pelvis and hip
iliolumbar ligament
-between T.P. of L4-5 vertbrae and posterior iliac crest -stabilizing L4-5 -deep to thoracolumbar aponeurosis, multifidi muscles, and quadrates lumborum M.
sacrotuberous ligament
-between ischial tuberosity and edge of sacrum -deep to gluteus Maximus M. -about one inch wide and inflexible
function of trochanteric bursa
-reduce friction between greater trochanter and gluteus Maximus M. -other bursa around greater trochanter also reduces friction of the gluteus medium and minimus M's.
inguinal ligament
-superficial between ASIS and pubic tubercle -superior border of the femoral -triangle and lower edge of abdominal aponeurosis -part of attachment site of external oblique muscle
posterior sacroiliac ligaments
-superficial to sacroiliac jt -supports union of posterior sacrum and ilium -oblique fibers with several sections between the sacrum and area around the PSIS -deep to thoraculumbar aponeurosis
muscles that May Assist on the Coxal or Hip joint flexion
Adductor Magnus: anterior fibers Gluteus Medius: anterior fibers
action piriformis
ER coxal JT
what primary muscles use extension on the Coxal or Hip joint?
Gluetues maximus- all fibers Biceps femurs long head semitendinosus semimembranosus
assist action semimembranosus
IR coxal JT
from the location of the axis motion on the piriformis M. what is the degree must it be in order to change the Rotation at the coxal JT.
IR of coxal JT at >90 degrees of hip flexion
assist action semitendinosus M.
IR the coxal JT
what is another name for lateral fascia?
Iliotibial band
what are the "Borders" of the Femoral Triangle?
Inguinal ligament top Sartorius Adductor Longus
what is another name for the Anterior Border of the Tibia?
Pes Anserine
what primary muscles use flexion on the Coxal or Hip joint?
Psoas major Iliacus Tensor Fasciae Latae Sartorius Rectus Femoris Gluteus Minimus Adductor Longus Pectineus Adductor Brevis
primary action of gluteus minimus
abduct and IR
primary action of the gluteus medius of all fibers
abduct coxal JT
may assist Gemellus inferior
abducting flexed thigh
may assist Gemellus superior
abducting flexed thigh
may assist obturator internus
abducting flexed thigh
may assist piriformis
abducting flexed thigh extension of coxal JT
action adductor brevis
adduct coxal joint; flex coxal joint
action pectineus
adduct coxal joint; flex coxal joint
action on both fibers at adductor magnus
adduct coxal jt
action adductor longus
adduction of coal joint; flex coxal joint
action gracilis
adduction of coal joint; flex knee ( tibiofemoral JT)
may assist obturator externus
adduction of coxal jt
what muscles are adductor group?
adductor Magnus adductor longus adductor brevis pectineus gracilis
what primary M. use adduction on the coxal or hip joint?
adductor Magnus adductor longus adductor brevis pectineus gracilis
what May Assist muscles use extension on the Coxal or Hip joint?
adductor Magnus: posterior fibers gluteus medius: posterior fibers piriformis: at <90 degrees of hip flexion
what are the motions of the pelvis with regards to one or more hip joints being in weight bearing?
anterior and posterior pelvic tilt lateral tilt forward and backward rotation
insertion gluteus minimus
anterior border of greater trochanter of the femur and the hip JT capsule
ligaments at the pelvis
anterior longitudinal ligament anterior sacroiliac ligament posterior sacroiliac ligament sacrospinous ligament sacroturberous ligament inguinal ligament pubic symphysis obturator membrane
origin tensor fasciae latae
anterior part of the external lip of the iliac crest outer surface of the anterosuperior iliac spine and deep surface of the fascia lata
what are the motions of the pelvis and hip in R LE WB( L LE NWB) and upright posture
anterior pelvic tilt> hip flexion posterior pelvic tilt> hip extension lateral pelvic tilt(drop on LT side)> RT hip adduction lateral pelvic tilt (hike on LT side)> RT hip abduction forward ROT. of LT side> RT hip IR backward ROT. of LT side> RT hip ER
what are the motions of the pelvis and lumbar spine in R LE WB (L LE NWB) and upright posture?
anterior pelvic tilt> increased lordosis of L spine posterior pelvic tilt> decreased lordosis of L spine lateral pelvic tilt(drop on LT side)> LT lateral sideband of L spine
origin sartorius
anterior superior iliac spine (ASIS) and superior half of the notch just distal to the spine
origin Piriformis
anterior surface of sacrum
origin adductor longus
anterior surface of the pubis at the junction of the crest and the symphysis
assisting actions of the upper fibers of gluteus Maximus
assist to abduct coxal JT; helps to stabilize knee in Exentsion through ITB
assisting actions of the lower fibers of gluteus maximus
assist to adduct coxal JT
where is the location of the iliotibial band?
between the tubercle of the iliac crest and the lateral condyle of the tibia B.
what Assisting muscles use external or lateral ROT. action on the Coxal or Hip joint?
biceps femoris long head psoas major Iliacus
anteriorly pelvic rotation on the left side goes what direction?
clockwise rotation
anteriorly pelvic rotation on the right side goes what direction?
counterclockwise rotation
insertion adductor brevis
distal 2/3 pectineal line and proximal half of the medial lip of liner aspera of the femur bone
origin of the long head at the biceps femoris M.
distal part of the sacrotuberous ligament and posterior part of the tuberosity of the ischium
action of the long head at the biceps femoris
extend coxal JT
primary action of all fibers of the gluteus Maximus
extend, externally ROT. Coxal JT
may assist action on gluteus medius on the posterior fibers
extension of coxal JT
may assist action of adductor Magnus posterior fibers
extension of the coxal jt
what is deep and covers a certain region of the leg?
extensive deep Fascia Lata covers gluteal region a thigh like sleeve
may assist action with origin fixed of psoas major
external ROT. and abduction of coxal JT
what is the proximal attachment at the Fascia Lata?
external lip of iliac crest sacrum and coccyx sacroturberous ligament ischial tuberosity ischiopubic rami inguinal ligament
origin gluteus minimus
external surface of ilium between anterior and inferior gluteal lines and margin of greater sciatic notch
origin of the gluteus medius
external surface of the ilium bone, between the iliac crest and posterior gluteal line dorsally, and the anterior gluteal line ventrally, and gluteal aponeurosis
origin Gemellus superior
external surface of the spine of the ischium
primary action of gluteus medius on the posterior fibers
externally ROT Coxal JT
action obturator externus
externally rot. coal jt
assist action of the long head at the biceps femoris
externally rot. coxal JT
action Gemellus inferior
externally rotate coxal JT
action Gemellus superior
externally rotate coxal JT
action quadratus femoris
externally rotate coxal JT
may assist action iliacus
externally rotate coxal JT abduction coxal JT
action Obturator internus
externally rotate coxal JT;
what is in the "Inside" of the Femoral Triangle?
femoral N., A., V. Inguinal lymph nodes great saphenous V.
innervation sartorius
femoral N., L 2 *, 3 *, (4)
innervation iliacus
femoral N., L(1), 2*, 3*, 4
innervation pectineus
femoral and obturator N., L2*-3*, 4
what are the non-contractile tissues of the hip and pelvis area?
femoral triangle trochancteric bursa sciatic N. ligaments
action sartorius
flex externally rot. abduct coxal jt. flex tibiofemoral jt
action with origin fixed iliacus
flex Coxal JT (by flexing femur on trunk)
may assist actions of gluteus minimus
flex coxal JT
insertion fixed and bilaterally action iliacus
flex coxal JT (by flexing trunk on femur)
primary action with origin fixed of psoas major
flex coxal JT flexing femur on trunk
primary action with insertion fixed and bilaterally acting of psoas major
flex coxal JT (flex trunk on femur), increase lumbar lordosis
action semitendinosus M.
flex knee (tibiofemoral JT); internally rot. the knee (tibiofemoral JT); extend the coxal JT
action semimembranosus M
flex knee at tibiofemoral JT, IR knee at tibiofemoral JT, extend coxal JT
action of the long and short head at the biceps femoris
flex knee. (at tibiofemoral JT); laterally rot. knee (at tibiofemoral JT)
action tensor fascia latae
flex, IR, and abduct coxal JT, tenses the fascia lata
what are the motion of the Hip/ Coxal joint
flexion extension IR/ medial rotation ER/ lateral rotation Adduction ABduction
may assist action on gluteus medius on the anterior fibers
flexion of coxal JT
may assist action of adductor Magnus anterior fibers
flexion of coxal jt
whats another word for pelvic rotation?
forward rotation
what assisting M. use adduction on the coxal or hip joint?
gluteus Maximus lower fibers obturator externus
what Assisting muscles use abduction on the coxal or hip joint?
gluteus maximus upper fibers psoas major iliacus
what primary muscles use external or lateral ROT. action on the Coxal or Hip joint?
gluteus maximus- all fibers piriformis quadratus femoris obturator internus obturator externus gemellus superior gemellus inferior gluteus medius: posterior fibers sartorius
what primary muscles use abduction on the Coxal or Hip joint?
gluteus medius- all fibers gluteus minimus tensor fasciae latae sartorius piriformis: when hip is flexed
what are the muscles for the second pelvis and hip?
hamstrings adductors sartorius tensor fasciae latae
when you're upright during posterior pelvic tilt, what happens to the hip?
hip joint extend
when you're upright during anterior pelvic tilt, what happens to the hip?
hip joints flex
innervation of Gluteus Maximus
inferior gluteal N., L5*, S1*-2*
origin gracilis
inferior half of the symphysis of the pubis and medial margin of the inferior ramus of pubic B.
origin of the anterior fibers at the adductor magnus
inferior rami of the pubis, rami of ischium
what is the structural arrangement with TFL and 2/4 of the gluteus Maximus?
insertion allows for their influence on the stablity of the extended knee joint
origin Obturator Internus
internal or pelvic surface of the obturator membrane and margin of the obturator foramen, pelvic surface of the ischium posterior and proximal to the obturator foramen, and to a slight extent the obturator fascia
primary action of the gluteus medius on the anterior fibers
internally ROT Coxal JT
assist action sartorius
internally rot the knee
insertion of gluteus maximus at the Deep fibers of the distal portion?
into gluteal tuberosity of the femur bone
Insertion of Gluteus Maximus on the larger proximal portion and superficial fibers of distal portion of the muscle?
into iliotibial tract of the fascia lata
insertion tensor fascia latae
into the iliotibial tract of the fascia lata at the junction of the proximal and middle thirds of the thigh
origin of the posterior fibers of the adductor Magnus
ischial tuberosity
origin semimembranosus M.
ischial tuberosity, proximal and lateral to the biceps femoris and semitendinosus
ligaments at the hip
ischiofemoral ligament iliofemoral ligament pubofemoral ligament
may assist action of the tensor fascia
knee extension
assist action with insertion fixed and unilaterally action of psoas major
lateral flexion of trunk ipsilaterally
origin of the short head at the biceps femoris M.
lateral lip of liner aspera of femur bone, proximal 2/3 of supracondylar line of femur bone, and lateral inter muscular septum
what is another name for Hip Hike?
lateral pelvic tilt
insertion iliacus
lateral side of tendon of Psoas major and just distal to the lesser trochanter of the femur bone
insertion biceps femoris M.
lateral side of the head of the fibula, lateral condyle of the tibia, deep fascia on the lateral side of the leg
insertion psoas major
lesser trochanter of the femur bone
innervation psoas major
lumbar plexus, L1, 2*, 3*, 4
insertion Gemellus superior
medial surface of greater trochanter (with tendon of obturator internus)
insertion Gemellus inferior
medial surface of greater trochanter (with tendon of the obturator internus)
insertion Obturator internus
medial surface of greater trochanter, proximal to the trochanteric fossa
insertion gracilis
medial surface of the body of the tibia, distal to the condyle (pes anserine); proximal to insertion of semitendinosus and lateral to the insertion of the sartorius
insertion adductor magnus
medial to the gluteal tuberosity, middle of line aspera, medial supracondylar line, and adductor tubercle of the medial condyle of the femur bone
insertion adductor longus
middle 1/3 medial lip of liner aspera of the femur bone
what is the posterior position in the saggital plane in the upright position?
most anterior part of the pelvis should be in a vertical line (ASIS and pubic symphysis)
insertion of the gluteus medius
oblique ridge of lateral surface of greater Trochanter of the femur bone
innervation gracilis
obturator N, L2*-4*
innervation adductor brevis
obturator N., L2*, 3*, 4*
innervation adductor longus
obturator N., L2*-3*, 4
innervation adductor magnus
obturator N., L2,3*,4* sciatic N., L4*,5,S1
innervation obturator externus
obturator N., L3*-4*
what May Assisting muscles use abduction on the coxal or hip joint?
obturator internus gemellus superior and inferior piriformis
origin adductor brevis
outer surface of the inferior ramus of pubis
what is the distal attachment at the Fascia Lata?
patella tibial condyles head of fibula medial fascia is thin lateral fascia is thick
insertion pectineus
pectineal line of femur B.
how does forward rotation work?
pelvis rotates around the left hip joint, right leg unweighted and moves forward on the right. results in IR at the left hip joint.
Origin of Gluteus Maximus?
posterior gluteal line of the ilium and portion of the bone superior and posterior to it, posterior surface of the lower part of the sacrum, side of the coccyx, aponeurosis of the erector spinae, sacrotuberous ligament and gluteal aponeurosis
Location of trochanteric bursa
posterior/lateral side of greater trochanter
insertion semimembranosus M.
posteromedial aspect of the medial condyle of tibia
origin quadratus femoris
proximal part of the lateral border of the tuberosity of the ischium
insertion semitendinosus M.
proximal part of the medial surface of the body of the tibia (often called Pes Anserine) and the deep fascia of the leg
insertion sartorius
proximal part of the medial surface of the tibia near Anterior Border
insertion quadratus femoris
proximal part of the quadrate line, extending distally from the intertrochanteric crest
origin Gemellus inferior
proximal part of the tuberosity of the ischium
what muscles make up the hip external rotator group?
quadratus femoris obturator internus obturator externus Gemellus superior Gemellus inferior piriformis
Origin Obturator Externus
rami of pubis and ischium, external surface of the obturator membrane
innervation quadratus femoris
sacral plexus, L4*, 5*, S1*, (2)
innervation Gemellus inferior
sacral plexus, L4-5, S1- (2)
innervation Obturator internus
sacral plexus, L5*, S1*, 2*
innervation Gemellus superior
sacral plexus, L5*, S1*, S2*
innervation piriformis
sacral plexus: L (5), S1*-2*
innervation of the short head at the biceps femoris
sciatic N. ( perineal branch), L5*, S1*-2*
innervation semimembranosus
sciatic N. (tibial branch), L4, 5*,S1*,2
innervation semitendinosus M.
sciatic N. (tibial branch), L4-5*, S1*-2*
innervation of the long head at the biceps femoris
sciatic N. (tibial branch), L5, S1*-2*, 3
origin iliacus
superior 2/3 of iliac fossa, internal lip of iliac crest, iliolumbar and ventral sacroiliac ligaments, and Ala of sacrum
insertion piriformis
superior aspect of greater trochanter
innervation gluteus minimus
superior gluteal N., L4*-5*, S1*
innervation tensor fascia latae
superior gluteal N., L4*05*, S1*
innervation of the gluteus medius
superior gluteal N., L4*_5*, S1*
origin pectineus
surface of the superior rams of pubis, ventral to the pecten, between the iliopectineal eminence and the pubic tubercle
what happens during lateral pelvic tilt?
the WB leg hip ADducts with lateral tilt, and the NWB leg hip ABducts
what are the hip abductor muscles doing during later pelvic tilt?
the hip abductor muscles on the WBL work to keep the pelvis level with the other leg in the air
when standing what happens during the lateral pelvic tilt?
the iliac crests should be level
what happens during Hip Hike?
the pelvis goes up on the unsupported leg
insertion obturator externus
trochanter fossa of femur
origin semitendinosus M.
tuberosity of the ischium by the tendon common with the long head of the biceps femoris M.
origin psoas major
ventral surfaces of the transverse processes of all lumbar vertebrae, sides of the bodies and corresponding intervertebral disks of the last thoracic and all lumbar vertebrae, and the membranous arches that extend over the sides of the bodies of the lumbar vertebrae
what is a hip drop?
when you pick up the LT or RT leg and the same leg that was lifted that hip drops
