Lecture 5A: Hip Anatomy

Question 1

What direction does the head of the femur face?
is it larger or smaller than acetabulum

Answer 1

medially, superiorly and anteriorly
femur head larger than acetabulum

Question 2

resting position of the hip joint (open pack)

Answer 2

30 flexion
30 abduction
slight ER

Question 3

closed packed position of hip

Answer 3

full extension
IR
abduction

Question 4

Capular pattern

Answer 4

flexion, abduction, IR

(but in some cases IR limited the most)

Question 5

if we wanna bias the hip
if we wanna bias SI

Answer 5

Hip manip: lock SI
SI manip: lock the hip

Question 6

T/F hip joint is designed for mobility

Answer 6

F (Stability)

Question 7

undercoverage of femoral head by acetabulum

Answer 7

hip dysplasia (PEDS)

Question 8

Excessive bony development / overcoverage of femoral head by acetabulum

Answer 8

femoro-acetabular impingement (FAI)

Question 9

_____ _____ is integral to successfully evalute and treat hip dysfunction

Answer 9

regional interdependence

Question 10

acetabulum faces

Answer 10

anteriorly
laterally
inferior

while the head of the fumr faces: medially, superiorly and anteriorly

Question 11

this structure is filled w/ fat pad - very important for shock absorption and proprioceptioin

Answer 11

acetabular fossa

Question 12

angle of inclincation:
adults
infants
elderly

Answer 12

125-139
150
120

Question 13

coxa valga
coxa vara

Answer 13

valga: >139
vara: <125

Question 14

a horizonal plane b/t axis through femoral neck and axis through condyles

Answer 14

angle of torsion (anteversion)

Question 15

normal range of anteversion?
infants?

Answer 15

10 - 15

30

Question 16

excessive anteversion >15 degrees causes

Answer 16

• Causes toe-in and IR hip
• Predispose OA and excessive anterior glide
• overall less acetabulum coverage

Question 17

relative retroversion
absolute retroversion

Answer 17

relative: <10
absolute: <0

Question 18

hip jont capsule is thicker

Answer 18

anterior/superior
- more predisposed to shortening and restriction

Question 19

hip joint capsule is thin and loose

Answer 19

posterior/inferior
- more predisposed for dislocation and laxity

Question 20

*Attaches to acetabular margin
*↑’s congruency of articulation
* Disperses the load

Answer 20

fibrocartilage Acetabular Labrum

Question 21

• Flex and ER the hip or tilts pelvis anteriorly
  *** Only mm. that flexes hip at end range of hip flexion
• Can have shortness that correlates w/ short anterior capsule**

Answer 21

Iliopsoas

Question 22

effects of ilioposas on the lumbar spine
* In upright position, contraction of iliopsoas ↑’s lumbar ____
* Creates ____ shear on lumbar spine
* When lumbar spine is flexed, contraction of iliopsoas ____ lumbar spine

Answer 22

• lordosis
• anterior
• flexes

Question 23

• Flexes hip, extends knee
• Pulls innominate into anterior tilt
• Short muscle length often correlates w/ short hip anterior capsule
• Related to ↑’d patello-femoral compression
• Particularly PFPS (patellofemoral pain syndrome)

Answer 23

RF

Question 24

TFL:
* ____, ____ and ____ the hip
* Stabilizs knee when knee is ____
* Commonly short and ____

Answer 24

flex, IR, abduct
extended
stiff

Question 25

sartorius

Answer 25

• flex and ER and abduct hip
• flex and IR at knee

Question 26

glute med: posterior fibers vs anterior fibers and glute min

Answer 26

posterior fibers: extend, ABduct and ER the hip. They are weaker than anterior

anterior fibers / G min: flex, ABDuct and IR the hip

Question 27

glute max mm action

Answer 27

• Superior fibers ABduct the hip
• Inferior fibers ADDuct the hip

80% of the muscle inserts into ITB

Question 28

G MAX commonly atrophied in pts w/:

Answer 28

• sway back
• spinal DJD
• Hip DJD

Question 29

piriformis MM action

Answer 29

ER, extends and ABducts the hip when hip is flexed <90°
Piriformis is an IR (and adductor) when hip is flexed >90°
Potential site of sciatic entrapment

Question 30

other short ERs

Answer 30

Obturator internus and externus
Superior and inferior gemelli
Quadratus femoris

Question 31

hamstrings

Answer 31

Medial hamstrings:
Semimembranosus and semitendinosus
Extend and IR the hip
Flex and IR the knee

Lateral hamstrings:
Biceps femoris
Long head crosses 2 joints
Extends and ER the hip
Flexes and ER the knee

Question 32

pectineus

Answer 32

ADDucts, IR and flexes the hip

Question 33

gracilis

Answer 33

ADDucts the hip
IR and flexes the knee

Question 34

which adductor mm most commonly strained?

Answer 34

adductor longus

Question 35

adductor longus/brevis

Answer 35

adduct and flex hip

Question 36

adductor magnus

Answer 36

ADDucts the hip
Anterior fibers flex the hip
Posterior fibers extend the hip

Question 37

largest and most constant bursa around the hip.

cushions tendon from anterior structures on the hip capsule

Answer 37

iliopsoas bursaa

Question 38

Nerves of muscles that cross the hip joint

Answer 38

also supply the joint capsule and the joint

Therefore, pain referred from the hip joint may be felt anywhere in the thigh, leg, or foot

Question 39

femoral triangle

• superior
• medial
• lateral

Answer 39

superior: inguinal ligament
medial: adductor longus
lateral: sartorius

Question 40

review last slides about glides