Applied Kinesiology Exam 3

HIP & PELVIC GIRDLE

HIP & PELVIC GIRDLE

ball & socket joint

femur (head)

Pelvic girdle

ilium, ischium, and pubis

BONES of the Hip

What type of joint?

What connects with the acetabulum of the pelvic girdle?

What is the right and left pelvic bones joined together posteriorly by the sacrum (extension of the spinal column) ?

What does the pelvic bones consist of?

stable

bony

strong

large supportive

weight bearing & locomotion

HIP (acetabular femoral) is

relatively _________

__________ architecture

__________ ligaments

__________ _____________ muscles

_____________ and __________ are enhanced significantly by the hips wide range of motion

-Provides the ability to run, cross-over, side-step and jump

sacrum

coccyx, sacrum

BONES of Hip and Pelvic Girdle

What is the extension of the spinal column with 5 fused vertebrae?

The _________ extends inferiorly from the ________

3

upper two fifths

posterior & lower two fifths

Anterior & lower one fifth

BONES of Hip and Pelvic Girdle

Pelvic bone is divided into how many areas?

illium =

Ischium =

Pubis =

symphysis pubis (amphiarthrodial)

sacroiliac joints

JOINTS of Pelvic Girdle

Anterior:

Two pelvic bones join to form _______

Posterior:

Sacrum is between the 2 pelvic bones and forms the _____________

Strong ligaments unite these bones to form rigid, slightly movable joints

minimal oscillating-type movements

entire pelvic girdle and hip joints

flexion & extension, rotation

increases

Things to know about hip and pelvic joints:

Very _______________ occur in sacroiliac joints (walking)

Movements usually involve the ENTIRE ____________

In walking, hip _______________ occur with pelvic girdle _________ (forward in hip flexion & backward in hip extension)

Pelvic rotation _________ the length of stride in running; in kicking it results in a greater distance or more speed to the kick

Hip flexion

Hip extension

Hip abduction

Hip adduction

Hip external rotation

Hip internal rotation

Hip diagonal abduction

Hip diagonal adduction

Anterior pelvic rotation

Posterior pelvic rotation

Movements of Hip and Pelvic Girdle

-Movement of femur straight anteriorly toward pelvis

-Movement of the femur straight posteriorly away from the pelvis; sometimes referred to as hyperextension

-Movement of femur laterally to side away from midline

-Movement of femur medially toward midline

-Rotary movement of femur laterally around its longitudinal axis away from midline

-Rotary movement of femur medially around its longitudinal axis toward the midline

-Movement of the femur in a diagonal plane away from the midline of the body

-Movement of the femur in a diagonal plane toward the midline of the body

-Anterior movement of the upper pelvis; iliac crest tilts forward in the sagittal plane

-Posterior movement of upper pelvis; iliac crest tilts backward in the sagittal plane

mobile

glenohumeral

Multiaxial

stability

hip joint subluxations & dislocations

Diarthrodial

acetabulum

anteriorly

Hip JOINT

Acetabulofemoral joint - Extremely _______ joint (second to __________)

_________ arrangement

Bony architecture provides _____________

Relatively few __________

____________ type joint

Femoral head inserts into the ________

Reinforced by extremely STRONG & DENSE ligamentous capsule, especially _________

up toward the trunk

downward

flexion

Hip & Pelvic Girdle Muscles

Hip flexors are used in moving the thighs ________

Hip extensors muscles are used eccentrically when the pelvis and trunk move __________ slowly on the femur and concentrically when trunk is raised on femur (rising to standing position)

In the downward phase of knee-bend exercises, movement at the hip and knees is _________

Iliofemoral or Y ligament

Pubofemoral ligament

Ischiofemoral ligament

Acetabulofemoral joint

- located anteriorly, prevents hyperextension

- located anteromedially & inferiorly, limits excessive extension & abduction

- located posteriorly, extends from ischium to trochanteric fossa of femur, limits internal rotation

labrum

stability

shock absorption

Acetabulofemoral joint

Similar to glenoid fossa of shoulder joint, the acetabulum is lined around most of its periphery with a __________ to enhance _________ and provide some __________

Acetabulofemoral joint

Ischiofemoral ligament - located posteriorly, extends from ischium to trochanteric fossa of femur, limits internal rotation

Iliopsoas

Pectineus

Rectus femoris

Sartorius

Adductor brevis

Adductor longus

Adductor magnus

Gracilis

Gluteus maximus

Biceps femoris

Semitendinosus

Semimembranosus

External rotators

Gluteus medius

Gluteus minimus

External rotators

Tensor fasciae latae

Hip & PG muscles

Anterior - primarily hip FLEXION

1.

2.

3.

4.

Medial - primarily hip ADDUCTION

1.

2.

3.

4.

Posterior - primarily hip EXTENSION

1.

2.

3.

4.

5.

Lateral - primarily hip ABDUCTION

1.

2.

3.

4.

5.

inner surface of ilium, T12, 1-5 lumbar vertebrae and bottom of sacrum

pectineal line, trochanter femur and shaft

flexion of the hip

Iliopsoas

Origin:

Insertion:

Activity:

lower extremity; supine

Leg raising

flexing

lift the legs

Strength & Conditioning

The iliopsoas are powerful in raising the ___________ ____________ from the floor while in a _________ position

Origin of the psoas on the lower back moves the lower back anteriorly, or in the supine position, pulls up the lower back as it raises the thighs (lower back problems are often aggravated; bilateral 6-in raises are not recommended)

_________________ is primarily hip flexion and not abdominal action. Prolonged leg raises can cause hyperextension and increase injury risk

The more flexed and/or abducted the hips are, the less the iliopsoas will be activated with abdominal strengthening exercises

**Exercised by supporting the arms on a dip bar or parallel bar and then ______ the hips to ________

Bent knees

Straight knees

anterior inferior iliac spine & groove above acetubulum

superior aspect of patella & patellar tendon to tibial tuberosity

Flexion of Hip & Extension of Knee

Rectus Femoris

O:

I:

A:

squats

knee extensions

box jumps

clean & jerks

Rectus Femoris Strength & Conditioning

Can rotate the pelvis anteriorly like the iliopsoas

Running, jumping, hopping and skipping

Strength: Use hip flexion (_________) extensions (___________) exercises to strengthen

Power: _______ (plyometrics), ___________

Stretching: Side lying position by having a partner take the knee into full flexion and simultaneously take the hip into extension

anterior superior iliac spine & notch just below spine of ilium

anterior medial condyle of tibia

Flexion of Hip & Extension of Knee

similar to I and RF

Sartorius LONGEST muscle in the body

O:

I:

A:

Strength Training & Conditioning:

space 1 inch wide in front of pubis above crest

rough line leading from lesser trochanter to linea aspera

flexion of hip & adduction of hip

Pectineus

O:

I:

A:

front of inferior public ramus

lower 2/3 of pectineal line of femur & upper half of lineal aspera

adduction of hip

Adductor Brevis

O:

I:

A:

anterior pubis just below crest

middle third of linea aspera

adduction of hip

Adductor Longus

O:

I:

A:

edge of entire ramus of pubis

whole length of linea aspera, inner condyloid ridge and adductor tubercle

adduction of hip

Adductor Magnus

O:

I:

A:

anterior medial edge of ramus of pubis

anterior medial surface of tibia below condyle

adduction of hip

Gracilis

O:

I:

A:

Any movement with resistance where the thighs move toward each other

Strength & Conditioning for Medial Muscles

ischial tuberosity

upper anterior medial surface of tibia

hip extension & flexion of knee

Semitendinosus

O:

I:

A:

ischial tuberosity

posteriormedial tibial condyle

flexion of hip & flexion of knee

Semimembranosus

O:

I:

A:

ischial tuberosity & lower half of linea aspera

lateral condyle of tibia & head of fibula

extension of hip & flexion of knee

Biceps Femoris

O:

I:

A:

hamstring curls

deadlifts

Strength & Conditioning

Knee flexion exercise against resistance (________________)

_____________ work because each of the hamstring muscles cause posterior pelvic tilt during the downward phase of the movement

posterior 1/4 ilium crest & posterior sacrum and coccyx

ridge of lateral surface of greater trochanter

hip extension

Gluteus Maximus

O:

I:

A:

Gluteus maximus is activated when the pelvis and femur goes beyond 15° of extension

Strong action in running and jumping

Extension of the thigh from a squatting position

The gluts are most emphasized when the hip starts from a flexed position and moves to full extension

Resistance training movements: Squats, Leg press, Hacksquats, Lunges, Hip extensions

lateral surface ilium

posterior & middle greater trochanter of femur

abduction of hip

Gluteus Medius

O:

I:

A:

lateral surface of ilium below gluteus medius

anterior surface of greater trochanter of femur

hip abduction & flexion of hip

Gluteus Minimus

O:

I:

A:

anterior iliac crest

1/4 of the way into thigh into the iliotibial tract

Tensor Fasciae Latae

O:

I:

A:

ANKLE & FOOT JOINTS

ANKLE & FOOT JOINTS

Support

Propulsion

Improper footwear and foot mechanics

Gait abnormalities

Functions of the foot include

1.___________

2.__________

What can lead to foot injury?

____________

___________

26

Connect with the thigh through the tibia and fibula

Transferred from the tibia to the talus and the calcaneus (tarsal bones)

Navicular

Cuboid

5

5

3

2

BONES of Foot & Ankle

-How many bones does each foot have to form an arch?

-How do they connect?

-How is body weight transferred ?

5 other rear and midfoot tarsal bones:

What is between the talus and 3 cuneiform bones?

What is between the calcaneus and 4th & 5th metatarsals?

How many metatarsals? - anterior to tarsals

How many phalanges?

___ phalanxes in each except 1st toe (____ phalanxes)

enlarged and protrude horizontally and inferiorly

pulley

inversion & eversion

BONES

Distal malleoli of tibia and fibula:

How does it look?

Serve as a __________ for posterior tendons to increase mechanical advantage of muscles in performing __________ and _________ actions

Syndesmotic amphiarthrodial joint

Ligaments and a strong, dense interosseus

support

sprained

High ankle sprain

JOINTS

Tibiofibular joint

What type of joint?

_________________________________ membrane between tibia and fibula shafts provide _____________.

Distal joint becomes _______ occasionally in heavy contact sports

- for example _______

Hinge type joint

50

15 to 20

3 to 5

JOINTS

Talocrural (Ankle) Joint

What type of joint? _______ which includes the trochlear surface of the talus and distal tibia and fibula

Permits _____° of plantar flexion and ____ to ___° of dorsiflexion

The fibula rotates ___ to ___° externally with ankle dorsiflexion & ___ to ___° internally during plantarflexion

Inversion

Eversion

JOINTS

Subtalar and transverse tarsal joints

__________ - weight on outer edge

__________ - weight on inner edge

Metatorsophalangeal joints

Ankle sprains

Sprain

Inversion

JOINTS

What are common injuries?

What involves stretching or tearing of one or more ligaments?

Most common ankle sprain results from excessive _______ that causes damage to the lateral ligamentous structures (anterior talofibular ligament and calcaneofibular ligament)

Ankle sprains due to excessive eversion forces injures the deltoid ligament (far less common)

arches

extends from the calcaneus to the 3 medial metatarsals

extends from the calcaneus to the 4th and 5th metatarsals

Extends across the foot from the 1st metatarsal to the 5th metatarsal

JOINTS

LIGAMENTS in foot and ankle maintain _______

Two longitudinal arches:

-Medial longitudinal arch =

-Lateral longitudinal arch =

Transverse arch=

medial calcaneal tuberosity

proximal phalanges of the toes

medial longitudinal arch

JOINTS

Plantar fascia (plantar aponeurosis)

A broad structure extending from the_______________ to the _______________

Assists in stabilizing the ________________ and in propelling the body forward during the latter part of the stance phase

Plantar fasciitis

Dorsiflexion

Plantar flexion

Eversion

Inversion

Pronation

Supination

Toe flexion

Toe extension

MOVEMENTS

-Movement of the top of the ankle and foot toward the anterior tibia

-Movement of the ankle and foot away from the tibia

-Turning the ankle and foot outward, away from the midline; weight is on the medial edge of the foot

-Turning the ankle and foot inward, toward the midline; weight is on the lateral edge of the foot

-Combination of ankle dorsiflexion, subtalar eversion, and forefoot abduction (toe-out)

-Combination of ankle plantar flexion, subtalar inversion, and forefoot adduction (toe-in)

-Movement of the toes toward the plantar surface of the foot

-Movement of the toes away from the plantar surface of the foot

DORSIFLEXORS:

Tibialis anterior

peroneus tertius

extensor digitorum longus

extensor hallucis longus

EVERTORS

Peroneus longus and brevis

PLANTAR FLEXORS

Gastrocnemius

soleus

plantaris

Flexor digitorum longus

flexor hallucis longus

popliteus

tibialis posterior

(plantar flexors and inverters; except popliteus)

MUSCLES

Divided into four compartments of dense fascia which facilitates venous return and prevents excessive swelling of muscles during exercise

1. Anterior compartment =

2. Lateral compartment

3. Superficial posterior compartment

4. Deep posterior compartment

anterior

acute or chronic

passive stretching

flexing

Paresthesia

MUSCLES

Compartment Syndrome

-Most common in _______ compartment

-May be ______ or _________

-May occur secondarily to muscle injury, trauma, or overuse

Pain is aggravated by ___________ of the muscle group within the compartment or by actively ________ it and is not relieved by analgesia up to and including morphine

What is ("pins & needles") in the cutaneous nerves? ___________

paralysis

tense and firm

tense, swollen, shiny skin

MUSCLES

__________ of the limb is often a late finding. The compartment may also feel very _____ and _____ (pressure). Feet and even legs "fall asleep" because of inadequate blood flow.

Diminished pulse rarely occurs in patients, as pressures that cause compartment syndrome are often well below arterial pressure and pulse is only affected if the relevant artery is contained within the affected compartment.

_____________________ skin, sometimes with obvious bruising of the skin.

Congestion of the digits with prolonged capillary refill time.

shin splints

musculotendinous

tibialis posterior, tibialis anterior, and extensor digitorum longus tendons

Sprints and long-distance running

plantar flexors & strengthening dorsiflexors

Acute & chronic injuries are common

-common term describing painful leg condition often associated with running activities=

-Attributed to a number of different specific ______________ injuries

-Most often involves inflammation of the ________________________________

_________________________ are common causes

-May be partially prevented by stretching ____________ & strengthening _______________

Painful cramps

dorsiflexion

Acute muscle spasm in gastrocnemius and soleus =

May be relieved through active and passive ___________________

Causes are unclear but include neuromotor and or muscle fatigue, dehydration, electrolyte depletion, poor conditioning

Complete rupture of Achilles tendon

upper 2/3 of lateral tibia

inner medial cuneiform/ 1st metatarsal

dorsiflexion of ankle & inversion of foot

Tibialis Anterior

O:

I:

A:

distal 3rd anterior fibula

base of 5th metatarsal

dorsiflexion of ankle & eversion of foot

Peroneus Tertius

O:

I:

A:

lateral condyle of tibia & head and upper 2/3 fibula

tops of middle & distal phalanges of 4 lesser toes (NOT BIGT TOE)

dorsiflexion of ankle & eversion of foot

Extensor Digitorum Longus

O:

I:

A:

middle 2/3 of medial, anterior fibula

top of distal phalanx of great toe (BIG TOE)

dorsiflexion of ankle & inversion of foot

Extensor Hallicus Longus

O:

I:

A:

Strengthening is accomplished by manually applying a downward force on the toes while attempting to extend them

Strength and Conditioning: Dorsiflexors

lateral 2/3 of fibula

tuberosity of 5th metatarsal bone

eversion of foot & plantar flexion of ankle

Peroneus Brevis

O:

I:

A:

head and upper 2/3 of fibula

undersurface of medial cuneiform & 1st metatarsal bone

eversion of foot & plantar flexion ankle

Peroneus Longus

O:

I:

A:

posterior 2 condoles of femur

posterior calcaneus

plantar flexion of ankle & flexion of knee

Gastrocnemius

O:

I:

A:

proximal 2/3 of tibia & fibula (posterior)

posterior calcaneus

plantar flexion of ankle

Soleus

O:

I:

A:

upper half of interosseous membrane

inferior navicular, cuneiform, and cuboid bone

2nd 3rd & 4th metatarsal bone

plantar flexion of ankle & inversion of foot

Tibialis Posterior

O:

I:

A:

middle 3rd posterior tibia

distal phalanx of 4 lesser toes

plantar flexion of ankle & inversion of foot

Flexor Digitorum Longus

middle 2/3 fibula

undersurface of distal phalanx great toe

plantar flexion of ankle & inversion of foot

Flexor Hallucis Longus

O:

I:

A:

Running, jumping, hopping and skipping

Heel-raising exercises with the knees in full extension (maximizes contribution of the gastrocnemius) and the toes resting on a block of wood with a barbell on the shoulders (or on a leg press machine)

Seated calf raises (however, flexion of the knee reduces contribution of the gastrocnemius and places more work on the soleus)

Strength and Conditioning: Plantar Flexors

KNEE JOINT

KNEE JOINT

knee

Hinge joint

tibial condyles

tibia

What is the largest diarthrodial joint in the body?

What type of joint is it?

Femoral condyles articulate on the______________

The ______ bears most of the weight

Fibula

Sesamoid (floating) bone

quadriceps & patellar tendon

pulley

knee extension

What is the attachment for the knee joint structures but does not articulate with the knee and is not part of the knee joint?

Patella

- What type of bone?

-Imbedded in __________ & _____________

-Serves similar to a __________ in improving angle of pull, resulting in greater mechanical advantage in _____________

-Medial and lateral femoral condyles

-Medial and lateral tibial condyles

-Tibial tuberosity

-Gerdy's tubercle

-Upper anterior medial tibial surface

-Head of fibula

-Patella (knee cap)

Key bony landmarks of the KNEE:

provide

produce

articular cartilage

(menisci)

tibia

JOINTS

Ligaments __________ static stability while the quadriceps & hamstrings ___________ dynamic stability during contraction

The surface of the femur and tibia are protected by ___________ (true for all diarthrodial joints)

- Specialized cartilage (__________) form cushions between the bones

- _________ are attached to the _______, deepen the tibial plateaus and enhance stability

medial meniscus

lateral meniscus

thicker

taper down

slip

small ligaments

large open

closed

JOINTS

What forms a receptacle for the medial femoral condyle?

What forms a receptacle for the lateral femoral condyle?

-Both are _______ on the outside border & __________ to the inside border

-Can ________ about slightly, but are held in place by various ______

-Medial meniscus has a ___________ C appearance

-Lateral meniscus has a _______ C configuration

Either or both

compression

shear forces

running

Injuries to the MENISCI

______ or ______ menisci may be torn in several different areas from a variety of mechanisms

Tears often occur due to significant _____________ and _____________ during rotation while flexing or extending during quick directional changes in _________

tibia & femur

Ligaments

Anterior (ACL) and posterior cruciate ligaments (PCL)

-Cross within the knee between the ________ & __________

-Vital in maintaining anterior & posterior stability, respectively, as well as rotatory stability

most serious

women than men

tibia FOWARD on the femur

arthroscopic removal

patellar tendon

semitentinosus

Anterior cruciate ligament (ACL)

One of ______________ injuries to the knee

-More common in _________ than _____ (in similar sports such as basketball and soccer)

-Often involves non-contact rotary forces associated with planting & cutting, hyperextension, or by violent quadriceps contraction which pulls the __________________________________

-Detailed conditioning to improve neuromuscular coordination and control of the hamstrings and quads, proper knee alignment and landing techniques decrease risk of injury

-Reconstruction after a tear requires ________________ ____________ of the torn ACL and usually involves autograft (or allograft) with a part of the _____________ or ______________

Rarely

direct contact

partial

Nonsurgical

Posterior cruciate ligament (PCL)

-_____________ injured

-Injuries usually occur with _____________ with an opponent or the playing surface

-Most are _________ tears

-_____________ treatment and rehabilitation

Medial collateral ligament (MCL)

Maintains medial stability by resisting valgus forces or preventing the knee from being abducted

contact or collision

lateral

MCL Injuries

-Injuries are common in ________ or _________

sports

-Teammate or opponent falls against ________ aspect of knee or leg causing medial opening of knee joint & stress to medial ligamentous structures

Lateral collateral ligament (LCL)

Infrequently injured ligament of the knee is?

Anterolateral ligament (ALL) = not everyone has this!

synovial fluid

patellar tendon

"plica"

JOINTS

Synovial cavity

-Supplies the knee with ____________

-Lies under the patella and between surfaces of the tibia & femur

"Capsule of the knee"

Infrapatellar fat pad

-Located just posterior to the ___________

-An insertion point for synovial folds of tissue known as "_______" (extension of the synovial capsule)

-Can be irritated or inflamed with injuries or overuse of the knee

10

synovial cavity

Bursae

-More than _____ bursae in and around the knee

-Some are connected to _____________

-Absorb shock and reduce friction

Knee Flexion

Knee Extension

External rotation of knee

Internal rotation of knee

Movements of the KNEE

-Bending or decreasing the angle between the femur & lower leg (heel moving toward buttocks)

-Straightening or increasing angle between the femur & lower leg

-Rotary movement of the lower leg laterally away from the midline

-Rotary movement of the lower leg medially toward the midline

extend the knee

anterior compartment of thigh

Rectus femoris

Vastus lateralis

Vastus intermedius

Vastus medialis

MUSCLES

Quadriceps muscles

What do they do to the knee?

Where are they located?

Consists of 4 muscles=

ASIS to the center of patella

patella to center of tibial tuberosity

intersection

15

20

higher

wider

Q angle

-Central line of pull for entire quadriceps runs from _____________________

-Line of pull of patella tendon runs from center of _____________________

-Angle formed by the _____________ of these two lines at the patella is the Q angle

-Normally, angle will be ______ degrees or less for males & ______ degrees or less in females

-Generally, females have ________ angles due to a ___________ pelvis

Higher

________________ Q angles generally predispose people in varying degrees to a variety of potential knee problems including lateral patellar subluxation or dislocation, patellar compression syndrome, chondromalacia, and ligamentous injuries

knee flexion

posterior compartment of the thigh

Semitendinosus - medial, internal rotator

Semimembranosus - medial, internal rotator

Biceps femoris - lateral, external rotator

Hamstrings

-Responsible for ______________

-Located in the __________________

Consists of 3 muscles=

patella then on the tibial tuberosity via the patellar tendon

vertical jump tests

25% to 33%

Rectus femoris (two-joint), vastus medialis, vastus intermedius, vastus lateralis (largest)

-ALL attach (insert) on the _________

-All 4 are superficial & palpable except the vastus intermedius (under rectus femoris)

-Power may be determined by ___________

-Generally desired to be ____% to ____% stronger than hamstrings

intertrochanteric line

lateral patella and patellar tendon tibial tuberosity

extension of knee

Vastus Lateralis

O:

I:

A:

upper 2/3 femur

extension of knee

Vastus Intermedius

O:

I:

A:

whole length of middle femur

patella & palla tendon tibial tuberosity

extension of knee

Vastus Medialis

O:

I:

A:

Strength Conditioning

Leg extensions, Squats, Leg press, Hacksquats, Lunges

Semitendinosus

Biceps femoris

Semimembranosus

3 Hamstring muscles =

very common

Running muscles

Antagonists

cordlike

HAMSTRINGS

Hamstring muscle strains are __________

"_______________" function in acceleration

Softball and basketball example

_______________ to quadriceps muscles at the knee

Named for ______________ attachments at the knee

All originate on the ischial tuberosity of the pelvis

TRUNK & SPINAL COLUMN

TRUNK & SPINAL COLUMN

24 articulating and 9 fused vertebrae

7 cervical (neck) vertebrae

12 thoracic (chest) vertebrae

5 lumbar (lower back) vertebrae

5 sacrum (posterior pelvic girdle) vertebrae

4 coccyx (tail bone) vertebrae

Shape of the first 2 cervical vertebrae allow for extensive rotary movements of the head, as well as forward and backward movement