CH. 18 Review Questions

Which hip joint muscles are not prime movers in any single action but are effective in a combination of movements? List the movements.

-Sartorius is involved in hip flexion, abduction, and lateral rotation -Ttensor fasciae latae is involved in flexion and abduction.

Bones that make up the hip joint.

Acetabulum of the innominate and head of the femur

If hip lateral rotation was limited, the femoral head is restricted from gliding in the __________ direction.

Anterior

Bones that make up the innominate.

Fused bones of the ilium, ischium, and pubis

A right-handed tennis player strikes a ball with a forehand swing and follows through. The left hip is moving into what positions (Fig. 18-35)?

Hip extension and medial rotation, and maybe some adduction

What is the end feel of hip flexion? Hip extension?

Hip flexion—soft; Hip extension—firm

When a tennis player hits the ball (see Fig. 18-35), what type of kinetic chain activity is occurring at the hip? At the shoulder?

Hip—closed chain; shoulder—open chain

Bones that make up the greater sciatic notch.

Ilium and ischium

Bones that make up the acetabulum.

Ilium, ischium, and pubis

Bones that make up the pelvis.

Innominate bones, the sacrum, and the coccyx

Bones that make up the obturator foramen.

Ischium and pubis

Does the femoral head surface glide in the same or opposite direction as the thigh during hip flexion/extension?

Opposite

When an assistive device is used as a result of hip pain, which hand should the cane be held in, and why?

Opposite so the cane can bear body weight and help prevent lateral tilt on the non-weight-bearing side

Why is the hip joint not prone to dislocation?

The acetabulum forms a deep socket holding most of the femoral head, and the joint is surrounded by three very strong ligaments.

What is referred to as the Y ligament? Why?

The distal attachment of the iliofemoral ligament; because it splits into two parts, forming an upside-down Y

What is the direction of the line of attachment of the hip ligaments—vertical, horizontal, or spiral? What does this line of attachment allow for?

The line of attachment of the ligaments is a spiral. This arrangement causes the ligaments to become taut as the joint moves into extension and to slacken with flexion, thus limiting hyperextension without impeding flexion.

Which two-joint hip muscles attach below the knee?

The rectus femoris, sartorius, gracilis, semitendinosus, semimembranosus, biceps femoris (long head), and tensor fascia latae muscles

What muscles keep your pelvis from dropping on one side when you lift one foot off the floor? Describe what happens.

When you lift your right foot off the floor, the left hip abductors and right trunk extensors contract to keep the right side of the pelvis from dropping. -A force couple exists when the hip abductors are pulling down while the trunk extensors are pulling up.

How would you determine whether an unattached femur is a right or left one?

With the femur in the vertical position, the linea aspera and lesser trochanter are posterior, and the head faces medially. Therefore, in this position the head of the right femur faces toward the left.

If you were handed an unattached innominate bone, what landmarks would you use to determine whether it was a right or left bone?

With the greater sciatic notch posterior and the body of the pubis anterior, the acetabulum faces laterally. Therefore, if the acetabular opening is facing to the right in this position, it is a right innominate bone.

If the position in Figure 18-37 was changed by holding the left knee in more flexion (difficult to achieve comfortably, but pretend), do you think this is a good position in which to stretch the rectus femoris? Why?

Yes. The rectus femoris is being stretched over both joints at the same time.

Pretend that you cannot completely extend your hip due to tight hip flexors. How might you compensate for this when standing?

You may compensate by standing with the lumbar spine in lordosis and the pelvis in anterior tilt or by leaning forward in a slightly flexed hip position.

Describe the hip joint: a)Number of axes: b) Shape of joint: c) Type of motion allowed:

a) 3 b) ball and socket c) flexion/extension, abduction/adduction, and rotation

Standing in anatomical position and keeping your pelvis fairly level, shift your weight to your right foot. a) What hip joint motion has occurred at your right hip? b) What muscle group initiates this action? c) Is this an open- or closed-chain activity?

a) Adduction b) Right hip adductors c) Closed

Regarding the statement "hanging on the Y ligaments": a) What position are the hips in relative to the shoulders? b) Where does the line of gravity fall relative to the hip joint axis of rotation? c) Gravity exerts a force that wants to move the hip into ____________. d) This strategy is most helpful when the hip ___________ muscles group is weak.

a) Anterior/ hips are in extension b) Posterior c) Extension d) Extensor

Starting in a supine position with the knees flexed, move into the position shown in Figure 18-39. a)What type of kinetic chain activity is this? b) What hip motion is occurring? c) What type of contraction is occurring? d) What hip muscle group is the agonist? e) If this motion could not be completed because a muscle was passively insufficient, what muscle would that be?

a) Closed b) Hip extension c) Concentric d) Hip extensors—gluteus maximus and hamstrings e) Hip flexor—rectus femoris

Repeat the exercise in question 4 with your left hip in approximately 30 degrees of flexion. Describe what has occurred in terms of: a) joint motion b) whether stretching or strengthening is occurring c) muscle(s) involved

a) Combination of hip abduction and flexion b) Strengthening c) Tensor fascia lata

Lie on your back with your hips and knees in extension. Raise your right leg toward the ceiling. a) Is a concentric or eccentric contraction occurring at the hip? b) The hip flexors are demonstrating what class of lever? c) What force do the hip flexors want to exert at the pelvis? d) What muscle group needs to contract to prevent the motion in (c)?

a) Concentric b) Third class c) Anterior tilt d) Trunk flexors

Figure 18-38 shows an individual doing hip flexion exercises two different ways. The starting position in both exercises is hip extension and knee extension. In exercise A, the person flexes the hips with the knees flexed. In exercise B, the person performs the same hip flexion motion but with the knees extended. a) Which exercise is more difficult? b) Why? c) In which exercise is an anterior pelvic tilt more likely to occur, and why?

a) Exercise B is more difficult. b) With the knees in extension, the resistance arm is much longer than in Exercise A. The force arm remains the same length in both. c) Exercise B, because the legs have created a longer lever and therefore exert more torque at the pelvis

a) How is hip flexion affected by sitting on a low surface versus a higher one (e.g., a regular versus a raised toilet seat)? b) What accompanying hip motions or positions may occur if a person has her feet apart, knees together, and hands on her knees, and she pushes down to assist when standing

a) Greater hip flexion is required with a low surface. b) Medial rotation and adduction may accompany the increased flexion.

Lying on your right side with your left hip and knee in extension, raise your left leg toward the ceiling about 2 feet. Describe what has occurred in terms of: a) joint motion b) whether stretching or strengthening is occurring c) muscle(s) involved

a) Hip abduction b) Strengthening c) Hip abductors—gluteus medius and gluteus minimus

Sitting on the floor with your legs far apart, lean forward from the hips while keeping your back straight. Describe what has occurred in terms of: a) hip joint motion b) whether stretching or strengthening is occurring c) muscle(s) involved

a) Hip abduction and flexion b) Stretching c) Adductors—pectineus, adductor longus, adductor brevis, adductor magnus d) Extensors (hamstrings)—semimembranosus, semitendinosus, biceps femoris

While lying prone with your right knee flexed, raise your right leg straight up, keeping your pelvis flat on the table. Describe what has occurred in terms of: a) hip joint motion b) whether stretching or strengthening is occurring c) muscle(s) involved

a) Hip hyperextension b) Strengthening c) Gluteus maximus

In the position shown in Figure 18-37, move your right leg forward until your right knee is directly over your right ankle. Your left hip is hyperextended and your left knee is flexed and resting on the floor. Rock your weight forward onto the front (right) leg without moving your right foot. Describe what has occurred at the left hip in terms of: a) joint motion b) whether stretching or strengthening is occurring c) muscle(s) involved

a) Hip hyperextension b) Stretching c) Iliopsoas

From the position described in question 5, slowly slide your feet down the table until your hips and knees are extended. Again, note the position of your pelvis and determine whether you can put your hand on the small of your back. Repeat this again, keeping your right knee and hip flexed with your foot flat while you move your left foot down until your left hip and knee are extended. a) What is accomplished at the pelvis by keeping your right hip and knee flexed? b) What can be said about left hip muscle length if you cannot rest your left thigh completely on the table? In other words, why would you not be able to extend your left hip? c) What is the one-joint hip muscle attaching on the pelvis and lumbar spine that may be responsible for this limitation? d) What difference does the position of the pelvis have on anterior hip muscle length?

a) It maintains the pelvis in a posterior tilt. b) There is not sufficient length of the hip flexors to complete the range of motion. c) Iliopsoas d) The anterior hip muscles must be elongated more when the pelvis is in a posterior tilt position versus an anterior tilt position.

What hip motions occur in: a) the transverse plane around the vertical axis? b) the sagittal plane around the frontal axis? c) the frontal plane around the sagittal axis?

a) Medial and lateral rotation b) Flexion/extension c) Abduction/adduction

While lying prone with your left knee flexed, raise your left leg straight up, keeping your pelvis flat on the table. a) Are the hamstrings contracting at their strongest? b) Why or why not?

a) No b) By having the knee flexed, the hamstrings are already shortened. As the hip goes into more hyperextension, the hamstrings will quickly become actively insufficient.

Lie supine on a table with your knees bent and feet flat. Note the position of your pelvis and determine whether you can put your hand on the small of your back. a) If you cannot, what is the position of your pelvis? b) If you can, what is the position of your pelvis and lumbar spine?

a) Posterior tilt b) Anterior tilt with increased lumbar lordosis

While weight-bearing on the left leg, note the motions of your right hip as you swing your right leg in the following activities: a) Walking b) Stepping up onto a curb c) Getting into a car d) Getting on what is commonly called a boy's bicycle (bar between handlebars and seat)

a) Swing phase includes hip flexion, extension, and hyperextension. b) Greater hip flexion than walking c) Hip flexion and abduction d) Combination of hip hyperextension, abduction, flexion, adduction as you swing your leg over the bike, and may also include some rotation

You are seated at a table. Stand up while turning to the right. Stop halfway through this motion (before you move your feet). a) The right hip is in what positions? (1) flexed/extended, (2) abducted/adducted, or (3) medially rotated/laterally rotated b) The left hip is in what positions? (1) flexed/extended, (2) abducted/adducted, or (3) medially rotated/laterally rotated

a) The right hip is flexed, adducted, and medially rotated. b) The left hip is extended, abducted, and laterally rotated.