attachment site for mm and ligaments

superior and inferior facets come off the base of the transverse these

formed by the articulation of the superior and inferior vertbral plateaus of adjacent vertebral bodies (except C1-2)

provides a central, elastic material to allow pivoting, compression and torsion

limits motion of vertebrae

protects the facet joints from compression

shock absorption- has gelatinous center

annulus fibrosis

control vertebral motions

protects disc from excessive shear, flexion, side bending and rotation

orientation determines the motions available at each level

each individual joint has a small amount of motion -ROM in the spine is cumulative effect of all the individual facet joints working together

broad, dense, strong ligament that attaches to the anterior vertebral bodies and the annulus fibrosis from C2 to the sacrum 

atlanto-occipital ligament is an extension of ALL from C2 to occiput 

stretched with extension, compressed with flecion

limits extension of the spine

continuous band of tissue that extends along posterior aspect of vertebral bodies within vertebral canal from C1 to sacrum

becomes very narrow at lumbar region, provides limited support for the intervertebral joints where its axial tension is low

stretched with flexion, compressed with extension

restricts flexion of spine, but this restraint is small

lateral curvature of the spine

named by side of convexity

unilateral contraction where trunk rotation to the opposite side and bending to the same side

bilaterally stabilizes trunk to allow hip motion

lateral flexion and trunk rotation to same side

bilateral-flexion of trunk

made up of 3 separate bones: ilium, ischium and pubis

they are connected by hyaline cartilage at birth and fuse at the age of 20-25

upper edge of ilium

designates your waist

most anterior part of the iliac crest

use for mesuring leg length and Q-angle

concave roughened area of anterior border of the iliac crest

origin of rectus femoris muscle

most posterior border of the iliac crest

use as landmark to evaluate posture

"sit bone" posterior-inferior projection of ischium

origin of hamstrings, adductor mm, ligamentous attachment, houses pudendal nerve

joint between two innominate bones (fibrocartilaginous disc)

only point at which the right and left innominate bones articulate with each other

malalighment between the right and left innominate bones can be due to dysfunctions at this joint and the SI joint

stiffening of a joint with fibrous or bony union across a joint

can begin in 30's in SI joint

suspend the sacrum from the 2 ilium

act as shock absorbers during weight-bearing

connect lower aspect of the sacrum to the ischial spine and ischial tuberosity 

hold the distal aspect of the sacrum in place against anterior weight-bearing forces

ASIS's move anteriorly and inferiorly, greater than 15 degress

with foot fixed, produces hip flexion and lumbar extension

ASIS's move posteriorly and superiorly 

with foot fixed, produces hip extension and lumbar flexion

left lateral pelvic tilt, right ASIS is raised

right hip adduction, left hip abduction

right lateral pelvic tilt, left ASIS raised

left hip adducted, right hip abducted

most structurally stable joint with greatest mobility

deep concave socket

Y ligament of Bigelow that originates from iliac portion of acetabul and extends anteriorly and superiorly up to the AIIS

strongest ligament of the hip

limits hip extension, lateral rotation and adduction. assists in limiting abduction and adduction

used to support body when standing without muscles support as long as the hip joint is maintained in an extended position (ex. LE paralysis)

originates from the pubic portion of the acetabular rim, attaches to inferior portion of capsule.

limits extension and abduction

originates on the ischial portion of the acetabular rim and labrum and spirals around the neck of the femur and attaches to greater trochanter

limits hyperextension, medial rotation and adduction when hip is flexed

deep in joint to head of femur

slight mechanical support to hip

artery provides some blood supply to femoral head

moderate flexion, mid-range lateral rotation and slight abduction

this is the point of Greatest articulator contact, however, the ligamentous structure of the hip joint are the most lax in this position. most other joints of the body have the greatest artcular contact when it is close-packed position

end range extension/hyperextension, medial rotation, slight abduction

this is the least amount of articular contact between the head of the femur and the acetabulum but the ligamentous structure are tightest

palpated on both sides of patella, not quite parallel

rocker-like and medial condyle at slant and slightly longer

palpate above condyles

soft tissue attaches here

location of medial and lateral meniscus

articular surface is slightly concave

femur rotates laterally approximately 20 degrees and rolls posteriorly

abuction of femur approximately 5 degrees

femur rotates medially (screw home mechanism)

femur rolls anteriorly and adduction of  femur

increases angle of application and mechanical advantage of quadriceps tendon

protects patellar tendon from excess friction from the femur during knee flexion

fibrocartilaginous discs

firmly attached to tibial plateaus

nutrition through synovial fluid and limited bloody supply

anterior segment attaches distally to medial surface of the tibia, posterior segment attaches distally to tibial condyle, joint capsule and medial meniscus

stabilize against Valgus forces and medial lateral rotations

remains taut during all knee motions; most taut during knee extension

small bursa lies in between superficial and deep layers

passes from lateral epicondyle to the head of the fibula

stabilize the knee against varus force and lateral rotations

most taut with extension

control stability of knee through flexion and extension

helps control sliding motions of the condylar surfaces

stabilzer of anterior displacement of tibia on femur in open-chain

stabilizer of posterior displacement of femur on tibia in close-chain

stabilizer of medial and lateral rotation at knee

pulled tightest in extension

*contibutes to varus, valgus and rotational stability

function of primary stabilizer of: 

posterior displacement of tibia on femur in open-chain

anterior displacement of femur on tibia in closed chain

restraint to maximum knee flexion

*contributes to varus, valgus and rotational stability

tendinous portion of tensor fascia latae muscle

acts as a tense ligament of knee to assist LCL in stabilizing against varus forces to knee, assists ACL in preventing posterior displacement of femur on tibia when knee fully extended and gives support to patella

distal end of tibia deviates laterally away from midline

5-10 degrees

normal valgus do narrows BOS and requires less lateral shift to keep COG over BOS in gait

>195 degrees and can increase weight-bearing forces on the lateral aspect of knee joint (compression)

can increase medial stress on the knee joint capsule and MCL (distraction

Genu Varus (Bow legs)

distal end of tibia deviates medially toward midline

always abnormal in adults

increased weight-bearing on medial aspect of knee joint (compression)

increased lateral stresses of knee joint capsule and LCL

often associated with OA and DJD

knee joint abnormally hyperextended in standing

can be result of muscle imbalance at knee or ankle

increased stresses on posterior capsule and other posterior soft tissue

possible lengthening of hamstring muscles and decreased dorsiflexion

increases angle of application and moment arm of quadriceps tendon

protect quadriceps tendon during knee flexion

estimates the resultant line of pull of the quadriceps muscles

formed by the intersection of a line drawn from the ASIS to the center of the patella and a line drawn from the center of the patella to the center of the tibial tuberosity 

normal between 10-20 degrees

weakness of the VMO

tight IT band

muscular weakness of hip abductors

abnormal mechanics of the foot during gait

primary action is to unlock a fully extended knee by initiating internal rotation of the knee joint

can rotate the femur externally or rotate the tibia internally to initiate flexion

dynamic stabilizer of the knee which assists PCL by preventing posterior glide of the tibia and assists in pulling lateral meniscus posteriorly during knee flexion and prevents varus and lateral rotation

insertion of the sartorius, gracilis, and semitendinosus

these muscles flex and rotate knee but have different functions at hip

insertion site/muscles placement contributes to stabilization of the knee against balgus and rotary forces during active movement

shock absorption/force distribution

surface accommodation

joints of foot lock up and become rigid

creates a rigid push-off lever for walking, running, and jumping

maintain contact between tibia, fibula, and talus

provide lateral stability

inversion is common mechanism of injury

provide medial stability

*stronger and thicker due to continually resisting force of gravity to evert and DF foot

pronation (eversion of calcaneous) and supination (inversion of calcaneous) 

around an oblique axis, but is in frontal plane

dampens rotational forces imposed by the body weight while maintaining contact of the foot on the supporting surface

talus receives full weight of body and transfers to calcaneous in weight-bearing

calcaneus everts (valgus), talus adducts and PF, tibiotalar jt DF, lower leg MR, knee flexes

*dominated by eccentric contractions

calcaneus inverts (varus), talus abducts and DF, tibiotalar jt PF, lower leg LR, knee extends

*dominated by concentric contractions=accelerate

transitional link between rear foot and forefoot

lowers longitudinal arch in pronation

elevates longitudinal arch in supination

compensates in the forefoot for hind foot position

amplifies the motions of ankle.hind foot