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Biomechanics Hip Flashcards

1
Q

What type of joint is the hip?

A

Enarthrodial Joint

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2
Q

How many degrees of freedom does the hip have?

A

3

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3
Q

Where does stabilization for the hip come from?

A

Static-Ligaments
Dynamic-Muscles
Negative joint capsule pressure

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4
Q

What is the angle of inclination for the hip?

A

(In the frontal plane)

120-125 degrees

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5
Q

What’s the angle of inclination at birth?

A

150 degrees

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6
Q

What is Coxa vara

A

(

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7
Q

What is Coxa Valga

A

(>) greater than 135 degrees

Increased compression force on the femoral head

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8
Q

What is the anteversion?

A

~20 degrees

(allows the femoral condyles to face anteriorly

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9
Q

What is excessive anteversion?

A

(>) greater than 20 degrees (excessive angle)

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10
Q

What is retroversion?

A

(

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11
Q

What happens with anteversion

A 
In-toeing
(>) Increase angle
increased anterior exposure
increased chance of dislocation
labral lesions
Internal Rotation
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12
Q

What happens with retroversion?

A

toes pointed out
decreased angle
External Rotation

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13
Q

What type of joint is the femoralacetabular joint?

A

Synovial ball and socket joint

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14
Q

Where’s the axis of motion in the hip?

A

Through the center of the femoral head

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15
Q

What type of capsule encompasses the hip?

A

a loose, fibrous capsule

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16
Q

What’s the Zona Orbicularis?

A

A band of circular fibers that encircle the neck of the femur
(It’s stronger anteriorly)

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17
Q

What is the labrum?

A

Fibrocartilage that increases the articular surface of the of the acetabulum by 10%

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18
Q

What 3 ligaments strengthen the joint capsule?

A

Iliofemoral (Anterior)
Pubofemoral (Anterior)
Ischiofemoral (Posterior)

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19
Q

What movements do the ligaments in the joint prevent?

A

All prevent extension
Anterior portions prevent ER
Posterior prevent IR

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20
Q

Which ligament is referred to as the “Y” or Bigelow ligament?

A

Iliofemoral

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21
Q

Where does the iliofemoral ligament go?

A

AIIS to intertrochanteric line

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22
Q

Which ligament is the strongest?

A

Iliofemoral ligament

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23
Q

Where does the pubofemoral ligament go?

A

Pubis to intertrochanteric line

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24
Q

What motions does the pubofemoral ligament prevent?

A

Abduction, ER, and extension

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25
Where does the ischiofemoral ligament go?
Posterior acetabulum to the trochanteric fossa | Limits IR
26
What is the ligamentum teres?
Intracapsular ligament that goes from acetabular notch to the fovea
27
What are some of the bursae around the hip?
Superficial and deep greater trochanter Ischial bursa Iliopsoas bursa
28
Where does the IT band run?
Runs along lateral hip and inserts distally below the knee (Gerdy's tubercle)
29
What is the primary motion of the hip?
Spin of the femoral head (accompanied with a glide)
30
With femur-on-pelvis what are the arthokinamatics during flexion/extension
Flexion - Posterior/inferior spin & glide | Extension - Anterior/superior spin & glide
31
With femur-on-pelvis what are the arthokinamatics during Abduction/adduction?
Abduction - (NWB) - Superior roll/Inferior glide | Adduction - (NWB) - Inferior roll/superior glide
32
With femur-on-pelvis what are the arthokinamatics during IR/ER
IR - Anterior Roll/Posterior glide | ER - Posterior Roll/anterior glide
33
What do tight hip flexors cause?
Increase Anterior pelvic tilt | Increase lumbar lordosis
34
What are hip extensors important for?
postural correction
35
Name some of the hip flexors
Iliopsoas, Sartorius, Rectus Femoris, TFL, Pectineus
36
Name some hip extensors
Glut max, Hamstrings, Post glut medius, piriformis
37
What are the pelvic force couples during anterior tilt
Flexors: Psoas major, iliacus, sartoris Extensors: Erector Spinea
38
What are the pelvic force couples during posterior tilt
Trunk flexors: Rectus abdominis, external obliques | Hip extensors: Glut max, Hamstrings
39
Which muscles stabilize the hip during walking?
Hip abductors
40
Which group of muscles can provide motion in all 3 planes?
Hip adductors | Also assist hip flexors and extensors
41
Which muscles work during the stance face?
Hip internal rotators | rotates the pelvis over the femur during the stance phase
42
Which muscles are most active during change of direction motions?
Hip external rotators | glut max is most powerful
43
Which muscle can provide hip extension and flexion when hip is in flexed position?
Adductor Longus | Allows frontal plane stability during running
44
During 2 legged standing how much weight does each hip carry?
33% | Head, arms, and trunk get the rest
45
During 1 legged standing how much force is on the hip?
2.5 times body weight
46
What side do we teach patients to hold a cane?
Opposite the injured extremity
47
What happens with osteoarthritis
Hip pain Less than 115 degrees of hip flexion less than 15 degrees of IR
48
What causes osteoarthritis?
unknown (idiopathic)
49
How often does osteoarthritis occur?
10-20% of aging population
50
Name the two types of acetabular impingement.
Cam- Shear forces on the acetabular rib (jams the femoral head against the acetabulum Pincer-impingement between the acetabulum and femoral head-neck junction (seen with acetabular retroversion
51
Open Packed position of hip joint?
30 degrees flexion and abduction. Slight ER
52
Closed Pack Position of Hip?
Full extension, slight IR and abduction
53
Capsular Pattern of Hip?
Flexion, Abduction, IR >ER
54
Arthrokinematics of Pelvis-on-Femur Flexion and Extension
Flexion- Anterior pelvic tilt | Extension- Posterior Pelvic Tilt
55
Arthrokinematics of Pelvis-on-Femur Abduction and Adduction
Abd.- Ipsilateral Tilt, Contralateral Shift | Add. - Contralateral tilt, Ipsilateral shift
56
Arthrokinematics of Pelvis-on-Femur IR and ER
IR- Ipsilateral Posterior Rot. Contralateral Anterior Rot. ER- Ipsilateral Anterior Rot. Contralateral Posterior Rot.
57
Lumbopelvic Rhythm- Ipsidirectional
Hip & spine moving in the same direction (bending over)
58
Lumbopelvic Rhythm- Contradirectional
Hip and spine moving opposite ( standing up straight, sitting, or walking)
59
Reasons to use cane on opposite side of injury:
1. Wider BOS 2. Improved Balance 3. Off load weight bearing of injured leg 4. Should help follow normal gait
60
Small Q-angle increases compression where?
increases medial knee compression
61
Larger Q-angle increases compression where?
Increases lateral knee compression
62
What is Gene Recurvatum?
- Extension beyond 10 degrees of neutral. - Contact decreases during end ROM b/c lack of SA - Lack of SA, increases pressure on anterior portion
63
Tibiofemoral Arthrokinematics (open) Flexion/ Extension
Flexion- Posterior Roll and Glide | Extension- Anterior Roll and Glide
64
Tibiofemoral Arthrokinematics (Closed) Flexion/ Extension
Flexion- Posterior Roll Anterior Glide Extension- Anterior Roll Posterior Glide
65
Tibiofemoral Lateral and Medial Rotation
Open- tibia on femur | Closed- femur on tibia
66
Screw-home Mechanism
``` -Occurs at final 20-30 degrees of knee extension -Closed Chain - ACL Tightens restricting lateral condyle -Medial Condyle continues -Tibia ER and Femur IR -Locks the knee @ full extension ```
67
What muscle unlocks the knee?
popliteus, causes tibia to IR (MR)
68
ACL
Attaches anterior tibia and runs posterior, lateral, and proximal to the lateral condyle -Resists knee extension
69
Open Packed position for Tibiofemoral
25-30 degrees of knee flexion
70
Closed Packed position for Tibiofemoral
Full extension with ER
71
Capsular Pattern for Tibiofemoral
Flexion > Extension
72
Patella Alta
- High riding - Lengthening of inferior patella tendon - Tight quads - Subluxation common
73
Patella Baja
- Low riding | - More bone on bone issues
74
3 Factors that influence the length of the internal moment arm of knee extensors
1. Shape and position of Patella 2. Shape of distal femur 3. The migrating medial-lateral axis of rotation
75
Functions of Proximal Tibiofemoral Joint
1. Dissipation of torsional stress applied 2 the ankle 2. Dissipation of lateral tibial bending movements 3. Tensile (max) weight bearing
76
Open Packed position of Tibiofemoral Joint
0 degrees of plantar flexion (neutral)
77
Closed Packed position of Tibiofemoral Joint
Full ankle dorsiflexion
78
Capsular Pattern of Tibiofemoral Joint
pain with biceps femoris muscle contraction
79
Two types of Patellar Tracking?
Lateral and Medial, Lateral is more common
80
Lateral Patellar Tracking
ITB and Lateral retinacular fibers are tight. Bowstringing W/ external force (valgus, ER on the femur, or IR of the tibia)--> causes increased tension on quads and PT, and bowstring force. Results= increased lateral displacement of patella Quad tendon and Patellar Tendon run more oblique
81
Medial Patellar Tracking
VMO- overdeveloped and pulling Raised lateral facet- pushing Medial Patellar retinacular fibers- pull

Rolf (45 decks)

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