Pelvic Elevation, Hip Flexion, and Extension PDF, 1446 H/2024 A.D

# 17^th lecture_Theoretical Part : Pelvic Elevation, Hip Flexion, and Extension. ## 1446 H/2024 A.D ## Pelvic Elevation, Hip Flexion, and Extension. ### Manual Muscle Test 200 PHT- ### Theoretical Part. ### Jazan University, College of Nursing and ### Health Sciences, Physical Therapy ###...

# 17^th lecture_Theoretical Part : Pelvic Elevation, Hip Flexion, and Extension. ## 1446 H/2024 A.D ## Pelvic Elevation, Hip Flexion, and Extension. ### Manual Muscle Test 200 PHT- ### Theoretical Part. ### Jazan University, College of Nursing and ### Health Sciences, Physical Therapy ### Department. ## 17^th lecture_Theoretical Part : Pelvic Elevation, Hip Flexion, and Extension. ### Objectives: at the end of this lecture the student will be able to: 1. Identify the primary muscles involved in pelvic elevation, hip flexion, and extension 2. Identify the range of motion of pelvic elevation, hip flexion, and extension. 3. Describe effect of weakness of hip flexion, and extension ### Content: 1. Primary muscles involved in pelvic elevation, hip flexion, and extension 2. Range of motion of pelvic elevation, hip flexion, and extension. 3. Effect of weakness of hip flexion, and extension ## Pelvic Elevation Motion ### Primary Muscles: 1. Quadratus Lumborum. ### Range of Motion: In standing position pelvis may he raised on one side until foot is well clear of floor. *(Reverse action of Quadratus lumborum.)* ### Factors Limiting Factors of Range of Motion: 1. Tension of spinal ligaments on opposite side. 2. Contact of iliac crest with thorax. ### Anatomy of Quadratus Lumborum muscle. #### Origin - Iliac crest. - Iliolumbar ligament. #### Insertion Apices of transverse processes of L1-4, iliolumbar ligament and Inferior border of 12th rib *(Fig.1.)*. #### Nerve supply Anterior primary rami of T12, L1, L2, L3. ## Hip Flexion Motion ### Primary Muscles: 1. Psoas major. 2. Iliacus. ### Range of Motion: The hip flexion with the knee flexed will permit a range of motion approximately 115 to 125. ### Factors Limiting Factors of Range of Motion: 1. The contact of thigh on abdomen when the movement is performed with the knee in flexion. 2. The tension of the hamstring muscles when the movement is performed With the knee in extension. ### Accessory Muscles: 1. Rectus Femoris 2. Sartorius 3. Tensor fasciae late 4. Pectineus ### Anatomy of Psoas Major Muscle: #### Origin - Transverse processes of all lumbar vertebrae L1-5. - Bodies of T12-L5 and intervertebral discs below bodies of T12-L4. #### Insertion: Middle surface of lesser trochanter of femur *(Fig.2.)*. #### Action: Flexes and laterally rotates hip. #### Nerve: Anterior primary rami of L1,2,3,4. ### Anatomy of Iliacus Muscle: #### Origin - Iliac fossa within abdomen. #### Insertion: Lowermost surface of lesser trochanter of femur *(Fig. 3.)*. #### Action: Flexes and laterally rotates hip. #### Nerve: Femoral nerve. ## Hip Extension Motion ### Primary Muscles: 1. Gluteus Maximus. 2. Biceps Femoris. 3. Semimemberanosus. 4. Semitendinosus. ### Range of Motion: - Extension: 115° – 125° to 0°. - Extension beyond midline 0° to 10° - 15°. ### Factors Limiting Factors of Range of Motion: 1. Tension of iliofemoral ligament. 2. Tension of hip flexor muscles. ### Anatomy of Gluteus Maximus: #### Origin: 1. Outer surface of ilium behind posterior gluteal line. 2. posterior third of iliac crest lumbar fascia. 3. lateral mass of sacrum. 4. sacrotuberous ligament and coccyx. #### Insertion: Deepest quarter into gluteal tuberosity of femur, remaining three quarters into iliotibial tract *(anterior surface of lateral condyle of tibia)* *(Fig. 4.)*. #### Action: Extends and laterally rotates hip. Maintains knee extended via iliotibial tract. #### Nerve: Inferior gluteal nerve ### Anatomy of Biceps Femoris *(Lateral Hamstring)*: #### Origin: - Long head: upper inner quadrant of posterior surface of ischial tuberosity. - Short head: middle third of Linea aspera, lateral supracondylar ridge of femur. #### Insertion: - Styloid process of head of fibula. - Lateral collateral ligament and lateral tibial condyle *(Fig. 5.)*. #### Action: Flexes and laterally rotates knee. Long head extends hip. #### Nerve: - Long head: tibial portion of sciatic nerve. - Short head: common peroneal portion of sciatic nerve. ### Anatomy of Semimembranosus: *(Medial Hamstring)* #### Origin: Upper outer quadrant of posterior surface of ischial tuberosity. #### Insertion: Medial condyle of tibia below articular margin, over popliteus and oblique popliteal ligament. *(Fig.6.)*. #### Action: - Flexes fascia and medially rotates knee. - Extends hip. #### Nerve: Tibial portion of sciatic nerve. ### Anatomy of Semitendinosus: *(Medial Hamstring)* #### Origin: Upper inner quadrant of posterior surface of ischial tuberosity. #### Insertion: Upper medial shaft of tibia below Gracilis *(Fig.7.)*. #### Action: - Flexes and medially rotates knee. - Extends hip. #### Nerve: Tibial portion of sciatic nerve. ## Effects of weakness of the hip extensor muscles: Bilateral marked weakness of the Gluteus maximus muscle makes walking extremely difficult, and necessitates the aid of crutches.