Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ECOS 1 > Approach to Hip Complaint LECT and LAB > Flashcards

Approach to Hip Complaint LECT and LAB Flashcards

1
Q

What are newborn hip problems? (5)

A 
Septic Arthritis (SA)
DDH
Fracture
Congenital
Somatic Dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are Adolescent hip problems? (9)

A 
SA
Perthes 
SCFE
AVN
FAI
Labral tear (LT)
Trochanter bursitis (TB)
Piriformis syn
Somatic Dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are common adult hip problems? (8)

A 
SA
Osteoarthritis
AVN
FAI
Labral tear (LT)
Trochanter bursitis (TB)
Meralgia paresthetica (MP)
Piriformis syn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are common Geriatric hip problems? (9)

A 
SA
Osteoarthritis 
Fracture
AVN
FAI
Labral tear (LT)
Trochanter bursitis (TB)
Meralgia paresthetica (MP)
Piriformis syn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are signs of Developmental Dysplasia of the Hip (DDH)?

A

NEWBORN, breech position, female sex, and first gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to diagnose DDH?

A

Hip Clunk, Hip click, Mild instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hip clunk test?

A

Distinct and pronounced palpable (and at times audible) shift of femoral head, felt as the femoral head is dislocated or reduced on examination with the Ortolani and Barlow maneuvers 90 degree flexed hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Perthes Disease?

A

(3-12 yr old) More common in boys. the blood supply to the head of the femur is interrupted. The femoral head then “necroses,” or loses blood supply, which weakens the bone and can lead to multiple fractures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Signs of Perthes Disease

A

Limping
Pain or stiffness in the hip, groin, thigh or knee/Limited range of motion of the hip joint
Pain that worsens with activity and improves with rest
Xray: smashed femer head look above the growth plate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Slipped Capital Femoral Epiphysis (SCFE)

A

SCFE is a disorder of adolescents in which the growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur. The head of the femur stays in the cup of the hip joint while the rest of the femur is shifted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs/ Diagnosis of SCFE?

A

8-15 obese boys. presenting with hip pain with limping and impaired internal rotation, occasionally after minor trauma
Pain in the groin, inner thigh, or knee.
May be a change in their gait or they may walk with the leg rotated outward.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Avascular necrosis (AVN)?

A

Avascular necrosis is a disease that results from the temporary or permanent loss of blood supply to the bone. When blood supply is cut off, the bone tissue dies and the bone collapses. If avascular necrosis happens near a joint, the joint surface may collapse. This may occur in any bone but most commonly happens in the ends of a long bone. Need X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Signs and Diagnosis of AVN?

A

(30-50 yr old) This is like perthes but with an adult.
Long term use of corticosteroids or alcohol
Minimal early joint pain
Limited range of motion due to pain
Increased joint pain as bone and joint begin to collapse
Pain with activity and rest
Need X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Trochanteric Bursitis?

A

inflammation of a bursa ontop of Trochanter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risks of Trochanteric Bursitis?

A

Trochanteric bursitis, is often the result of injury, overuse, spinal/postural abnormalities, arthritis, or surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Signs of Trochanteric Bursitis?

A

Pain on the outside of the hip and thigh or in the buttock.
Pain when lying on the affected side.
Pain when you press in or on the outside of the hip.
Pain with walking up stairs.
Pain worsening during activities such as getting up from a deep chair or getting out of a car.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diagnosis of Trochanteric Bursitis?

A

History, Exam, X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of Osteoarthritis of hip

A

The MC symptom of osteoarthritis is pain after overuse or inactivity of a joint.
Pain, stiffness (especially after sleep or inactivity), and limited movement of joints.
Symptoms usually develop slowly over years with less movement in the joint over time.
A grinding feeling of the joint when moved, as the cartilage wears away (in more advanced stages)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risks if Osteoarthritis of hip?

A

Most people over age 60 have osteoarthritis to some degree, but its severity varies Heredity, excess weight, injury or overuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Diagnosis of Osteoarthritis of hip

A

X-rays: bone spurs with joint narrowing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diagnosis of xray of SCFE?

A

Femur head looks broken off and rotated above growth plate. IE its name.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Meralgia paresthetica?

A

Meralgia paresthetica is a condition characterized by tingling, numbness and burning pain in the outer part of your thigh. The condition is caused by compression of the lateral femoral cutaneous nerve, which supplies sensation to your upper leg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Signs of Meralgia paresthetica?

A

Tingling and numbness in the outer (lateral) part of your thigh
Burning pain on the surface of the outer part of your thigh
These symptoms commonly occur on one side of your body and might intensify after walking or standing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Causes of Meralgia paresthetica?

A

Tight clothing, obesity or weight gain, and pregnancy are common causes of meralgia paresthetica.
However, meralgia paresthetica can also be due to local trauma or a disease, such as diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Femoracetabular Impingement (FAI)?

A

Femoroacetabular impingement (FAI), also called hip impingement, is a condition where the hip joint is not shaped normally. This causes the bones to painfully rub together.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Risks for FAI?

A

FAI is a common cause of hip pain in adolescents, adults, and athletes of all ages.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Signs and Diagnosis of FAI?

A

Limping
Stiffness in the hip
Hip pain that worsens during physical activity or long periods of sitting
Need History, Exam, Imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a hip Labral Tear?

A

Hip impingement occurs when the ball of the hip pinches against the socket. This can cause damage to the labrum, the cartilage that surrounds the hip socket, and lead to stiffness, pain and/or arthritis in the hip.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Symptoms of hip labral tear?

A

A locking, clicking or catching sensation in your hip joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Causes of hip labral tear?

A

Trauma. Injury to or dislocation of the hip joint — Structural abnormalities. Repetitive motions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a hip fracture?

A

Ahip fractureis a partial or complete break of the femur (thigh bone), where it meets your pelvic bone. It’s a serious injury that requires immediate medical attention.The MCC of hip fractures are falls in the elderly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Risks of hip fracture?

A

Age - Women aged>85 years are 10 times more likely than women aged 60-69 years to sustain a hip fracture.
Sex - White women aged>65 years are at higher risk for hip fracture than black women.
Osteoporosis, tobacco and alcohol use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Signs of hip fracture?

A

Inability to get up from a fall or to walk Bruising and swelling in and around your hip area
Inability to put weight on your leg on the side of your injured hip
Severe pain in your hip or groin
Shorter leg on the side of your injured hip Outward turning of your leg on the side of your injured hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a pelvic fracture?

A

Fracture of the os coxa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Signs of pelvic fracture?

A

Significant trauma. A pelvic fracture is usually diagnosed by the presence of bone tenderness, difficulty walking or doing other movements and any loss of nerve function in the lower part of the. There may be injuries to organs within the pelvic ring such as the intestines, kidneys, bladder or genitals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is Septic Arthritis in the hip?

A

Septic arthritis is a painful infection in a joint. The infection can come from germs that travel through your bloodstream from another part of your body. Septic arthritis can also occur when a penetrating injury delivers germs directly into the joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Risks/Cause of SA of hip?

A

Infants and older adults are most likely to develop septic arthritis.
Knees are MC affected, but septic arthritis also can affect hips, shoulders and other joints.
Risk factors: Age >80, DM, RA, Prosthetic joint, recent joint surgery, skin infection, IV drug abuse,
previous intra-articular corticosteroid injection, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Signs of SA of hip?

A

Septic arthritis typically causes extreme discomfort and difficulty using the affected joint. The joint could be swollen, red and warm, and you might have a fever.
Xray looks similar to OA or FAI.

39
Q

what is Piriformis Syndrome

A

Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot

40
Q

Symptoms of Piriformis syndrome?

A

Increasing pain after sitting for longer than 15 to 20 minutes
Pain/paresthesia radiates to posterior thigh, usually stops above knee
Pain improves with ambulation
Pain with rising from seated to standing.
Change of position does not relieve pain completely
Buttock pain with posterior thigh radiation, sciatica symptoms.
Weakness and numbness are rare compared to lumbar radicular symptoms.

41
Q

Tests of Piriformis Syndrome?

A

Positive log roll with sciatic notch tenderness

Unlike sciatica from disk herniation, piriformis syndrome is exacerbated by active external hip rotation

42
Q

Hip Flexion (knee straight) ROM

A

90°

43
Q

Hip Flexion (knee flexed) ROM

A

120-135°

44
Q

Hip Extension ROM

A

15-30°

45
Q

Hip Internal rotation ROM

A

30-40°

46
Q

HIP External rotation ROM

A

40-60°

47
Q

Abduction w/ knee extended

A

45-50°

48
Q

Adduction w/ knee extended

A

20-30°

49
Q

Reflex Scoring?

A

Documentation:
4+/4: Very brisk, hyperactive, with clonus (rhythmic
oscillation between flexion and extension)
3+/4: Brisker than average, possibly but not necessarily indicative of disease
2+/4: Average, normal
1+/4: Somewhat diminished, low normal
0/4: No response

50
Q

Patellar Reflex root?

A

L3/L4 Nerve Root

51
Q

Achilles Reflex root?

A

S1 Nerve Root

52
Q

Muscle strength scoring?

A

+0/5: No muscular contraction detected
+1/5: Barely detectable flicker/trace of contraction
+2/5: Active movement with gravity eliminated
+3/5: Active movement against gravity
+4/5: Active movement against gravity and some resistance
+5/5: Active movement against full resistance without evidence of fatigue (normal muscle strength)

53
Q

Hip Flexion muscle and nerves?

A

Iliopsoas muscle
Femoral nerve (L2-4)
Ventral rami of lumbars (L1-2)

54
Q

Hip extension muscle and nerves?

A

Gluteus maximus muscle

Inferior Gluteal nerve (L5,S1, S2)

55
Q

Hip Abduction muscle and nerves?

A

Gluteus medius & minimus m.

Superior Gluteal nerve (L5, S1)

56
Q

Hip adduction muscles and nerve

A 
Adductor longus muscle, Adductor brevis, Addcutor magnus, Pectineus, Gracilis
Obturator nerve (L2-4)
57
Q

HIP internal rotation muscle and nerve

A 
Iliopsoas
Femoral nerve (L2-4)
58
Q

HIP external rotation muscles and nerve

A 
Internal and external obturators, quadratus femoris, Superior and Inferior gemelli
Sacral plexus (L4-S2)
59
Q

Knee dermatome root

A

L4

60
Q

Inguinal ligament dermatome root

A

L1

61
Q

Great toe dermatome root

A

L5

62
Q

Posterolateral calf and little toe dermatome root

A

S1

63
Q

Pulse Scoring?

A 
\+4/4: Bounding
\+3/4: Strong, full, increased
\+2/4: Average intensity (normal)
\+1/4: Diminished, barely palpable
0/4: Absent, not palpable
64
Q

Edema Scoring

A

0: Absent (normal)
1+: Barely detectable, slight pitting (2mm); disappears rapidly
2+: Slight indentation (4mm); 10-15 sec
3+: Deeper indentation (6mm); >1 min
4+: Very marked indentation (8mm); 2-5 min

65
Q

How to do Log Roll test

A

Roll the patient’s leg into internal and external rotation.

(+) Test: Pain

66
Q

Log Roll Indications:

A

Anterior/groin pain: indicates intra-articular pathology (SCFE, FAI, AVN, etc.)
• Posterior pain: indicates piriformis syndrome with TTP in sciatic notch.

67
Q

How to do FAIR test

A

Flexion, Adduction, Internal Rotation, while stabilizing the hip.

68
Q

Indications of a FAIR test

A

(+) Test: Pain in the sciatic/gluteal area

• Indicates: Piriformis syndrome

69
Q

What is a C-sign and what does it indicate?

A

Patient characteristically points to the source of pain with two fingers or cups just above the trochanter with the thumb and index finger
• Indicates: Intra-articular pathology

70
Q

What is Labral Loading?

A

Flex the patient’s knee and hip to 90 °, load into the femur towards the innominate

71
Q

What does Labral loading test for?

A
  • (+) Test: hip pain

* Indicates: Labral or cartilaginous pathology

72
Q

What is Labral Distraction?

A

Distract patient’s femur away from innominate

73
Q

What does labral distraction test for?

A

(+) Test: Improvement of pain

• Indicates: Labral or cartilaginous pathology

74
Q

What is a scour test?

A

Flex and externally rotate patient’s hip. Load into socket and articulate through annular range of motion.

75
Q

What does a scour test for?

A

(+) Test: Pain

• Indicates: Labral or articular cartilage pathology

76
Q

What is a FABER test?

A

Patient’s hip is flexed, abducted and externally rotated. Physician induces further external rotation by applying a posterior force at the knee.

77
Q

What does a FABER test for?

A

(+) Test= anterior subluxation of hip or pain
• Indicates: Intra-articular pathology.
Also -iliopsoas bursitis/strain, SI joint dysfunction.

78
Q

What is a jump sign?

A

Patient seated. Pressure is applied to greater trochanter

79
Q

What does jump sign test for?

A

(+) Test: patient withdraws or “jumps” with pressure

• Indicates: Trochanteric Bursitis

80
Q

What is a Straight Leg Raise Test?

A

Patient supine. Passively flex patient’s ipsilateral hip with knee extended

81
Q

What does Straight Leg Raise Test for?

A

Pain with resisted straight leg raise= SCFE, femoral acetabular impingement
(+) Test: Lateral leg pain occurring between 15-30˚ indicates IT band contracture
• (+) Test: Pain occurring between 30-60˚indicates lumbosacral radiculopathy and/or sciatic neuropathy
• (+) Test: Pain occurring between >70˚ is more likely mechanical low back pain due to muscle strain or joint disease.

82
Q

What is the Modified Trendelenberg?

A

Patient stands with feet shoulder width apart and lifts one leg off the ground

83
Q

What does Modified Trendelenberg test for?

A

(+) Test: Drop in the height of the iliac crest on the side of the lifted leg
• Positive test indicates weakness in hip abductor muscles, including gluteus medius and gluteus minimus on planted leg side

84
Q

What is Ober’s Test

A

Patient lateral recumbent with physician standing behind patient. Physician abducts the top leg and then lowers leg to the table (adducts) while stabilizing hip.

85
Q

What does Ober’s test for?

A

(+) Test: Inability to adduct

• Indicates: IT band contracture

86
Q

What is Thomas test?

A

• Patient supine and pulls knees to chest. One leg is lowered to the table to test the flexibility of the hip flexors.

87
Q

What does the thomas test look for?

A

(+) Test: Inability to fully extend leg, or opposite leg raises off table
• Indicates: Hip flexor (iliopsoas) contraction

88
Q

How to treat Psoas?

A

MET/ART for Hip Flexion SD

89
Q

how to treat Hamstrings

A

MET/ART for Hip Extension SD: Hamstrings

patient supine with leg on shoulder of physician

90
Q

How to treat Gluteus maxiumus?

A

MET/ART for Hip Extension SD

supine with hip and knee flexed.

91
Q

How to treat Internally Rotated Hip SD

A

Hip and knee flexed and go into external rotation

92
Q

How to treat Hip Abduction?

A

ITB/Tensor fascia lata

Go into hip adduction with patient supine

93
Q

How to treat long Adductors?

A

Supine with leg extended and abduct the leg.

94
Q

How to treat short adductors?

A

Supine with knee flexed. One hand on contralateral hip and on on the ipsilateral knee. and pushes down on the knee to abduct it.

ECOS 1 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions