Transcript PTA Hip Presentation

PTA Students Curtis, Tonya, Emilee, & Zeke
Them Bones…..
…Of the iliofemoral joint.
And one extra.
Os Coax: The Pelvic Trifecta
Medial View
Lateral View, with a side of landmarks
Find the Angry Bird
The Femur: Foreplay for cave men
Tibia- Not part of the hip, but it was
on the list, so here goes….
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Iliofemoral ligament
Pubofemoral ligament
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Ischiofemoral ligament
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Sacrotuberous ligament
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Transverse acetabular ligament
Acetubular labrum
Articular cartilage of head of femur
Ligament of head of femur
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Synovial membrane
Fibrous layer
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Zona orbicularis
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Trochanteric bursa
 Deep
 Superficial
Gluteofemoral bursa
Ischial Bursa
Pectineus
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Innervation:
 Femoral Nerve, also fibers from obturator nerve
Origin:
 Superior Ramus of Pubis
Insertion:
 Pectineal line inferior to lesser trochanter of femur
Action:
 Flexes, adducts and assists with medial rotation
Synergist:
 Flexion = Rectus Femoris and Iliopsoas
 Adduction = Adductors (all 3) and gracilis
 Medial Rotation = Gluteus Minimus
Antagonist:
 Extension = Gluteus Maximus, Semimembranosus, Semitendinosus, and Biceps
Femoris
 Abduction = Gluteus Medius and Minimus
 Lateral Rotation = Gluteus Maximus
Sartorius
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Innervation:
 Femoral Nerve
Origin:
 Anterior superior iliac spine
Insertion:
 Upper medial surface of body of tibia
Action:
 Flexes knee
 Flexes, abducts and laterally rotates hip
Synergist:
 Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
 Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Hip Abduction = Gluteus Medius and Minimus
Antagonist
 Knee Extension = Quadriceps muscles
 Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus &
Biceps Femoris
 Hip Adduction = Adductors (all 3), Pectineus & Gracilis
Iliopsoas
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Psoas Major & Iliacus
Innervation:
 Lumbar Nerves
 Femoral Nerves
Origin:
 Transverse Process of T12-L5
 Iliac Crest, Iliac Fossa, Anterior Sacroiliac Ligament
Insertion:
 Lesser Trochanter
Action:
 Hip/Thigh Flexion
Synergist:
 Hip Flexion = Rectus Femoris & Pectineus
Antagonist:
 Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps
Femoris
Quadriceps Femoris: Rectus Femoris
 Innervation:
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Origin:
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Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action:
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Anterior inferior iliac spine
Insertion:
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Femoral Nerve
Knee Extension and Hip Flexion
Synergist:
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Knee Extension = Vastus Medialis, Intermedialis & Lateralis
 Hip Flexion = Iliopsoas & Pectineus
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Antagonist:
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Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
 Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps Femoris
Quadriceps Femoris: Vastus Medialis
 Innervation:
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Origin:
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Knee Extension
Synergist:
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Patella via the quadriceps tendon and then tibial tuberosity via the patellar ligament
Action:
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Linea Aspera of the femur
Insertion:
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Femoral Nerve
Knee Extension = Rectus Femoris, Vasus Lateralis and Intermedius
Antagonist:
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Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Quadriceps Femoris: Vastus Lateralis
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Innervation:
 Femoral Nerve
Origin:
 Intertrochanteric line and linea aspera of the femur
Insertion:
 Patella via the quadriceps tendon and then tibial tuberosity via the patellar
ligament
Action:
 Knee Extension
Synergist:
 Knee Extension = Rectus Femoris, Vastus medialis and intermedialis
Antagonist:
 Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Quadriceps Femoris: Vastus Intermedius
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Innervation
 Femoral Nerve
Origin
 Anterior 2/3 and lateral shaft of femur
Insertion
 Patella via quadriceps tendon and then tibial tuberosity via patellar ligament
Action
 Knee Extension
Synergist
 Knee Extension = Rectus Femoris, Vastus Lateralis and Medialis
Antagonist
 Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Adductor Brevis
 Innervation:
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Origin
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Superior half of linea aspera of femur
Action
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Anterior surface of the inferior ramus of the pubis
Insertion
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Obturator Nerve
Adducts, flexes and helps to laterally rotate the hip
Syngerist
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Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus
 Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Lateral Rotation = Gluteus Maximus
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Antagonist
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Hip Abduction = Gluteus medius and minimus
 Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps
Femoris
 Medial Rotation = Gluteus Minimus
Adductor Longus
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Innervation:
 Obturator Nerve
Origin:
 Body of pubis inferior to pubic crest and lateral pubic symphysis
Insertion:
 Middle 1/3 of linea aspera of the femur
Action:
 Adducts, flexes & laterally rotates the hip
Synergist:
 Hip Adduction = Adductors longus and magnus, Gracilis & Pectineus
 Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Lateral Rotation = Gluteus Maximus
Antagonist:
 Hip Abduction = Gluteus medius and minimus
 Hip Extension = Gluteus maximus, Semimembranosus, Semitendinosus & Biceps
Femoris
 Medial Rotation = Gluteus Minimus
Adductor Magnus
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Innervation:
 Obturator and Tibial Nerves
Origin:
 Inferior ramus of pubis and ischium to ischial tuberosity
Insertion:
 Linea aspera of the femur and medial supracondylar line
Action:
 Adducts thigh, superior horizontal fibers flex the thigh and posterior portion
extends thigh at hip joint
Syngerist:
 Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus
 Hip Flexion = Rectus femorus, Iliopsoas & Pectineus
Antagonist:
 Hip Abduction = Gluteus medius and minimus
 Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps
Femoris
Gracilis
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Innervation:
 Obturator Nerve
Origin:
 Body and inferior ramus of pubis
Insertion:
 Anterior medial proximal tibis
Action:
 Adducts and medial rotates hip
 Knee Flexion
Synergist:
 Hip Adduction = Adductors Brevis, Longus & Magnus, Pectineus
 Medial rotation of hip = Gluteus Minimus
 Knee Flexion = Semimembranosus, Semitendinosus & Biceps Femoris
Antagonist:
 Hip Abduction = Gluteus Medius and Minimus
 Lateral rotation of hip = Gluteus Maximus
 Knee Extension = Rectus Femoris & Vastus medialis, lateralis & intermedius
Tensor Fasciae Latae
 Innervation:
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Origin:
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Tibia by way of the iliotibial tract
Action:
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Anterior superior iliac spine and anterior iliac crest
Insertion:
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Superior Gluteal Nerve
Flexes and abducts the thigh at the hip joint and helps to stabilize and stead the hip and
knee joints by putting tension on the iliotibial band of fascia
Synergist:
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Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Hip Abduction = Gluteus medius and minimus
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Antagonist:
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Hip Extension = Gluteus Maximus, Semimembranosus, Semitendinosus & Biceps
Femoris
 Hip Adduction = All 3 Adductors, Gracilis & Pectineus
Gluteus Maximus
 Innervation:
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Origin:
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Iliotibial tract of fascia lata and lateral part of linea aspera under greater trochanter
(gluteal tuberosity) of the femur
Action:
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Iliac crest, Sacrum, Coccyx & Aponeurosis of Sacrospinalis
Insertion:
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Inferior Gluteal Nerve
Extends the thigh at the hip and laterally rotates thigh – middle fibers abduct the hip
Synergist:
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Hip Extension = Semimembranosus, Semitendinosus & Biceps Femoris
 Hip Abduction = Gluteus medius and minimus
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Antagonist:
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Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Hip Adduction = Adductors longus and brevis, Gracilis & Pectineus
 Medial Rotation of Hip = Gluteus Minimus
Gluteus Medius
 Innervation:
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Origin:
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Abducts and medially rotates the hip
Synergist:
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Greater Trochanter of the Femur
Action:
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Dorsal ilium inferior to the iliac crest
Insertion:
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Superior Gluteal Nerve
Gluteus Minimus (for both)
Antagonist:
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Hip Adduction = All 3 Adductors, Gracilis & Pectineus
 Lateral Rotation of the Hip = Gluteus Maximus
Gluteus Minimus
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Origin:
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Abducts and medially rotates the hip
Synergist:
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Greater trochanter of the femur
Action:
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Dorsal Ilium between inferior and anterior gluteal lines
Insertion:
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Superior Gluteal Nerve
Gluteus Medius (for both)
Antagonist:
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Hip Adduction = All 3 Adductors, Gracilis & Pectineus
 Lateral Rotation of the Hip = Gluteus Maximus
Piriformis
 Innervation:
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Origin:
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Superior border of the greater trochanter
Action:
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Anterior surface of lateral process of sacrum and gluteal surface of ilium at the margin
of the greater sciatic notch
Insertion:
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Piriformis Nerve
Laterally rotates and abducts the thigh at the hip joint
Synergist:
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Hip Abduction = Gluteus medius and minimus
 Lateral Rotation of Hip = Gluteus Maximus
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Antagonist:
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Hip Adduction = All 3 Adductors, Gracilis & Pectineus
 Medial Rotation of Hip = Gluteus medius and minimus
Biceps Femoris
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Innervation:
 Tibial Nerve
Origin:
 Long Head: Ischial Tuberosity
 Short Head: Linea aspera of the femur
Insertion:
 Head of fibula and lateral condyle of the tibia
Action:
 Long Head: Extends hip and flexes knee
 Short Head: Flexes knee and laterally rotates hip
Synergist:
 Hip Extension = Gluteus Maximus
 Extension of Hip and Flexion of Knee = Semitendinosus and
semimembranosus
 Lateral Rotation of Hip = Gluteus Maximus
Antagonist:
 Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Knee Flexion = Vastus (lateralis, medialis & intermedialis)
 Medial Rotation = Gluteus Minimus
Semitendinosus
 Innervation:
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Origin:
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Ischial Tuberosity
Insertion:
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Tibial Nerve
Proximal part of medial surface of shaft
Action:
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Knee Flexion
 Extends and medially rotates hip
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Synergist:
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Knee Flexion = Biceps Femoris, Semimembranosus
 Hip Extension = Gluteus Maximus, Biceps Femoris & Semimembranosus
 Medial Rotation of Hip = Gluteus Minimus
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Antagonist:
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Knee Extension = Rectus Femoris, Vastus (medialis, lateralis & intermdialis)
 Hip Flexion = Rectus Femoris, Iliopsoas & Pectineus
 Lateral Rotation of Hip = Gluteus Maximus
Semimembranosus
 Innervation:
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Origin:
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Ischial Tuberosity
Insertion:
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Tibial Nerve
Posterior medial condyle of tibia
Action:
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Knee Flexion
 Extends and medially rotates the hip
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Synergist:
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Knee Flexion = Biceps femoris & Semitendinosus
 Medial Rotation = Gluteus minimus
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Antagonist:
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Knee Extension = Rectus Femoris & Vastus (medialis, lateralis & intermedialis)
 Lateral Rotation of Hip = Gluteus maximus
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Femoral Nerve
Obturator Nerve
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Sciatic Nerve
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Superior Gluteal nerve
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Inferior gluteal nerve
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Common peroneal nerve
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Femoral artery
Lateral circumflex
artery
 Obturator artery
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Deep femoral
(Profunda) artery
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Superior Gluteal Artery
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Inferior Gluteal Artery
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Femoral Vein
Profunda
(Deep Femoral) Vein
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Great Saphenous Vein
-Gluteal fold/Gluteal Sulcus
-Sacrum
-Posterior superior
iliac spine
-Tip of Greater trochanter
-Intergluteal cleft
-Iliac crest
-Supracristal plane
-Anterior superior
iliac spine
-Inguinal ligament
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Piriformis Syndrome-is a
neuromuscular disorder
that occurs when the
sciatic nerve is
compressed or otherwise
irritated by the Piriformis
muscle causing pain,
tingling and numbness in
the buttocks and along
the path of the sciatic
nerve descending down
the lower thigh and into
the leg.