L18: Hip Musculature (excl Os and Is)

Question 1

Bones of the innominate when unfused

Answer 1

• Ilium, ischium, pubis

Question 2

Joints of the pelvis

Answer 2

1. ) SI joints
2. ) Hip joints (femur with innominate)
3. ) Pubic symphysis

Question 3

Ligaments of the hip joint that form the joint capsule

Answer 3

1. Iliofemoral: anteriorly from AIIS to intertrochanteric line
2. Pubofemoral: anteriorly from pubic bone and margin of obturator foramen to femoral neck
3. Ischiofemoral: posteriorly from ischium to greater trochater of femur

Question 4

What hip dislocations are more likely?

Answer 4

• Posterior dislocations

Question 5

Motions of hip

Answer 5

Flexion, extension, abduction, adduction, external rotation, internal rotation, circumduction

Question 6

Hip flexor muscles

Answer 6

• RIP muscles, think dead animal with legs flexed

- Rectus femoris, iliacus, psoas major

Question 7

Hip extensor muscles

Answer 7

• Gluteus maximus

- Hamstrings: BITE ME (BIceps femoris, SemiTEndinosus, SemiMEmbranosus)

Question 8

Knee flexor muscles

Answer 8

• Hamstrings: BITE ME

- BIceps femoris, SemiTEndinosus, SemiMEmbranosus

Question 9

Hip adductor muscles

Answer 9

• Fill in GAAAP muscles

- Gracilis, adductors (longus, magnus, brevis), pectineus

Question 10

Hip abductor and internal rotator muscles

Answer 10

• Gluteus medius, gluteus minimus, tensor fascia lata

Question 11

External hip rotator muscles

Answer 11

• Gotta Pee GO GO quick
• Gluteus maximus, piriformis (chief rotator), gemellus superior, obturator internus, gemellus inferior, obturator externus, quadratus femoris

Question 12

Knee extensor muscles

Answer 12

• Quadriceps femoris = vastus (lateralis, medialis, intermedius), rectus femoris

Question 13

Muscle groups of hip assessed using muscle energy. Name the muscles

Answer 13

1. ) Hip flexors: RIP muscles (rectus femoris, iliacus, psoas major)
2. ) Hip abductors: gluteus medius/minimus, TFL
3. ) Hip adductors: GAAAP muscles (gracilis, adductors x 3, pectineus)
4. ) Hip external rotators: Gotta Pee GO GO quick (glut max, piriformis – primarily, gemellus inf, obturator externus, gemellus sup, obturator int, quad femoris)
5. ) Knee flexors: BITE ME (biceps femoris, semitendinosus, semimembranosus)
6. ) Knee extensors: quadriceps femoris (vastus x 3 and rectus femoris)

Question 14

True / False. Muscle energy is indirect technique

Answer 14

• False, it is a direct technique as you are moving muscle into barrier

Question 15

Steps of isometric muscle energy

Answer 15

1. ) Address and approach restrictive barrier
2. ) Pt gently isometrically contracts muscle for 3-5 seconds (against equal resistance from physician)
3. ) Pause for 1-2 seconds (this is where treatment is happening)
4. ) Engage next barrier, repeat for total of 4 barriers
5. ) Re-evaluate for increased ROM

Question 16

Steps of strain/counterstrain

Answer 16

1. ) Locate TP
2. ) Place pt passively in a position that results in greatest reduction (75-100%) of relief
3. ) Fine-tune position
4. ) Maintain position for 90 seconds
5. ) Continuously monitor for tissue texture change
6. ) Slowly and passively return pt to pre-tx position while maintaining contact with TP
7. ) Re-evaluate for resolution

Question 17

True / False. Strain/counterstrain is a direct technique

Answer 17

• False, it is an indirect technique as you are moving muscle away from barrier