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34 Cards in this Set
- Front
- Back
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bony anatomy of pelvis
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innominate bone - ilium, ischium, pubis
acetabulum need with hip for gait - stability (intersection of forces - up and down) |
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pelvic ring
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3 joint complex
sacroiliac joint - sacrum/ilium, mostly synovial (some fibrous cartilage-unique that enhances stability) symphysis pubis |
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female pelvis
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wider
shorter smaller inclination @ pubis symphysis |
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male pelvis
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narrower
taller steeper inclination @ pubis symphysis - more stable than females |
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spatial orientation-acetabulum
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acetabular anteversion angle-lateral margins of acetabular wall, plane of concavity. position of acetabulum in space direction treatment of femur
transverse plane - position of acetabular rim, coverage of anterior femoral head normal is 20* *someone with less than 20*=retroversion someone with more than 20*=excess anteversion |
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acetabulum - center edge angle
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angle of wiberg -from center of femur head to most lateral edge of acetabulum, can be measured in xray
frontal plane coverage - acetabulum coverage of femoral head normal is 35-40* how much of femoral head is covered? |
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bony anatomy - femur
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shaft-femur not straight
compression/tension causes this...curve helps with shock absorption femoral head - and epicondyles not the same thing. femoral neck trochanters |
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spatial orientation - femur - frontal plane
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angle of inclination - frontal plane
angle between shaft and head/neck. normal is 125*, optimizes coverage of head of femur by acetabulum less than 125*=coxa vara (distal end moves medial), puts femoral neck more at risk for fractures more than 125*=coxa valga (distal end moves lateral) changes the biomechanics of hip joint |
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spatial orientation - femur - transverse plane
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torsion angle - transverse plane
looking down at the femur normal = face forward 15* faces forward more than 15*=excessive femoral antiversion (walk with toes point inward, internal roation bias) faces forward with less than 15*=retroversion |
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bony closed pack position - hip
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90* flexion
slight abduction slight external rotation |
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hip joint cartilage
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articular cartilage = type 1 cartilage
acetabulum - lunate shaped, absent deep femur - thickest anterior and superior non-uniform thickness labrum=type 2 cartilage fibrocartilage triangle aids joint congruity and nutrition significant source of pathology- |
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hip capsule - 3 lig
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iliofemoral - y-ligament : extension, ADD, ER
pubofemoral - ABD, extension, +/- ER ischiofemoral - extension, IR, ADD *commonality is that they all resist extension imp. for stability, versus muscular support |
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closed packed position - hip joint ligamentous
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full extension
slight ABD slight IR hip has 2 closed packed position - most other joints only have one closed packed position max tension in capsular ligamentous structures, not the bony |
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loose packed - hip joint
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30* flexion
slight ABD slight ER least tension b/w ligamentous struc, least bony congruency. Used in joint mobility |
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hip flexors
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primary -
I RF S Adductor longus Pec TFL secondary: Add. Brevis Grac GMe Most imp.- RF, I Chains = deep, superficial, and functional front line |
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hip extensors
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primary -
GM Sm St Bf Add mag secondary: GMe Chains = superficial back line, functional back line, spiral and lateral line |
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hip abductors
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GMe
GMi TFL Chains = lateral line spiral line functional back line |
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hip adductors
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primary:
Pec Grac A A A Secondary: Bf GM QF Chains=deep front functional front spiral lines hockey and kick boxers have issues with this *active when abductors are active to balance - flex/ext |
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hip ER
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Primary:
P OE QF GS GI GM secondary: OE S Bf GMe GMi Chains-deep frontal line |
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hip IR
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primary - none
secondary- GMe GMi TFL Add longus Add brevis Pec Chains - all but arm chains we will use TFL when we test |
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bursae of hip - common bursitis problems
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trochanteric bursitis (over greater tubercle) - caused by hyper ADDuction of the thigh
ischial bursitis - caused from prolonged sitting iliopectineal bursitis - caused by tight iliopsoas |
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muscle chains influences at the hip
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Deep frontal line - maj inf. on pelvic stability
superficial back line -- postural control of toes-knees/knee-head. nec. for dev of secondary spinal curve functional back and front - power house from LE to trunk and reverse superficial front - postural role along with DFL (deep frontal line) |
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functional demands of hip ROM
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wide range for daily activities -
80* flexion - lower/raise from chair *need more for squatting 60-65* flexion - climb stairs 30* flexion - descend stairs gait needs- 35-40* flexion 12* toal abd/add 10-12* total rotation |
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arthrokinematics - hip joint
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femur on pelvis - convex on concave
pelvis on femur - concave on convex |
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osteokinematics - hip joint
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pelvis on stable femur-
sagittal - flex/ext (flexion -- roll anterior, slide poster) frontal-abd/add (abd-roll superior/slide inferior) transverse-rot femur on stable pelvis- sagittal frontal transverse |
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lumbopelvic rhythm
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trunk stabilizing muscles
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for LE movement -
abdominals pelvic floor erector spinae quadratus lumborum lumbodrosal fascia chains? deep frontal spiral superficial functional back |
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femur stabilizing muscles
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for pelvis movement-
pelvis moving on femur-creating IR of hip joint for unilateral activities- hamstrings RF TFL/IT tract glutes hip abd - Gme, Gmi, S, P, TFL hip add - A, A, A, G, Pec |
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dynamic muscle control
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functional across midline - gait transfers forces from stance to swing limb
stabilizes pelvis, mobilizes femur chains? deep frontal functional front/back spiral lateral superficial front |
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hip disease:flexion contracture
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alters line of gravity
impacts gait likely co-exists findings = GM weakness overdeveloped quads tight lumbar extensors r hip flexion contracture = left stride length will be shorter |
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hip disease:trendelenburg
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abductor weakness - hip drop
if left side is weak, you will right hip drop compensation = trunk lean to side of weakness |
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hip osteoarthritis
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primary - because of genetics
secondary-degeneration from trauma causes loss of motion - special tests can ID as femoral head degenerates, abductor muscle moment arm is altered - leads to collapse into adduction and IR |
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hip abductor muscle moment arm
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determines=
the effectiveness of hip abductors length of limb forces acting on hip joint and femoral neck--normal/coxa vara/coxa valga coxa vara - fracture at femoral neck - inc moment arm hip abd forces, dec func length of hip abd mm coxa valga = oa at hip joint - dec moment arm hip abd forces, inc length of hip abd mm - alignment may favor dislocation |
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use of a cane
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hip abd forces-counterclockwise
bw segment - clockwise cane - counterclockwise abd moment arm + cane = less force demands on involved limb cane can hold 30% of BW |
