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USA Term 2 > Biomechanics Final *Hip* > Flashcards

Biomechanics Final *Hip* Flashcards

1
Q

In the hip, what is a common cause of DJD (Degenerative Joint Disease)?

A

Non-Congruencies of the acetabulum and the pelvis

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2
Q

Abnormal motor development may contribute to dysplasia, what can this affect?

A

This can affect the acetabular and/or femur
- This may cause adductor spasticity, Coxa Valga, and Excessive Anteversion.

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3
Q

Why is the Femoral Head important? What happens if there is a hip dislocation?

A

The femoral head is 2/3 sphere and has a ‘Fovea’ that is not covered with cartilage.
- This Fovea is an attachment site for the Ligamentum Teres.
- This ligament has specific biomechanical function, But carries blood supply to the femoral head

  • A Hip Dislocation often results in Avascular Necrosis of Femoral Head
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4
Q

What is the Center Edge of the Acetabulum?

A

The Vertical line through the center of the femoral head and a line connecting the center of the femoral head and boney edge of the acetabulum.
The acetabular labrum deepens the acetabulum

Center Edge Angle = ~ depth of fossa

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5
Q

Where are Hip fractures common?

A

Hip fractures are almost always in the Femoral Neck

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6
Q

What are the Trabecular Systems?

A

“Zones of Weakness”, areas with decreased density

  • Typically at the base of the femoral neck.
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7
Q

What are the two major trabecular systems that show primary transmission of forces?

A
  • The Medial Compressive System
  • The Lateral Tensile System
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8
Q

What are the Mechanisms of Hip Fractures?

A
  • Tensile failure of superior aspect of femoral neck
  • Compressive failure of inferior aspect of femoral neck
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9
Q

What is the result of the entire neck being within the joint capsule?

A

There is an increase of internal pressure, which increases blood pressure

  • There is limited healing
  • One of many types of compartment syndrome
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10
Q

Prescription of a Hip fracture usually involves what?

A
  • Internal Fixation
  • Arthroplasty
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11
Q

Why is the shape of the proximal femur important and what are two commonly identified features?

A

Its important because it usually acts as part of a closed kinetic chain

  • Two commonly identified features are:
    1. Angle of Inclination (Frontal Plane)
    2. Angle of Anteversion (Transverse plane)
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12
Q

What is normal angle of inclination of the hip?

A

120 - 135°

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13
Q

What angle is Coxa Vara?

A

< 120°

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14
Q

What angle is Coxa Valga?

A

> 135°

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15
Q

What are potential impacts of Coxa Valga?

A
  • Decrease in Abductor moment arm
  • Increased risk of dislocation
  • ‘Longer’ femur if coxa valga is unilateral
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16
Q

What are potential impacts of Coxa Vara?

A
  • Increased risk of fracture
  • ‘Shorter’ femur if coxa vara is unilateral
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17
Q

What is Anteversion? What is Retroversion?

A

The tendency towards “in-toeing”

  • This has an increased risk of anterior dislocation with external rotation.

Retroversion is the opposite (Not that common):
Tendency towards “out-toeing”
increased risk of posterior dislocation with internal rotation

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18
Q

What is normal angle of anteversion?

A

8 - 15°

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19
Q

If there is a situation of a person in two scenarios, the first scenario being the person is in Excessive Anteversion and the other the person is in Excessive Anteversion with “In-Toeing”, which is better for Joint congruity?

A

Excessive Anteversion with “In-Toeing”

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20
Q

In Hip capsules and ligaments, when are capsules and ligaments relaxes and taut?

A

They are relaxed in Flexion and Taut in Extension

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21
Q

In terms of Capsules and Ligaments, what happens if the Line of Gravity (LOG) is posterior to the hip joint?

A

No flexor muscle activity is required to prevent extension

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22
Q

What does the Iliofemoral ligament resist/limit?

A

Extension and ER

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23
Q

What does Pubofemoral Ligament Resist/limit?

A

Extension, Abduction and ER

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24
Q

What does Ischiofemoral resist/limit?

A

Extension, Adduction, and IR

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25
Q

What happens when some one performs a split?

A

Splits require hip flexion
- Hip flexions ‘Reverse Action’ is Anterior Pelvic Tilt.
- Anterior Pelvic Tilt is typically accompanied by lumbar extension (Lordosis)

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26
Q

What happens if there is inflammation in the hip?

A

This will cause pain in the hip capsule and ligaments

  • The preferred position is with hip in 60 to 90° of flexion
  • Flexion is the “Loose Packed” position and its the more comfortable position
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27
Q

What degrees of hip flexion experiences the most amount of intracapsular pressure?

A

~120° of hip flexion, experiences ~400 mm HG of Intracapsular pressure

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28
Q

With Hip Flexion, what structure limit their ROM?

A
  • Inferior Capsule
  • Gluteus Maximus
  • The stomach
    (If someone has hip p! when fully flexing hip, it can potentially be a “Red Flag”, can be a problem with the internal organs of the pelvis)
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29
Q

With Hip Extension, what structures limit their ROM?

A
  • Iliofemoral lig.
  • Psoas Maj.
  • Rectus Fem.
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30
Q

With Hip Abduction, what structures limit their ROM?

A
  • Pubofemoral Lig.
  • Adductor Brevis
  • Adductor Longus
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31
Q

With Hip Adduction, what structures limit their ROM?

A
  • Ischiofemoral Lig.
  • Glute Med.
  • TFL and IT band
32
Q

With Hip IR, what structures limit their ROM?

A
  • Piriformis
  • Ischiofemoral Lig.
33
Q

With ER, what structures limit their ROM?

A
  • Iliofemoral Lig.
  • Pubofemoral Lig.
34
Q

What is the normal ROM of the femur on a fixed pelvis during Hip Flexion?

A

0 - 120°

35
Q

What is the normal ROM of the femur on a fixed pelvis during Hip Hyperextension?

A

0 - 20°

36
Q

What is the normal ROM of the femur on a fixed pelvis during Hip Abduction?

A

0 - 40°

37
Q

What is the normal ROM of the femur on a fixed pelvis during Hip Adduction?

A

0 - 25°

38
Q

What is the normal ROM of the femur on a fixed pelvis during Hip IR?

A

0 - 35°

39
Q

What is the normal ROM of the femur on a fixed pelvis during Hip ER?

A

0 - 45°

40
Q

What is the normal ROM of Hip flexion during ADLs?

A

120°

41
Q

What is the normal ROM of Hip ER during ADLs?

A

20°

42
Q

What is the normal ROM of Hip Abduction during ADLs?

A

20°

43
Q

When the hip is in Open Chain its a Convex on Concave mover. What is the Arthrokinematics movement during Hip Abduction?

A

Superior Roll and Inferior Glide

44
Q

When the hip is in Open Chain its a Convex on Concave mover. What is the Arthrokinematics movement during Hip Adduction?

A

Inferior Roll and Superior Glide

45
Q

When the hip is in Open Chain its a Convex on Concave mover. What is the Arthrokinematics movement during Hip IR?

A

Anterior Roll and Posterior Glide

46
Q

When the hip is in Open Chain its a Convex on Concave mover. What is the Arthrokinematics movement during Hip ER?

A

Posterior Roll and Anterior Glide

47
Q

When the hip is in Open Chain its a Convex on Concave mover. What is the Arthrokinematics movement during Hip Flexion?
If there is limited hip flexion, what is the appropriate thing to do?

A

Spinning motion

  • During spinning motion the posterior and inferior structures get taut.
  • If there is limited hip flexion, it would be appropriate to perform inferior and posterior glides to improve flexion.
48
Q

If the Hip Abducts what is the reverse movement (Closed chain) of the pelvis?

A

There will be contralateral elevation (Ipsilateral depression) on the pelvis

49
Q

If the Hip Adducts what is the reverse movement (Closed chain) of the pelvis?

A

There will be Ipsilateral Elevation (Contralateral depression) of the pelvis

50
Q

If the Hip Flexes what is the reverse movement (Closed chain) of the pelvis?

A

The Pelvis Anteriorly Tilts

51
Q

If the Hip Extends what is the reverse movement (Closed chain) of the pelvis?

A

The pelvis Posteriorly Tilts

52
Q

If the Hip Internally Rotates what is the reverse movement (Closed chain) of the pelvis?

A

Contralateral Forward rotation (Ipsilateral backward rotates) of the pelvis

53
Q

If the Hip Externally Rotates what is the reverse movement (Closed chain) of the pelvis?

A

Ipsilateral Forward Rotation (Contralateral Backward Rotation) of the pelvis

54
Q

If someone is a sitting down (Closed chain) what would be the position of the lumbar spine if they anteriorly tilt their pelvis?

A

There will be increased lordosis in the lumbar spine

55
Q

If someone is a sitting down (Closed chain) what would be the position of the lumbar spine if they Posteriorly tilt their pelvis?

A

There will be decreased lordosis in the lumbar spine

56
Q

If a person is standing on one leg (For example the Right leg), what would happen if they abduct their pelvis from that right leg?

A

The right leg (Support side) will drop

57
Q

If a person is standing on one leg (For example the Right leg), what would happen if they adduct their pelvis from that right leg?

A

The left leg (Non-support side) will drop

58
Q

Are joint Reaction Forces high or low at the hip?

A

They’re high

Joint reaction forces (JRFs) are the forces that bones and surrounding structures experience when resisting loads, muscle forces, and inertial forces during movement and exercise

59
Q

In the hip, what happens if the angle of application is ~90°?

A

There will be large torques and small translational force

60
Q

In the hip, what happens if the angle of application is ~0°?

A

There will be small torques and large translational forces

61
Q

How do the Hip flexors/Iliopsoas affect the lumbar spine?

A

The iliopsoas/Hip Flexors applies an anterior and inferior pull on the lumbar vertebral bodies to stabilize the lumbar spine or it contributes to the lumbar lordosis

62
Q

How can the Psoas muscles tightness affect the pelvic tilt?

A

psoas tightness increases the anterior pull on the lumbar spine causing spinal extension which increases the lordosis and produces anterior pelvic tilt

63
Q

What are force couples? What are some examples for the hip?

A

2 or more forces with different translational direction and same rotational direction.

Ex:
- Hip Flexors and Spinal extensors
- Hip Extensors and Spinal flexors
- Hip Abductors and contralateral QL

64
Q

If a patient is in supine, what happens if they try to perform a single leg raise (SLR) and their Rectus Abdominis does not activate?

A

There will be a direct pull of the iliopsoas, this will then cause an anterior tilt and increased lordosis leading to LBP.

65
Q

When standing and trying to maintain an ideal standing posture, what happens if there is hip flexion contracture (Very tight psoas)?

A

When trying to stand in an ideal posture with hip flexion contracture, the hip extensors will also activate to prevent further hip flexion. Also the femoral head is going to be shifted anteriorly (Knees will be slightly bent)

66
Q

The Hip Adductors are dual action muscles, what actions do they also do?

A

When the knee is full extended they help the hip flex,

When the knee is full flexed they help the hip extend

67
Q

What are the secondary muscles of hip IR?

A

90° hip flexion orients line of force of secondary IRs close to perpendicular longitudinal axis of rotation

Anterior Glute Med./Min
TFL
Piriformis
Pectineus
Adductor Brevis, and Longus

There are no muscles with TRUE Primary Function as IRs in anatomical Position

68
Q

What is the role of the Internal Rotators during walking?

A

Forward rotation of Contralateral pelvis

69
Q

How can tight Hamstrings affect the pelvis and pelvic tilt?

A

Tight hammies limit flexion of the trunk and anterior tilting without physiological energy expenditure

70
Q

The Hip Extensors are part of a force couple that causes what?

A

Posterior Pelvic Tilt

71
Q

What are the differences these two Hip Abductors, Glute Med and TFL? When are they more active?

A

The Glute Med is much larger
The TFL has a greater distance to insertion (Distal attachment) via IT Band

  • The Glute Med. is more active in hip extension
  • The TFL is more active in hip flexion
72
Q

What are 3 functional parts of the Gluteus Medius? What are the actions to each part?

A

Anterior Part: Primary Abductor, Secondary Flexor and Medial Rotator

Middle Part: Primary Abductor

Posterior Part: Primary Abductor, Secondary Extensor and Lateral Rotator

73
Q

When the Glutes Medius is weak, how might the person compensate?

A

With Ipsilateral Trunk lean

74
Q

What are the effects of hip position on Piriformis function? (Extension vs. 90° flexion)

A

When the hip is in extension
- The Greater Trochanter is anterior to the sacrum
- This enables the line of action of the piriformis to externally rotate the femoral head

When the hip is in 90° of flexion
- The Greater Trochanter is posterior to the sacrum
- This enables the line of action of the piriformis to internally rotate the femoral head

75
Q

How does pain occur with patients with DJD?

A

Pain in DJD patients emanates from pressure on eburnated bone

Eburnation is when the articular cartilage is wearing away

76
Q

What is the biomechanical use of a cane in the opposite hand with a patient with Hip DJD?

A
  • The pressure of DJD is a result of joint reaction forces (JRF) and weight bearing (Force-gravity Fg)
    JRF are typically much greater than Fg
  • JRF are primarily a result of muscles contractions, muscular effort is used to counteract the torque, which is secondary to gravity. (this torque lowers the contralateral side of the pelvis in a single-limb stance, and hip abductors counter this torque)

A Cane in the hand contralateral to a painful secondary to DJD acts as a force couple, it reinforces typical gait, it also increases BOS
(F on cane on pelvis and trunk,
F on abductor on pelvis and trunk)

USA Term 2 (45 decks)

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