Dr. OD Hip Lecture Flashcards
t/f: the pelvis is a system of functionally interdependent joints
true
what forces go to the pelvis?
from the head, arms, trunk, and LEs
what is the labrum of the hip?
an extra rim of stability around the acetabulum
is the labrum innervated?
yes
is the labrum vascular?
no
what are the clinical implications of an innervated avascular structure?
it can be painful and will heal slow or not heal at all
if a fx is closer to the femoral head, is it more or less likely to be spared?
less likely to be spared
what is the difference be a full jt replacement and a hemi hip jt replacement?
a full replacement involved the femoral head and acetabular cup, a hemi-replacement is just the femoral head
what are the 3 Rs of an examination?
reproducible sign
region of origin
reactivity level
what is the reproducible sign?
the action that brings about the pain that the patient has been experiencing
what is another name for the reproducible sign?
comparable sign
what is the region of origin?
where the pain is specifically coming from (more helpful in the spine)
what is reactivity level?
the level of irritability and behavior of the condition
what is the relationship of P1/2 to R1/2 in a highly reactive pt?
P1 and P2 will be close or the same and come before R1
if a pt is highly reactive, what grade mobs would be recommended?
grade 1 and 2
what are 2 good qualities of a historical interview in the exam?
focuses and empathetic
what is meralgia paraesthetica?
entrapment of the femoral nerve, often in the inguinal region, that created burning/tingling in the thigh
what conditions can contribute to hip pain?
ankylosing spondylitis
OA
congenital dysplasia (DDH), SCFE, LCPD
osteoporosis
surgical and traumatic hx
celiac
Crohn’s disease
bone tumors
lumbar radiculopathy
what is ankylosing spondylitis?
an autoimmune disease causing inflammation in the spine
what is DDH?
development dysplasia of the hip
what is included in the HPI?
MOI
pain location and type
relationship to activity/time of day
snapping, catching, locking (intra vs extra articular)
radiating symptoms
what is a normal femoral head/shaft angle?
125 degrees
what is coxa vara?
decreased femoral angle
what is coxa valga?
increased femoral angle
with coxa Vara/valga, what may be seen?
in/out toeing
pro/sup
leg length discrepancies
genu valgus/varus
would a pt with coxa vara appear to have a longer or shorter leg ipsilaterally?
shorter leg
would a pt with coxa valga appear to have a longer or shorter leg ipsilaterally?
longer leg
if a pt has femoral anteversion, would you likely see in toeing or outtoeing to compensate?
in-toeing
if a pt has femoral retroversion, would you likely see in toeing or outtoeing to compensate?
out-toeing
what is the OPP of the hip?
30 degrees of flexion
what is the CPP of the hip?
max extension, IR, and abd
what is the end feel of hip flexion?
elastic/tissue approximation
what is the end feel of hip extension?
tissue stretch, elastic
what is the end feel of hip abduction?
tissue stretch, elastic
what is the end feel of hip adduction?
elastic/tissue approximation
what is the end feel of hip IR/ER?
tissue stretch, elastic
in the pyramid of mobility testing, what do we do first, PROM, AROM, or mobs?
AROM
in the pyramid of mobility testing, what do we do after AROM, PROM or mobs?
PROM
what is the last and sometimes not done step in the pyramid of mobility testing?
mobs