503 Pelvis and Thigh

what is the name of the joint where the ilium articulates with the sacrum?

sacroiliac

what is in the iliopsoas group

illiacus and posts major and minor

what is trendelenburg’s gait?

weakness of gluteus medius causes pelvis to lower on the left side when left leg side when left leg is NWB

What forms the femoral triangle?

inguinal ligament

adductor longus

sartorius

what is in the femoral triangle?

femoral nerve

femoral artery

femoral vein

What nerves break off the lumbosacral plexus?

femoral nerve

obturator nerve

sacral plexus

superior gluteal

inferior gluteal

what does the femoral never innervate?

quads

what does the obturator nerve innervate?

adductors

what does the sacral nerve innervate?

intrinsic hip external rotators

what does the superior gluteal nerve innervate?

gluteal medius and minimus

what does the inferior gluteal nerve innervate?

gluteal maximus

what is the name of the ligament that is crossed out?

Inguinal Ligament

what is the ligament crossed out?

ligamentum teres

what is the tissue crossed out?

acetabulum labrum

what ligament is crossed out in the picture?

Iliofemoral ligament

what ligament is crossed out in the picture?

pubofemoral ligament

what ligament is in this picture?

ischiofemoral ligament

what is Legg-Calve-Perthes Disease?

avascular necrosis of femoral head after the ligament of the femoral head tears off the head of the femur

what is slipped capital femoral epiphysis?

femoral shaft displacement relative to the femoral head

what will you notice about someones walk if they have a hamstring strain?

shortened swing phase

If someone has an anterior tilt of the pelvis what is wrong with their hip flexors?

they are tight

injuring force for a rectus femora strain

hyperextension of hip and flexion of knee

dynamic overload

isometric contraction

AROM for rectus femoris strain

Hip flexion and knee extension pain or deficit

PROM for rectus femoris strain

hip extension and knee flexion pain or deficit

injuring force for iliopsoas strain

hyperextension of hip

resisted hip flexion

injuring force for vastus muscles strain

hyperflexion of knee

dynamic overload

resisted knee extension

injuring force for hamstring strain

dynamic overload

Eccentric contraction

tensile force

overstretching the muscle

injuring force of a gluteus Maximus strain

dynamic overload

eccentric contraction

isometric contraction

injuring force for adductor group strain

tensile force

overstretching the muscle

dynamic overload

eccentric contraction

isometric contraction

AROM for iliopsoas strain

hip flexion pain or deficit

PROM for iliopsoas strain

hip extension pain or defect

AROM for vastus muscles strain

Knee extension with flexed hip pain or deficit

PROM for vastus muscles strain

knee flexion pain or deficit

AROM for hamstring muscles strain

knee flexion and hip extension with an extended knee pain or deficit

PROM for hamstring muscles strain

knee extension and hip flexion pain or deficit

AROM for a gluteus maximus strain

hip extension with a flexed knee pain or deficit

PROM for a gluteus maximus strain

hip flexion with a flexed knee pain or deficit

AROM for adductor group strain

hip adduction pain or deficit

PROM for adductor group strain

hip abduction pain or deficit

angle of inclination of femur

the angle between the long axes of the femoral neck and the femoral shaft

angle of torsion of femur

the amount of twist in the femur

what is the name go the hip joint?

coxofemoral joint

what motions does the anterior fibers of the iliofemoral ligament restrict?

hyperextension

what motions does the superior fibers of the iliofemoral ligament restrict?

adduction

what motion does the inferior fibers of the iliofemoral ligament restrict?

abduction

what motion does the pubofemoral ligament restrict?

abduction and hyperextension

what motion does the ischiofemoral ligament restrict?

extension and extreme flexion

what motion does the iliofemoral joint restrict because it reinforces the anterior joint capsule?

extension and internal rotation

Muscles that flex the hip

Anterior fibers of glutes medius

Psoas Major and minor

rectus femoris

Sartorius

gluteus minimus

iliacus

TFL

muscles the extend the hip

Biceps femoris

gluteus maximus

Posterior fibers of gluteus medius

semimembranosus

semitendinosus

muscles that abduct the hip

TFL

gluteus medius

gluteus minimus

sartorius

muscles that adduct the hip

Adductor Brevis

Adductor Longus

Adductor Magnus

gluteus maximus

gracilis

pectineus

muscles that internally rotate the hip

Adductor Bevis

Adductor longus

Adductor magnus

Anterior fibers of gluteus medius

gluteus minimus

semimembranosus

semitendinosus

TFL

muscles that externally rotate the hip

biceps femoris

Gemellus inferior

Gemellus superior

gluteus Maximus

posterior fibers of gluteus medius

obturator externus

obturator internus

piriformis

quadratus femoris

sartorius

how might coxa valga manifest?

through either gene varum or a laterally positioned patella

what is the term for an increased angle of inclination?

coxa valga

what is the term for a decreased angle of inclination?

coxa vara

how might coxa vara manifest?

gene valgum or a medially positioned patella

what is an anteverted femur?

an increase of more than 20 degrees in the angle or torsion

consequences of femoral anteversion?

internal femoral rotation

squinting patella

pigeon toe gait

what is retroverted femur?

when the angle of torsion is less than 15 degrees

consequences of femoral retroversion

duck foot gait

laterally positioned patella

decrease in hip internal rotation

How to you assess hamstring muscle length?

flexing hip with knee extended

how do you assess length of rectus femoris?

extending hip with knee flexed

what is degrees of motion for abduction?

45 degrees

what is degrees of motion for adduction?

20-30 degrees

with the hip flexed what are the degrees of motion for external rotation?

40-50 degrees

with the hip flexed what are the degrees of motion for internal rotation?

about 45 degrees

for ROM of internal and external rotation of the hip, what happens if you fully extend the hip?

ROM decreases

What is the Thomas Test?

Hip flexor tightness

How to isolate the iliopsoas group with the Thomas test?

Lay the patient flat on the table with their legs on the table as well

how do you isolate the iliopsos and rectus femoris?

have patient hang legs off table by knee

What is Ely’s test for?

hip flexor tightness

Pain characteristics of femoral head stress fractures

localized pain in femoral shaft or triangle that occurs during activity and relieved at rest

Pain characteristics of slipped capital femoral epiphysis

walking increases pain in adductor group or hip

pain may be referred to quads, adductor area, or butt

AROM for slipped capital femoral epiphysis

possible decrease in internal rotation, hip flexion and/or abduction

MMT for slipped capital femoral epiphysis

weak internal rotation

PROM for slipped capital femoral epiphysis

possible decrease in internal rotation, hip flexion and/or abduction

AROM for iliac crest contusion

pain during his flexion, trunk rotation and trunk flexion

MMT for iliac crest contusion

pain with muscles that are involved

PROM for iliac crest contusion

pain with muscles that are stretched

where can avulsion fractures of the pelvis happen?

ASIS, AIIS and ischial tuberosity

what causes avulsion fractures of the ASIS?

excessive tension on the sartorius or TFL

what causes avulsion fractures of the AIIS?

sudden eccentric muscle contraction of the rectus femoris.

what causes avulsion fractures of the ischial tuberosity?

eccentric hamstring muscle contraction

Pain characteristics of a femoral acetabular impingement

groin pain that extends to lateral thigh; exacerbated by activity or prolonged flexed postures

AROM of femoral acetabular impingement

internal rotation and adduction may be limited, especially with the hip flexed at 90 degrees

MMT of femoral acetabular impingement

weak hip external rotators

PROM of femoral acetabular impingement

decreased hip internal rotation when hip is flexed to 90 degrees

increased pain with hip flexion

pain characteristics of labral tear

most commonly presents anteriorly and medially

night pain is common

clicking, catching, locking, popping and giving away

AROM for labral tear

adduction, flexion, internal or external rotation limited secondary to pain at end range

PROM for labral tear for anterior tear

pain and or catching when hip is moved from flexion internal rotation and adduction

what does an anterior impingement test test for?

femoral acetabular impingement and/or labral tear

what does the hip scoring test test for?

defect in articular cartilage of femur or acetabulum

labral tear

what does the McCarthy test test for?

labral tear

what does the Fitzgerald test test for?

Anterior or posterior labral tear

What bursa is marked out?

Trochanteric Bursa

what bursa is marked out?

Iliopsoas Bursa

what bursa is marked out?

Gluteus medius bursa

what bursa is marked out?

Ischiogluteal Bursa