Pelvis and Hip Part 2

Question 1

Iliofemoral limits

Answer 1

Extension, ER

Question 2

Pubofemoral

Answer 2

Hip ABD and Extension

Question 3

Ischiofemoral

Answer 3

Extension

IR

Question 4

• Iliofemoral Ligament
  • Assists gait of

Answer 4

paraplegic

Question 5

with only Knee/ankle/foot orthoses and leaning posterior, iliofemoral ligaments

Answer 5

stabilize the hips for gait

Question 6

Hip Axis of Rotation/Joint Center:

Answer 6

• Assumed to be center of femoral head
• Reasonable estimate for nearly spherical head
• Reasonable for flex/ext

Question 7

Consider IR/ER occurring around vertical axis running through center of femoral head

Answer 7

• It would also run through the center of the knee

Question 8

Axis is also influenced by

Answer 8

anterior bowing of femoral shaft

Question 9

The longitudinal axis for rotation would actually be

Answer 9

extramedullary

Question 10

Hip max congruency

Answer 10

90 deg flexion
moderate abduction and ER

Question 11

Close Pack

Answer 11

Full extension with slight int rotation & abduction

Question 12

Capsular Pattern of the Hip

Answer 12

Flexion > Abduction > Medial Rotation

sometimes medial rotation has greatest limitation

Question 13

Hip sagittal plane motion

Answer 13

flexion ext

Pelvis on femur
- anterior/posterior tilt

Question 14

Frontal plane Hip motion

Answer 14

abduction/adduction

Pelvis on femur
Contralateral hip hike/drop =Pelvic Ab/Adduction on Femur

Question 15

Transverse Plane Hip Motions

Answer 15

Internal/external rotation

Pelvis on femur
Pelvis rotation CW/CCW (superior view) = Pelvic IR/ER on Femur

Question 16

• Anterior Pelvic Tilt AKA - Pelvic on Femoral Hip Flexion
  
  • A force couple action of

Answer 16

Anterior hip flexors (sartorius too) &- Posterior L/S extensors

Question 17

anterior pelvic tilt must be counterbalanced by the

Answer 17

rectus abdominis stabilizing the pelvis & lumbar spine

Question 18

• Posterior Pelvic TiltPelvic on Femoral Hip Extension
  Force couple action of

Answer 18

Rectus Abdominis

Hip extensors (gluteus maximus & hamstrings)

Question 19

• Problems of Hip Flexion Contracture
  
  • common with

Answer 19

Excessive sitting without exercise interruption.

Disorders of hip flexor spasticity

Painful/inflamed hip joints

Adaptive shortening then follows

Question 20

Problems of Hip Flexion Contracture
Disrupts

Answer 20

normal biomechanics of walking & standing

Question 21

• Standing could be passive via
  
  • via Y ligament suspension & leaning back, but

Answer 21

HFC requires active stabilization/energy demand

Question 22

• Hip Adductors: Dual Sagittal Plane Function
  
  • A) From a position of hip flexion

Answer 22

adductor longus extends the hip, assisted by adductor magnus

Question 23

Hip Adductors: Dual Sagittal Plane Function
From a position of hip extension

Answer 23

adductor longus flexes the hip, assisted by rectus femoris

Question 24

R IRs rotate the pelvis _____ on the stance femur during the first 30% of gait cycle

Answer 24

CW

Question 25

Secondary IRs (No Primary)

Answer 25

Longus Glute med/min TFL

Question 26

Most of the hip adductors are also

Answer 26

IRs

Question 27

- Hip Extensor Control of Trunk Forward Lean - Subtle forward lean recruits

Answer 27

glut max, hamstrings & adductor magnus

Question 28

After subtle forward lean

Answer 28

glut max gets quiet and hamstrings & adductor magnus increase

Question 29

- Ant Pelvic tilt increase torque arm of

Answer 29

hamstrings while reducing it for glut max

Question 30

Femoral on Pelvic Hip Extension

Answer 30

Hip extensors & adductors (from hip flex position)

Question 31

Femoral on Pelvic Hip Extension Lumbar spine extensors support the flexed trunk posture &

Answer 31

stabilize the pelvis (required for foundation of hip extensors)

Question 32

- Hip Abductors and Trendelenberg - Hip Abductor Function:

Answer 32

Little functional need to abduct femur on pelvis Stabilizing pelvis abduction on stance femur = focus

Question 33

- Trendelenberg Sign - a functional test of

Answer 33

abductor strength

Question 34

+ Trendelenburg

Answer 34

contralateral pelvis drops due to abductor weakness on stance side

Question 35

Trendelenberg (compensatory) Gait:

Answer 35

Trunk shifts over stance side to bring CG over stance leg (within base of support) Will see ”wobble” gait

Question 36

Hip Abductors Contribution

Answer 36

Gluteus Medius - 60-65% CSA Gluteus Minimus - 20-30% CSA TFL - 4-10% CSA

Question 37

Function and Stretching of Piriformis Hip Extended

Answer 37

external rotator stretched during IR

Question 38

Function and Stretching of Piriformis Hip Flexed

Answer 38

an Internal rotator stretched during ER

Question 39

Tightness of Piriformis muscles May limit ______ May compress the ______

Answer 39

IR Sciatic Nerve

Question 40

Tightness of Piriformis muscles Could cause abnormal stress on

Answer 40

SI Joint

Question 41

Tightness of Piriformis muscles May cause buttock pain with radiation of pain into the

Answer 41

hip, posterior thigh, or proximal lower leg

Question 42

- With right leg fixed in stance – in preparation for Cutting to the Left: - Contraction of R external rotators turns the L pelvis to the

Answer 42

left (CCW from above)

Question 43

For abrupt Change of Direction

Answer 43

- Uses glut max (w/ simultaneous hip extension) + the short external rotators: piriformis, obturator internus, gemellus superior, gemellus inferior, quadratus femoris, & obturator externus