Pelvis and Hip

AC copy

head, arm, trunk (HAT)

What are the pelvis and hips supports for?

stability

The pelvis and hips supply proximal __________.

between the 5th lumbar vertebrae and the coccyx

Where is the sacrum located?

five (fused together)

How many sacral vertebrae are there?

2 - coxal bones, ilium, ischium, pubis

The pelvis is formed by ___ bones. Each have 3 parts, called…

ilium, specifically the iliac crest is the part you can feel

What bone is at the top of the 2 bones that form the pelvis that you can palpate?

pubic symphysis

made of CT, in between the coxal bones

acetabulum

fossa of the pelvis where the femur sits

femur

longest bone in the body

femural head

What sits in the acetabulum?

greater trochanter

sits just below the hip joint, on the lateral (outer) side of the femur

absorb, transfer

Joints of the pelvis and hip _____ and _____ forces.

Sacroiliac joint (SI)

joint located right where the sacrum meets the pelvis

• synovial joint

• stabilizes the pelvis under strain of opposing forces

Sacroiliac joint (SI)

at the bottom of the pelvis

Where does the hamstrings tendon attach?

• ball-and-socket

• triaxial

• flexion, extension, abduction, adduction, external rotation, internal rotation

Hip joint

external rotation

toes pointing outward, ballerina

internal rotation

toes pointing inward, pigeon-toed

Ankylosing Spondylitis

inflammatory condition of the spine where skeletal structures fuse together

the SI joint and progresses into the vertebrae

What joint does Ankylosing Spondylitis beging?

They lose their shock absorption function and lose pain control.

What happens to the intervertebral discs with Ankylosing Spondylitis?

mobility, pain

Ankylosing Spondylitis brings significant ____ limitation of the spine and _____.

pelvic floor

inferior muscular wall of the pelvic cavity

circular

The pelvic floor consists of a _______ formation of muscles.

psoas major, iliacus

What muscles flex (bringing hip up into 90 degrees) the hip?

• moving leg forward for ambulation (walking)

• flex the trunk

• tilt the pelvis anteriorly

What is involved with hip flexion?

gluteus maximus, hamstrings

What muscles extend the hip?

gluteus maximus

largest gluteal muscle that extends the hip

gluteus maximus

muscle that is used for hip extension and high force demands like running and climbing

hamstrings

origin is at the ischial tuberosity

gluteus medium and minimus

muscle for hip abduction

tensor fascia latae

supportive layer of fascia on the lateral thigh

Adductors are stronger.

Are abductors or adductors stronger?

• adductor magnus

• adductor longus

• adductor brevis

• pectineus

• gracilis

muscles for hip adduction

piriformis, quadratus femoris, obturator internus, obturator externus, gemellus superior, gemellus inferior

hip rotators

Sciatica

sensory innervation of the lower leg, nerve gets pinched around the gluteus medius

• pain and paresthesia (abnormal sensation on the skin) in the legs

• pins and needles, sharp pain

symptoms of sciatica

posterior pelvic tilt

backward rotation of the pelvis (ischial tuberosities (sit bones) are positioned forward)

lumbar, flexion

Posterior pelvic tilt flattens the _____ spine and increases thoracic _____.

posterior pelvic tilt

pelvic tilt that is like a hunchback

anterior pelvic tilt

forward rotation of the pelvis

lordosis

Anterior pelvis tilt increases lumbar _____ and increases the extension of the upper trunk.

pelvic tilt

sagittal plane position, can be anterior or posterior

pelvic rotation

transverse plane position, can be anterior or posterior

pelvic obliquity

frontal plane position, where one side of the pelvis is superior or inferior to the other

• transitioning body from one place to another

• transferring from one surface to another

• navigating an environment

What can pelvis issues make people struggle with regarding functional mobility?

Incontinence

loss of control of bowels or bladder

pelvic floor weakness

What results from incontinence?

stress incontinence

abdominal pressure increases from a bodily function (like sneezing or coughing)

• causes involuntary leaking of urine or feces

urge incontinence

inability to control the bladder or bowels until appropriate

• can’t hold it once they feel like they need to go

femoral neck fracture, intertrochanteric fracture (lower)

What are the two types of proximal hip fractures?

Total Hip Arthroplasty (THA) and Hemiarthroplasty

two types of hip arthroplasty

Total Hip Arthroplasty (THA)

arthroplasty, where the femoral head and acetabulum are replaced, a metal piece is put in for both of them

Hemiarthoplasty

Arthroplasty, where the femoral head is replaced

hip rotation, adduction, flexion

What might be included in hip precautions?