DIAG 2730 Hip - Chapter17 TheHip Overview The hip...

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    Chapter 17 The Hip
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Overview The hip articulation is formed between the head of the femur and the acetabulum of the pelvic bone Due to its location and function, the hip joint transmits truly impressive loads, both tensile and compressive. In addition, the hip provides a wide range of lower limb movement
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The hip joint is classified = ball and socket joint This arrangement permits motion in 3 planes: sagittal (flexion & extension around a transverse axis), frontal (abduction and adduction around an anterior-posterior axis), and transverse (internal & external rotation around a vertical axis) All 3 of these axes pass through the center of the femoral head
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Anatomy The os coxa (hip bone) initially begins as 3 individual bones: Ilium, Ischium, Pubis The body of the ilium forms the superior 2/5 th ’s of the acetabulum The ischium = a body, which contributes to the acetabulum, and the ramus The ischium forms the posterior 2/5 th ’s of the acetabulum. Ischium + ramus form the ischial tuberosity .
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Anatomy Pubis The pubis is the smallest of the 3 bones, consists of a body, and inferior and superior rami. The pubis forms the anterior 1/5 th of the acetabulum
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Acetabulum The ilium, ischium and pubis fuse together within the acetabulum The majority of acetabular development is completed by the age of 8, the depth of the acetabulum increases additionally at puberty, due to the development of three secondary centers of ossification
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  Acetabulum The acetabulum is angled laterally, inferiorly and anteriorly The acetabular rim, or labrum, deepens the acetabulum thereby increasing the stability of the hip joint The whole of the acetabulum is covered with hyaline cartilage, except for the fovea capitis
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Pelvic Girdle Therefore; the pelvic girdle composed of 3 joints - 1) hip joint (acetabularfemoral) 2) sacroiliac joint 3) pubic symphysis
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Examination Inspection The patient is observed from the front, back and sides for general alignment of the hip, pelvis, spine and lower extremities
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Inspection ASIS – in the same horizontal plane – if not pelvic obliquity (pelvic unleveling) Lumbar spine should be slightly lordotic if excessive could be weak abs ( what test to confirm?)  
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Inspection Iliac crests should be level in relation with each other, the iliac tubercle marks the widest point on the crests.
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Iliac Crest Contusion Contusion to the site of or an avulsion of the quadratus lumborum and or the abdominal muscles from the crest Very painful and disabling if periosteum is involved Patient experiences pain when lateral flexing away from the side of injury, abduction of both legs together in side-lying position will elicit pain Etiology usually is TRAUMA
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Inspection The greater trochanters are level with the pubic tubercles Congenital hip dislocation or hip fracture could heal in the improper position and make the levels of the trochanters unequal
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This note was uploaded on 11/23/2011 for the course DIAG 2730 taught by Professor Ronaldg.mayne during the Winter '11 term at Life Chiropractic College West.

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DIAG 2730 Hip - Chapter17 TheHip Overview The hip...

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