9-17-09 handout

9-17-09 handout - Nerves of the Hip Femoral supplies...

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Nerves of the Hip Femoral – supplies muscles of the anterior lateral hip Obturator – supplies muscles of the anterior medial hip Gluteal - supplies muscles of the posterior hip Sciatic – supplies muscles of the posterior thigh Femoral Nerve ISRP Iliopsoas Sartorius Rectus femoris Pectineus Obturator Nerve Adductor longus Adductor brevis Adductor magnus – only the anterior fibers Gracilis Obturator externus Gluteal Nerve Gluteus maximus Gluteus minimus Gluteus medius Tensor fascia latae Sciatic Nerve (Sacral nerve) All deep external rotators except obturator externus Posterior fibers of adductor magnus Hamstrings 2 Joint Muscle Theory A muscle crosses 2 joints Action joint and control joint Can only work one joint at a time effectively, and only when the muscle is stretched across the opposite joint
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For muscle to work it has to be on stretch, not slack – like a rubber band must be stretched around pencils so they can stay together Joint #1 – action joint – the joint the patient will move Joint #2 – control joint – joint that is passively postioned by therapist Closer – what muscle does at joint it will be on slack Farther – muscle on stretch
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2 Joint Muscle Theory Stretch position is the opposite position that the muscle would normally perform Slack position is the same position the muscle would normally produce Stretch = action Slack – eliminate Ex: If a muscle normally produces elbow flexion at control joint, the stretch position is elbow extension and the slack position is elbow flexion Knee Extension with Rectus femoris Identify joint 1. Knee – extends – action joint 2. Hip – flexion – control joint (stretch/slack) Stretch hip extension opposite of what it does ? see pg. 13 Hip Flexion with Rectus femoris ? see pg. 13 Rectus femoris Joint it works on Hip – flexion – action joint Knee – extension – control joint (stretch/slack) To work – stretch at knee flexion Tensor Fascia Latae - Extras In most people, the tensor fascia latae is poorly developed and tight + TFL tightness test – Obertest; + test is problem; If knee doesn’t reach plinth, the test is + If tight, requires stretching – passive manual stretchis same as test position Sartorius - Extras Weak Sartorius is common Longest muscle in body + tight Sartorius test – the patient cannot “W” sit Tailor sitting muscle; pretzel sitting
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Rectus femoris - Extras Reverse action (RA) – anterior pelvic tilt Patients with low back pain often have a tight rectus femoris and need stretching 2 joint muscle Iliopsoas - Extras Reverse action (RA) – trunk flexion and anterior pelvic tilt; psoas major – trunk lateral flexion Tight hip flexors cause the position of lordosis and a + Thomas test To stretch the right iliopsoas put the patient in the Thomas position *** This is the only muscle which flexes the hip beyond 90° Strongest hip flexor
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This note was uploaded on 02/11/2010 for the course AHS 234 taught by Professor Bial during the Fall '09 term at Nassau CC.

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9-17-09 handout - Nerves of the Hip Femoral supplies...

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