Pelvis, Hip, and Thigh Conditions Chapter 14

Pelvis Sacrum Coccyx Innominate bone Ilium Ischium Pubis Collectively protect the inner organs, bear weight, site of muscular attachments.

Sacroiliac Joints Help bear weight Provide elasticity to pelvic ring Iliac articulation covered in fibrocartilage Sacral articulation covered in hyaline

Sacrococcygeal Joint Usually a fused junction United by a fibrocartilaginous disc

Pubic Symphysis Cartilaginous joint with a disc of fibrocartilage called the interpubic disc Spreads Compresses Rotates

Femur Strongest and longest bone in the body Weakest link is the surgical neck Angles at 125° in the frontal plane

The hip joint Acetabulum of the pelvis=socket Head of the femur=ball Both surfaces covered in cartilage Acetabulum has a U-shaped cartilage structure known as the acetabular labrum

Hip joint capsule Coxofemoral joint is large and loose Capsular fibers encircle the neck giving it great stability

Ligaments of the Hip Joint Ligament of Bigelow AIIS-Femur Pubofemoral ligament Isciofemoral Ligamentum teres Occurs within the joint Inguinal ligament ASIS-pubic symphysis

Femoral Triangle Inguinal ligament Sartorius Adductor longus Femoral nerve, artery, and vein all exist within

Bursae Iliopsoas – Iliopsoas and the articular capsule Trochanteric – Greater trochanter and the gluteus maximus Gluteofemoral – Gluteus maximus from the vastus lateralis Ischial – Iscial tuberosity from the gluteus maximus

Q-Angle Angle between the quads and the tibial tuberosity Lines drawn between ASIS and patella and between patella and tibial tuberosity Generally 13° in males Generally 18° in females

Muscles-Flexion Iliopsoas Rectus femoris Pectineus Sartorius Tensor fasciae latae

Muscles-Extension Gluteus maximus Biceps femoris Semitendinosus Semimembranosus Adductor magnus

Muscles-Abduction Gluteus medius Gluteus minimus Tensor fasciae latae Sartorius Piriformis

Muscles-Adduction Pectineus Adductor brevis Adductor magnus Adductor longus Gracilis

Muscles-Medial Rotation Gluteus medius Gluteus minimus Tensor fasciae latae

Muscles-Lateral Rotation Piriformis Obturator internus Obturator externus Superior gemelli Ingerior gemelli Quadratus femoris Gluteus maximus

Nerves Lumbar plexus First four lumbar nerves Sacral plexus L4-S4 nerves

Physical conditioning Flexibility and strengthening of all overlapping muscle groups

Presentation guidelines What is the injury? Show pictures, videos, demonstrations to help us understand what is involved. How does it happen? Again pictures, videos, demonstrations to show how it happens. How do you treat it acutely? What is the long term treatment? What special procedures help this problem? Surgeries, immobilization, rehabilitation, mobilizations…

Contusions Hip pointer Quadriceps contusion Myositis Ossificans Acute compartment syndrome

Bursitis Greater Trochanteric Bursitis Iliopsoas Bursitis Ischial Bursitis Snapping Hip Syndrome

Sprains and Dislocations Posterior-superior dislocation

Strains Quadriceps Strain Hamstrings Strain Adductor Strain Gluteal Strains Piriformis Syndrome

Vascular and Neural Disorders Legg-Calvé-Perthes Disease Venous Disorders Thrombophlebitis Phlebothrombosis Toxic Synovitis Obturator Nerve Entrapment

Fractures Avulsion fractures Slipped capital femoral epiphysis Stress fractures Osteitis Pubis Displaced and Nondisplaced Pelvic fractures Sacral and Coccygeal fractures Femoral Fractures