Pelvis/Hip LAB/Lec 17 Flashcards
Hip Flexors Muscles
1) ilacus= O:iliac fossa; I:Lesser trochanter of femur
2) psoas major=O:bodies & TP of L1-L5; I: Lesser trochanter of femur
3) rectus femoris=O:AIIS and acetabulum; I:Patella via the quad tendon and through the patellar ligament to tibial tuberosity
Knee Flexors Muscles
1) Hamstrings=O:ischial tuberosity; I:?
2) semimembranosus=O:ischial tuberosity; I:Medial tibial condyle
3) Semitendinosus=O:ischial tuberosity;I:proximal medial tibia
4) Biceps femoris=O:ischial tuberosity;I:fibular head
Hip Flexor Diag/Treat
—diagnosis: prone;same side;grab knee flexed perp foot on your shoulder-ish;stabilize IT with other hand; extend until restriction;compare sides for asymmetry
- –treat: Muscle energy w/ isometric flexion
- –If does not help ROM try ant hip capsular mobilization
Knee Flexor Diag/Treat
—diag: supine; same side;hand on achiles tendon area holding leg up and other hand on knee;extend knee up until barrier; asymmetry
—treat: Muscle energy w/ isometric flexion
Knee Extensor Muscles
1) vastus lateralis=O:greater trochanter; I:ALL
2) Vastus medialis=O:intertrochanteric line;I:ALL
3) vastus intermedius=O:ant and lat surgace of femoral shaft;I:ALL
4) Rectus femoris=O:AIIS;I:ALL
ALL=I: patella via the quad tendon and through patellar lig to the tibial tuberosity
Knee extensor diag/treat
diag: prone;same side flex knee(toward butt);barriers&asymmetry
treat: ME and isometric extension
Hip ADductor Muscles
1) gracilis=O:Inf ramus of pubis;I:proximal and med surface of tibia
2) adductor magnus=O:body &inf remus of the pubis;I:femoral linea aspera and ADductor tubercle of femur
3) adductor longus=O:body&inf ramus of the pubis;I:middle1/3 of femoral linea aspera
4) adductor brevis=O:body and inf ramus of pubis;I:prox part of femoral linea aspera
5) pectineus=O:sup ramus of pubis;I:distal to lesser trochanter of femur
hip ADductor diag/treat
—diag:supine;same side;toes upward;ext rotate hip to barrier (just off table pull to side);hold other leg so doesnt move
treat: ME w/ isometrical adduction of the hip
Hip ABductors muscles (AND INT ROTATORS OF THE HIP)
1) gluteus medius & minimus=O:lat surface of ilium;I:greater trochanter of femur
2) tensor fascia lata (TFL)=O:iliac crest jsut post to ASIS;I:iliotibial tract proximal and lateral tibia
Hip ABductors diag/treat
daig: supine;head of table; lift leg not testing;toes upward;foot under other IE abducting the hip
treat: ME w/ isometric ABduction of hip
External Rotator muscles
PRIMARY=piriformis but many muscles contribute
1) piriformis=O:ant surface of sacrum;I:greater trochanter of femur
2) gluteus maxims=O:lateral ilium, dorsal sacrum; I:iliotibial tract, gluteal tuberosity of femur
3) obterator internus=O:Ishial tuberosity;I:Greater trochanter of femur
4) gemellus superior and inferior=O:upper aspect of IT;I:medial side of greater trochanter
5) quad femoris=O:lateral ischium; I:intertrochanteric crest
6) obturator externis=O:obturator formaen;I:greater trochanter
GOTTA PEE GO GO QUICK
External Rotator diag/treat
diag: supine;hold ankles;internally rotatehip-WATHCING THE HIP
treat: Below 90deg - IF HIP OR KNEE PAIN=supine;same side;flex knee and place foot lateral side of other leg;stabilize ASIS;internally rotate and ADduct the hip (push away from you); ME w/ knee into hand
Above 90deg=supine;same side; knee 90deg;externally rotate hit to restriction;flex and ADduct the hip to restrictive barrier;ME w/ knee into hand
If does not help try post hip capsule mobilization
Iliacus tenderpoint loc/treat
loc: 1/3 distance ASIS to midline; press deep in post lateral direction toward iliacus
treat: starin/counterstain: supine; SAME SIDE; hips flexed and knees bend on your knee w/ your foot on table near pt butt;cross ankles to create ABduction and external rotation of hips (move forward ish)
ADductor tenderpoint loc/treat
loc: anywhere along adductor muscle (medial thigh)
treat: S/CS=prone;OPPOSITE SIDE; slight flex the hip and knee with Adduction of hi and slight external rotation
Piriformis tenderpoint loc/treat
loc: midpoint b/w lower half of lateral aspect of the sacrum and ILA and the greater trochanter
treat: S/CS=prone near edge of table;same side sitting down w/ pt knee kind of bw your legs;flexion and ABduction of hip; fine tune with external or internal rotation
Ant Hip Capsule diag/treat
ASK ABOUT HIP/KNEE ISSUES
diag:prone;knee to 90;OPP SIDE; gentle pressure ant on proximal femur (basically push into the table where the butt meets the leg); check for tightness and symmetry
treat:prone;OPP SIDE?; extend hip w/ gentle pressure other hand LVMA pressure anteriorly against prox femur. fine tune w/ internal and external rotation of femur and with medial and lateral forces
Post Hip Capsule
ASK ABOUT HIP/KNEE ISSUES
diag:supine;same side;flex hip to 90 and flex knee;pressure posteriorly through the femur;assess for tightness
treat:supine; same sime;LVMA pressure posteriorly through the femur; re-direct force to fine tune
Psoas Tenderpoint loc/treat
loc: starting 2/3 dist from ASIS to midline pressing deep posterior direction toward psoas
treat: S/CS=supine;same side;knees flexed ankle on your thigh;your foot on table; flex and side bend pelvis toward side with tender point
pelvic girdle composed of
sacrum
coccyx
two hip bones
w/ pubic symphysis
innominate bones
ilium ishium and pbuis (all 3 = acetabulum or joint that olds the femur)
hip joint is a ___ joint
ball and socket
ligaments of the hip jint
iliofemoral
pubofemoral
ischiofemoral
iliofeoral ligament
O: at AIIS
I: intertrochanteric line
pubofemoral lig
O_pubic bone and margin of obturator foramen
I: femoral neck
ischiofemoral ligament
O: ischium
I: greater trochanter of femur
WEAKEST LIG - its in back
labrum
fibrocartilagenous part of hip joint that extends to make socket deeper = harder to dislocate - stability
hip extensor
1) gluteus maximus: O: lateral ilium, dorsal sacrum; I: iliotibilal tract, gluteal tuberosty of femus
2) hamstrings: semimembranous, semitendinus, bicepts femorus
