Download presentation
Presentation is loading. Please wait.
1
Hip & Pelvis
2
Hip Joint Between Acetabulum (Pelvis) & Head of Femur
Ball and Socket Joint Weight Bearing
3
Acetabulum Formed from Ilium, Ischium, and Pubis
Oriented laterally, anteriorly, inferiorly Acetabular Rim Acetabular Notch Netter 453
4
Femur Head Neck Greater Trochanter Lesser Trochanter
Netter 453 Head Neck Greater Trochanter Lesser Trochanter Intertrochanteric Line Intertrochanteric Crest
5
Femoral Neck Angles Coronal Plane
125 > Normal < Normal Normal Coxa Valga Coxa Vara
6
Femoral Neck Angles Horizontal Plane
Normal 15° anterior Anteversion > 15° anterior Toe-In Posture Retroversion < 15° anterior Toe-Out Posture
7
Joint Capsule Acetabular Labrum Transverse Acetabular Ligament
Ligamentum Teres Capsular Ligaments Accessory Ligaments Netter 454
8
Accessory Ligaments Anterior Posterior
limit extension & external rotation Iliofemoral Ligament (Y) Pubofemoral Ligament Posterior Ischiofemoral Ligament Netter 454
9
Movements of the Hip & Pelvis
10
Movement at the Hip Flexion Extension Abduction Adduction
Internal Rotation External Rotation Circumduction
11
Movement of the Pelvis Anterior Rotation (AS Ilium, +X)
Posterior Rotation (PI Ilium, - X) Lateral Flexion (High or Low Ilium (+ or - Z) Rotation (+ or - Y)
12
Determining API Compare angle between PSIS & ASIS to horizontal
13
Posture - Pelvis ( X) Angle of Pelvic Inclination (API)
Anterior & Posterior Rotation Angle of Pelvic Inclination (API) Males = 0° to 5° anterior Females = 5° to 10° anterior
14
Combined Movements Movement of the Pelvis at the end range of Hip movement Due to ligamentous attachments Movements of the Pelvis and Lumbar Spine with a Fixed Femur (standing) Effects of Contracture/Shortening of muscles on Posture and Movement
15
Hip Flexion Anatomy of Movement 186
16
End Range of Hip Flexion - Effects on Pelvis & Lumbar Spine
Posterior Rotation of Pelvis Decreased Lumbar Lordosis Anatomy of Movement 206
17
Muscles that Flex the Hip
Iliopsoas Rectus Femoris Tensor Fascia Lata (TFL) Sartorius Anatomy of Movement 231
18
Major Hip Flexor Iliopsoas Proximal Attachments Distal Attachment
Psoas Major - Lumbar vertebral bodies & discs Iliacus - Entire internal iliac fossa Distal Attachment Common tendon attaches to lesser trochanter of femur Netter 462
19
Other Hip Flexors Rectus Femoris Sartorius Tensor Fascia Lata
AIIS to patella (via quadriceps tendon) Sartorius ASIS to Pes Anserine insertion (Tibia) Tensor Fascia Lata ASIS to Iliotibial Band fascia 458 Netter 458
20
Action of Hip Flexors with Femur fixed
Anterior rotation of Pelvis Increased Lumbar Lordosis Anatomy of Movement 214
21
Effects of Contracture of Hip Flexors on Posture & Movement
Anteriorly Rotated Pelvis Sagittal Plane +X rotation (anterior ilium) Increased Lumbar Lordosis Limited Hip Extension
22
Hip Extension Anatomy of Movement 187
23
End Range of Hip Extension - Effects on Pelvis & Lumbar Spine
Anterior Rotation of Pelvis Increased Lumbar Lordosis Anatomy of Movement 222
24
Muscles that Extend the Hip
Gluteus Maximus Hamstrings Biceps Femoris Semimembranosus Semitendinosus Anatomy of Movement 231
25
Hip Extensors Gluteus Maximus
Medial Attachments - Medial Ilium, Lateral Sacrum, Sacrotuberous Ligament Lateral Attachments - Posterior shaft of Proximal Femur, Iliotibial Band Also externally rotates hip Netter 461
26
Hip Extensors Hamstrings Attach proximally on Ischial Tuberosity
Distal Attachments Biceps Femoris (lateral on fibular Head) Semimembranosus & Semitendinosus (medial on tibia) Netter 461 & 468
27
Action of Hip Extensors with Femur fixed
Posterior rotation of Pelvis Decreased Lumbar Lordosis Anatomy of Movement 222
28
Effects of Contracture of Hip Extensors on Posture
Posteriorly rotated pelvis Indirectly causes Lumbar Hypolordosis Limited Hip flexion (with knee extended - Hamstrings)
29
Hip Abduction Anatomy of Movement 188
30
Position of Femur Femur must be externally rotated for full abduction
Internal Rotation External Rotation Anatomy of Movement 188
31
End Range of Hip Abduction - Effects on Pelvis & Lumbar Spine
Contralateral Lateral Flexion of Pelvis Ipsilateral Lateral Flexion of Lumbar Spine Anatomy of Movement 188
32
Hip Abductors Gluteus Medius Gluteus Minimus Tensor Fascia Lata
Gluteus Maximus Anatomy of Movement 231
33
Hip Abductors - Attachments
Gluteus Medius Upper part of External Iliac Fossa to Lateral aspect of Greater Trochanter Gluteus Minimus Lower part of External Iliac Fossa to Lateral aspect of Greater Trochanter Netter 469
34
Tensor Fascia Lata ASIS to Iliotibial Band
Actions - Abduction, Flexion & Internal Rotation Anatomy of Movement 227 Netter 460
35
Action of Hip Abductors with Fixed Femur
Ipsilateral lateral flexion of pelvis Stabilization of Pelvis during stance on one leg Anatomy of Movement 227 & 229
36
Effects of Contracture of Hip Abductors on Posture
Low ilium (ipsilateral lateral flexion of pelvis) Limits adduction (widened stance) May limit flexion or extension of hip
37
Weakness of Hip Abductors
Weakness causes contralateral lateral flexion of Pelvis during stance on one leg Trendelenberg Test
38
Adduction of the Hip Anatomy of Movement 187
39
Hip Adductors Pectineus Adductor Longus Adductor Brevis
Adductor Magnus Gracilis Anatomy of Movement 232
40
External Rotation of the Hip
Anatomy of Movement 189
41
Hip External Rotators Gluteus Maximus
Medial Attachments - Medial Ilium, Lateral Sacrum, Sacrotuberous Ligament Lateral Attachments - Posterior shaft of Proximal Femur, Iliotibial Band Also extends hip Netter 461
42
Hip External Rotators Piriformis Short External Rotators
Anterior sacrum to greater trochanter Short External Rotators Gemelli Obturators Quadratus Femoris Netter 469
43
Internal Rotation of the Hip
Anatomy of Movement 189
44
Internal Rotators Tensor Fascia Lata
Anterior fibers of Gluteus Medius and Gluteus Minimus Netter 460
Similar presentations
