Lumbar and hips
Bones
Femur
Gets blood from obturator N.
Fovea Capitis
Lesser Trochanter
Greater Trochanter
Neck
Head
Patella
Odd facets, medial facets, and lateral facets
seasmoid bone and its embedded into the quadriceps tendon
Tibia
2 Condyles : medial (C shaped) lateral (O shaped)
Pelvic Girdle
Function: support the abdomen, links vertebral column to the lower limbs and transmits forces from the lower limbs to the vertebral column through trabecular systems
Sacrum and coccyx
Fused posteriorly by the sacroiliac joint
Fused Anteriorly by the pubic symphysis
Composed of ilium, ischial, pubic known as innominate bone or os coxae
Blood Supply
Abdominal aorta
Common iliac artery
External and internal iliac artery (at L4 and L5)
External iliac artery turns into femoral artery & internal iliac artery turns into anterior and posterior iliac artery (below the inguinal ligament)
The internal iliac artery becomes anterior and posterior iliac artery and they innervate the pelvic girdle
Under the inguinal ligament the femoral nerve then enters the femoral triangle
In the femoral triangle, the profunda femoris artery arises and travels posteriorly giving off : perforating branches, lateral femoral circumflex, medial circumflex.
Femoral Artery then goes down the adductor canal and exits through the adductor hiatus and turns into popliteal artery
Pelvic Girdle Muscles
Levator Ani
Iliococcygeus
Iliococcygeus: Coccygeus (ishiococcygeus)
Pubococcygeus which includes puborectalis & pubovaginalis
Piriformis
Closes floor of inferior bony pelvis
Supports pelvic viscera
Obturator internus
Lower Limb Muscles
Anterior Compartment
Majority innervated by the femoral artery
Ilium
Tensor Fascia Latae
Vastus Intermedius
Vastus Lateralis
Vastus Medialis
Rectus Femoris
Preforms: knee extension & hip flexion
Sartorius
Performs: Hip flexion, abduction, and external rotation & Knee flexion
Pectinous
Psoas Major
Medial Compartment
Adducts the hip
Majority Innervated by the Obturator N.
Gracilis
Subtopic
Adductor Magnus: Has 2 components (adductor innervated by the obturator n.) (hamstring portion and innervated by the sciatic n. tibial)
Adductor Brevis
Adductor Longus
Posterior
Flexes the knee and Extend the hip
Gets supplied by the inferior gluteal artery and perforating branches of the deep femoral artery
Majority innervated by the Sciatic N. tibial portion
Adductor Magnus
Semitendinosus
Semimembranosus
Bicep Femoris: Has 2 heads (short head: origin is linea aspera and innervated by common fibular) (long head: origin ischial tuberosity and innervated by the sciatic n. tibial
Male Reproductive Organs
Processes of ejaculation
Testes
Epididymus
Ductus Deferens & Seminal Glands
Ejaculatory Duct
Prostate
Urethra
Female Reproductive Organs
Vagina
Discharges menstrual fluid and other vagina fluids
Fallopian Tube
Where oocytes get fertilized
Uterus
3 Layers: Endometrium (inner layer: Baby develops), Myometrium (middle layer: menstruation occurs), perimetrium (outer layer)
Anterior Thigh Compartment
Femoral Triangle
Roof: Fascia Lata
Floor: Iliopsoas
Lateral Border: Sartorius
Medial Border: Adductor Longus
Superior Border: Inguinal Ligament
Includes: Femoral Artery, Femoral Vein, Femoral Nerve
Adductor Canal
Contents: Femoral A.&V. , Saphenous N.
The femoral a. become the popliteal A. after passing thorough the adductor hiatus
Anterior-medially: Sartorius
Lateral: Vastus Medialis
Posterior: Adductor Longus & Adductor Magnus
Ligaments of the Hip
Iliofemoral Ligament
Prevents excess extension & external rotation
Y ligament
Pubofemoral Ligament
Prevents excess extension & abduction
Ishiofemoral Ligament
Prevents excess extension & Adduction
Joints
Femorotibial Joint
Formed by articulation of the medial and lateral condyles of the femur with the lateral tibial condyles on tibial plateau
Knee Joint
Modified Hinge Joint
Femoropatellar Joint
Medial and lateral condyles with condylopatellar facets/surfaces
Knee Angels
Alignment in Frontal Plane
>20 degrees is abnormal
A slight Valgus is normal
Valgus
Knocked Knees
<165 degrees
Excessive Genu Valgum
Varus
Bow string
>180 degrees
Excess Genu Varus
Q Angle
Abnormal >20 degrees
normal Q angle 10-15 degrees
Another measurement of valgus
Ligaments of Knee
MCL Limits
Valgus
Femur ADD
Tibial ABD
LCL Limits
Varus
Femur ABD
Tibial ADD
ACL Limits
Anterior translation of tibia relative to femur
PCL Limits
Posterior translation of tibia relative to femur
Biomechanics Hip Motion/Lsp Motion/ Lsp Arthrokinematics/ open chain/ closed chain
Anterior Pelvic Tilt
Lsp Arthrokinematics: Posterior/ Inferior
Lsp Motion: Extension
Hip: Flexion
Posterior Pelvic Tilt
Facets fo anterior/ superior
Flexion of back
Extension of Hip
(Right side weight bering) Lateral tilt Pelvic drop
Abduction on hip
L facet goes up and R facet goes down
Lateral flexion of right side (compensation)
Left Hip drop
(Right side weight bearing) Lateral Tilt pelvic hike
Hip is Abduction
Left facet goes down R Facet goes Up
Lateral Flexion on Left side
Left hip Hip
Open Chain
Flexion: Posterior Roll; Posterior glide
Extension: Anterior Roll; anterior glide
Closed Chain
Extension (sit -> stand) Anterior Roll; posterior glide
Flexion (stand -> sit) Posterior Roll; Anterior glide
Gluteal Region
Superficial
Gluteus Maximus Externally rotates and extends the leg while the rest of superficial muscles internally rotates
Tensor Fasia Lata
Gluteus Medius
Gluteus Minimus
Gluteus Maximus
Deep
The Deep muscles externally rotate the leg
Quadratus Femoris
Inferior Gemelles
Obturator Internus
Superior Gemelles
Piriformis
Bursae
Obturator Internus Bursa: Located between the obturator internus muscle and then ischial spine and tuberosity
Obturator Externus Bursa: Located between the Obturator externus muscle and the posterior neck of the femur
Trochanter Bursa: Located between the greater trochanter and the gluteus maximus
Gluteofemoral bursa: Located between the Gluteus maximus and then greater trochanter
Ischial Bursa: Located between the Gluteus maximus and the Ischial tuberosity
Physical Therapy Applications
Trochanteric Bursitis
This occurs when there is an inflammation of the bursitis. Results from repetitive actions such as climbing stairs or even running on a treadmill. These movements involve the gluteus maximus which moves superior tendinous fibers repeatedly back and forth over the bursa of the greater trochanter.
Trendelenburg Sign
Produced when a patient is asked to stand on one leg and the opposite side that is not standing on the ground drops (pelvic drop). Superior glute nerve innervates the gluteus medius and minimus which plays an important role in stabilizing the pelvis during locomotion.
If the right gluteal muscle is weak = left side will drop when the patient stands on right leg
Menisci
Gets Nutrition vis osmosis
Semimembranosus attaches to medial meniscus and Popliteus attaches to lateral meniscus
Provides proprioception via tension on coronary ligaments and muscular attachments
Increases concavity of the tibial condyle (Joint Stability)
Reduces localized pressure on the articular surfaces by improving congruency