KINESIOLOGY EXAM 3

4/17

bones of the hip/pelvis

• pelvic bones (allium, ischium, pubis)

• sacrum (contains five fused bones)

• femur

joints of hip/pelvis

• pubic symphysis (amphirarthrotic)

  • anterior articulation of hip bones

• sacroiliac (si) joint (plane joint)

  • formed by hip bones and sacrum

• hip joint (ball and socket joint/diathrotic)

  • formed by femur head, inserts into hip bone’s acetabulum

pelvic girdle movements

• no joints w/in pelvis where movement is “normal”

• si joints and pelvic bone joints are fused

• pelvic motion is a result of combination of motion in the hip joint and vertebral column

pelvic girdle motions

• anterior rotation

  • movement of upper pelvis anteriorly (iliac crest tilts forward - anterior tilt)

  • trunk extension and hip flexion

• posterior rotation

  • movement of upper pelvis posteriorly (iliac crest tilts backwards - posterior tilt)

    • trunk flexion and hip extension

hip ligaments

• iliofemoral ligament (y ligament)

• pubofemoral ligament (limits hip abduction)

• ischiofemoral ligament (limits medial rotation)

  • all of these limit hope hyperextension

hip joint movements

• flexion and extension

• abduction and adduction

• medial and lateral rotation

iliopsoas

• combination of iliac and posts major

• strongest hip flexor

  • ORIGIN: iliac fossa, anterior and lateral surfaces of T12 - L5

  • INSERTION: lesser trochanter of femur

  • ACTION: hip flexion and external rotation

  • NERVE: femoral nerve (iliacus) and lumbar nerves L1-L3 (psoas major)

• exercises

  • supine leg raises

  • leg lifts from parallel bar

  • multi hip machine

pectineus

• uppermost of medial thigh muscles

• sometimes considered an extension of iliopsoas

  • ORIGIN: superior ramus of pubis

  • INSERTION: pectineal line of femur

  • ACTION: hip flexion and adduction

  • NERVE: femoral nerve

• exercises

  • supine leg rises

  • flexion and adduction against resistance

rectus femoris

• part of the quadriceps group

• only muscle that crosses knee and hip

• combined action seen as leg swings forward while walking

  • ORIGIN: anterior inferior iliac spine

  • INSERTION: tibial tuberosity

  • ACTION: hip flexion and knee extension

  • NERVE: femoral nerve

• exercises

  • leg raises

  • leg lifts

  • multi hip machine

  • leg extension

  • leg presses

  • squats

sartorius

• longest muscle in the body

• most superficial thigh muscle

• forms lateral boarder of femoral triangle

• not a powerful synergist

  • ORIGIN: anterior superior iliac spine

  • INSERTION: proximal medial tibia

  • ACTION: hip flexion, abduction and external rotation, WEAK knee flexion

  • NERVE: femoral nerve

• exercises

  • leg lifts

  • leg raises

tensor fasciae latae

• together with the gluteus maximus, it acts on the iliotibial band that inserts on the lateral side of the tibia

  • ORIGIN: anterior superior iliac spine

  • INSERTION: lateral condyle of tibia

  • ACTION: hip flexion, abduction, and internal rotation

  • NERVE: superior gluteal nerve

• exercises

  • hip abduction

  • supine leg raises w femur internally rotated

gluteus maximus

• mostly used for power - ring up stairs, rising from seated/squatting position, climbing, running (not used during walking)

  • ORIGIN: posterior ilium, sacrum and coccyx

  • INSERTION: gluteal tuberosity and iliotibial band

  • ACTION: hip extension, hyperextension, external rotation

  • NERVE: inferior gluteal nerve

• exercises

  • squats

  • lunges

  • leg press

  • extensions on multi hip machine

biceps femoris

• one of three muscles forming the hamstring group

• EXTERNALLY ROTATES HIP WHEN KNEE IS FLEXED

  • ORIGIN: ischial tuberosity (long head) and lines aspera (short head)

  • INSERTION: head of fibula

  • ACTION: extend hip and flex knee (long head); flex knee (short head)

  • NERVE: sciatic nerve

• exercises

  • hamstring curls (prone or standing)

  • hip extension w extended knee

semitendonosis

• middle of hamstring group

  • ORIGIN: ischial tuberosity

  • INSERTION: medial side of proximal tibia

  • ACTION: hip extension and internal rotation; knee flexion

  • NERVE: sciatic nerve

• exercises

  • leg curls

  • hip extension

semimembranosus

• third muscle in hamstring group

  • ORIGIN: ischial tubersoity

  • INSERTION: medial condyle of tibia

  • ACTION: hip extension and internal rotation; knee flexion

  • NERVE: sciatic nerve

• exercises same as semitendinosus

deep lateral hip rotators

• group of six muscles that we will consider as one

  • ORIGIN: posterior sacrum, ischium, pubis

  • INSERTION: greater trochanter area

  • ACTION: externally rotates extended hip

  • NERVE: various nerves

• exercises

  • external rotation against resistance

gluteus medius

• when standing on one foot this muscles contracts on that side to keep pelvis from tilting to the unsupported side

  • ORIGIN: outer surface of ilium

  • INSERTION: lateral surface of greater trochanter

  • ACTION: hip abduction

  • NERVE: superior gluteal nerve

• exercises

  • side lying leg raises

  • multi hip machine

• ANTERIOR FIBERS CONTRIBUTE TO HIP FLEXION AND INTERNAL ROTATION

• POSTERIOR FIBERS CONTRIBUTE TO HIP EXTENSION AND EXTERNAL ROTATION

gluteus minimus

• deepest of the three gluteal muscles

• works w gluteus medius

  • ORIGIN: lateral ilium

  • INSERTION: anterior surface of greater trochanter

  • ACTION: hip abduction and internal rotation

  • NERVE: superior gluteal nerve

• exercises

  • similar to gluteus medius

trendelenburg gait

• dysfunction of the gluteus medius and/or minimus resulting in abnormal gait

• pelvis tilts toward unsupported side in walking

adductor brevis

• deep to adductor longus

• smallest adductor muscle

  • ORIGIN: pubis

  • INSERTION: proximal linea aspera of femur

  • ACTION: hip adduction

  • NERVE: obturator nerve

• exercises

  • medial leg raises from a side lying position

  • multi hip machine

  • thigh master

adductor longus

• ORIGIN: pubis

• INSERTION: middle line aspera of femur

• ACTION: hip adduction

• NERVE: obturator nerve

• exercises

  • same as adductor brevis

adductor magnus

• longest and deepest adductor muscle

  • ORIGIN: ischium and pubis

  • INSERTION: entire lines aspera and adductor tubercle of femur

  • ACTION: hip adduction

  • NERVE: obturator nerve

• exercises

  • same as other adductors

gracilis

• most superficial adductor

• forms letter V w shaft of femur

  • ORIGIN: pubis

  • INSERTION: proximal tibia (medial side)

  • ACTION: hip adduction

  • NERVE: obturator nerve

• exercises

  • same as other adductors

hip contusions

• usually a result from direct blow to a body part such as the quads (charley horse) or pelvic area (hip pointer)

• very painful and potentially debilitating

• if not treated properly, can lead to myositis ossifications

myositis ossifications

• conditions in which calcification develops repeated trauma

• can be caused by poor treatment such as vigorous massage, or returning from injury too soon

bones of the knee

• femur

  • longest bone in body

• tibia

  • medial bone of lower leg; weight bearing

• fibula

  • lateral bone of lower leg; not weight bearing

  • does not articulate w femur/patella

  • provides attachment sites for knee joint structure/muscles

• patella

  • sesamoid bone embedded in patellar tendon

  • protects structures beneath and change angle of pull to create greater rotary force

knee joint

• hinge joint

• not entirely accurate bc it allows some rotation

• complex, and somewhat unstable

• often injured in athletics

menisci

• cartilage discs attached to tibia allowing enhanced stability and a deeper tibial plateu

• both thicker on outside border, taper to very thin on inside border

collateral ligaments

• medial collateral ligament (MCL)

  • protects knee from valves forces

  • often injured by blows to lateral side of knee

• lateral collateral ligament (LCL)

  • protects knee from virusforces

  • injured by blows to medial side of knee

• anterior cruciate ligament (ACL)

  • prevents tibia from moving forward

  • attaches to the tibia anteriorly and the femur posteriorly

  • helps maintain rotary stability

• posterior cruciate ligament (PCL)

  • prevents the tibia from moving posteriorly

  • attaches anteriorly to the femur and posteriorly to the tibia

knee motions

• flexion

• extension

• external rotation

• internal rotation

vastus lateralis

• most lateral muscle of the quadriceps group

  • ORIGIN: linea aspera of femur

  • INSERTION: tibial tuberosity (via patellar tendon)

  • ACTION: knee extension

  • NERVE: femoral nerve

• exercises

  • seated knee extension

  • seated leg press

  • hip sled

  • squats

  • lunges

vastus intermedius

• middle of the three vests muscles

• deep to the rectus femoris

  • ORIGIN: anterior femur

  • everything else is same as vastus lateralis

vastus medialis

• most medial of vastus muscles

• often the target for biopsies when the quadriceps muscle is studied

  • same OIAN and exercises as vastus lateralis

popliteus

• “the key that unblocks the knee”

• deepest muscle of the posterior knee

  • ORIGIN: lateral condyle of femur

  • INSERTION: posterior proximal tibia

  • ACTION: initiate knee flexion

  • NERVE: tibial nerve

• exercises

  • leg curls

  • knee flexion w internal rotation

knee flexion assisters

• sartorius

• gracialis

  • both flex and internally rotate knee

• gastrocnemius

  • flexes knee

• plantaris

  • assists with knee flexion; missing in some people

ACL Injury

• many sports apply external and internal forces to the knee

• ACL is the most commonly damaged ligament of the knee

• often caused by cutting, twisting, and/or hyperextension

• due to poor vascularity, a torn ACL does not have the capacity to heal

• once injured, it does not reconstitute as a functional entity

ACL Injury and Gender

• ACL injury rates are 4-8 times higher in female athletes who partake in soccer, basketball, track, and softball (compared to baseball) than male athletes

• sagital plane landing mechanisms may play less of a role in gender-related ACL injury than frontal and transverse plane mechanisms

• effect of fatigue on knee valves and internal rotation may have more of a consequence in females than males

ACL Injuries and Gender Theories

• women have a wider pelvis, increasing the “Q” angle of knee

• the place where the ACL passes through the knee is smaller in females

• hormones

  • women in preovulatory phase have more ACL injuries; presumably due to laxity - more compliance means more instability

Collateral Ligament Injury

• one of the most frequent knee injuries

• usually cause by blow to lateral knee

• deep fibers of the MCL attach to the medial meniscus which could disrupt the meniscus too

meniscus tear

• frequency caused by planting foot during weight bearing while body undergoes rotation

• symptoms include pain accompanied by locking or buckling of the knee

chondromalacia

• affects the articulating cartilage on the interior surface of the patella

• possibly caused by incongruence between patella and femur

• symptoms include pain, swelling, and grating sensation

osgood schlatter disease

• usually affects children

• inflammation of the patellar tendon at the tibial tuberosity caused by repeated usage of knee extensors

• symptoms include pain, swelling, hemorrhage

• severe overuse may result in tearing or avulsion of patellar tendon