Ch 4 - MSK: Hip and Pelvis Flashcards
What are the 5 joints of the pelvic girdle?
Bilateral femoroacetabular (hip) joints Pubic symphysis Bilateral sacroiliac (SI) joints
What is the angle between the femoral neck and shaft of the femur?
Males: 125°
Females: 115°–120°
What is Coxa vara?
Femoral neck and shaft angle is decreased
Affected leg is shortened
Hip abduction limited
Knee valgus deformity
What is Coxa valga?
Femoral neck and shaft angle is increased
Affected leg is lengthened
Knee varus deformity
Describe muscles and innervation of hip flexion.
- Iliopsoas
- Sartorius
- Rectus femoris
- Pectineus
- Tensor fasciae lata (TFL)
- Adductor brevis
- Adductor longus
- Adductor magnus
- Gracilis
Describe muscles and innervation of anteriorly placed hip adductors.
- Gracilis
- Pectineus
- Adductor longus
- Adductor brevis
- Adductor magnus
Describe muscles and innervation of posteriorly placed hip adductors.
- Gluteus maximus
- Obturator externus
- Gracilis
- Long head of the biceps femoris
- Semitendinosus
- Semimembranosus
Describe muscles and innervation of hip abduction.
- Gluteus medius
* Gluteus minimus
Describe muscles and innervation of hip internal rotators and abductors.
- TFL
- Sartorius
- Piriformis
- Gluteus max, superior fibers
Describe muscles and innervation of hip extension.
• Gluteus max • Gluteus med, posterior fibers • Gluteus min, posterior fibers • Piriformis • Adductor magnus • Hamstring muscles: – Long head of the biceps femoris – Semimembranosus – Semitendinosus
Describe muscles and innervation of hip external rotation.
- Piriformis
- Obturator internus
- Superior gemellus
- Inferior gemellus
- Obturator externus
- Quadratus femoris
- Gluteus max
Describe muscles and innervation of hip internal rotation.
"TAGGGSS" • TFL • Adductor magnus • Adductor longus and adductor brevis • Gluteus med • Gluteus min • Gracilis • Semitendinosus • Semimembranosus
What is the function of the acetabular labrum?
Deepen the acetabulum and hold femoral head in place
Where does the acetabular fibrous capsule extend?
Acetabular rim to intertrochanteric crest
What is the strongest ligament in the body?
Iliofemoral ligament (Y-ligament of Bigelow)
Where does the Iliofemoral ligament extend?
ASIS to intertrochanteric line
What is the function of the Iliofemoral ligament?
Limit extension, abduction, and external rotation of the hip
Where does the Ischiofemoral ligament extend?
From the ischium behind the acetabulum to blend with the capsule
What is the function of the Ischiofemoral ligament?
Limit hip abduction
Where does the capitus femoris ligament extend?
Acetabular notch to the femur
What is the function of the capitus femoris ligament?
80% carry small artery to femoral head
Describe normal ROM of the hip.
- Flexion: 120°
- Extension: 30°
- Abduction: 45° to 50°
- Adduction: 0° to 30°
- ER: 35°
- IR 45°
What hip ROM direction will be limited by OA first?
Internal rotation
What is Patrick’s Test?
Provocative maneuver to assess for intra-articular hip pathology or SI joint dysfunction
Motion: FABERE
(+) Groin pain: hip
(+) Posterior pain: SI
What is Thomas’ Test?
Assesses hip contractures
Pt supine, one hip flexed
(+) Opposite hip doesn’t extend
What is Ober’s Test?
Test for ITB tightness
Pt side lying with involved leg knee flexed to 90°, hip extended to 0°, and abduct the involved leg as far as possible
(+) leg remains abducted
What does Trendelenburg test assess?
Gluteus medius weakness
What are causes of gluteus medius weakness?
– Radiculopathies – Poliomyelitis – Meningomyelocele – Fx of the greater trochanter – SCFE – Congenital hip dislocation – Deconditioning
What is Ely’s test?
Assesses femoral nerve irritation
Pt prone with knee > 90° and hip extended
(+) Anterior thigh pain
How is true leg length discrepancy assessed?
Patient supine, measure from the ASIS to the medial malleoli (two fixed bony points)