15 1 Kinesiology for Manual Therapies Chapter 15

15 -2 Learning Outcomes 15 -1 Define key terms. o 15 -2 Identify on

15 -3 Learning Outcomes (cont. ) 15 -4 Draw on a skeletal chart the

15 -4 Learning Outcomes (cont. ) ¡ ¡ ¡ Mc. Graw-Hill 15 -6 Palpate

15 -5 Introduction The pelvic girdle provides a sturdy foundation for the trunk and

15 -6 Bones The head of the femur connects with the cup-shaped acetabulum of

15 -7 Bones (cont. ) The pelvic girdle consists of the right and left

15 -8 Bones (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -9 Bones (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -10 Bones (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -11 Bones (cont. ) Additional important bony landmarks include the ischial tuberosity of

15 -12 Joints The pelvic bones join in the front to form the symphysis

15 -13 Joints (cont. ) The hip joint is classified as an enarthrodial-type joint

15 -14 Joints (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -15 Joints (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -16 Movements Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All

15 -17 Movements (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -18 Movements (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -19 Movements (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -20 Muscles Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All

15 -21 Muscles (cont. ) The hip flexor iliopsoas muscle is composed of the

15 -22 Muscles (cont. ) The deep six lateral rotators are the piriformis, obturator

15 -23 Muscles (cont. ) The thigh has three compartments. The anterior compartment houses

15 -24 Muscles (cont. ) The posterior compartment contains the hamstrings consisting of the

15 -25 Muscles (cont. ) The medial compartment contains the adductor group of adductor

15 -26 Muscles (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -27 Muscles (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -28 Muscles (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -29 Muscles (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -30 Muscles (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -31 Nerves The hip and pelvic girdle muscles are all innervated from the

15 -32 Nerves (cont. ) The femoral nerve innervates the anterior muscles of the

15 -33 Nerves (cont. ) The sciatic nerve is composed of the tibial nerve

15 -34 Nerves (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -35 Nerves (cont. ) Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies,

15 -36 Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior Iliopsoas

Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont. ) Iliopsoas

Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont. ) Sartorius

Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont. ) Rectus

Individual Muscles of the Hip Joint and Pelvic Girdle – Anterior (cont. ) Tensor

Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior Gluteus Maximus Mc.

Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont. ) Gluteus

Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont. ) Lateral

Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont. ) Hamstrings

15 -53 Individual Muscles of the Medial Thigh Adductor Brevis Mc. Graw-Hill © 2011

15 -54 Individual Muscles of the Medial Thigh (cont. ) Adductor Brevis Mc. Graw-Hill

Individual Muscles of the Medial Thigh (cont. ) Adductor Longus Mc. Graw-Hill © 2011

Individual Muscles of the Medial Thigh (cont. ) Adductor Magnus Mc. Graw-Hill © 2011

Individual Muscles of the Medial Thigh (cont. ) Pectineus Mc. Graw-Hill © 2011 by

Individual Muscles of the Medial Thigh (cont. ) Gracilis Mc. Graw-Hill © 2011 by

15 -63 Chapter Summary The bones, joints, movements, muscles, and nerves of the hip

15 -64 Chapter Summary (cont. ) Individual muscles of the hip joint and pelvic

15 -65 Chapter Review ¡ The Chapter Review is divided into true and false,

15 -66 Explore and Practice ¡ Students should utilize the questions and charts at

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15 -2 Learning Outcomes 15 -1 Define key terms. o 15 -2 Identify on a human skeleton selected bony features of the hip joint and pelvic girdle. o 15 -3 Label on a skeletal chart selected bony features of the hip joint and pelvic girdle. o Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -3 Learning Outcomes (cont. ) 15 -4 Draw on a skeletal chart the individual muscles of the hip joint, including origins and insertions. ¡ 15 -5 Demonstrate all the active and passive movements of the hip joint and pelvic girdle with a partner. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -4 Learning Outcomes (cont. ) ¡ ¡ ¡ Mc. Graw-Hill 15 -6 Palpate the muscles of the hip joint and pelvic girdle, including attachments, on a partner. 15 -7 Organize and list the agonists, antagonists, and synergists that produce movement of the hip joint and pelvic girdle. 15 -8 Practice flexibility and strengthening exercises for each muscle group. © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -5 Introduction The pelvic girdle provides a sturdy foundation for the trunk and spine. ¡ The hip joint, or acetabular femoral joint, performs free range of movement like the shoulder joint. ¡ The lower extremities depend on the hip joint to be relatively stable. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -6 Bones The head of the femur connects with the cup-shaped acetabulum of the pelvic girdle. ¡ Bony landmarks, the greater and lesser trochanter, provide attachments for many muscles spanning from the pelvic bones and even the vertebrae anteriorly. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -7 Bones (cont. ) The pelvic girdle consists of the right and left pelvic bone joined together posteriorly by the sacrum; inferior to the sacrum is the coccyx. ¡ The pelvic bones consist of three bones: the ilium, the ischium, and the pubis. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -11 Bones (cont. ) Additional important bony landmarks include the ischial tuberosity of the posterior ischium and the linea aspera on the posterior femur. ¡ Anterolaterally, Gerdy’s tubercle provides the insertion point for the iliotibial tract. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -12 Joints The pelvic bones join in the front to form the symphysis pubis, an amphiarthrodial joint. ¡ The sacrum is located between two bones and form the sacroiliac joint made up of strong ligaments. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -21 Muscles (cont. ) The hip flexor iliopsoas muscle is composed of the iliacus, the psoas major, and the psoas minor. ¡ The posterior gluteal region contain the gluteal maximus, gluteus medius, and gluteus minimus. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -22 Muscles (cont. ) The deep six lateral rotators are the piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferior, and quadratus femoris. ¡ The tensor fasciae latae attaches anteriorly and laterally to abduct and flex the hip. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -23 Muscles (cont. ) The thigh has three compartments. The anterior compartment houses the quadriceps; the rectus femoris and the knee extenders vastus medialis, vastus intermedius, and vastus lateralis. ¡ The sartorius runs superficial to the quadriceps. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -24 Muscles (cont. ) The posterior compartment contains the hamstrings consisting of the biceps femoris, the semitendinosus, and the semimembranosus. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -25 Muscles (cont. ) The medial compartment contains the adductor group of adductor brevis, adductor longus, adductor magnus, pectineus, and gracilis. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -31 Nerves The hip and pelvic girdle muscles are all innervated from the lumbar plexus and sacral plexus known as the lumbosacral plexus. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -32 Nerves (cont. ) The femoral nerve innervates the anterior muscles of the thigh and provides sensation to the anterior and lateral thigh and medial leg and foot. ¡ The obturator nerve innervates the adductor as well as the obturator externus and sensation to the medial thigh. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -33 Nerves (cont. ) The sciatic nerve is composed of the tibial nerve and common peroneal nerves. ¡ The sciatic nerve tibial division innervates the hamstrings and adductor magnus. Both nerves continue down the lower extremity to function the muscles of the leg and foot. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

Individual Muscles of the Hip Joint and Pelvic Girdle – Posterior (cont. ) Hamstrings The hamstrings provide hip extension and knee flexion. They are saved for the knee joint chapter. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved 15 -52

15 -63 Chapter Summary The bones, joints, movements, muscles, and nerves of the hip joint and pelvic girdle are explored in this chapter. l Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -64 Chapter Summary (cont. ) Individual muscles of the hip joint and pelvic girdle are reviewed in depth with regard to palpation, origin, insertion, action, and innervation. ¡ Each muscle includes information with clinical notes, muscle specifics, clinical flexibility and strengthening. ¡ Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -65 Chapter Review ¡ The Chapter Review is divided into true and false, short answers, and multiple choice questions. ¡ The questions are designed for the students to test their knowledge. ¡ Worksheets are at the end of the text as an aid for learning. Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved

15 -66 Explore and Practice ¡ Students should utilize the questions and charts at the end of the chapter to help focus on the content of the chapter. Mc. Graw-Hill © 2011 by The Mc. Graw-Hill Companies, Inc. All rights reserved