongest bone in the body Landmarks: -Femoral head & neck -Greater trochanter -Lesser trochanter -Epicondyles ```

KNES 360 EXAM 2 Hip & Pelvis Flashcards by Natalie Hirst

Femur

"Thigh bone"
Longest and strongest bone in the body
Landmarks:
-Femoral head &amp; neck
-Greater trochanter
-Lesser trochanter
-Epicondyles

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Pelvis

"Hip bone"
AKA innominate bone
Three fused bones in one:
-Illium: Superior
-Pubis: Anterior/Inferior
-Ischium: Posterior/Inferior
Bony landmarks:
Acetabulum (socket)
Illiac Crest
ASIS
PSIS
Ischial Tuberosity

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Sacrum

Triangular shaped
Fites between pelvic bones
Five fused bones in one: S1, S2, S3, S4, S5
Terminates at coccyx (tail bone)

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Acetabular Joint

Bones:
-Head of Femur
-Acetabulum of Pelvis
"Ball and Socket"
Very strong joint because:
-Bony architecture
-Thick fibrous ligaments
-Several muscles cross joint

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Hip Labrum

Rim of cartilage around the hip socket
Function:
-Deepens socket to keep head of femur in the acetabulum
-Provides buttress
-Increases stability

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Sacroiliac (“SI”) Joint

Bones:
-Pelvis
-Sacrum
Very little motion

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Gluteus Maximus

O: Outer surface of ilium behind posterior gluteal line, sacrum, coccyx
I: Iliotibial tract (IT band) and gluteal tuberosity on femur
A: Upper: Hip abduction and external rotation
Lower: Hip extension and external rotation
IN: Inferior Gluteal Nerve

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Gluteus Medius

O: Outer surface of allium inferior to iliac crest
I: Lateral surface of greater trochanter
A: Hip abduction and internal rotation; HIP ER when flexed 90 degress
IN: Superior Gluteal Nerve

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Gluteus Minimus

O: Outer surface of allium between middle and inferior gluteal lines
I: Anterior surface of greater trochanter
A: Hip abduction and internal rotation
IN: Superior Gluteal Nerve

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Piriformis

O: Internal surface of the sacrum
I: Superior border of the greater trochanter
A: Hip abduction and external rotation
IN: Anterior rami of 1st and 2nd sacral nerves

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Obturator Internus

O: Posterior surface of obturator membrane
I: Common tendon with gemelli to medial surface of greater trochanter
A: Hip external rotation
IN: Nerve from sacral plexus

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Obturator Externus

O: Outer surface of pubis and ischium
I: Trochanteric fossa of femur
A: Hip external rotation
IN: Obturator Nerve

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Quadratus Femoris

O: Lateral border of the ischial tuberosity
I: Below intertrochanteric crest
A: Hip external rotation
IN: Sacral Plexus

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Gemellus Superior

O: Ischial Spine
I: With tendon obturator internus to upper border of greater trochanter
A: Hip external rotation
IN: Branch of nerve to obturator internus

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Gemellus Inferior

O: Upper margin of ischial tuberosity
I: With tendon of obturator internus to the upper border of the greater trochanter
A: Hip external rotation
IN: Branch of nerve to quadratus femoris

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Deep Six Hip External Rotators

Piriformis
Gemellus Superior
Obturator Internus
Gemellus Inferior
Obturator Externus
Quadratus Femoris

Tensor Fascia Latae

O: Outer edge of iliac crest; ASIS
I: Lateral condyle of the tibia via IT band
A: hip flexion and abduction
IN: Superior Gluteal Nerve

Psoas Major

O: Transverse Processes T12/L1-5 and bodies of lumbar vertebra
I: Lesser Trochanter (with iliacus)
A: Psoas major and iliacus muscles acting together create hip flexion and external rotation and trunk flexion
IN: Branches from Lumbar plexus

Iliacus

O: Upper 2/3 iliac fossa, sacrum, AIIS
I: Tendon of psoas major to lesser trochanter of femur
A: hip flexion
IN: Femoral nerve

Sartorius

O: Anterior Superior Iliac Spine
I: Pes anserine
A: FABER hip; Flexion and Internal Rotation of knee
IN: Femoral Nerve

Pectinius

O: Pectineal line on pubis
I: Lesser trochanter to linea aspera
A: Hip flexion and adduction (when flexed)
IN: Femoral nerve

Gracilis

O: Pubic symphysis and pubic arch
I: Pes Anserine
A: FADIR hip; knee flexion
IN: Obturator Nerve

Adductor Longus

O: Pubic crest and pubic symphysis
I: Medial lip of linea aspera of femur
A: Hip flexion, adduction, and internal rotation
IN: Obturator Nerve

Adductor Brevis

O: Inferior ramus of pubis
I: Superior half of linea aspera of femur
A: Hip flexion, adduction, and internal rotation
IN: Obturator Nerve

Adductor Magnus

O: Inferior Pubis and ischial tuberosity I: linea aspera of femur; adductor tubercle of femur A: Hip flexion, adduction, and internal rotation IN: Obturator nerve

Adductor Hiatus

Allows for the passage of the femoral vessels from the anterior thigh to posterior thigh Femoral artery and vein pass through and become the popliteal artery and vein

Pes Anserine

``` 3 muscles: -Sartorius -Gracilis -Semitendinosus Site for pos anserine bursitis ```

Anterior Pelvic Tilt

``` Weak/Inhibited -Abdominals -Gluteals Tight/Overactive -Hip flexors -Back extensors ```

Posterior Pelvic Tilt

``` Weak/Inhibited -Hip flexors -back extensors Tight/Overactive -Hamstrings -Gluteals ```

Gluteal region | Piriformis Syndrome

Sciatic nerve pierces the piriformis in ~15% of the population Tightness or spasm of the piriformis impinges the sciatic nerve, resulting in referred pain in the lower leg and weakness in ABD and ER

Hamstring Strain

``` High recurrence rate: -Athletes who return to sport before full recovery are at risk of recurrent and possibly more severe injury Biarticular muscle: -Eccentric knee extension -> concentric hip extension Potential risk factors: -HQ fatigue -Muscle fatigue -Hamstring tightness -Insufficient warm up -Previous history ```

Gluteal Amnesia

Due to our tendency to sit on our gluten more than use them, they tend to shut down in a lot of people and not work the way they should -Consequence -> overactive hamstrings Glute activation exercises important in prevention of injury/disease and in improving athletic performance

Gluteal Region | Gluteus Maximus Gait

Cause by weakness or paralysis of the gluteus maximus Results in a lurching of the trunk as the thorax is thrust posteriorly to maintain hip extension during stance phase of gait

Trendelenburg Gait

Caused by weakness or paralysis of the gluteus medius | Results in a dropping of the unaffected side as the thorax lists toward the affected side

Glute Activation

Utilize the fact that gluteal max has two main actions: -Hip extension -Hip external rotation Train gluteal med as frontal place hip stabilizer

Decreasing the Stress on the Knee

There is evidence that proper activation of the hip musculature may help control the knee loads during activities of daily living