Hip & Pelvis

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138 Terms

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hip functions

- link between the trunk and lower extremities

- supports the upper body in erect position and sitting

- provides mobility for ambulation

- functions primarily in "closed chain"

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pelvic girdle

comprised of low back (L4 & L5), pelvis, and femur

<p>comprised of low back (L4 &amp; L5), pelvis, and femur</p>
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pelvic ring

"ring" formed by the pelvic girdle

*between the 2 pelvic bones

<p>"ring" formed by the pelvic girdle</p><p>*between the 2 pelvic bones</p>
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pelvic bone

aka os coxae, coxal bone, or innominate

*ilium, ischium, & pubis

**separate bones until skeletal maturity (15-25 years)

<p>aka os coxae, coxal bone, or innominate</p><p>*ilium, ischium, &amp; pubis</p><p>**separate bones until skeletal maturity (15-25 years)</p>
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iliac crest

upper margin of iliac bones

<p>upper margin of iliac bones</p>
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PSIS (posterior superior iliac spine)

the point of the iliac crest in back

<p>the point of the iliac crest in back</p>
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ASIS (anterior superior iliac spine)

the point of the iliac crest in front

<p>the point of the iliac crest in front</p>
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greater sciatic notch

Name this specific part of the pelvic bone.

<p>Name this specific part of the pelvic bone.</p>
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lesser sciatic notch

Name this specific part of the pelvic bone.

<p>Name this specific part of the pelvic bone.</p>
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ischial tuberosity

Name this specific part of the ischium.

<p>Name this specific part of the ischium.</p>
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ischial spine

Name this specific part of the pelvic bone.

<p>Name this specific part of the pelvic bone.</p>
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obturator foramen

Name this specific part of the pelvic bone.

HINT: obturator VAN runs through here

<p>Name this specific part of the pelvic bone.</p><p>HINT: obturator VAN runs through here</p>
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AIIS (anterior inferior iliac spine)

a bony projection on the ilium below the ASIS

<p>a bony projection on the ilium below the ASIS</p>
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ilium, ischium, pubis

The acetabulum is composed of what 3 bones?

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articular surface of acetabulum

horseshoe shaped "lunate surface"

*faces anterior, inferior, lateral (50 degrees inferior, 20 degrees anterior)

<p>horseshoe shaped "lunate surface"</p><p>*faces anterior, inferior, lateral (50 degrees inferior, 20 degrees anterior)</p>
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pubic symphysis, sacroiliac joint, coxofemoral joint

What are the 3 articulations of the innominate bone?

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pubic symphysis

two pubic bones covered with hyaline cartilage, with a fibrocartilaginous disc

*synarthrodial or amphiarthrodial joint

**some motion occurs (2 mm of translation, 3 degrees of rotation)

<p>two pubic bones covered with hyaline cartilage, with a fibrocartilaginous disc</p><p>*synarthrodial or amphiarthrodial joint</p><p>**some motion occurs (2 mm of translation, 3 degrees of rotation)</p>
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hyaline

The pubic symphysis is covered by which type of cartilage?

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sacroiliac joint

auricular surface of ilia (fibrocartilage) and the first 3 sacral bones (fused and covered with hyaline cartilage)

*part synovial and part fibrous

**diarthrodial in childhood, modified synarthrodial in adulthood

<p>auricular surface of ilia (fibrocartilage) and the first 3 sacral bones (fused and covered with hyaline cartilage)</p><p>*part synovial and part fibrous</p><p>**diarthrodial in childhood, modified synarthrodial in adulthood</p>
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fibrocartilage, hyaline cartilage

In the SI joint, the ilia are covered by _______________________, while the sacrum is covered with ______________ ___________________.

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coxofemoral joint

hip joint

ball and socket diarthrodial joint between the acetabulum of the innominate and the head of the femur

<p>hip joint</p><p>ball and socket diarthrodial joint between the acetabulum of the innominate and the head of the femur</p>
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ilium, ischium, pubic

The acetabulum is 2/5 ____________, 2/5 ____________, and 1/5 __________ bone.

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mechanical advantage

Because the greater trochanter is far from the head of the femur, it increases what?

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articular cartilage

The head of the femur (excluding the fovea) is covered by what?

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femoral head

1/2 to 2/3 of a sphere, almost completely covered by articular cartilage

<p>1/2 to 2/3 of a sphere, almost completely covered by articular cartilage</p>
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fovea

small depression on the femoral head that serves as an attachment for the ligamentum teres

<p>small depression on the femoral head that serves as an attachment for the ligamentum teres</p>
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femoral neck

3/4 the diameter of the head

*angle of inclination

*angle of torsion

<p>3/4 the diameter of the head</p><p>*angle of inclination</p><p>*angle of torsion</p>
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angle of inclination

angle between the femoral neck/head and the femoral shaft (frontal plane)

infant = 150-175 degrees

adult = 125 degrees (110-144 range)

<p>angle between the femoral neck/head and the femoral shaft (frontal plane)</p><p>infant = 150-175 degrees</p><p>adult = 125 degrees (110-144 range)</p>
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coxa vara

decreased angle of inclination

*less than 110 degrees

<p>decreased angle of inclination</p><p>*less than 110 degrees</p>
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coxa valga

increased angle of inclination

*greater than 144 degrees

<p>increased angle of inclination</p><p>*greater than 144 degrees</p>
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angle of torsion

angle of the head/neck of the femur with a line through the femoral condyles

*rotation in transverse plane

infant = 30-40 degrees

adult = 10-15/20 degrees

(M=15, F=18)

<p>angle of the head/neck of the femur with a line through the femoral condyles</p><p>*rotation in transverse plane</p><p>infant = 30-40 degrees</p><p>adult = 10-15/20 degrees</p><p>(M=15, F=18)</p>
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anteversion

turning forward

>15/20 degrees

<p>turning forward</p><p>&gt;15/20 degrees</p>
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retroversion

turning backward

<15/20 degrees

<p>turning backward</p><p>&lt;15/20 degrees</p>
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greater trochanter

attachment for:

1. glut med

2. glut min

3. piriformis

4. gemellus sup

5. obturator internus

6. gemellus inf

7. vastus lateralis

<p>attachment for:</p><p>1. glut med</p><p>2. glut min</p><p>3. piriformis</p><p>4. gemellus sup</p><p>5. obturator internus</p><p>6. gemellus inf</p><p>7. vastus lateralis</p>
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lesser trochanter

attachment for:

1. iliacus

2. psoas

<p>attachment for:</p><p>1. iliacus</p><p>2. psoas</p>
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insertion of obturator externus

trochanteric fossa of femur

<p>trochanteric fossa of femur</p>
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linea aspera

proximally becomes the pectineal line and gluteal tuberosity

attachment for:

1. 3 vasti muscles

2. 3 adductors

3. short head of biceps fem

4. glut max

5. pectineus

<p>proximally becomes the pectineal line and gluteal tuberosity</p><p>attachment for:</p><p>1. 3 vasti muscles</p><p>2. 3 adductors</p><p>3. short head of biceps fem</p><p>4. glut max</p><p>5. pectineus</p>
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shaft

bows with posterior concavity/anterior convexity

*b/c of weight bearing

<p>bows with posterior concavity/anterior convexity</p><p>*b/c of weight bearing</p>
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center edge angle

the degree to which the acetabulum covers the femoral head

<p>the degree to which the acetabulum covers the femoral head</p>
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deeper acetabulum

What does a LARGE center edge angle indicate?

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increased chance of dislocation

What does a SMALL center edge angle indicate?

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labrum

deepens acetabulum

*increases stability

**increases contact area between the femur and acetabulum

<p>deepens acetabulum</p><p>*increases stability</p><p>**increases contact area between the femur and acetabulum</p>
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transverse acetabular ligament

bridges a gap in the inferior margin of the acetabular labrum

<p>bridges a gap in the inferior margin of the acetabular labrum</p>
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joint capsule

encloses head and proximal neck, attaches to intertrochanteric line anteriorly and 1.5 cm above the intertrochanteric crest posteriorly

<p>encloses head and proximal neck, attaches to intertrochanteric line anteriorly and 1.5 cm above the intertrochanteric crest posteriorly</p>
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zona orbicularis

deep fibers of the capsule which run circular around the neck of femur

<p>deep fibers of the capsule which run circular around the neck of femur</p>
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iliofemoral ligament

Y ligament from AIIS to intertrochanteric line

*fan-shaped/inverted Y

(A IN IMAGE)

<p>Y ligament from AIIS to intertrochanteric line</p><p>*fan-shaped/inverted Y</p><p>(A IN IMAGE)</p>
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pubofemoral ligament

connects pubic bone to underside of femoral neck

<p>connects pubic bone to underside of femoral neck</p>
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ischiofemoral ligament

connects ischial portion of acetabulum to greater trochanter

<p>connects ischial portion of acetabulum to greater trochanter</p>
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extension, flexion

The iliofemoral, pubofemoral, and ischiofemoral ligaments are all tense in __________________ and slack in _______________.

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ligamentum teres

ligament of the head of the femur

*NOT really strong, but does increase hip stability

**protects artery to head of femur

<p>ligament of the head of the femur</p><p>*NOT really strong, but does increase hip stability</p><p>**protects artery to head of femur</p>
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interarticular, extrasynovial

The ligamentum teres can be described as _____________________ and __________________.

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bursae

fluid filled sacs that reduce friction

*about 20 in the hip

**iliopectineal & trochanteric

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30 degrees flexion, 30 degrees abduction, slight ER

What is the open pack position for the coxofemoral joint?

HINT: frog leg

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full extension, medial rotation

What is the close pack position for the coxofemoral joint?

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90 degrees of flexion, mod. abduction, slight lateral rotation

What is the position of greatest joint congruency of the hip?

HINT: NOT closed pack position

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anteversion, angle of inclination, center edge angle

What 3 things does coxofemoral congruency depend on?

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mechanical axis

adductors IR femur (despite posterior insertion)

<p>adductors IR femur (despite posterior insertion)</p>
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anatomical axis

through the shaft of femur

*head of femur to center of knee

<p>through the shaft of femur</p><p>*head of femur to center of knee</p>
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anteriorly, superiorly

In anatomical position, there is exposure of the femoral head ________________ and ________________ due to the directions the acetabulum and femoral head face.

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quadruped

In the _________________ position, there is increased congruency.

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flexion

There is the most congruency during which hip motion?

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iliofemoral ligament, iliopsoas muscle

What 2 structures contribute to the ANTERIOR aspect of the hip joint stability?

HINT: 1 ligament, 1 muscle

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glutes, ischiofemoral ligament

What 2 structures contribute to the POSTERIOR aspect of the hip joint stability?

HINT: 1 muscle group, 1 ligament

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HAT, ground reaction force, muscular contraction

Force transmission at the hip occurs from what 3 places?

HINT: above, below, within

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cantilever configuration

bending relationship between femoral head/neck vs shaft

*results in trabecular patterns within head/neck

<p>bending relationship between femoral head/neck vs shaft</p><p>*results in trabecular patterns within head/neck</p>
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zone of weakness

area in the femoral neck have fewer trabecular fibers

<p>area in the femoral neck have fewer trabecular fibers</p>
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3 (F/E, IR/ER, AB/AD)

How many degrees of freedom does the hip have?

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0-120 degrees

What is the normal ROM for hip FLEXION?

<p>What is the normal ROM for hip FLEXION?</p>
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0-20 degrees

What is the normal ROM for hip EXTENSION?

<p>What is the normal ROM for hip EXTENSION?</p>
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0-45 degrees

What is the normal ROM for hip ABDUCTION?

<p>What is the normal ROM for hip ABDUCTION?</p>
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0-30 degrees

What is the normal ROM for hip ADDUCTION?

<p>What is the normal ROM for hip ADDUCTION?</p>
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0-45 degrees

What is the normal ROM for hip INTERNAL ROTATION?

<p>What is the normal ROM for hip INTERNAL ROTATION?</p>
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0-45 degrees

What is the normal ROM for hip EXTERNAL ROTATION?

<p>What is the normal ROM for hip EXTERNAL ROTATION?</p>
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30 degrees flexion, 10 degrees extension, 5 degrees abduction

What is the functional ROM needed for WALKING?

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60 degrees flexion

What is the functional ROM needed for STAIRS?

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90 degrees flexion (could be less than 90 if lumbar spine is rounded)

What is the functional ROM needed for SITTING?

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pelvis, femur

In most activities the _____________ moves over a fixed ___________.

HINT: closed chain

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sagittal

Anterior and posterior pelvic tilting occurs in what plane?

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neutral position (of pelvis)

ASIS and pubic symphysis are oriented vertically

<p>ASIS and pubic symphysis are oriented vertically</p>
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anterior tilt

force couple of hip flexors and back extensors

*ASIS is anterior to PS = hip flexion

<p>force couple of hip flexors and back extensors</p><p>*ASIS is anterior to PS = hip flexion</p>
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posterior tilt

force couple of hip extensors and trunk flexors

*ASIS is posterior to PS = hip extension

<p>force couple of hip extensors and trunk flexors</p><p>*ASIS is posterior to PS = hip extension</p>
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lateral tilt

frontal plane motion of pelvis around one supporting limb

*named according to motion of opposite side from the supporting limb

<p>frontal plane motion of pelvis around one supporting limb</p><p>*named according to motion of opposite side from the supporting limb</p>
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hip elevation (hike)

abduction of stance limb

(A IN IMAGE)

<p>abduction of stance limb</p><p>(A IN IMAGE)</p>
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hip depression (drop)

adduction of stance limb

(B IN IMAGE)

<p>adduction of stance limb</p><p>(B IN IMAGE)</p>
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rotation

transverse plane motion of the pelvis around one supporting limb

*named according to motion of opposite side from supporting limb

<p>transverse plane motion of the pelvis around one supporting limb</p><p>*named according to motion of opposite side from supporting limb</p>
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anterior pelvic rotation

IR of stance limb

<p>IR of stance limb</p>
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posterior pelvic rotation

ER of stance limb

<p>ER of stance limb</p>
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open chain arthrokinematics

1. flexion

2. extension

3. abduction

4. adduction

5. internal rotation

6. external rotation

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anterior/superior, posterior/inferior

During hip FLEXION, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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posterior/inferior, anterior/superior

During hip EXTENSION, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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superior/lateral, inferior/medial

During hip ABDUCTION, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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inferior/medial, superior/lateral

During hip ADDUCTION, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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anterior/medial, posterior/lateral

During hip IR, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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posterior/lateral, anterior/medial

During hip ER, the convex femoral head rolls ____________/_____________ and glides ______________/____________.

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closed chain arthrokinematics

1. anterior tilt

2. posterior tilt

3. upward lateral tilt

4. downward lateral tilt

5. anterior rotation

6. posterior rotation

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anterior, anterior

During pelvic ANTERIOR TILT, the concave acetabulum rolls _____________ and glides _______________.

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posterior, posterior

During pelvic POSTERIOR TILT, the concave acetabulum rolls _____________ and glides _______________.

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lateral, lateral

During pelvic UPWARD LATERAL TILT, the concave acetabulum rolls _____________ and glides _______________.

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medial, medial

During pelvic DOWNWARD LATERAL TILT, the concave acetabulum rolls _____________ and glides _______________.

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anterior, anterior

During pelvic ANTERIOR ROTATION, the concave acetabulum rolls _____________ and glides _______________.