Module #8: Hip & Pelvic Flashcards
What is Outflare?
A condition in which the ASIS is rotated laterally
ASIS stands for Anterior Superior Iliac Spine, a bony prominence on the pelvis.
What is inflare?
A condition in which the ASIS is rotated Medially
What is the purpose of the pelvis Girdle?
Provides Structure and balance
What vertebrae’s make up the Sacrum?
S1-S5
What is the purpose of the sacral?
Provides support for the spine and accommodation for the spinal nerves
True of False: The sacral articulates with the pelvis bones?
True
What is the function of the SI joints?
Shock absorption for the spine, during torque conversions it allows for rotation movement up the spine
Sacral flexion is also known as
Nutation
Sacral Extension is also known as:
Counternutation
What plane does motion happen at SI joint?
Sagittal Plane
Nutation means to ____ and is similar to the concept of the slight tilting of the earth on its axis.
Nod
Counternutation is simply movement in _______ direction of earths axis.
opposite
What is the SI Joint?
the junction between the sacrum and ilium, located medial to the PSIS, Deep to the thoracolumbar aponeurosis and posterior sacrociliac ligaments.
What holds the sacrum and ilium together?
ligaments and Fascia-No muscles hold it together.
What are the intervertebral joints? And what is it made up of?
L5-S1-Annulus Fibrosus (outer layer), Nucleus Pulposus (inner surface of vertebral disc)
What makes up the inguinal triangle?
medial border, lateral part of rectus sheath, later border of inferior epigastric vessels, inferior border of inguinal ligament
how many pairs of nerve roots exit from the spine?
31
Damage of the femoral nerve can be caused by what?
Direct injury, tumour, growth, blocking nerve, pelvic injury,
what is hyperlordosis?
exaggerated curvature in the lumbar spine
what is self care for hyperlordosis?
Stretch hip flexors, stretch lower back, strengthen abdomen, strengthen glute max
what is hyper kyphosis?
“Hunchback” increase in the thoracic curve
What are the lower myotomes?
Lumbar
* L2 Hip flexion
* L3 Knee extension
* L4 Ankle dorsiflexion
* L5 Great toe extension
* S1 Ankle plantarflexion/Ankle eversion/Hip extension
*S2: Knee Flexion
Absence or diminished reflexes
can indicate
Damage to sensory or motor neurons, Spinal cord injury, Space occupying lesion
What does the Anterior/Posterior Innominate Rotation Test assessing?
Asses for the degree of anterior/posterior innominate rotation.
How to you perform the Anterior/posterior innominate rotation test?
Client stands barefoot, feet shoulder Width apart. Therapist places one finger on ASIS and another finger on PSIS. Normal:Level, Anterior: ASIS 1/2 inch lower, Posterior: Lower.
How do you perform Lateral pelvic tilt test?
Client stands barefoot, Practitioner uses both
thumbs to find the high
point of the iliac crest on
each side. Positive test would be one higher ilium.
Which side of the pelvis tilt in the lateral pelvic tilt test is the naming tilt?
Lower Side
What is the Hip Scour assessing?
Assesses for hip pathology. positive sign would be pain or irregular movement.
What does faber (patrick’s) tests look for?
Assesses for SI joint pathology, hip joint capsule, iliopsoas spasm. Positive sign would be pain.
What tests assesses for piriformis syndrome?
Pace abduction Test
How is the Pace Abduction Test performed?
- Client is seated on table
- Hips partially abducted
- Practitioner places each hand on the lateral sides of client’s knees
- Client pushes their knees apart while practitioner applies
resistance
What is the squish test?
Assess the posterior Sacroiliac Ligament.
How is the squish test performed?
- Client is supine
- Therapist places one hand
on the lateral side of each
ASIS and applies pressure
from lateral to medial, then
posteriorly towards the SI
joints at a 45 degree angle
Capsular pattern for the hip:
Medial Rotation, Flexion, Abduction
What joint play do you perform to increase hip extension and external rotation?
Anterior Glide-Client prone. Stabalize hand with one hand, and the other distal to ischial tuberosity. Mobile into table
How do you perform a long axis distraction?
Client Supine, Therapist hands proximal to malleoli, Distract the hip by leaning back
and pulling entire leg
What Acetabulofemoral Joint Play would you do to increase abduction?
Medial Glide
Name 4 factors that produce weakness in a muscle that tests weak in a resisted test.
Lack of use, Pain causing the weakness, Fatigue, neurological pathology.
What are the movements of the iliofemoral (hip) joint?
Flexion, Extension, Lateral Rotation, Medial Rotation, Abduction, Adduction
What are the movements of the sacroiliac Joint (SI) jOINT?
Nutation, Counternutation
What is the purpose of pelvic stabilization?
To increase Lumbar Lordosis
What does an anterior pelvic tilt do to the curvature of the spine?
Increases Lumbar Lordosis
What muscles cause an anterior pelvic tilt?
Tight quads and Iliopsoas, Weak hamstring and abdominals.
What does posterior pelvic tilt do to the curvature of the spine?
Decrease Lumbar Lordosis
What muscles contribute to a posterior pelvic tilt?
Tight abdominals and hamstrings, weak hip flexors and quads
What does a lateral pelvic tilt do to the spine?
Causes scoliosis
Other than a tight QL, what else can contribute to a lateral pelvic tilt?
Sitting on wallet, low back spasms, poor posture, scoliosis
Does a right lateral pelvic tilt mean the right side is high or low?
Low
List some postural muscles:
QL, ESG, Rectus Femoris, adductors, piriformis
List some phasic muscles:
Rectus Abdominis, Glutes, Vastus lateralis/medialis
Why do piriformis syndrome and sciatica produce similar symptoms?
They both compress the sciatic nerve
What is the origin and insertion of the piriformis?
O: Anterior surface of sacrum
I:Greater Trochanter of the femur
What is the main action of the piriformis?
Laterally rotate the hip at coxal joint
What bones does the sacrotuberous ligament connect?
Sacrum and Ischial Tuberosity
What muscle group is the sacrotuberous ligament connected with?
The deep 6, and the glute maximus and biceps femoris
What is sacroiliac joint dysfunction?
Joint Misalignment
What is the major factor contributing to sacroiliac joint dysfunction?
Ligament Sprains
What tests test for sacroiliac joint dysfunction?
Fabers, Gapping, Squish, Gaenslen’s test
What is the strongest ligament in the pelvis and femur that prevents excessive extension?
Iliofemoral ligament
What are the three ligaments of the pelvis and femur?
Iliofemoral, pubofemoral, ischiofemoral
Which ligament in the pelvis and femur is the weakest out of the 3?
Ischiofemoral
The sacroiliac joint is a large diarthrodical joint made up the pelvis and two _________ of the pelvis.
Innominate
What is each innominate formed by
Three fusion of bones of pelvis: ilium,ischium, pubic bone.
Which way is nutation motion?
Anteriorly & inferiorly
Which way is counternutation motion?
Posteriorly and superiorly
What are the deep 6 muscles?
Piriformis, quadratis femoris, Gemellus inferior, Gemellus superior, obturator externus, obturator Internus.
What is IBS also called?
Spastic Constipation
What are the three types of cancer?
1.carcinoma-malignant tumor in epithelial tissue.
2 sarcoma- tumour within the connective tissue
3. Giloma- tumour of glial nerve cells
What does the sciatic nerve run from?
L4-S3
What type of pain medication also known simply by its acronym: NSAIDS
Non-Steroidal anti-inflammatory drugs.
Inflammation of the colon
Colitis
Contraction of surrounding muscles acting on a joint to create compression and stability
Force closure
Term for a condition in which pain radiates from a compressed or inflamed nerve root
Radiculopathy
What actions are not capable of at the vocal joint that happen at shoulder?
Horizontal Adduction and Horizontal abduction
When identifying sacral movements of nutation and counter nutation, use this sacral landmark as your guide.
Sacral Promontory
Describe your treatment plan for trochanteric bursitis. Which areas are important to treat and what techniques would you use?
Reduce tension in TFL, ITB, GLUTEALS, VASTUS LATERALIS, stripping, pin and stretch
How do you measure leg length discrepancy?
measure from the inferior lip of the ASIS to underside of medial malleulos