Kinesiology Exam 2

• Femur
• Sacrum
• Ilium
• Pubis
• Ischium

• right and left halves
• made of three bones
• **ilium
• **ischium
• **pubis
• Separate bones at birth
• fused at maturity

• Long bone
• function: lever
• longest bone in the body

• extension of the spinal column
• 5 fused vertabrae
• located posteriorly between the two pelvic bones
• sacroiliac joint formed by the juntion of the pelvis and sacrum

• flat bone
• function: for protection

• irregular bone
• function: protection

• irregular bone
• function: protection

• large stable joint
• Made of: head of femur(ball) and  acetebulum of pelvis(socket)
• structure: synovial joint
• Function: ball and socket joint

• stability
• mobility
• shock absorption
• protection

• 3 degrees of freedom
• frontal plane moption
• sagittal plane motion
• transverse plane motion

• ball
• spherical, smooth surface
• covered by articular cartilage

• cartilage that covers the ends of bones that form joints
• called hyaline cartilage
• shock absoprtion
• joint nutrition

• socket
• lined by hyaline articular cartilage
• needs to support entire body weight
• latin: little vinegar cup

• fibrocartilage
• deepens the socket
• provides more stability
• provides proprioception(awareness)
• latin: lip

• illiofemoral ligament
• ischiofemoral ligament
• pubofemoral ligament
• function: stability
• strong ligaments

• ilium to femur
• anterior to hip joint
• prevents abduction and external rotation

• connects the ischium to the femur
• triangular band of strong fibers
• posterior side of hip
• limits medial rotation

• pubis to femur
• anterior to hip joint
• limits abduction

• flexion
• extension
• hip abduction
• hip adduction
• internal rotation
• external rotation

• movement of the femur straight anteriorly toward the pelvis
• normal ROM: 0-130°
• large variability in "normal" ROM
• saggital plane motion

• movement of the femur straight posteriorly away from the pelvis
• normal ROM: 0-30°
• saggital plane motion

• movement of the femur laterally to the side away from the midline
• natural ROM: 0-30°
• frontal plane motion

• movement of the femur medially towards the midline
• normal ROM: 0-30°
• frontal plane motion

• rotary movement of the femur medially around its longitudinal axis towards the midline
• also called medial rotation
• normal ROM: 0-45°
• transverse plane motion

• rotary movement of the femur laterally around its longitudinal axis away from the midline
• also called lateral rotation
• natural ROM: 0-50°
• transverse plane motion

• psoas (major and minor)
• illiacus
• rectus femoris
• sartorius
• tensor fascia latae
• adductor longus
• PIRSTA

• O: T12-L5 vertebrae
• I: lesser trochanter of femur
• A: hip flexion

• O: Inner part of illium
• I: Lesser trochanter of femur
• A: Hip flexion

• O: Iliac spine
• I: tibial tuberosity
• A: Hip flexion, knee extension

• O: Anterior illium
• I: Upper medial tibia
• A: Hip Felxion

• O: Anterior iliac crest
• I: IT band
• A: Hip flexion, hip abduction

• O: anterior pubis
• I: Proximal medial femur
• A: hip flexion, hip adduction

• movement of femur straight posteriorly away from the pelvis
• normal ROM: 0-30°
• saggital plane of motion

• gluteus maximus
• semimembranosis
• semitendinosus
• biceps femoris

• O: posterior ilium
• I: greater trochanter of femur and IT band
• A: hip extension, external rotation

• O: ischial tuberosity
• I: proximal medial tibia
• A: hip extension, knee flexion

• O: ischial tuberosity
• I: proximal medial tibial
• A: hip extension, knee flexion

• O: ischial tuberosity
• I: lateral condyle
• A: hip extension, knee flexion

• movement of the femur laterally to the side away from the midline
• normal ROM: 0-45°
• frontal plane motion

• gluteus medius
• gluteus minimus
• tenso fascia latae

• O: lateral ilium
• I: Greater tochanter
• A: Hip abduction, also internal rotation (anterior fibers) and external rotation (posterior fibers)

• O: lateral ilium (below gluteus medius)
• I: greater trochanter
• A: Hip abduction also internal rotation (anterior fibers) and external rotation (posterior fibers)

• O: anterior iliac crest
• I: IT band
• A: Hip abduction

• movement of the femur medially towards the midline
• normal ROM: 0-30°
• Frontal plane motion

• adductor longus
• adductor brevis
• adductor magnus
• pectinius
• gracilis

• O: anterior pubis
• I: Proximal medial femur
• A: Hip adduction and hip flexion

• O: anteroinferior pubis
• I: proximal medial femur
• A: hip adduction

• O: pubis, ischium and ischial tuberosity
• I: posterior and medial femur
• A: hip adduction

• O: pubis
• I: upper medial femur
• A: hip flexion, adduction of hip and internal rotation

• O: pubis
• I: medial tibia
• A: hip adduction, hip internal rotation

• gracilis
• pectinius
• gluteus medius (anterior fibers)
• gluteus minimus (anterior fibers)
• tensor fascia latae

• gluteus medius (posterior fibers)
• gluteus minimus (psoterior fibers)
• gluteus maximus
• 6 deep external rotators
•      piriformis
•      superior glemellus
•      inferior glemellus
•      obturator internus
•      quadratus femoris
•      obturator externus

• O: sacrum and/or ischium
• I: great trochanter
• A: hip external rotation

• hip impingement/femoroacetabular impingement
• avascular necrosis
• greater trochanter bursitis
• hip fracture
• slipped capital femoral epiphysis
• hip pointer/contusion
• hip labral tear
• stress fractures
• adductor strain
• total hip replacement

• disruption of blood supply due to:
• trauma
• steroid use: asthma
• alcoholism: fatty deposits in bloodstream
• symptoms: pain in groin, ROM loss
• treatment: activity modification/surgery

• Incidence:
• 2 out of 100,000 children
• most common after onset of puberty
• makes>females
• more common in obese children
• bilateral  involvement occurs in over 25% of patients
• cause:
• unknown
• weakening of growth plate due to: trauma, inflammation, changes in hormone levels

• 25% of patients present with knee pain
• worsens with activity
• walks with limp
• cannot put weight affected leg in sever cases
• affected leg is often turned outward in comparison to normal leg
• loss of flexion and internal rotation ROM

• surgery: stabilize bone with pins or screws(bones are left with tilt seen at presentation
• possible complications:
• chondrlysis
• avascular necrosis
• greater risk of OA
• 1 short limb due to premature closer of the growth plate.

• usually to the femoral neck of the femur
• cause by trauma:
• falls, car accisdents
• usually over 65, bones become less dense with age, women>men
• Symptoms:
• pain in groin
• unable to bear weight on lef
• swelling and bruising
• Treatment:
• surgery

• most common affected tissue:
• gluteus medius tendon
• trochanteric bursa (hip bursitis)
• Common symptoms:pain over the greater trochanter
• pain with increased hip movements (walking, and stair climbing)
• if sever, pain when sleeping on affected side.

• tests and measures: pain when stretch IT band
• pain when a contract gluteus medius ro tensor fascia latae
• prevalence and etiology:
• 15% in women and 6.6% in men
• acute trauma(falls, impact)
• repetitive trauma (rubbing of IT band against bursa during repetitive motion) often related to increased activity or exercise
• management:
• addresses inflammation, ice, NSAIDs, rest, cortisone shot of severe
• stretch IT band
• restore hip ROM
• strengthen gluteus medius and tensor fascia latae

• bruise to the illium
• pain ABOVE groin
• treated with rest, ice, padding

• caused by overuse:
• runners
• military
• poor biomechanics
• usually occurs at femoral neck
• pain in groin:
• pain with running
• often no pain with walking or sitting
• treatment:
• rest
• pool running
• biomechanics analysis
• training modification

• pain in adductors (usually adductor longus)
• excessive motion
• treatment:
• rest, ice
• regain motion
• eccentric loading when able

• tear of fibrocartilage labrum
• causes:
• trauma
• excessive motion---> golf, hockey, gymnastics
• symptoms:
• may have no symptoms
• may have groin pain--->catching or popping
• pain with twisting
• motion loss
• treatment:
• nonsurgical: motion restoration, neuromuscular control
• surgical: repair debridement

• pain in groin due to SEVERE osterarthritis or trauma
• protective cartilage of the hip erodes

• protects the ends of bones:
• tough but elastic
• deformable yet stiff
• if it wears away-underlying bone is exposed and this is painful

• replaces the ball and socket
• end stage operation
• nothing else helped
• patient cant walk, function or sleep
• good outcome but has risks
• risks:
• infection
• blood clots
• death

• big femoral neck
• "linebacker"

overgrown acetabulum

CAM and pincer together

• ROM needs to be considered when considering the etiology of osteoarthritis in the hip
• often goes undiagnosed for years

• anterior groin pain
• limited hip flexion
• limited hip internal rotation
• positive FAI test
• pain with sitting
• pain with bending
• pain with twisting

• avascular necrosis
• slipped capital femoral epiphysis
• labral tearain
• hip fracture
• femoral nerve entrapment
• lumbar radiculopathy
• hernia
• hip frature
• stress fracture
• OA
• cancer
• adductor strain
• psoas strain

the act of moving from one place to another

the manner of walking

a smooth, highly coordinated,rhythimcal, undulating, reciprocal movement by which the body moves step by step in the required direction at the necessary speed

the period of time from one event(usually initial contact)od one foot to following occurrence of the same even with the ipsilateral foot

the period from the initial contact of a particular limb to the point of initial contact of the SAME limb and is equivalent to one gate cycle

• the period from initial contact of one limb to the initial contact of the contralateral limb.
• therefore there are two steps in each stride (or gait cycle)

the period of time when the foot is in contact with the ground

• the period of time when the foot is not in contact with the ground.
• in those cases where the foot never leaves the ground (drag foot) it can be defined as the phase when all portions of the foot are in forward motion

• the period of the time when both feet are in contact with the ground
• this occurs twice in the gait cyle
• at the beginning of stance phase and at the end

• the period of time when only one foot is in contact with the ground.
• in walking this is equal with the swing phase of the other limb

• the point in the gait cycle when the foot initially makes contact with the ground
• represents the beginning of stance phase
• foot strike

• the point in the gait cycle when the foot leaves the ground
• this represents the end of the stance phase OR the beginning of the swing phase
• toe-off should not be use in situations where the to is not the last part of the foot to leave the ground

when terminal contact is made with the toe

the point in time in the stance phase when the full foot is in contact with the ground

the point in the stance phase when the heel leaves the ground

• the distance from a point of contact with the ground of one foot to the following occurrence with the other foot
• the right step length is the distance from the left heel to the right heel when both feet are in contact with the ground.
• expressed in meters

• the period of time taken for one step and is measured from an even of one foot to the following occurrence of the same event of the other foot
• expressed in seconds

• the distance from initial contact of one foot to the following initial contact of the same foot.
• sometimes referred to as cycle length
• measured in meters

• the period of time from initial contact of one foot to the following initial contact of the other same foot
• measured in seconds

• the reate of change of the linear displacement along the direction of progression measured over one or more strides
• meter per second

• the rate at which a person walks
• steps per minute

• the ratio of stance period to swing period
• 60% stance
• 40% swing

the side to side distance between the feet which is typically measured from ankle joint center

the rate of walking that is voluntarily assumed

• maintenance of the position of the head, arms and trunk against gravity(75% of total body weight)
• maintenance of upright posture and balance
• control of foot movement for safe ground clearance and gentle heel contact

• controlled by the central nervous system postural (reflex activity)
• major afferent stimuli is provided by: tactile impulses from the sole of the foot
• proprioceptive impulses (from the lower limb, trunk and neck)

• the body can stand upright and bear the weight evenly on both lower limbs
• the body can alternately maintain weight on one limb while bringing the other limb foward
• the movements necessary for walking are present and coordinated (such as movements of trunk and arms)

• initial contact
• mid-stance
• foot off/push off

• begins at the time that one extremity contacts the ground (initial contact) and continues as long as some portion of the same foot is in contact with the ground
• ends when the reference foot lifts off the ground (foot off/push off)
• weight bearing phase
• provides stability of the gait
• necessary for accurate swing phase to take place

• initial contact
• loading response
• midstance
• terminal stance
• pre-swing

• position of double support
• the initial contact of the leading stance foot and the toes of the other foot are both on the ground

• weight is transfered onto the outstretched limb
• the first period of double support

• defined as the time the opposite limb leaves the floor until the body weight is aligned over the forefoot
• body progresses over a single, stable limb

• the heel is raised as the body moves forward over the stance limb
• the body moves ahead of the limb

• the second (and final) double support stance period
• defined from the time of initial contact of the contralateral limb to ipsilateral toe-off
• unloading the limb occurs as weight is transferred to the contralateral limb

• pre-swing
• mid-swing
• terminal swing