The Hip Flashcards
Origin, insertion and action of Gracilis
Origin- Anterior body of pubis, inferior pubic ramus, ischial ramus
Insertion- Medial surface of proximal tibia (via pes anserinus)
Action- Hip joint: Thigh flexion, thigh adduction;
Knee joint: leg flexion, leg internal rotation
Origin, insertion and action of Adductor Longus
Origin- Body of pubis, inferior to pubic crest and lateral to the pubic symphysis
Insertion- Middle third of linea aspera of femur (medial lip)
Action- Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization
Origin, insertion and action of Adductor brevis
Origin- (Anterior surface of) Body and inferior ramus of pubis
Insertion-Linea aspera of femur (medial lip)
Action- Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation; Pelvis stabilization
Origin, insertion and action of Adductor Magnus
Origin- Adductor part- Inferior pubic ramus, Ischial ramus
- Ischiocondylar part: Ischial tuberosity
Insertion: Adductor part- Gluteal tuberosity, Linea aspera (medial lip), Medial supracondylar line, Ischiocondylar part: Adductor tubercle of femur
Action- Hip joint: Thigh flexion, Thigh adduction, Thigh external rotation (adductor part), Thigh extension, Thigh internal rotation (ischiocondylar part); Pelvis stabilization
Origin, insertion and action of Pectineus
Origin- Superior pubic ramus (Pectineal line of pubis)
Insertion- Pectineal line of femur, Linear aspera of femur
Action- Hip joint: Thigh flexion, Thigh adduction, Thigh external/internal rotation; Pelvis stabilization
Origin, insertion and action of Sartorius
Origin- Anterior superior iliac spine (ASIS)
Insertion- Medial surface of proximal tibia (via pes anserinus)
Action- Hip joint: Thigh flexion, Thigh abduction, Thigh external rotation; Knee joint: Leg flexion, Leg internal rotation
Origin, insertion and action of Rectus femoris
Origin: Anterior inferior iliac spine, Superior margin of acetabulum
Insertion- Tibial tuberosity (via patellar ligament)
Action- Hip joint: Thigh flexion; Knee joint: Leg extension
Origin, insertion and action of Psoas Major
Origin- Vertebral bodies of T12- L4, Intervertebral discs between T12-L4, Transverse processes of L1-L5 vertebrae
Insertion- Lesser trochanter of femur
Action- Hip joint: Thigh/trunk flexion, Thigh external rotation; Trunk lateral flexion
Origin, insertion and action of Iliacus
Origin- Iliac fossa
Insertion- Lesser trochanter of femur
Action- Hip joint: Thigh flexion, Thigh external rotation
Origin, insertion and action of Gluteus Minimus
Origin: Gluteal surface of ilium (between anterior and inferior gluteal lines)
Insertion: Anterior aspect of greater trochanter of femur
Action- Hip joint: Thigh abduction, Thigh internal rotation (anterior part); Pelvis stabilization
Origin, insertion and action of Gluteus Medius
Origin- Gluteal surface of ilium (between anterior and posterior gluteal lines)
Insertion- Lateral aspect of greater trochanter of femur
Action- Hip joint: Thigh abduction, Thigh internal rotation (anterior part); Pelvis stabilization
Origin, insertion and action of Tensor fascia lata
Origin- Outer lip of anterior iliac crest, Anterior superior iliac spine (ASIS)
Insertion- Iliotibial tract
Action- Hip joint: Thigh internal rotation, (Weak abduction)
Knee joint: Leg external rotation, (Weak leg flexion/ extension); Stabilizes hip & knee joints
Origin, insertion and action of Short Lateral rotators
Obturator externus:
Origin- Anterior surface of obturator membrane, Bony boundaries of obturator foramen
Insertion- Trochanteric fossa of femur
Action- Hip joint: Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Obturator internus:
Origin- Ischiopubic ramus, Posterior surface of obturator membrane
Insertion- Medial surface of greater trochanter of femur
Action- Hip joint: Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Superior gemellus:
Origin- Ischial spine
Insertion- Medial surface of greater trochanter, (via tendon of obturator internus)
Action- Hip joint: Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Inferior gemellus:
Origin- Ischial tuberosity
Insertion- Medial surface of greater trochanter, (via tendon of obturator internus)
Action- Hip joint: Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Piriformis:
Origin- Anterior surface of sacrum (between the S2 and S4), Gluteal surface of ilium (near posterior inferior iliac spine), Sacrotuberous ligament
Insertion- Apex of greater trochanter of femur
Action- Hip joint: Thigh external rotation, Thigh abduction (from flexed hip); Stabilizes head of femur in acetabulum
Quadratus femoris:
Origin- Ischial tuberosity
Insertion- Intertrochanteric crest of femur
Action- Hip joint: Thigh external rotation; Stabilizes head of femur in acetabulum
Origin, insertion and action of Gluteus Maximus
Origin- Lateroposterior surface of sacrum and coccyx, Gluteal surface of ilium (behind posterior gluteal line), Thoracolumbar fascia, Sacrotuberous ligament
Insertion- Iliotibial tract, Gluteal tuberosity of femur
Action- Hip joint: Thigh extension, Thigh external rotation, Thigh abduction (superior part), Thigh adduction (inferior part)
Origin, insertion and action of Biceps femoris
Origin-
-Long head: Medial impression of ischial tuberosity
- Short head: Linea aspera of femur (lateral lip), Lateral supracondylar line of femur
Insertion: Head of fibula
Action- Hip joint: Thigh extension, Thigh external rotation; Knee joint: Leg flexion, Leg external rotation
Origin, insertion and action of semitendinosus
Origin- Medial impression of ischial tuberosity
Insertion- Proximal end of tibia below medial condyle of tibia (via pes anserinus)
Action- Hip joint: Thigh extension, Thigh internal rotation; Knee joint: Leg flexion, Leg internal rotation; Pelvis stabilization
Origin, insertion and action of semimembranosus
Origin- Medial impression of ischial tuberosity
Insertion- Medial condyle of tibia
Action- Hip joint: Thigh extension, Thigh internal rotation; Knee joint: Leg flexion, Leg internal rotation; Pelvis stabilization
What are the stabilising features of the hip?
- Joint capsule- iliofemoral, pubofemoral and ischiofemoral ligaments.
- Acetabular labrum
- muscles which run parallel to the femoral head such as iliopsoas, short lateral rotators (names)
- bursae and fat pads
- Congruency between femoral head and acetabulum
What are the features of a synovial joint?
Synovial joints are freely mobile joints which are usually limited in movement by a joint capsule, ligaments and muscles surrounding the joint. The articular surfaces are covered with hyaline cartilage which allows minimal friction between the joint surfaces. Synovial membranes are present and they lubricate, nourish and reduce friction between the articular surface cartilage. Bursae can be present and can communicate directly with the joint space.
Define what happens in medial rotation? Does it matter if the knee is bent or straight? If so why?
Medial rotation is the action of the thigh moving inwards toward the midline.
If the leg is straight the foot goes in the direction of the femur. If the knee is bent the foot goes in the opposite direction to the femur
Identify and explain which other structures may be under stretch with the FABER test.
What is the end feel of Abduction of the hip?
Firm end feel due to the capsular and ligament limitations
What structures are put under stretch in lateral rotation of the hip?
Gluteus Medius, Gluteus Minimus and tensor fascia lata (main medial rotators)
Pubofemoral and iliofemoral ligaments
What is the close packed position of the hip?
Hip extension, medial rotation and Abduction
How does this position relate to functional activities?
It is the maximal congruency in the joint and the maximal joint stability. Functionally, it gives a position of stability in stance for swing phase of other leg.
Identify and explain normal and abnormal findings of Obers test and how this can contribute to your reasoning
The leg being tested should drop below the level of the bed. If the testing leg doesn’t drop then that is a positive test with indicates a tight TFL and ITB
State the health and safety principles that the therapist needs to ensure during passive movements of the hip.
- Safe bed height, brakes on before patient gets on, clean
• Hand hygiene
• Consent
• Therapist positioning
• Communicate with the patient and check their position
• Soft hands, move limb slowly to end of range of motion and gently return to anatomical position
What is the normal range of movement of hip extension?
AROM- 0-20 degrees of movement
What is an accessory movement and why should they be tested?
They are joint glides that occur during normal movement that an individual cannot perform themselves.
Identify and explain the end feel concept of hip flexion and how this can contribute to your reasoning
Hip flexion is a soft feel due to the quadriceps ROM being stopped by soft tissue of the abdomen. Hard end feel may indicate bone on bone contact, excessive movement may indicate laxity in the hip ligaments or muscles
Identify and explain how shortness of semitendinosus. could affect active and passive movements at both the hip and the knee.
Identify and explain which structures limit normal movement of hip medial rotation
Identify and explain the muscles involved in hip adduction
Identify and explain the role of the hip abductors In walking.
Identify and explain how shortness of gracilis could affect active and passive movements at the hip.
What is the function of the Acetabular labrum
deepens the acetabulum by raising the rim of the acetabulum slightly, thereby increasing the acetabular articular area
What are the differences between the Shoulder joint and Hip joint
