KIN 307 Exam 3

What type of chain is hip/pelvic girdle complex?

closed

What is the name of the hip joint?

acetabular femoral

What makes the hip joint relatively stable?

Bony architecture, Strong ligaments, Large supportive muscles

How does the acetabular femoral joint function?

Functions in weight bearing, locomotion and has enhanced substantially but sacrifices its wide ROM

What is the classification of the hip joint?

ball and socket

What two things articulate to form the hip joint?

head of the femur and the acetabulum

What joins the two pelvic bones to form the pelvic girdle?

posteriorly by the sacrum

What three bones for the pelvic bone?

illium, ischium, and pubis

What joint does the sacrum and the pelvic bone form?

sacroiliac joint

What unites the sacrum and the pelvic bones to make them a strong joint?

ligaments

Where is the most common site for low back injury?

sacroiliac region

What type of joint is the sacroiliac joint?

synovial gliding or plane joint

How does the pelvic girdle differ for females?

Lighter, thinner, Wider in area, Wider, flatter sacrum

How do the pelvic bones join anteriorly?

amphiarthrodial articulation

What is the acetabulum?

cuplike area of the pelvis composed of 3 pelvic bones

Similar to glenoid fossa of shoulder joint, the acetabulum is lined around most of its periphery with a _______ to enhance stability and provide some shock absorption and aid in __________

labrum; buttress effect

What percentage of the head of the femur articulates with the acetabulum?

70%

which ligaments attach from deep in acetabulum to a depression in femoral head and slightly limits adduction?

Ligament of femur; round ligament or teres ligament

What holds the femur away from the pelvis?

the neck of the femur

What is the neck of the femur formed by?

cancellous trabecular bone and reinforced with cortical bone, particularly on the inferior portion

The angle of inclination

measured in the frontal plane and typically ranges from 90 – 135° degrees, with 125° considered average

coxa vara

<125 degrees

coxa valga

125 degrees

angle of anteversion

The angle of the femoral neck in the transverse plane

Excessive Anteversion

Femoral neck points more anteriorly

Retroversion

Femoral neck points more medially

Role of anterior musculature is primarily:

hip flexion

Role of posterior musculature is primarily:

hip extension

Role of medial musculature is primarily:

hip adduction

Role of lateral musculature is primarily:

hip abduction

Hip flexors:

Iliopsoas, Pectineus, Rectus femoris, Sartorius

Hip extensors:

Gluteus maximus, Biceps femoris, Semitendinosus, Semimembranosus

Hip adductors:

Adductor brevis, Adductor longus, Adductor magnus, Gracilis, pectineus

Hip abductors:

Gluteus medius, Gluteus minimus, Tensor fasciae latae

How many planes of movement does the pelvic girdle have?

3

Anterior/posterior pelvic rotation occurs in the:

sagittal plane

Anterior pelvic rotation accomplished by ____ and/or______

hip flexion; lumbar extension

Posterior pelvic rotation accomplished by ____ and/or ______

hip extension; lumbar flexion

Anterior pelvic rotation:

anterior movement of upper pelvis; iliac crest tilts forward in a sagittal plane; anterior tilt; downward rotation.

Posterior pelvic rotation:

posterior movement of upper pelvis; iliac crest tilts backward in a sagittal plane; posterior tilt; upward rotation.

Left lateral pelvic rotation:

in frontal plane left pelvis moves inferiorly in relation to right pelvis; either left pelvis rotates downward or right pelvis rotates upward; left lateral tilt

Right lateral pelvic rotation:

in frontal plane right pelvis moves inferiorly in relation to left pelvis; either right pelvis rotates downward or left pelvis rotates upward; right lateral tilt

Left transverse pelvic rotation:

in horizontal plane pelvis rotates to body's left; right iliac crest moves anteriorly in relation to left iliac crest, which moves posteriorly (counter clockwise)

Right transverse pelvic rotation:

in horizontal plane pelvis rotates to body's right; left iliac crest moves anteriorly in relation to right iliac crest, which moves posteriorly (clockwise)

Right/left lateral pelvic rotation occurs in the

frontal plane

Right/left transverse pelvic rotation occurs in the

transverse/horizontal plane

Standing on both feet and contracting hip flexors, the trunk and pelvis

rotates anteriorly

Lying supine and contracting hip flexors, the thighs _______ on the stable pelvis.

move forward into flexion

In lowering to sitting position, hip extensor muscles used ____ when pelvis and trunk move downward slowly on the femur and ________ when trunk is raised on femur (rising to standing position).

eccentrically; concentrically

What is the primary hip flexor?

iliopsoas group

What are the assistive hip flexors?

pectineus, tensor fascia latae, sartorius, rectus femoris

External rotators of the hip

gluteus maximus, biceps femoris (long head), deep external rotator group

Internal rotators of the hip

gluteus medius, gluteus minimus, tensor fascia latae, gracilis, semitendinosus, semimembranosus

What movements happen during anterior pelvic girdle rotation?

lumbar spine: extension, right hip motion: flexion, left hip motion: flexion

What movements happen during posterior pelvic girdle rotation?

lumbar spine: flexion, right hip motion: extension, left hip motion: extension

What movements happen during right lateral pelvic girdle rotation?

lumbar spine: left lateral flexion, right hip motion: abduction, left hip motion: adduction

What movements happen during left lateral pelvic girdle rotation?

lumbar spine: right lateral flexion, right hip motion: adduction, left hip motion: abduction

What movements happen during right transverse pelvic girdle rotation?

lumbar spine: left lumbar rotation, right hip motion: internal rotation, left hip motion: external rotation

What movements happen during left transverse pelvic girdle rotation?

lumbar spine: right lumbar rotation, right hip motion: external rotation, left hip motion: internal rotation

What is considered the largest joint in the body?

the knee joint

What type of joint is the knee joint and what actions is it capable of?

hinge; flexion, extension, internal rotation, external rotation

What articulates to form the knee joint?

Enlarged condyles of the femur articulate on enlarged condyles of the tibia

What are the articulations within the area of the knee joint?

Medial tibiofemoral, Lateral tibiofemoral, Patellofemoral

What is the patellofemoral joint?

patella is covered with thick hyaline cartilage on the posterior surface and slides in the trochlear groove of the femur; it functions in improving the angle of pull and centralizes forces

What bone bears all the weight of the femur?

tibia

What is the patella and what is its function?

sesamoid bone imbedded in quadriceps and patella tendon; Serves as a pulley to improve the angle of pull, resulting in a greater mechanical advantage during knee extension

What is the fibula?

serves as the attachment for knee joint structures. -Does not articulate with femur or patella -Not considered part of knee joint.

What produces dynamic stability of the knee joint?

Contractions of quadriceps and hamstrings

What produces static stability of the knee joint?

ligaments

what are the menisci of the knee and what are their functions?

form cushions between bones.fibrocartilage disks attached to tibia.Deepen tibial fossa to enhance stability (deepens joint contact by 70%)Thicker on outside border and taper down very thin to inside border.Absorbs Shock (also lessens friction in joint by 20%).Site of secondary muscle attachment.

What are the ligaments of the knee?

Role is to hold the femur in contact with the tibial plateau. Anterior Cruciate Ligament (ACL)Posterior Cruciate Ligament (PCL)Medial Collateral Ligament (MCL)Lateral Collateral Ligament (LCL)

What is the MCL?

Medial Collateral Ligament (MCL) maintains medial stability by resisting valgus forces or preventing knee from being abducted

What is the LCL?

Lateral Collateral Ligament (LCL) maintains lateral stability by resisting varus forces or preventing knee from being adducted

What is the ACL and PCl named for?

tibial attachment

What type of stability does the ACL and PCL provide?

anterior/posterior stability, as well as rotatory stability

The ACL prevents the femur from sliding _____ on the tibia or the tibia from sliding ________ on the femur

posteriorly; anteriorly

The PCL prevents the femur from sliding _____ on the tibia or the tibia from sliding _________ on the femur

anteriorly, posteriorly

Other stability of the knee joint:

Tendons of Pes Anserinus: Sartorius, Gracilis, & SemitendinosusMedial/Lateral retinaculumIliotibial band: thick, strong band of tissue connecting tensor fascia latae to femur and tibia

The screw home mechanism:

Automatic external rotation of tibia as the knee moves from 15° of knee flexion to full extension, this happens because of osteokinematics

What is the automatic external rotation caused by?

Larger medial femoral condyle.Longer anterior-posterior dimension of tibial medial condyle – through passive tension in ACL.Lateral pull of QuadricepsKnee is unlocked by the internal rotation function of the popliteus.

Quadriceps “Q” angle

angle formed by intersection of lines connecting: ASIS & mid-patellaTibial tuberosity & mid-patella

true or false: the “q” angle is larger in females than it is in males

true

Can higher “q” angles cause problems?

yes; lateral patellar subluxation or dislocation, patellar compression syndrome, chondromalacia, and ligamentous injuries

How can high “q” angles be maintained?

high levels of strength and endurance in vastus medialis so as to counteract lateral pull of vastus lateralis

genu varum

a Q-angle less than normal often leads to a “bowlegged” appearance

genu valgum

a Q-angle greater than normal often leads to a “knock-kneed” appearance

What type of muscles in the knee mostly made up of?

biarticulate muscles (hamstrings and rectus femoris)

What movements can the knee complete?

flexion/extension; internal/external rotation

What muscles extend the knee?

Rectus femoris, Vastus medialis, Vastus intermedius, Vastus lateralis

What muscles flex the knee?

Biceps femoris, Semimembranosus, Semitendinosus

What muscles assist in knee flexion?

Sartorius, Gracilis, Popliteus, Gastrocnemius

Two-joint muscles are most effective when either the origin or insertion is _______ to prevent movement in direction of the contracting muscle

stabilized

To a degree, muscles are able to exert greater force when ______ than when ________

lengthened; shortened

pes anserinus is formed by:

Gracilis, sartorius, and semitendinosus joined together distally

How do the Gracilis, sartorius, and semitendinosus provide dynamic stability in any knee rotation movement?

Their attachment to proximal tibia combined with posteromedial line of pull enables them (particularly external rotation once the knee is flexed and hip is externally rotated)

The _______ increases its total length and becomes a better flexor at knee when pelvis is rotated posteriorly and stabilized by abdominal muscles

sartorius (think about leaning back in a chair and crossing your leg vs leaning forward)

_______ inserts on lateral side of knee while _________ insert on medial side of knee

Biceps Femoris; semitendinosus & semimembranosus

What muscles externally rotate the knee?

biceps femoris

What muscles internally rotate the knee?

semitendinosus, semimembranosus, popliteus