REIDER PART 2 08
168 Charter 5_Pelvis, Hip, and Thigh
Figurę 5-6. A, B, and C, Posterior aspect of ihe thigh. A, biceps femoris; B, scmitcndinosus; C, semimembranosus.
knee extension, whereas passive extension of the knee may cause iiwoluntary hip extension by the same mechanism. Medial Aspect
Thigh. The medial thigh is bordered by the vastus medi-alis and sartorius anteriorly and by the hamstrings pos-teriorly (Fig. 5-8). Bctwcen these margins are located the adductor magnus, the adductor longus and the gracilis muscles. The adductor magnus originates from the ischial tuberosity and inferior pubie ramus and inserts on the femur in two places: the linea aspera of the posterior femoral shaft and above the medial epicondyle in the area often referred to as the adductor tubercle. The adductor magnus is the bulkiest of the adductor muscles. The adductor longus arises from the anterior pubis near the pubie symphysis and inserts on the linea aspera. The adductor longus is the most distinctly visible of the adductors. Its proximal portion stands out in the medial groin when the leg is maximally abducted or placed in the figure-four position (Fig. 5-9). The gracilis originates on the medial pubis and inserts on the tibia, where, along with the overlying sartorius and adjacent semitendinosus tendons, it forms the pes anserinus.
■ ALIGNMENT
Two aspects of alignment are usually associated with a hip examination: evaluation for leg length discrepancy (lower limb length discrepancy) and evaluation for rota-tional malalignment of the lower limbs. Both of these qualities may be affected by factors outside of the hip, the pelvis> and the thigh. For purposes of coherence and con-tinuity, these other factors are discussed herc.
Leg Length Discrepancy
Differences in the lengths of a patients lower limbs are usually described as leg length discrepancies, although lower limb length discrepancies would really be morę accurate because the overall lengths of the lower extrem-ities are what are being compared.
Pelvic Obliquity. Abnormalities of limb length usually result in obliquity of the pelvis; therefore, a check for pelvic obliquity is an excellent starting point to begin the alignment examination. In a normal patient, the two sides of the pelvis should be level with each other when the patient is standing. To check for pelvic obliquity, the patient is asked
Wyszukiwarka
Podobne podstrony:
REIDER PART 2 55 Chaptek 6 _ Knee 215 CVl . Figurę 6-25. A, Single leg stance during normal gait. B,
REIDER PART 292 352_Chaptf.r 9_Lumbar Spine Figurę 9-20. Assessing L5 motor function. A, Extensor h
REIDER PART 211 Chapter 7 Lower Leg, Foot, and Ankle 271 Chapter 7 Lower Leg, Foot, and Ankle 271 7
REIDER PART 2 01 Pelvis, Hip, and Thigh John M. Martell The pelvis is a complex bony structurc that
REIDER PART 2 02 162 Chaptkr 5_Pclvis, Hip, and Thigh Figurę 5-1. A, B, and C, Anterior aspect of th
REIDER PART 2 03 The tensor fascia lata is a superficial muscle that arises from the anterior portio
REIDER PART 2 05 Chapter 5_Pelvis, Hip, and Thigh 165 insert into the superior pole of the patella a
REIDER PART 2 06 166__Chaptf.r 5__Pelvis, Hip, and Thigh fold. These folds, which are formcd as the
REIDER PART 2 09 Chaptf.r 5_Pelvis, Hip, and Thigh 169 Figurę 5-7. Distal posterior thigh with resis
REIDER PART 2 11 Charter 5_Pelvis, Hip, and Thigh 171 Figurę 5-9. Figure-four position brings out th
REIDER PART 2 12 172_Chaptkr 5_Pelvis, Hip, and Thigh Figurę 5-12. Measuring a functional leg length
REIDER PART 2 13 Charter 5_Pelvis, Hip, and Thigh 173 Figurę 5-13, cont d. soles of the patient’s fe
REIDER PART 2 14 174_Chapter 5 Pelvis, Hip, and Thigh A B Figurę 5-15. A, Simulate
REIDER PART 2 15 Chapter 5_Pelvis, Hip, and Thigh 175 lower limbs by inspecting the standing patient
REIDER PART 2 16 176__Chapter 5_Pelvis, Hip, and Thigh Figurę 5-19. Normal standing position. examin
REIDER PART 2 17 _Chapter 5 Felvis, Hip, and Thigh 177 perpendicular to the length of the table (Fig
REIDER PART 2 18 178_Chaiter 5 Pelvis, Hip, and Thigh Figurę 5-22. A and B, Diagram of forces across
REIDER PART 2 19 Charter 5 Pelvis, Hip, and Thigh 179 Figurę 5-24. Abductor limp (lurch). droop or o
REIDER PART 2 20 180 Chapter 5_Pelvis, Hip, and Thigh A B Figurę 5-26. A, Pelvic f
więcej podobnych podstron