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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
with coxa Vara/valga, what may be seen?
in/out toeing pro/sup leg length discrepancies genu valgus/varus
26
would a pt with coxa vara appear to have a longer or shorter leg ipsilaterally?
shorter leg
27
would a pt with coxa valga appear to have a longer or shorter leg ipsilaterally?
longer leg
28
if a pt has femoral anteversion, would you likely see in toeing or outtoeing to compensate?
in-toeing
29
if a pt has femoral retroversion, would you likely see in toeing or outtoeing to compensate?
out-toeing
30
what is the OPP of the hip?
30 degrees of flexion
31
what is the CPP of the hip?
max extension, IR, and abd
32
what is the end feel of hip flexion?
elastic/tissue approximation
33
what is the end feel of hip extension?
tissue stretch, elastic
34
what is the end feel of hip abduction?
tissue stretch, elastic
35
what is the end feel of hip adduction?
elastic/tissue approximation
36
what is the end feel of hip IR/ER?
tissue stretch, elastic
37
in the pyramid of mobility testing, what do we do first, PROM, AROM, or mobs?
AROM
38
in the pyramid of mobility testing, what do we do after AROM, PROM or mobs?
PROM
39
what is the last and sometimes not done step in the pyramid of mobility testing?
mobs
40
what is the most specific test for joint motion?
mobs
41
what are some compensatory patterns for coxa Vara?
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
what are some compensatory patterns of coxa valga?
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
what are some compensatory patterns of femoral anteversion?
ipsi external tibial torsion ipsi sup ipsi knee ext
44
what are some compensatory patterns of femoral retroversion?
ipsi internal tibial torsion ipsi pro ipsi knee flex
45
what is normal femoral anteversion?
15-25 degrees
46
what is the angle of femoral anteversion?
>25 degrees anteverted
47
what is the angle of femoral retroversion?
<15 degrees anterversion
48
what would be an example of a bottom up problem causing a shorter leg?
overpronation
49
what would be an example of a top down problem causing a shorter leg?
coxa vara
50
what is inhibited in upper crossed syndrome?
deep cervical flexors LT/SA
51
what is facilitated in upper crossed syndrome?
UT/LS SCM/pecs
52
what is inhibited in lower crossed syndrome?
abdominals glut med/min/max
53
what is facilitated in lower crossed syndrome?
thoraco-lumbar extensors rectus femoris and illiospoas
54
what should be strengthened in crossed syndrome?
core (TA, multifidi, pelvic floor) and glutes
55
what should be stretched in crossed syndrome?
lumbar extensors and HS
56
what is the capsular pattern of the hip?
limited in flexion, abd, and IR is variable flex=abd=IR variable
57
to facilitate hip flexion, the femur rolls ___and glides ____ _____
anterior, posterior/inferior
58
to facilitate hip extension, the femur rolls ____ and glides ____
posterior, anterior
59
to facilitate hip abduction, the femur rolls ____ and glides ____
lateral, medial
60
to facilitate hip adduction, the femur rolls ____ and glides ____
medial, lateral
61
to facilitate hip IR, the femur rolls ____ and glides ____
medial, lateral/posterior
62
to facilitate hip ER, the femur rolls ____ and glides ____
lateral, medal/anterior
63
what is the roll and glide for hip flexion in the OKC?
roll anterior glide posterior and inferior
64
what is the roll and glide for hip extension in the OKC?
roll posterior glide anterior
65
what is the roll and glide for hip abduction in the OKC?
roll lateral glide medial
66
what is the roll and glide for hip adduction in the OKC?
roll medial glide lateral
67
what is the roll and glide for hip IR in the OKC?
roll medial glide lateral and posterior
68
what is the roll and glide for hip ER in the OKC?
roll lateral glide medial and anterior
69
what is the roll and glide for hip flexion in the CKC?
roll anterior glide anterior
70
what is the roll and glide for hip extension in the CKC?
roll posterior glide posterior
71
what is the roll and glide for hip abduction in the CKC?
roll lateral glide lateral
72
what is the roll and glide for hip adduction in the CKC?
roll medial glide medial
73
what is the roll and glide for hip IR in the CKC?
roll medial glide medial
74
what is the roll and glide for hip ER in the CKC?
roll lateral glide lateral
75
what is normal open chain hip flexion?
120-125 degrees
76
what is normal open chain hip extension?
9-19 degrees
77
what is normal open chain hip abd?
39-46 degrees
78
what is normal open chain hip add?
15-31 degrees
79
what is normal open chain hip ER?
32-47 degrees
80
what is normal open chain hip IR?
32-47 degrees
81
what is the hip equivalent motion for ant/post rotation of the pelvis?
flex/ext
82
what is the hip equivalent motion for upslip/downslip?
add/abd
83
what is the hip equivalent motion for outflare/inflare?
ER/IR
84
what is the lumbopelvic rhythm?
lumbar spine lumbo-pelvic spine hip
85
with hip flexion, what is lumbopelvic contribution at the beginning, middle, and end of motion?
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
with hip extension, what is the lumbopelvic contribution at the beginning, middle, and end of motion?
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
with the hips in neutral, is IR or ER stronger?
ER
88
with the hip in neutral, what do the glut max, most of med, and deep rotators do?
ER
89
with the hip in >90 degrees flexion, what do the glut med, and piriformis do?
IR
90
with the hip in >90 degrees flexion, is IR or ER stronger?
IR
91
what is the process for palpation?
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
what are some functional tests?
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
what hip range is required for squatting?
flexion: 115 degrees abduction: 20 degrees IR: 20 degrees
94
what hip range is required for sitting?
flexion: 115 degrees
95
what hip range is required for ascending stairs?
flexion: 70 degrees
96
what hip range is required for descending stairs?
flexion: 40 degrees
97
what hip range is required for donning pants?
flexion: 90 degrees
98
what hip range is required for crossing legs?
flexion: 120 degrees abduction: 20 degrees ER: 20 degrees
99
why do pts prefer ascending stairs to descending stairs?
because they can bend forward up stairs to activate the glutes more for more power

DPT 616 : MSK (23 decks)

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