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Pelvic and Hip Joint

Pelvic and Hip Joints

QuestionAnswer
What does the pelvic girdle support and protect? Abdominal organs
What is the function of the pelvic girdle besides support and protection? Transmits forces from head and arms and trunk to lower extremities
How many joints are formed by the pelvic bones? 7
What are the joints formed by the pelvic bones? Lumbosacral Sacroiliac Sacrococcygeal Symphysis pubis Hip joint
Which joints are the most stable but mobile? Hip joint
What is the function of hip joints? Transmits large forces between the trunk and the ground - 3X body weight with each step Locomotion
What are the structural classifications of joints? Fibrous Cartilagenous Synovial
Based on the axis of movement, what types of joint are non-axial? Plane
Based on the axis of movement, what types of joint are monoaxial? Hinge Pivot
Based on the axis of movement, what types of joint are biaxial Ellipsoid Condylar
Based on the axis of movement, what types of joint are multiaxial? Ball/socket Saddle
Which axises of movements have circumduction? Biaxial Multiaxial
What are the functional classifications of joints? Synarthrosis Amphiathrosis Diathrosis/arthrosis/diarthrodial
Describe the movement of a synarthrosis joint? Immovable - all synchrosis
Describe the movement of an amphiathrosis joint Slightly immovable - all symphysis
Describe the movement of a diarthrosis/arthrosis/diarthrodial Moveable - all synovial
Which joint is the site of lower back pain? Sacroiliac joint
What would cause lower back pain in the SI joint? Childbirth Hyper/hypo-mobility Inflammatory conditions
What is the SI joint typically classified as? Synovial planar (gliding)joint
What is the functional classification of the SI joint? Upper 1/3 - syndesmosis Middle 1/3 - symphysis Lower 1/3 - synovial
What makes up the posterior side of the sacrum? Interosseous ligaments that fill the space between the sacrum and inner side of the iliac tuberosity
What covers the interosseous ligaments of the SI joint? Posterior sacroiliac ligaments
What is on the anterior side of the SI joint? Anterior sacroiliac ligaments
What is the mechanism of the posterior and anterior sacroiliac ligaments? Suspend the sacrum from ilia, acting as shock absorbers as weight bearing drives the sacrum distally on ilia
What connects the spinous process and ischial tuberosity? Sacrotuberous and sacrospinous ligaments
What is the function of the sacrotuberous and sacrospinous ligaments? Provides leverage to hold distal aspect of sacrum in place against anterior weight-bearing forces
What joint acts as a self locking mechanism? SI joint
How does the SI joint act as a self locking mechanism? Force increase to cause downward movement of the sacrum on the ilia The posterior ligaments tighten and pull ilia closer together like a clamp
How would you classify a sacrococcygeal joint? Synovial planar (gliding) Synarthrosis *depending on age
How would you classify intercoccygeal joints? Synathrosis
What causes an increase in motion between coccygeal joints? Pregnancy and ossification from aging
What kind of cartilage covers the surface of the sacroiliac joint? Sacral surface - hyaline cartilage Iliac surface - fibrocartilage
What kind of cartilage covers the articulating surfaces of the pubic bones? Hyaline cartilage, separated by a fibrocartilage disk
What is the joint classification of the pubic symphysis? Amphiaarthrosis cartilaginous symphysis joint
What is the structural classification of the hip joint? Synovial joint, multiaxial, ball/socket
What is the functional classification of the hip joint? Diarthrosis
What is the articular surfaces of the hip joint? Lunar surface of acetabulum Head of femur
What is the shape of the femur head? About 2/3 of a sphere with a diameter of 4-5 cm
How does the axis run for the femoral head? Superiorly, medially, and anteriorly
The sphere is bigger for the femur than the humerus, what is the implication for the size? Bigger in femur - more stability Smaller in humerus - more mobility
The angle of inclination is made between the axis of what? Axis of shaft and axis of neck
How big is the angle between the head and shaft of the femur? 125 degrees
What is the function of the angle of inclination of femur? Place knee under weight bearing line of the head of the femur
What is it called when the neck-shaft angle is smaller than 125? Coxa varus
What is it called when the neck-shaft angle is larger than 125? Coxa valgus
What is the result of coxa varus in the neck-shaft angle? Decrease in leg length
What is the result of coxa valgus Increase in leg length
What is the implication on muscle from coxa varus/valgus in neck-shaft angle? Decreased muscle strength
Why is there a decrease in muscle strength when there is a change in neck-shaft angle? Changes in torque from alterations in muscle lever arms and length-tensio relationships Line of force of muscle will be changed
What is the angle of anteversion Head forming an angle (10-30 degrees) with frontal plane
What is an increase in the angle of anteversion called? Anteversion
Anteversion is one factor that is considered to cause what phenomenon? Pigeon toes
What is a decrease in the angle of anteversion called? retroversion
Retroversion is one factor that make cause what phenomenon? Out-toeing
Why are orthopedists conservative in treating children who are pigeon toed? Because the angle of anteversion usually decreases with growth and development of a child
The frontal plane passes between what? Shaft and condyles
Which direction will the femur shaft twist to increase the angle of anteversion? Medially
Which direction will the femur shaft twist to decrease the angle of anteversion? Laterally
What shape is the acetabulum? Hemispherical
What binds the acetabulum? Acetabular rim
What part of the acetabulum is lined by articular cartilage? The lunate surface of the acetabulum
What is the deeper central part of the cavity that is non-articular? Acetabular fossa
The acetabulum is directed in which directions? Laterally, inferiorly, anteriorly
The acetabular fossa permits movement of what structure? Ligamentum teres
What is the function of the ligamentum teres? Reservoir for synovial fluid when hip is heavily loaded
What happens to the synovial fluid once joint forces are decreased in the hip joint? Returns to joint space to provide lubrication and nutrition to the articular cartilages
The anatomic axis of femur is represented by a line through what? Femoral shaft
The mechanical axis of femur is represented by a line through what? Connecting centers of hip and knee joint -vertical when standing
Is there movement around the mechanical axis? Yes, because it passes through head of femur
Is there movement around the anatomical axis? No, because it does not pass through head of femur
What is the acetabular labrum? Fibrocartilageinous ring inserted into the acetabular rim
What is the function of the acetabular labrum? Deepens the acetabulum and fills out the various gaps of the acetabular rim
What ligament attaches to the acetabular labrum? Transverse acetabular ligament (TAL)
What is the function of the transverse acetabular ligament? Bridges over acetabular notch Acetabular notch needs a rim because it is open
Where does the ligamentum teres arise from? Acetabular notch
Describe the direction of the ligamentum teres from its origin to insertion Arises from the acetabular notch Runs at floor of acetabular fossa Inserts into fovea femoris capitis
What is the ligamentum teres embedded in? Fibroadipose tissue within acetabular fossa
What lines the ligamentum teres? Synovial membrane
How much force can the ligamentum teres tolerate? 45 Kg weight
What is the primary function of the ligamentum teres? Vascular supply to the head of femur
When does tension on the ligamentum teres occur? Extreme positions of adduction, flexion, and external rotation OR Adduction, extension, and internal rotation
Is the head of the femur completely covered by cartilage? No
Is the ligamentum teres the main head blood supply? No, but does carry vascular supply to head of femur
What part of ligamentum teres attaches to acetabular notch Arms
What is another function of the ligamentum teres besides vascular supply? Supports hip joint
What is a ligament? Thickening of joint capsule
What is an intrinsic ligament? Ligaments that are part of the capsule It reinforces capsule
What is an extrinsic ligament? Ligaments that aren't part of the capsule Could be outside or inside
If an extrinsic ligament is inside, what is it called? Intracapsule
What is an example of an intracapsular ligament? Cruciate ligaments
If an extrinsic ligament is outside, what is it called? Extracapsular
What is an example of an extracapsular ligament? Coracoclavicular ligament
What kind of ligament is the ligamentum teres? Extrinsic and intracapsular
Where is the hip joint capsule inserted? Medially - acetabular rim Laterally - line which runs along intertrochanteric line At junction of lateral and middle 1/3 of femoral neck
The hip joint capsule is strengthened by what three ligaments? Iliofemoral Pubofemoral Ischiofemoral
The movement of flexion and extension passes through what structure? Head of femur horizontally Frontal plane
What degree is reached during active hip flexion when knee is flexed? 120
What degree is reached during active hip flexion when knee is extended? 70-90
Why is the range for hip flexion smaller when the knee is extended? Hamstrings
Hyperextension of the hip is limited to 10-20 by which ligament? Iliofemoral ligament
What is really happening when there is a perceived hyperextension of the hip past 10-20 degrees? Extension of lumbar vertebrae
Why is there a decrease in hyperextension of the hip when the knee is flexed? Hamstrings lose efficacy as extensors of the hip because contraction largely utilized in knee flexion Rectus femoris also being stretched, limiting hip extension
What happens to the efficacy of muscles passing at two joints? Stretch at one end, increases efficacy at other end
What influences the efficacy of a two-joint muscle? Positions of the two involved joints - governing length-tension relationship
What is the degree of angle for hip abduction? 45
Hip adduction between two thighs is 0, how is it possible to have a more negative degree of angle? Crossing legs
Which axis of movement is identical to the mechanical axis of the femur? Internal/External rotation
When is hip rotation easier to observe? When knee is flexed to 90 and motion of tibia from neutral position is measured
Flexor muscles of the hip lie which direction to which plane? Anterior to frontal plane Passing through center of joint
What are the most important muscles for hip flexion Psoas major Iliacus Sartorius Rectus femoris TFL Pectineus Adductor longus Gracilis Glute med/min (anterior fibers)
Which muscle can produce enough tension to flex the hip beyond 90 degrees while sitting? Iliopsoas
What muscles control the vertebrae and pelvis on femur as person leans back and returns to upright position? Hip flexors Esp Iliopsoas
What would happen if there was a bilateral paralysis of the iliopsoas? Person would fall back as soon as the center of gravity line of the head, arms, and trunk falls behind hip joint axis
Extensor muscles of the hip lie which direction to which plane? Behind frontal plane Passing through center of joint
Where is each group of muscles inserted for hip extension? Femur Vicinity of the knee joint
What muscles are in each group responsible for hip extension? 1st group -glute max -glute med/min (posterior fibers) 2nd group -biceps femoris -semitendinosus -semimembranosus -adductor magnus
Rectus femoris can produce more force as a hip flexor if the knee is performing what action? Flexion
Why is the efficacy of two-joint muscles increased when the two joints are functioning similarly? Permits muscle to contract within a favorable range
Abductor muscles of the hip lie which direction to which plane? Lateral to sagital plane Transverses center of joint
What are the main abductor muscles? Glute med (anterior fibers) Glute min TFL Glute max (upper fibers)
What other muscles contribute to the force of abduction? Sartorius Piriformis Obturator internus Gemelli
Adductor muscles lie which direction to which plane? Medial to sagittal plane Transverses center of joint
What are the main hip adductors? Pectineus Adductor longus/brevis/magnus Gracilis
Lateral rotators of the hip lie what direction to what axis? Posterior to mechanical axis
What are the main lateral rotators of the hip joint? Piriformus Obturator internus/externus Quadratus femoris Glute max/med
Medial rotators of the hip lie what direction to what axis? Anterior to mechanical axis
What are the main medial rotator muscles? TFL Glute med/min (anterior fibers)
What other muscle groups that can do external rotation? Deep gluteal muscles
Created by: nnguyen44