The Lower Extremity Flashcards
Muscle length across the knee and hip affects ______ and ______ postures.
sitting & standing
The position of the _____ affects vertebral alignment.
pelvis
Tight hamstrings can lead to a ______ pelvic tilt
posterior
The hip provides ________ and ________ during weight bearing.
stability & mobility
Does the hip tend to have more closed chain or open chain movements?
closed chain
What other joint can we compare to the hip?
Is the hip more or less congruent than this joint?
Shoulder
The hip is more congruent than the shoulder, but it is not completely congruent unless carrying a heavy object
What is an important function of the knee?
Supports body weight at all positions between the extremities
Where do the ankle & feet support body weight?
What type of action occurs here?
Through the arches (absorb forces); transverse arch
Springing action
What bones make up the hip joint?
Ileum, ischium, pubis
What is another name for the hip joint?
Coxofemoral joint
The head of the femur articulates with the _________ of the pelvis.
Acetabulum
What is the function of the acetabulum?
Cushioning Absorb forces
What type of joint is the hip joint?
Diarthroidial (freely moveable) Ball & socket
How many degrees of freedom are there in the hip?
3
What is the primary function of the hip joint?
support in static erect postures & dynamic postures
Answer convex or concave: Head of femur is _____. Acetabulum is _______.
Which direction does the head of the femur slide?
convex concave
opposite direction
Spinning motions of the hip:
Spin _______ for flexion.
Spin _______ for extension
Spin & glide ______ for ABD.
Spin & glide ______ for ADD.
Spin ______ for IR/ER
Posterior
Anterior
Medial
Lateral
Opposite
When the hip is weight bearing, the femur is _____.
fixed
Hip motion is produced by movement of the _______ on the ______.
pelvis on the femur
The acetabulum moves in the ______ direction as the ______ side of the pelvis (anterior and posterior tilt, lateral tilt)
same, opposite
Which hip ligament is one of the thickest and strongest in the body?
Which letter of the alphabet is it shaped like?
Is it anterior or posterior?
What is the function?
Iliofemoral
Y ligament
Anterior
Limits externsion
Where is the pubofemoral ligament? What is the function?
inferior limits ABD minimally limits ER
Which of the hip ligaments is the weakest?
Where is is located?
What is the function?
Ischiofemoral
Posterior/inferior
Limits ADD
All hip ligaments are ______ in flexion, _______ in hyperextension.
What are the implications of this on wheelchair users?
Slack Taunt
W/C users: ligaments can be shorten because the ligaments are slack in flexion
The hip joint is a synovial joint supported by a _______ _______.
synovial capsule
What can cause the synovial capsule of the joint to stretch?
joint pain & inflammation
What motion puts slack on the hip synovial capsule?
What happens if this motion is prolonged?
Hip flexion
flexion contractures
What is the normal angle of inclination for the hip?
Why is this ideal?
125
Best position for muscle attachment & joint congruency
What is a pathological decrease in the hip’s angle of inclination?
Coxa Vara
110 degrees
What is a pathological increase in the hip’s normal of inclination?
Coxa valga
140 degrees
Is there more stability in coxa vara or coxa valga?
Why?
What types of forces can it have?
Coxa vara
Because the femoral head is deeper in the acetabulum
Can have more sheer forces
What impairments can coxa vara & coxa valga result in?
Gait abnormalities Increased wear & tear Knee problems
In coxa valga, there is ______ articulation, meaning that it is ____ congruent.
Decreased Less
How many degrees are there in hip flexion?
120
Anterior pelvic tilt/lumbar extension occurs if the _________ are weak.
This motion is limited by the ______ ligament/______ capsule
abdominals
ischiofemoral
inferior
What is the ROM for hip extension?
This motion is limited by the _______ ligament/_______ capsule.
What other motion is occurring during hip extension?
0-30
Iiliofemoral, Anterior capsule
flexion in lumbar spine
What is the ROM for hip ABD?
What is this movement limited by?
0-45
pubofemoral ligament
inferior capsule adductors
hamstrings
What is the ROM for hip ADD?
What is it limited by?
30 - 0
ischiofemoral ligament
iliotibial band
tensor fascia lattae
What is the ROM for IR?
What is it limited by?
0-45
ischiofemoral ligament piriformis
What is the ROM for hip ER?
What is it limited by?
0-45
iliofemoral ligament
iliotibial band
gluteus minimus
tensor fascia lattae
Where are the hip flexors located in relation to the axis of rotation?
Anterior to axis
Where are the extensors located in relation to the axis of rotation?
Posterior to the axis
The gluteals and hamstrings provide strong ______ for the hip in standing.
extension
The gluteals & hamstrings work together during ______ & ______ as we shift to balance ourselves
sitting & standing
The hip flexors help maintain the….
anterior and posterior trunk balance
The hip extensors prevent…
forward motion of the trunk
Illiopsoas affects anterior pelvic tilt. If illiopsoas is the agonist, _________ is/are the antagonist.
hamstrings
Normal length hamstrings allow full flexion of the _____ and _____.
Short hamstrings prevent further movement of the _____.
Is this active or passive insufficiency?
Trunk & pelvis
Pelvis
Passive
What is the reverse action of anterior pelvic tilt?
flexion
What is the reverse action of posterior pelvic tilt?
extension
What is the reverse action of depression of the right pelvis?
ABD of the right thigh
What is the reverse action of elevation of the right pelvis?
ADD of the right thigh
What are the lateral rotators of the hip?
Are they contralateral or ipsilateral rotators of the hip?
Piriformis Obturator externus & internus Superior & inferior gemelli Posterior gluteus medius
Contralateral rotators
What are the medial rotators of the hip?
Are the contralateral or ipsilateral rotators?
Anterior gluteus medius & minimus
Ipsilateral b/c they rotate the pelvis to the same side
Which mm. are one joint hip flexors?
Psoas major & minor Illiacus (Iliopsoas)
What mm. are two-joint hip flexors?
sartorius tensor fascia
latae rectus femoris
What is the function of pectineus?
power flexor adductor
In what position is iliopsoas ineffective?
knees bent [This is why you do sit ups with your knees bent, so you use your abdominals]
What is the primary one-joint hip extensor?
When is it lazy?
Gluteus maximus
during ADLs
What are the two-joint hip extensors?
When are they ineffective?
Hamstrings
Knee bent
What other mm. also extends the hip?
Adductor magnus
What muscle assists with hip ABD when force is required?
Gluteus maximus
What are the primary hip abductors?
Gluteus medius & minimus
What are the two joint hip ABD muscles?
TFL
Sartorius
The hip ABDs work with the hip ADD to maintain….
lateral stability & trunk balance
Hip ABDs maintain _____ _____ ______ during side to side and diagonal weight shifts.
active sitting balance
What are two examples for hip ABDs close chain activities?
walking, running
Hip ABD also provide support during ______ _______ ______.
single limb stance
What muscles make up the one-joint hip adductors?
pectineus
adductor magnus, brevis, longus
What muscles is a two-joint hip adductor?
gracilis
Hip adductors attach along the shaft femur anterior to the…
muscles mechanical axis for rotation
Hip adductors also have a moment arm for…
medial rotation
While sitting with the feet off the ground, what is the position of the knee during hip IR?
During hip ER?
IR: Knee is medial to neutral
ER: knee is lateral to neutral
What muscles make up the medial (internal) rotators of the hip?
Gleuteus minimus
TFL
Anterior fibers of gluteus medius
What muscles make up the external rotators of the hip?
Piriformis
Obturator internus & externus
Quadratus femoris
Gemellus superior & inferior
Where do the hip external rotators originate? Insert?
Origin: lower pelvis
Insertion: onto or near the greater trochanter
What is a secondary function of the hip external rotators?
hold femur into acetabulum
What is the open chain movement of the hip ERs?
closed chain?
Laterally rotate (ER)
Stability
What are the two-joint functions of quadriceps femoris?
If these motions are done at the same time, is it active or passive insufficiency?
Extend knee Flex hip
Active
What is the function of the hip flexors?
When are the hamstrings in active insuffiency?
When do they work best?
Knee flexors (cross 2 joints)
Knee flexion & hip extension
When the hip is flexed
When the hip is flexed, the ________ is the agonist, and _______ are the antagonist.
Rectus femoris
hamstrings
When the hip is extended, the _______ are the agonist and the ______ is the antagonist.
Hamstrings
rectus femoris
In knee flexion, the _______ are the agonist and the ____ id the antagonist.
Hamstrings
rectus femoris
In knee extension, the _________ is the agonist and the ________ is the antagonist.
rectus
femoris hamstrings
Simultaneous hip and knee flexion or extension requires both hamstrings and rectus femoris to be…
agonists at one joint and antagonists at the other joint
Hip flexion & knee extension results in _________ contracting & ________ relaxing
rectus femoris
hamstrings
The ______ is/are capable of generating more force at the hip due to a longer moment arm, and _________ is more forceful at the knee.
hamstrings
rectus femoris
Hip abductor muscles maintain a level pelvis during _________. During the swing pahse (of walking), one foot loses contact with the ground and the weight rotates the hip downward. This must be balanced by __________.
unilateral stance
contralateral hip adbuctors
Trendelenberg Sign:
During the swing phase, if the right side drops, which side is weak?
left
In the clinical screen for trendelenberg, what is considered a positive sign?
Single limb stance
+ for ABD weakness on the stance side: when the subject leans excessively toward the stance limp or when the pelvis drops on the sunsupported side
What ligament is #2?
What is the function?
Iliofemoral
Limits extension
What ligament is this?
What is the function?
Ischiofemoral
Limits ADD
