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Pelvis, Hip, and Thigh Conditions
Chapter 14
Pelvis
SacrumCoccyxInnominate bone Ilium Ischium Pubis
Collectively protect the inner organs, bear weight, site of muscular attachments.
Sacroiliac Joints
Help bear weightProvide elasticity to pelvic ringIliac articulation covered in fibrocartilageSacral articulation covered in hyaline
Sacrococcygeal Joint
Usually a fused junctionUnited by a fibrocartilaginous disc
Pubic Symphysis
Cartilaginous joint with a disc of fibrocartilage called the interpubic discSpreadsCompressesRotates
Femur
Strongest and longest bone in the bodyWeakest link is the surgical neckAngles at 125° in the frontal plane
The hip joint
Acetabulum of the pelvis=socketHead of the femur=ballBoth surfaces covered in cartilageAcetabulum has a U-shaped cartilage structure known as the acetabular labrum
Hip joint capsule
Coxofemoral joint is large and looseCapsular fibers encircle the neck giving it great stability
Ligaments of the Hip Joint
Ligament of Bigelow AIIS-Femur
Pubofemoral ligamentIsciofemoralLigamentum teres Occurs within the joint
Inguinal ligament ASIS-pubic symphysis
Femoral Triangle
Inguinal ligamentSartoriusAdductor longusFemoral nerve, artery, and vein all exist within
Bursae
Iliopsoas – Iliopsoas and the articular capsuleTrochanteric – Greater trochanter and the gluteus maximusGluteofemoral – Gluteus maximus from the vastus lateralisIschial – Iscial tuberosity from the gluteus maximus
Q-Angle
Angle between the quads and the tibial tuberosityLines drawn between ASIS and patella and between patella and tibial tuberosityGenerally 13° in malesGenerally 18° in females
Muscles-Flexion
IliopsoasRectus femorisPectineusSartoriusTensor fasciae latae
Muscles-Extension
Gluteus maximusBiceps femorisSemitendinosusSemimembranosusAdductor magnus
Muscles-Abduction
Gluteus mediusGluteus minimusTensor fasciae lataeSartoriusPiriformis
Muscles-Adduction
PectineusAdductor brevisAdductor magnusAdductor longusGracilis
Muscles-Medial Rotation
Gluteus mediusGluteus minimusTensor fasciae latae
Muscles-Lateral Rotation
PiriformisObturator internusObturator externusSuperior gemelliIngerior gemelliQuadratus femorisGluteus 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 pointerQuadriceps contusionMyositis OssificansAcute compartment syndrome
Bursitis
Greater Trochanteric BursitisIliopsoas BursitisIschial BursitisSnapping Hip Syndrome
Sprains and Dislocations
Posterior-superior dislocation
Strains
Quadriceps StrainHamstrings StrainAdductor StrainGluteal StrainsPiriformis Syndrome
Vascular and Neural Disorders
Legg-Calvé-Perthes DiseaseVenous Disorders Thrombophlebitis Phlebothrombosis
Toxic SynovitisObturator Nerve Entrapment
Fractures
Avulsion fracturesSlipped capital femoral epiphysisStress fracturesOsteitis PubisDisplaced and Nondisplaced Pelvic fracturesSacral and Coccygeal fracturesFemoral Fractures
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