lecture 4: biomes of the hip and pelvic gurdle Flashcards
what are the 3 bones that make up the hip/innominate
illium, ischium, pubis
what three bones make up the acetabulum
innominate
(illium, ischium, pubis)
the illium, ischium, pubis make up what structure
acetabulum
which of these is most posterior: illium, ischium, pubis
ischium
which of these is most anterior
illium, ischium, pubis
pubis
the acetabulum articulates with what bone
proximal femur
the pelvis is made up of what 2 structures
sacrum and the innominate bones
the head of the femur takes up what percentage of the acetabulum
2/3
what type of joint is the hip bone
synovial, ball and socket (triaxial(
how many degrees of freedom in the hip joint
3
what is the motion of the hip in the sagittal plane
flex/ext/
what is the motion of the hip in the frontal plane
abd.add
what is the motion of the hip in the tranverse plane
internal/external rotation
what are the hip muscles
gluteal (med, min, max), adductor (longus,brevis,magnus), iliopsoas, and lateral rotator (piriformis, obturator, inf fem etc)
what are the 3 ligaments of the hip compex
iliofemoral
pubofemoral
ischiofemoral
what is the function of the joint ligaments
provide stability to jt and holds structures together
which ligament of the hip is most posterio
ischiofemoral
what is the cartilage of the hip joint
labrum
what is the labrum and its function
fibrocartilaginous ring that depends the acetabulum (adds more surface area, decreases joint stress(
how do you injure the labrum cartilage
trauma and receptive movements
what is the orientation of the acetabulum
laterally
inferiorly
and anteriorly
true or false and explain: there is greater stability/less mobility in shoulder vs hip
false, greater stability in hip because of
1) greater bone congruency (the shoulder is a flatter shallow socket)
2) more support by ligaments/capsule
what is movement limitation of the hip caused by
ligaments
muscles
capsule
combo
is hip motion only at the acetabulum
no , also between the sacrum and vertebra
axes are BLANK to the plane
perpendicular
what is the axis for the saggital plane
medial/lateral
what is the axis for the frontal plane
ant/pot
what is the axis for the transverse plane
superior/ing
what is the range of motion for flexion in the sagittal plane of hip motion
0-125
what is the range of motion for extension in the sagittal plane of hip motion
0-15
what is the range of motion for abduction in the frontal plane of hip motion
0-45
what is the range of motion for adduction in the frontal plane of hip motion
0-30
what is the range of motion for external rot in the transverse plane of hip motion
0-45
what is the range of motion for internal rot in the transverse plane of hip motion
0-45
to do functional activities, what is the minimum hip flexion required
120
to do functional activities, what is the minimum hip abduction and external required
at least 20
if you do not have at least 120 degrees of hip flexion, what does that mean
cannot perform functional activities/everyday tasks
what is the degrees of hip motion needed for squatting
122
what is the degrees of hip motion needed for sitting down
104
what is the degrees of hip motion needed for trying to tie show
124
what is the solution for arthritis /trauma in th hip
hip replacement (arthroplasty)
explain the restricted ROM after hip replacement and why
no hip flexion past 90
no extremes of rotation
no adduction past midline
=ensure hip does not dislocate
with the lateral approach to hip replacement, what muscle to they cut
glute med
with the posterior approach to hip replacement, what muscle to they cut
glute max
what are some examples of adaptive equipments
sock aid
lifted toilet (increase seat height decreases the flexion)
reacher
coiled shoelace
what are the 3 types of pelvis-hip interaction
hip hiking-pelvic drop
forward/backwards rotation
posterior/anterior tilt
when standing with feet together and the pelvis is elevated on one side, explain the hip movement
the hip on the elevated side in adduction and the opposite hip is in abduction
when standing with feet together and the pelvis is elevated on one side, the hip on the elevated side is in BLANK
adduction
when standing with feet together and the pelvis is elevated on one side, the hip on the opposite of elevated side is in BLANK
abduction
when the pelvis rotates over the femur in the transverse plane, explain the hip movement
the hip on the forward side is laterally rotated, and the hip on the opposite side is medially rotated
when the pelvis rotates over the femur in the transverse plane, the hip on the forward side is BLANK rotated
laterally rotated
when the pelvis rotates over the femur in the transverse plane, the hip on the opposite side is BLANK rotated
medially
an anterior pelvic tilt flexes or extends the hip
flexes
a posterior pelvic tilt flexes or extends the hip
hip extension
anterior tilt is associated with hip flexion, true or false
true
true or false: posterior tilt is associated with flexion
false, extension
during an anterior tilt, explain the movement of the ASIS and PSIS
ASIS goes down
PSIS goes up
during an posterior tilt, explain the movement of the ASIS and PSIS
ASIS goes up
PSIS goes down
be able to understand the angle during the anterior and posterior tilt
during a hip hike, the elevated innominate is in hip adduction or abduction
adduction
during a hip hike, the lower innominate is in hip adduction or abduction
hip abduction
understand the angle of the hip hike
.
during a forward rotation, the forward innominate, the hip is in external or internal rotation
external/lateral
during a forward rotation, the back innominate, the hip is in external or internal rotation
internal.medial
be able to understand the forward/backwards rotation
a
be able to understand the forward/backwards rotation
a
a BLANK pelvic tilt can substitute for hip extension
anterior
a blank pelvic tilt can substitute for hip flexion
posterior
what is the spine-hip interaction in hip extension
spine arches (extension)
pelvic anterior tilt
what is the spine-hip interaction in hip flexion
spine rounds (flexion)
posterior pelvic tilt
a lateral tilt of the trunk and pelvis can substitute for what
hip abduction
true or false: a hip hike on the side increases abduction and lateral flexion to opposite side
true
understand the gait - stigmal angle chart
during 0-60 percent of gait cycle, is the sagittal angle for in flexion or extension
extension
true or false: at the beginning of the gait cycle (heel strike), the hip is in flexion
true
during the swing phase, explain the motion of the femur
femur moves anterior to pelvis therefore start getting flexion
be able to reproduce the wagtail angle gait phase
understand the frontal hip angle graph
.
at the beginning of the of the gait cycle, is the hip in adduction, abduction or neither
neither (neutral)
at 20% of gait cycle (full weight bearing) , the elevated hip (hip hike) is in adduction or abduction
adduction
from 20-60% of the gait cycle, the hip is in adduction or abduction and why
going into abduction because its dropping from the hip hike
be able to reproduce the frontal hip angle graph
.
at the beginning of the gait cycle, is the hip in internal or external rotation
external rotation
be able to understand the transverse hip angle graph
the angle of inclination is taken in what area of the femur
neck to shaft angle
what are the types of conditions seen from angle of inclination
coxa valga and coxa vara
what plane is the angle of inclination
frontal plane
the angle of inclination in normal alignment is approximately what
125-130
coxa alga predicted severity of what
joint degeneration
if there is an angle of inclination, higher than normal, is that coxa valga or vara
coxa valga
explain coxa valga and the appearance of the limb and muscle interaction
greater angle of inclination than normal (125)
muscles less effective because shorter moment arm
limb appears lengthened
in coxa valga, are the muscles more of less efection
lesss
in cova valga, the limb appears lengthened or shortened
lengthened
in coxa vara, the angle of inclination is less or more than normal
less
explain coxa vara and the appearance of the limb and muscle interaction
lesser than normal angle of inclination
muscles more efective (because of greater moment arm
limb appears shortened
in coxa vara, are the muscles more of less efection
more effective
in cova vara, the limb appears lengthened or shortened
shortened
antervision angle is in what plane
transverse plane
what is the normal orientation of the femur head
medially, superiorly and anterior
the hip normally exhibits approaximately what degree of ante version
15
what happens if there is no compensation for excessive anteversion
the femoral head projects too far anteriorly (or even outside the acetabulum)
in a decreased ante version (retroversion), what happens to the toe
toeing out
in in a increased ante version (), what happens to the toe
toeing in
to compensate for excessive femoral ante version, young children typically rotate the hip medially or laterally
medially (producing a pigeon-toed posture)
to compensate for excessive femoral ante version, adults do what
rotate the hip medially and lateral rotation of the tibia (so that toes point straight)
what is cerebral palsy and its cause
neurological condition
caused by damage to the developing brain during pregnancy or childhear
what condition can result in femoral anteversion
cerebral palsy
cerebral palsy can lead to what in the hip
femoral anteversion
what happens to the hip during femoral anteversion in cerebral palsy
hip subluxation/dislocation
internally rotated hips during gait
what is the solution to help kids with cerebral palsy and hip anteversion
cut proximal femur, realign femoral head in acetabulum, stabilize with pins/plates/rods
benefits: improve alignment, prevent deterioration/pain, improve gait
what are the benefits of femoral osteotomy for cerebral palsy
benefits: improve alignment, prevent deterioration/pain, improve gait
understand slide 34 about femoral derotation and cerebral palsy
the joint reaction force on the femur creates a BLANK type of moment on the neck of the femur
bending moment
the joint reaction force on the femur creates a bending moment on the neck of the femur , creating BLANK forces on the superior surface of the femoral neck and BLANK forces on its inferior side
tension forces superior
compressive forces o the inferior surface
what is the trabecular system/wolf’s law
bone will be organzized to resisted applied force
form follows function (load changes the appearance of bones)
what are the static hip reaction forces
ground reaction force
adduction moment (torque)
abduction muscle moment (torque)
hip reaction force`
for single leg stance, abduction muscle forces are what ratio to body weight
1.5-2 times body weight
for single leg stance, hip joint reaction forces are what ratio to body weight
2.5 times body weight
the lever arm is smaller for abductor muscle force or ground reaction force
smaller for abductor muscle force
can we change the abductor muscle force lever arm
no , attachment is fixed
can we change the ground reaction force lever arm
yes you can, by leaning
when standing on two feet, force is what percent of body weight
30%
when standinging on one foot, force increases to what
2.5-3x body weight
forces for stair climbing is what times body weight
3x BW
forces for walking is what times body weight
4-7x BW
forces for running is what times body weight
10x
the hip joint can withstand 12-15x BW before what
before fracture or breakdown in the osseous cmponenent will occur
hip abductor muscles (glute med) balance what
balance the adduction moment (torque)
what is the impact on hip joint reaction forces with a cane
cane reduced the demand of the hip abductor muscles (decrease lever arm)
tredelenburg gait is also known as what
gluteus medius lurch
what is trelendenburg gait due to
weakness in hip abductors (glute med/min) often due to pain in the hip from disease (hip osteoarthritis)
what does trendelenburg gait looking leg
theb standing on affected leg, contralto pelvis drops significantly on unsupported side
how is the tredelenburg compensated
by learning upper body and trunk over affected leg (decreases GRF, abductors work less)
what is the effect of lateral trunk lean for trendelenburg gait
decrease moment arm of the ground reaction force
less adduction torque
=less hip abductor muscle force
