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Pelvis, Hip, and Thigh Conditions

Pelvis, Hip, and Thigh Conditions. Chapter 14. Pelvis. Sacrum Coccyx Innominate bone Ilium Ischium Pubis Collectively protect the inner organs, bear weight, site of muscular attachments. Sacroiliac Joints. Help bear weight Provide elasticity to pelvic ring

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Pelvis, Hip, and Thigh Conditions

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  1. Pelvis, Hip, and Thigh Conditions Chapter 14

  2. Pelvis • Sacrum • Coccyx • Innominate bone • Ilium • Ischium • Pubis • Collectively protect the inner organs, bear weight, site of muscular attachments.

  3. Sacroiliac Joints • Help bear weight • Provide elasticity to pelvic ring • Iliac articulation covered in fibrocartilage • Sacral articulation covered in hyaline

  4. Sacrococcygeal Joint • Usually a fused junction • United by a fibrocartilaginous disc

  5. Pubic Symphysis • Cartilaginous joint with a disc of fibrocartilage called the interpubic disc • Spreads • Compresses • Rotates

  6. Femur • Strongest and longest bone in the body • Weakest link is the surgical neck • Angles at 125° in the frontal plane

  7. The hip joint • Acetabulum of the pelvis=socket • Head of the femur=ball • Both surfaces covered in cartilage • Acetabulum has a U-shaped cartilage structure known as the acetabular labrum

  8. Hip joint capsule • Coxofemoral joint is large and loose • Capsular fibers encircle the neck giving it great stability

  9. Ligaments of the Hip Joint • Ligament of Bigelow • AIIS-Femur • Pubofemoral ligament • Isciofemoral • Ligamentum teres • Occurs within the joint • Inguinal ligament • ASIS-pubic symphysis

  10. Inguinal ligament Sartorius Adductor longus Femoral nerve, artery, and vein all exist within Femoral Triangle

  11. Bursae • Iliopsoas – Iliopsoas and the articular capsule • Trochanteric – Greater trochanter and the gluteus maximus • Gluteofemoral – Gluteus maximus from the vastus lateralis • Ischial – Iscial tuberosity from the gluteus maximus

  12. Q-Angle • Angle between the quads and the tibial tuberosity • Lines drawn between ASIS and patella and between patella and tibial tuberosity • Generally 13° in males • Generally 18° in females

  13. Muscles-Flexion • Iliopsoas • Rectus femoris • Pectineus • Sartorius • Tensor fasciae latae

  14. Muscles-Extension • Gluteus maximus • Biceps femoris • Semitendinosus • Semimembranosus • Adductor magnus

  15. Muscles-Abduction • Gluteus medius • Gluteus minimus • Tensor fasciae latae • Sartorius • Piriformis

  16. Muscles-Adduction • Pectineus • Adductor brevis • Adductor magnus • Adductor longus • Gracilis

  17. Muscles-Medial Rotation • Gluteus medius • Gluteus minimus • Tensor fasciae latae

  18. Muscles-Lateral Rotation • Piriformis • Obturator internus • Obturator externus • Superior gemelli • Ingerior gemelli • Quadratus femoris • Gluteus maximus

  19. Nerves • Lumbar plexus • First four lumbar nerves • Sacral plexus • L4-S4 nerves

  20. Physical conditioning • Flexibility and strengthening of all overlapping muscle groups

  21. 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…

  22. Contusions • Hip pointer • Quadriceps contusion • Myositis Ossificans • Acute compartment syndrome

  23. Bursitis • Greater Trochanteric Bursitis • Iliopsoas Bursitis • Ischial Bursitis • Snapping Hip Syndrome

  24. Sprains and Dislocations • Posterior-superior dislocation

  25. Strains • Quadriceps Strain • Hamstrings Strain • Adductor Strain • Gluteal Strains • Piriformis Syndrome

  26. Vascular and Neural Disorders • Legg-Calvé-Perthes Disease • Venous Disorders • Thrombophlebitis • Phlebothrombosis • Toxic Synovitis • Obturator Nerve Entrapment

  27. Fractures • Avulsion fractures • Slipped capital femoral epiphysis • Stress fractures • Osteitis Pubis • Displaced and Nondisplaced Pelvic fractures • Sacral and Coccygeal fractures • Femoral Fractures

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