Hip Joint Kinesiology: Anatomy and Biomechanics, Exams of Nursing

Download Hip Joint Kinesiology: Anatomy and Biomechanics and more Exams Nursing in PDF only on Docsity! Chapter 18 Hip Joint Kinesiology QUESTIONS AND ANSWERS Lower Extremity includes - CORRECT ANSWER-pelvis, thigh, leg and foot. Hip - CORRECT ANSWER-Most proximal of lower extremity joints. -ball and socket, triaxial, more stable than shoulder but sacrifices some movement Ilium - CORRECT ANSWER-Fan Shaped superior portion of hip bone Iliac Fossa - CORRECT ANSWER-large, smooth, concave area, where iliopsoas muscle attaches Iliac Crest - CORRECT ANSWER-bony part you can feel, with ASIS Anterior Superior Iliac Spine & PSIS Posterior Superior Iliac Spine Anterior Superior Iliac Spine - CORRECT ANSWER-projection on anterior end of iliac crest -tensor fascia latae, sartorius, and inguinal ligament attach here Anterior Inferior Iliac Spine - CORRECT ANSWER-Projection just inferior to to ASIS, where rectus femoris attaches Posterior Superior Iliac Spine - CORRECT ANSWER-posterior projection on iliac crest Posterior Inferior Iliac Spine - CORRECT ANSWER-located just below PSIS Ischium - CORRECT ANSWER-posterior inferior portion of hip bone Ischial Body - CORRECT ANSWER-makes up 2/5 of acetabulum Ischial Ramus - CORRECT ANSWER-extends medially from body to connect with inferior ramus of pubis -adductor magnus, obturator externus and obturator internus muscles attach here Ischial Tuberosity - CORRECT ANSWER-rough, blunt projection of inferior part of the body, which is weight bearing when you are sitting -provides attachment for hamstring and adductor magnus muscles Ischial Spine - CORRECT ANSWER-located on posterior portion of body between greater and lesser sciatic notches -provides attachment for sacrospinous ligament Pubis - CORRECT ANSWER-forms anterior inferior portion of hip, 2 rami and 1 body Pubis Body - CORRECT ANSWER-externally forms 1/5 of acetabulum - internally provides attachment for obturator internus muscle Superior Ramus - CORRECT ANSWER-lies superior between the acetabulum and the body Pectineal Line - CORRECT ANSWER-runs from below the lesser trochanter diagonally toward the linea aspera, providing attachment for adductor brevis Patellar Surface - CORRECT ANSWER-located between medial and lateral condyle anteriorly, articulates with posterior surface of the patella Tibial Tuberosity (on Tibia) - CORRECT ANSWER-large projection anteriorly at the proximal end in the midline, providing attachment for patellar tendon Joint Capsule of Hip - CORRECT ANSWER-strong and thick, covers hip in a cylindrical fashion, attaching proximally around lip of acetabulum and distally to the neck of the femur 3 Ligaments: iliofemoral ligament, pubofemoral ligament, ischiofemoral ligament Iliofemoral Ligament - CORRECT ANSWER-most important hip ligament -reinforces caspsule anteriorly by attaching proximally to the anterior inferior iliac spine and crossing the joint anteriorly and LIMITS HYPEREXTENSION -splits into 2 parts distally to attach to intertrochanteric line of the femur, known as the Y ligament, or ligament of Bigelow Pubofemoral Ligament - CORRECT ANSWER-spans hip joint medially and inferiorly, attaches from medial portion of acetabular rim and superior ramis of the pubis, running down and back to attach on the head of the femur -limit hyperextension and abduction Ischiofemoral Ligament - CORRECT ANSWER-covers capsule posteriorly, attaches on the ischial portion of the acetabulum, crossing the joint in a lateral and superior direction and attaches on the femoral neck -limits hyperextension and medial rotation Ligamentum Teres - CORRECT ANSWER-small intracapsular ligament that serves little purpose, but significantly carries blood vessel that supplies head of the femur Acetabular Labrum - CORRECT ANSWER-fibrocartilaginous area around rim and acetabulum and increases its depth, free end surrounds femoral head and helps hold it in the acetabulum Inguinal Ligament - CORRECT ANSWER-no function at the hip joint but runs from anterior superior iliac spine to the pubic tubercle and is the landmark that separates the anterior abdominal wall from the thigh. -when the external iliac artery and vein pass under this ligament, they become the femoral artery and vein Iliotibial Band or Tract - CORRECT ANSWER-very long, tendinous portion of the tensor fascia latae muscle -attaches to anterior portion of iliac crest and runs superficially down the lateral side of the thigh to attach to the tibia -both gluteus maximus and tensor fascia latae muscles have fibers attaching to it End feel of all hip joint motions except flexion is - CORRECT ANSWER-firm, or soft tissue stretch because of tension in the ligaments, capsule and muscles. For flexion, end feel is soft tissue approximation, or soft, because of contact between anterior thigh and abdomen. One Joint Muscles of the Hip - CORRECT ANSWER--Anterior: Iliopsoas -Medial: Pectineus, Adductors Magnus/Longus/Brevis -Posterior: Gluteus Maximus & 6 Deep Rotators -Lateral: Gluteus Medius & Minimus Two Joint Muscles of the Hip - CORRECT ANSWER--Anterior: Rectus Femoris, Sartorius -Medial: Gracilis -Posterior: Semimembranosus, Semitendionsus, Biceps Femoris (long head) -Lateral: Tensor Fascia Latae Iliopsoas - CORRECT ANSWER-2 muscles with separate proximal attachments and common distal, contributes to trunk flexion when femur is stabilized O - Iliac Fossa, anterior & lateral surfaces of T12-L5 I - Lesser Trochanter A - Hip Flexion N - Iliacus portion: Femoral Nerve L2, L3 Psoas Major: L2 & L3 Rectus Femoris - CORRECT ANSWER-part of the quads group, only 1 to cross hip and blends with 3 vasti muscles into quad tendon aka patellar tendon O - Anterior Inferior Iliac Spine I - Tibial Tuberosity A - Hip Flexion, knee extension N - Femoral Nerve L2-L4 Sartorius - CORRECT ANSWER-longest muscle in the body, capable of many movements but not considered a prime mover and most effective when doing all 4 motions at the same time N - Numerous (see table 18-3) Hamstring Muscles - CORRECT ANSWER-3 muscles covering posterior thigh: semimembranosus, semitendinosus, biceps femoris Semimembranosus - CORRECT ANSWER-runs down medial side of thigh, deep to semitend O - Ischial Tuberosity I - Posterior surface of medial condyle of tibia A - Extend hip and flex knee N - Sciatic Nerve L5, S1, S2 Semintendinosus - CORRECT ANSWER-much longer and narrower distal tendon that spans knee joint posteriorly and attaches with gracilis & sartorius O - Ischial tuberosity I - Anteromedial surface of proximal tibia A - Extend hip and flex knee N - Sciatic Nerve L5, S1, S2 Biceps Femoris - CORRECT ANSWER-2 heads that run laterally down thigh on posterior side O - Long Head: Ischial Tuberosity Short: Lateral lip of Linea Aspera I - Fibular Head A - Long: extend hip and flex knee Short: flex knee N - Long: Sciatic S1, S2, S3 Short: Common Peroneal L5, S1, S2 Gluteus Medius - CORRECT ANSWER-Triangular, like the deltoid O - Outer surface of Ilium I - Lateral surface of Greater Trochanter A - Hip Abduction N - Superior Gluteal L4, L5, S1 Gluteus Minimus - CORRECT ANSWER-Lies deep and inferior to medius on lateral ilium O - Lateral Ilium I - Anterior Surface of Greater Trochanter A - Hip Abduction, medial rotation N - Superior Gluteal L4, L5, S1 Reversal of Muscle Function - CORRECT ANSWER-When origin of muscle moves toward insertion, seen in the hip to keep the pelvis fairly level Trendelenburg Gait - CORRECT ANSWER-If hip abductors are weak, one side of pelvis will drop significantly when you stand on one leg and lift the other off the ground Example: right abductors are weak, left pelvis will drop when you stand on right leg and lit left leg off ground Tensor Fascia Latae - CORRECT ANSWER-very short muscle with long tendinous attachment O - Anterior Superior Iliac Spine I - Lateral Condyle of tibia A - Combined hip flexion and abduction N - Superior Gluteal Nerve L4, L5 Congenital Hip Displacement AKA Dysplasia - CORRECT ANSWER-when unusually shallow acetabulum causes femoral head to slide upward, the capsule remains intact, though stretched Legg Calves Perthes Disease AKA Coxa Plana - CORRECT ANSWER-femoral head undergoes necrosis, usually seen in children ages 5-10 YO, may take 2-4 years for head to die, revascularize and then remodel Slipped Capital Femoral Epiphysis - CORRECT ANSWER-seen during growth spurt years, proximal epiphysis slips from its normal position on the femoral head Angle between shaft and the neck of the femur - CORRECT ANSWER-in the frontal plane is referred to as the angle of inclination, normally 125 degrees. At birth may be as much as 170, but decreases by adulthood. Coxa Valga - CORRECT ANSWER-neck shaft angle greater than 125 degrees, making the limb "straighter" and longer and more adducted during weight bearing Coxa Vara - CORRECT ANSWER-neck shaft angle is less than normal 125 degrees, more "bent", making limb shorter and dropping the pelvis on that side during weight bearing Angle between shaft and neck of femur in the TRANSVERSE plane - CORRECT ANSWER-is called angle of torsion, which normally has the head and neck rotated out from the shaft at 15-25 degrees