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Lower Extremity Anatomy & Biomechanics > Biomechanics Hip > Flashcards

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
Q

Where does the ischiofemoral ligament go?

A

Posterior acetabulum to the trochanteric fossa

Limits IR

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26
Q

What is the ligamentum teres?

A

Intracapsular ligament that goes from acetabular notch to the fovea

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27
Q

What are some of the bursae around the hip?

A

Superficial and deep greater trochanter
Ischial bursa
Iliopsoas bursa

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28
Q

Where does the IT band run?

A

Runs along lateral hip and inserts distally below the knee (Gerdy’s tubercle)

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29
Q

What is the primary motion of the hip?

A

Spin of the femoral head (accompanied with a glide)

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30
Q

With femur-on-pelvis what are the arthokinamatics during flexion/extension

A

Flexion - Posterior/inferior spin & glide

Extension - Anterior/superior spin & glide

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31
Q

With femur-on-pelvis what are the arthokinamatics during Abduction/adduction?

A

Abduction - (NWB) - Superior roll/Inferior glide

Adduction - (NWB) - Inferior roll/superior glide

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32
Q

With femur-on-pelvis what are the arthokinamatics during IR/ER

A

IR - Anterior Roll/Posterior glide

ER - Posterior Roll/anterior glide

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33
Q

What do tight hip flexors cause?

A

Increase Anterior pelvic tilt

Increase lumbar lordosis

34
Q

What are hip extensors important for?

A

postural correction

35
Q

Name some of the hip flexors

A

Iliopsoas, Sartorius, Rectus Femoris, TFL, Pectineus

36
Q

Name some hip extensors

A

Glut max, Hamstrings, Post glut medius, piriformis

37
Q

What are the pelvic force couples during anterior tilt

A

Flexors: Psoas major, iliacus, sartoris
Extensors: Erector Spinea

38
Q

What are the pelvic force couples during posterior tilt

A

Trunk flexors: Rectus abdominis, external obliques

Hip extensors: Glut max, Hamstrings

39
Q

Which muscles stabilize the hip during walking?

A

Hip abductors

40
Q

Which group of muscles can provide motion in all 3 planes?

A

Hip adductors

Also assist hip flexors and extensors

41
Q

Which muscles work during the stance face?

A

Hip internal rotators

rotates the pelvis over the femur during the stance phase

42
Q

Which muscles are most active during change of direction motions?

A

Hip external rotators

glut max is most powerful

43
Q

Which muscle can provide hip extension and flexion when hip is in flexed position?

A

Adductor Longus

Allows frontal plane stability during running

44
Q

During 2 legged standing how much weight does each hip carry?

A

33%

Head, arms, and trunk get the rest

45
Q

During 1 legged standing how much force is on the hip?

A

2.5 times body weight

46
Q

What side do we teach patients to hold a cane?

A

Opposite the injured extremity

47
Q

What happens with osteoarthritis

A

Hip pain
Less than 115 degrees of hip flexion
less than 15 degrees of IR

48
Q

What causes osteoarthritis?

A

unknown (idiopathic)

49
Q

How often does osteoarthritis occur?

A

10-20% of aging population

50
Q

Name the two types of acetabular impingement.

A

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
Q

Open Packed position of hip joint?

A

30 degrees flexion and abduction. Slight ER

52
Q

Closed Pack Position of Hip?

A

Full extension, slight IR and abduction

53
Q

Capsular Pattern of Hip?

A

Flexion, Abduction, IR >ER

54
Q

Arthrokinematics of Pelvis-on-Femur Flexion and Extension

A

Flexion- Anterior pelvic tilt

Extension- Posterior Pelvic Tilt

55
Q

Arthrokinematics of Pelvis-on-Femur Abduction and Adduction

A

Abd.- Ipsilateral Tilt, Contralateral Shift

Add. - Contralateral tilt, Ipsilateral shift

56
Q

Arthrokinematics of Pelvis-on-Femur IR and ER

A

IR- Ipsilateral Posterior Rot.
Contralateral Anterior Rot.
ER- Ipsilateral Anterior Rot.
Contralateral Posterior Rot.

57
Q

Lumbopelvic Rhythm- Ipsidirectional

A

Hip & spine moving in the same direction (bending over)

58
Q

Lumbopelvic Rhythm- Contradirectional

A

Hip and spine moving opposite ( standing up straight, sitting, or walking)

59
Q

Reasons to use cane on opposite side of injury:

A
  1. Wider BOS
  2. Improved Balance
  3. Off load weight bearing of injured leg
  4. Should help follow normal gait
60
Q

Small Q-angle increases compression where?

A

increases medial knee compression

61
Q

Larger Q-angle increases compression where?

A

Increases lateral knee compression

62
Q

What is Gene Recurvatum?

A
  • 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
Q

Tibiofemoral Arthrokinematics (open) Flexion/ Extension

A

Flexion- Posterior Roll and Glide

Extension- Anterior Roll and Glide

64
Q

Tibiofemoral Arthrokinematics (Closed) Flexion/ Extension

A

Flexion- Posterior Roll
Anterior Glide
Extension- Anterior Roll
Posterior Glide

65
Q

Tibiofemoral Lateral and Medial Rotation

A

Open- tibia on femur

Closed- femur on tibia

66
Q

Screw-home Mechanism

A 
-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
Q

What muscle unlocks the knee?

A

popliteus, causes tibia to IR (MR)

68
Q

ACL

A

Attaches anterior tibia and runs posterior, lateral, and proximal to the lateral condyle
-Resists knee extension

69
Q

Open Packed position for Tibiofemoral

A

25-30 degrees of knee flexion

70
Q

Closed Packed position for Tibiofemoral

A

Full extension with ER

71
Q

Capsular Pattern for Tibiofemoral

A

Flexion > Extension

72
Q

Patella Alta

A
  • High riding
  • Lengthening of inferior patella tendon
  • Tight quads
  • Subluxation common
73
Q

Patella Baja

A
  • Low riding

- More bone on bone issues

74
Q

3 Factors that influence the length of the internal moment arm of knee extensors

A
  1. Shape and position of Patella
  2. Shape of distal femur
  3. The migrating medial-lateral axis of rotation
75
Q

Functions of Proximal Tibiofemoral Joint

A
  1. Dissipation of torsional stress applied 2 the ankle
  2. Dissipation of lateral tibial bending movements
  3. Tensile (max) weight bearing
76
Q

Open Packed position of Tibiofemoral Joint

A

0 degrees of plantar flexion (neutral)

77
Q

Closed Packed position of Tibiofemoral Joint

A

Full ankle dorsiflexion

78
Q

Capsular Pattern of Tibiofemoral Joint

A

pain with biceps femoris muscle contraction

79
Q

Two types of Patellar Tracking?

A

Lateral and Medial, Lateral is more common

80
Q

Lateral Patellar Tracking

A

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
Q

Medial Patellar Tracking

A

VMO- overdeveloped and pulling
Raised lateral facet- pushing
Medial Patellar retinacular fibers- pull

Lower Extremity Anatomy & Biomechanics (11 decks)

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