Week 11: Pelvis and hip Flashcards

1
Q

5 Bones of the pelvic girdle

A
  1. ilium
  2. ischium
  3. pubis
  4. sacrum
  5. coccyx
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2
Q

4 bony prominances of the pelvic girdle?

A
  1. iliac crest
  2. ASIS
  3. PSIS
  4. SIT (ischial tuberosity)
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3
Q

Which ligament is responsible for limiting sacral and pelvic motions?

A

short posterior SI ligament

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4
Q

What are the main differences between men and women pelvis?

A

men: more stable, more weight bearing, more prone to osteophytes
women: more flexible, more prone to SI dysfunction

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5
Q

Why is the pelvic ring important?

A

it is the connection between the sacrum and pelvis; it helps transfer weight

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6
Q

how many joints are in the pelvic girdle?

A
7 joints
lumbosacral
2- sacroiliac
sacrococcygeal
symphysis pubis
2- coxofemoral
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7
Q

What is the SI joint?

A

transfer weight from spine to LE

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8
Q

What is nutation of the SI joint? Counter-nutation?

A

Nutation: anterior tilt of sacrum to ilium; PPT
Counter: posterior tilt of sacrum to ilium, APT

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9
Q

What is the open packed position of SI joint? Closed packed?

A

open: counter-nutation (Anterior tilt)
closed: nutation (posterior tilt)

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10
Q

What is the lumbosacral joint?

A

Connection between L5 and Sacral base

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11
Q

T/F with lumbar flexion, PPT always occurs?

A

No, at about 45* of flexion the ligaments are taut and vertebrae are stable and an APT occurs

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12
Q

APT and PPT occur in which plane?

A

Sagittal Plane

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13
Q

Lateral Pelvic Tilt occurs in which plane?

A

Frontal Plane

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14
Q

Rotation occurs in which plane?

A

Rotation

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15
Q

T/F: pelvic motion can be isolated?

A

false

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16
Q

With APT, what occurs at the pelvis, sacrum, hip, and lumbar spine?

A

APT
Sacral counternutatoin (posterior tilt)
Hip flexion
Lumbar extension

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17
Q

With PPT, what occurs at the pelvis, sacrum, hip, and lumbar spine

A

PPT
Sacral nutation (anterior tilt)
Hip extension
Lumbar flexion

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18
Q

With elevation/lateral pelvic tilt, what occurs at the hip and lumbar regions?

A

ipsilateral hip hikes up and adducts

ipsilateral lumbar lateral flexion

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19
Q

What depression/lateral pelvic tilt, what occurs at the hip and lumbar regions?

A

ipsilateral hip depression and abduction

contralateral lumbar flexion

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20
Q

With anterior pelvic rotation, what occurs at the hip and trunk?

A

Anterior hip swing
posterior trunk rotation towards the planted leg
Internal rotation planted hip

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21
Q

With posterior pelvic rotation, what occurs at the hip and trunk?

A

Posterior swing hip
Anterior trunk rotation towards planted leg
External rotation planted hip

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22
Q

What is the angle of inclination for normal hip alignment? Which plane?

A

125* frontal plane

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23
Q

What is the femoral anteversion for normal hip alignment? Which plane?

A

12-15* transverse plane

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24
Q

How many DOF does the coxofemoral joint have?

A

ball and socket
tri-axial (3 DOF)
concave acetabulum with convex femoral head

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25
Q

Strongest hip ligament?

A

Iliofemoral L. or “Y” ligament

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26
Q

Weakest hip ligament?

A

Ischiofemoral L.

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27
Q

3 hip ligaments

A

Iliofemoral L.
Pubofemoral L.
Ischiofemoral L.

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28
Q

3 closed packed position for hip motions?

A

Extension
ER
Abduction

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29
Q

3 Resting position for hip motion?

A

30* flexion
abduction
Slight ER

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30
Q

3 areas of capsular restriction for hip motion?

A

Flexion
Abduction
IR

31
Q

Iliofemoral L. restricts which 2 hip motions?

A

Extension

ER

32
Q

This muscle is responsible for lateral flexion of the trunk (closed chain) and lateral tilt to elevate the pelvis (open chain)

A

Quadratus Lumborum

33
Q

Attachments of Quadratus Lumborum?

A

TP of lumbar and rib 12 to posterior aspect of iliac crest

34
Q

4 main muscles involved in hip flexion?

A

iliopsoas**
Rectus femoris**
pectineus
sartorius

35
Q

Actions of Iliopsoas?

A

flex thigh
ER thigh
APT

36
Q

Innervation of Iliopsoas?

A

Femoral N.

Lumbar Plexus

37
Q

Actions of Rectus Femoris?

A

flex thigh
APT
extend knee

38
Q

Innervation of Rectus Femoris?

A

Femoral N.

39
Q

Attachments of Rectus Femoris?

A

ASIS to tibial tuberosity

40
Q

Passive insufficiency of the rectus femoris?

A

hip extension and knee flexion

41
Q

Active insufficiency of the rectus femoris?

A

hip flexion and knee extension

42
Q

Closed chain for hip extension? Open chain?

A

PPT

Hip extension

43
Q

Closed chain for hip flexion? Open chain?

A

APT

hip flexion

44
Q

2 Muscle groups involved in hip extension?

A

gluteus max

hamstrings (semimembranosus, semitendinosus, biceps femoris)

45
Q

Attachments of gluteus maximus?

A

sacrum to femur (GT)

46
Q

Actions of gluteus maximus?

A

extend thigh
ER thigh
PT and contralateral rotates

47
Q

Innervation of gluteus max?

A

inferior gluteal N.

48
Q

3 muscles that make up the hamstring group?

A

bicep femoris
semitendinosus
semimembranosus

49
Q

Actions of the hamstring group?

A

extend thigh
PPT
flex the knee

50
Q

Innervation of hamstring group

A

Sciatic N.

51
Q

Active insufficiency of the hamstring group? Passive insufficiency?

A

Extend hip and flex the thigh

Flex hip and extend thigh

52
Q

Open chain movement of hip abduction? Closed chain?

A

OC: hip abduction
CC: contralateral rotation; ipsilateral rotation

53
Q

2 main muscles involved in hip abduction?

A

gluteus medius, gluteus minimus

54
Q

Actions of gluteus medius and minimus

A

hip abduction
contralateral rotation
ipsilateral depression of pelvis

55
Q

Innervation of the gluteus medius and minimus?

A

Superior gluteal N.

56
Q

Attachments of gluteus medius and minimus?

A

external ilium to greater trochanter of the femur

57
Q

Open chain movement of hip adduction? Closed chain?

A

OC: hip adductors
CC: ipsilateral elevation of pelvis

58
Q

5 muscles of hip adduction

A
  1. Adductor longus
  2. Adductor brevis
  3. Adductor magnus
  4. Pectineus
  5. Gracilis
59
Q

2 main muscles in hip ER?

A

gluteus max

piriformis

60
Q

Attachments of the Piriformis?

A

Sacrum to the greater trochanter of the femur

61
Q

Actions of Piriformis?

A

Hip ER
Contralaterally rotates the pelvis
May Act As: IR at the thigh (if the thigh is first abducted >/ 60*)

62
Q

Innervation of the piriformis?

A

Inferior Gluteal N.

63
Q

What is a trendelenburg sign?

A

Weak gluteus medius

64
Q

Muscles of hip IR

A
  1. Tensor Fasciae Latae
  2. Gluteus minimus
  3. Gluteal medius (anterior)
  4. Contributions (SM and ST)
65
Q

Actions of Tensor Fasciae Latae?

A

Abducts the thigh
Flexes the thigh
Anterior pelvic tilt

66
Q

Innervation of TFL?

A

superior gluteal N.

67
Q

Attachment of TFL?

A

ASIS to IT band

68
Q

Piriformis tightness can result in what condition?

A

Sciatica

69
Q

Tight TFL can put an individual at risk for what syndrome?

A

ITB friction or greater trochanter bursitis

70
Q

Increased tension at the lateral femoral condyle that causes knee pain and tension at the greater trochanter is characteristic of?

A

ITB friction or greater trochanter bursitis

71
Q

What is a coxa vara position?

A

angle is less than 120-125*

Clinical Impact: leg length discrepancy, weakness in hip abductors, early arthritis

72
Q

What is coxa valga position?

A

Angle is greater than 125-135*

Clinical Impact: instability, subluxation, dysplasia, increased femoral anteversion, increase lumbar lordosis

73
Q

What is the normal torsion for femoral anteversion?

A

12-15*

74
Q

Which ROM in the LE has a soft end feel?

A

hip extension with 120-140* knee flexion