Lecture 18: Pelvis and Hip

Question 1

What does the pelvic girdle comprise of?

Answer 1

two pelvic bones and sacrum

Question 2

What are the coronal plane alignments of the pelvic girdle?

Answer 2

ASIS and pubic tubercles

left and right ASIS

Question 3

What are the sagittal plane alignments of the pelvic girdle?

Answer 3

inferior coccyx and superior pubic symphysis

ASIS and PIIS

Question 4

Where is the sacroiliac joint and what types of movements does it permit?

Answer 4

at the centre of our body, therefore centre of motion, and permits a very small amount of gliding and rotation

Question 5

What is nutation?

Answer 5

superior sacrum moves anteriorly and inferiorly

ligaments limit the extent of nutation

Question 6

What is counternutation?

Answer 6

occurs following nutation

superior sacrum moves superiorly and posteriorly

Question 7

What is counternutation?

Answer 7

occurs following nutation

superior sacrum moves superiorly and posteriorly

Question 8

What is the role of sacroiliac ligaments?

Answer 8

restrict lateral movement of ilia and anterior movement of sacrum

Question 9

What is the role of sacrotuberous and sacrospinous ligaments?

Answer 9

resist nutation by limiting posterior rotation of inferior sacrum during weight bearing

Question 10

What is the role of the pelvic girdle?

Answer 10

helps position the hip joint for effective limb movement

Question 11

What are the movements of the pelvis?

Answer 11

posterior pelvic tilt, anterior pelvic tilt, lateral pelvic tilt and pelvic rotation

Question 12

What happens during posterior pelvic tilt?

Answer 12

ASIS is tilted backward with respect to acetabulum, positions the head of femur in front of the femur to enable ease of flexion

Question 13

What is the role of anterior pelvic tilt?

Answer 13

promotes femoral extension

Question 14

What is the role of lateral pelvic tilt?

Answer 14

facilitates lateral movements of femur

Question 15

What type of joint is the hip joint?

Answer 15

synovial multiaxial ball and socket which is able to produce movement in all three planes

Question 16

What are the articular surfaces of the hip joint?

Answer 16

head of femur, acetabulum, acetabular notch and acetabular labrum

Question 17

Where is the hip joint capsule strongest?

Answer 17

anteriorly and superiorly

Question 18

What does the hip joint capsule attach to?

Answer 18

surrounding labrum, acetabulum

and transverse ligament at the notch

Question 19

What does the synovial membrane of the hip joint capsule line?

Answer 19

the capsule, labrum & ligament of head of femur

Question 20

Which ligaments strengthen the hip joint?

Answer 20

iliofemoral and pubofemoral ligaments (anteriorly)
ischiofemoral ligament (posteriorly)

Question 21

What are the bursae of the hip?

Answer 21

iliopsoas bursa, sciatic bursa of gluteus maximus, trochanteric bursa of gluteus medius and trochanteric bursa of gluteus maximus

Question 22

What is the angle of inclination?

Answer 22

angle between femoral neck and femoral shaft in the coronal plane

Question 23

What is coxa valga?

Answer 23

angle of inclination is increased

Question 24

What is coxa vara?

Answer 24

angle of inclination is decreased

Question 25

What is the weakest component of the femur?

Answer 25

the femoral neck as it has a smaller diameter than the rest of the femur

Question 26

What do hip fractures normally imply?

Answer 26

fractures to femoral head, neck or trochanters

Question 27

Which factors improve stability of the hip?

Answer 27

articular fit, acetabular labrum, strong joint capsule and many surrounding muscles and their line of pull across the hip joint

Question 28

Which factors improve mobility of the hip?

Answer 28

acetabular labrum and ball and socket joint

Question 29

Why is hip joint ROM small compared to shoulder?

Answer 29

to increase stability (due to its large weight bearing function)

Question 30

What is an example of a two joint muscle in the lower limb and when it is active? What does this muscle act with?

Answer 30

rectus femoris active during hip flexion and knee extension acts with iliopsoas at hip

Question 31

When does rectus femoris function more effectively as a hip flexor?

Answer 31

when knee is flexed e.g. kicking a ball

Question 32

What happens when sarcomere length is either too short or too long?

Answer 32

the overlap is no longer active and a progressive decrease in force is observed

Question 33

What is passive insufficiency?

Answer 33

two-joint muscle is lengthened to its maximum passive length at both joints, but is insufficient to allow full ROM at both joints simultaneously

Question 34

What is active insufficiency?

Answer 34

two-joint muscle is shortened to its maximum length at both joints, but is insufficient to produce full ROM at both joints simultaneously

Question 35

What type of muscle is gluteus maximus?

Answer 35

a massive, powerful hip extensor when the hip is flexed

Question 36

What type of muscles are the hamstrings?

Answer 36

two joint muscles (not short head) that contribute to both hip extension and knee flexion

Question 37

When are the hamstrings active?

Answer 37

during standing, running, normal locomotion, forward bending and lifting

Question 38

What type of muscle is gluteus medius?

Answer 38

the major hip adductor, with gluteus minimus and TFL assisting

Question 39

What is contraction of the hip abductors required for?

Answer 39

stabilising the pelvis during the swing phase of gait to prevent the swinging foot from dragging

Question 40

What is the role of muscles that adduct the hip?

Answer 40

active during the gait cycle and pull the supporting leg into adduction, hence moving the line of gravity over the supporting foot

Question 41

What are the major medial rotators of the femur?

Answer 41

the gluteus minimus and medius, with assistance from the tensor fasciae latae, semitendinosus & semimembranosus

Question 42

Why does lateral and medial rotation of the femur occur during the gait cycle?

Answer 42

to accommodate rotation of the pelvis

Question 43

What does a forward bending motion involve?

Answer 43

lumbar flexion with hip flexion and anterior pelvic tilt

Question 44

What is the prime mover of a forward bending motion?

Answer 44

initially eccentric contraction of erector spinae, semispinalis, multifidus towards the end of full trunk flexion, concentric contraction of rectus abdominis, IO & EO & passive posterior ligamentous support

Question 45

What are the synergists of a forward bending motion?

Answer 45

left and right obliques cancel out unwanted rotation to permit only flexion

Question 46

What are the stabilisers of a forward bending motion?

Answer 46

segmental stabilisers i.e. multifidus, rotatores

Question 47

What does anterior pelvic tilt facilitate? What does posterior pelvic tilt facilitate?

Answer 47

hip flexion and promotes lumbar flexion | hip extension and promotes lumbar extension

Question 48

What are the concentric and eccentric muscles of anterior pelvic tilt?

Answer 48

concentric: erector spinae, hip flexors eccentric: abdominal muscles, hip extensors

Question 49

What are the concentric and eccentric muscles of posterior pelvic tilt?

Answer 49

concentric: abdominal muscles, hip extensors eccentric: erector spinae, hip flexors

Question 50

What are pelvic movements in the coronal plane?

Answer 50

pelvic drop and pelvic lift

Question 51

What are pelvic movements in the horizontal plane?

Answer 51

pelvic rotation to the right and pelvic rotation to the left