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DPT 616 : MSK > Dr. OD Hip Lecture > Flashcards

Dr. OD Hip Lecture Flashcards

1
Q

t/f: the pelvis is a system of functionally interdependent joints

A

true

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2
Q

what forces go to the pelvis?

A

from the head, arms, trunk, and LEs

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3
Q

what is the labrum of the hip?

A

an extra rim of stability around the acetabulum

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4
Q

is the labrum innervated?

A

yes

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5
Q

is the labrum vascular?

A

no

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6
Q

what are the clinical implications of an innervated avascular structure?

A

it can be painful and will heal slow or not heal at all

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7
Q

if a fx is closer to the femoral head, is it more or less likely to be spared?

A

less likely to be spared

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8
Q

what is the difference be a full jt replacement and a hemi hip jt replacement?

A

a full replacement involved the femoral head and acetabular cup, a hemi-replacement is just the femoral head

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9
Q

what are the 3 Rs of an examination?

A

reproducible sign

region of origin

reactivity level

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10
Q

what is the reproducible sign?

A

the action that brings about the pain that the patient has been experiencing

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11
Q

what is another name for the reproducible sign?

A

comparable sign

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12
Q

what is the region of origin?

A

where the pain is specifically coming from (more helpful in the spine)

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13
Q

what is reactivity level?

A

the level of irritability and behavior of the condition

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14
Q

what is the relationship of P1/2 to R1/2 in a highly reactive pt?

A

P1 and P2 will be close or the same and come before R1

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15
Q

if a pt is highly reactive, what grade mobs would be recommended?

A

grade 1 and 2

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16
Q

what are 2 good qualities of a historical interview in the exam?

A

focuses and empathetic

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17
Q

what is meralgia paraesthetica?

A

entrapment of the femoral nerve, often in the inguinal region, that created burning/tingling in the thigh

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18
Q

what conditions can contribute to hip pain?

A

ankylosing spondylitis

OA

congenital dysplasia (DDH), SCFE, LCPD

osteoporosis

surgical and traumatic hx

celiac

Crohn’s disease

bone tumors

lumbar radiculopathy

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19
Q

what is ankylosing spondylitis?

A

an autoimmune disease causing inflammation in the spine

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20
Q

what is DDH?

A

development dysplasia of the hip

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21
Q

what is included in the HPI?

A

MOI

pain location and type

relationship to activity/time of day

snapping, catching, locking (intra vs extra articular)

radiating symptoms

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22
Q

what is a normal femoral head/shaft angle?

A

125 degrees

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23
Q

what is coxa vara?

A

decreased femoral angle

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24
Q

what is coxa valga?

A

increased femoral angle

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25
Q

with coxa Vara/valga, what may be seen?

A

in/out toeing

pro/sup

leg length discrepancies

genu valgus/varus

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26
Q

would a pt with coxa vara appear to have a longer or shorter leg ipsilaterally?

A

shorter leg

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27
Q

would a pt with coxa valga appear to have a longer or shorter leg ipsilaterally?

A

longer leg

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28
Q

if a pt has femoral anteversion, would you likely see in toeing or outtoeing to compensate?

A

in-toeing

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29
Q

if a pt has femoral retroversion, would you likely see in toeing or outtoeing to compensate?

A

out-toeing

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30
Q

what is the OPP of the hip?

A

30 degrees of flexion

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31
Q

what is the CPP of the hip?

A

max extension, IR, and abd

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32
Q

what is the end feel of hip flexion?

A

elastic/tissue approximation

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33
Q

what is the end feel of hip extension?

A

tissue stretch, elastic

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34
Q

what is the end feel of hip abduction?

A

tissue stretch, elastic

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35
Q

what is the end feel of hip adduction?

A

elastic/tissue approximation

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36
Q

what is the end feel of hip IR/ER?

A

tissue stretch, elastic

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37
Q

in the pyramid of mobility testing, what do we do first, PROM, AROM, or mobs?

A

AROM

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38
Q

in the pyramid of mobility testing, what do we do after AROM, PROM or mobs?

A

PROM

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39
Q

what is the last and sometimes not done step in the pyramid of mobility testing?

A

mobs

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40
Q

what is the most specific test for joint motion?

A

mobs

41
Q

what are some compensatory patterns for coxa Vara?

A

ipsi PF and sup

contra DF and pro

contra genu recurvatum

contra hip and/or knee flexion

ipsi ant pelvic rotation and/or contra post pelvic rotation in standing

42
Q

what are some compensatory patterns of coxa valga?

A

ipsi DF and pro

contra PF and sup

ipsi genu recurvatum

ipsi hip and/or knee flexion

ipsi post pelvic rotation and/or contra ant pelvic rotation in standing

43
Q

what are some compensatory patterns of femoral anteversion?

A

ipsi external tibial torsion

ipsi sup

ipsi knee ext

44
Q

what are some compensatory patterns of femoral retroversion?

A

ipsi internal tibial torsion

ipsi pro

ipsi knee flex

45
Q

what is normal femoral anteversion?

A

15-25 degrees

46
Q

what is the angle of femoral anteversion?

A

> 25 degrees anteverted

47
Q

what is the angle of femoral retroversion?

A

<15 degrees anterversion

48
Q

what would be an example of a bottom up problem causing a shorter leg?

A

overpronation

49
Q

what would be an example of a top down problem causing a shorter leg?

A

coxa vara

50
Q

what is inhibited in upper crossed syndrome?

A

deep cervical flexors

LT/SA

51
Q

what is facilitated in upper crossed syndrome?

A

UT/LS

SCM/pecs

52
Q

what is inhibited in lower crossed syndrome?

A

abdominals

glut med/min/max

53
Q

what is facilitated in lower crossed syndrome?

A

thoraco-lumbar extensors

rectus femoris and illiospoas

54
Q

what should be strengthened in crossed syndrome?

A

core (TA, multifidi, pelvic floor) and glutes

55
Q

what should be stretched in crossed syndrome?

A

lumbar extensors and HS

56
Q

what is the capsular pattern of the hip?

A

limited in flexion, abd, and IR is variable

flex=abd=IR variable

57
Q

to facilitate hip flexion, the femur rolls ___and glides ____ _____

A

anterior, posterior/inferior

58
Q

to facilitate hip extension, the femur rolls ____ and glides ____

A

posterior, anterior

59
Q

to facilitate hip abduction, the femur rolls ____ and glides ____

A

lateral, medial

60
Q

to facilitate hip adduction, the femur rolls ____ and glides ____

A

medial, lateral

61
Q

to facilitate hip IR, the femur rolls ____ and glides ____

A

medial, lateral/posterior

62
Q

to facilitate hip ER, the femur rolls ____ and glides ____

A

lateral, medal/anterior

63
Q

what is the roll and glide for hip flexion in the OKC?

A

roll anterior

glide posterior and inferior

64
Q

what is the roll and glide for hip extension in the OKC?

A

roll posterior

glide anterior

65
Q

what is the roll and glide for hip abduction in the OKC?

A

roll lateral

glide medial

66
Q

what is the roll and glide for hip adduction in the OKC?

A

roll medial

glide lateral

67
Q

what is the roll and glide for hip IR in the OKC?

A

roll medial

glide lateral and posterior

68
Q

what is the roll and glide for hip ER in the OKC?

A

roll lateral

glide medial and anterior

69
Q

what is the roll and glide for hip flexion in the CKC?

A

roll anterior

glide anterior

70
Q

what is the roll and glide for hip extension in the CKC?

A

roll posterior

glide posterior

71
Q

what is the roll and glide for hip abduction in the CKC?

A

roll lateral

glide lateral

72
Q

what is the roll and glide for hip adduction in the CKC?

A

roll medial

glide medial

73
Q

what is the roll and glide for hip IR in the CKC?

A

roll medial

glide medial

74
Q

what is the roll and glide for hip ER in the CKC?

A

roll lateral

glide lateral

75
Q

what is normal open chain hip flexion?

A

120-125 degrees

76
Q

what is normal open chain hip extension?

A

9-19 degrees

77
Q

what is normal open chain hip abd?

A

39-46 degrees

78
Q

what is normal open chain hip add?

A

15-31 degrees

79
Q

what is normal open chain hip ER?

A

32-47 degrees

80
Q

what is normal open chain hip IR?

A

32-47 degrees

81
Q

what is the hip equivalent motion for ant/post rotation of the pelvis?

A

flex/ext

82
Q

what is the hip equivalent motion for upslip/downslip?

A

add/abd

83
Q

what is the hip equivalent motion for outflare/inflare?

A

ER/IR

84
Q

what is the lumbopelvic rhythm?

A

lumbar spine

lumbo-pelvic spine

hip

85
Q

with hip flexion, what is lumbopelvic contribution at the beginning, middle, and end of motion?

A

lumbar more in early motion (2:1 L/H ratio)

lumbar/hips contribute equally in middle phase (1:1 L/H ratio)

hips in late motion (1:2 L/H ratio)

86
Q

with hip extension, what is the lumbopelvic contribution at the beginning, middle, and end of motion?

A

hips in early motion (1:2 L/H ratio)

lumbar/hips contribute equally in middle phase (1:1 L/H ratio)

lumbar in late motion (2:1 L/H ratio)

87
Q

with the hips in neutral, is IR or ER stronger?

A

ER

88
Q

with the hip in neutral, what do the glut max, most of med, and deep rotators do?

A

ER

89
Q

with the hip in >90 degrees flexion, what do the glut med, and piriformis do?

A

IR

90
Q

with the hip in >90 degrees flexion, is IR or ER stronger?

A

IR

91
Q

what is the process for palpation?

A

palpate for position early in the exam

palpate for condition

palpate for reproduction late in the exam to avoid a flare up during MMTs, special tests, etc

begin at the least painful sport and work towards the pain

92
Q

what are some functional tests?

A

squatting

stair negotiation (1, 2, at a time)

leg crossing

gait assessment

jogging/running assessment

jumping/hopping

one leg hop (time, distance, crossover)

step down test (powers)

93
Q

what hip range is required for squatting?

A

flexion: 115 degrees

abduction: 20 degrees

IR: 20 degrees

94
Q

what hip range is required for sitting?

A

flexion: 115 degrees

95
Q

what hip range is required for ascending stairs?

A

flexion: 70 degrees

96
Q

what hip range is required for descending stairs?

A

flexion: 40 degrees

97
Q

what hip range is required for donning pants?

A

flexion: 90 degrees

98
Q

what hip range is required for crossing legs?

A

flexion: 120 degrees

abduction: 20 degrees

ER: 20 degrees

99
Q

why do pts prefer ascending stairs to descending stairs?

A

because they can bend forward up stairs to activate the glutes more for more power

DPT 616 : MSK (8 decks)

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