E2- Hip and knee Flashcards
what can the shape of the femur be impacted by
growth of the ossification center
force of m activation
WB
circulation
trauma
what is coxa vara
less than 125-105 deg
hip bend inward
cause genu valga
what is coxa valga
greater than 125-140 deg
hip bend outward
cause genu vara
what is femoral torsion
relative RT between the shaft and neck
what is normal anteversion of femoral torsion
15 deg (8-20)
what is excessive anteversion
greater than 15-35
what is retroversion
less than 15 deg
what can excessive anteversion cause
hip dislocation
OA
increase contact stress
in toeing
how does increased anteversion affect motion
less ER more IR
how does retroversion affect motion
increase ER less IR
what is the normal for creg’s test
8-15 deg
where is the femoral head located
inferior to mid 1/3 of inguinal lig
posterior to center is fovea
what is the lig teres
tubular, synovial lined connective tissue
contains mechanoreceptors
what is housed in the lig teres
acetabular artery
what is the acetabulum
deep, cuplike socket
what is the acetabular notch
60-70 deg opening
what is in the acetabular fossa
fat, blood vessels, synovial membrane, ligaments
where is the normal contact of the femoral head
along the lunate surface
what is the lunate surface
covered in articular cartilage, sup-ant, where the femoral head contacts
when is the joint force highest for the lunate surface
walking
what happens to the acetabulum during midstance of the gait cycle
300% BW
notch widens
lunate deforms
increase contact area/decrease pressure
what is the acetabular labrum
strong, flexible ring of fibrocartilage rim of acetabulum
where is the transverse acetabular lig
spans the acetabular notch
where is the labro-chondral junction
internal labrum blends with the articular cartilage of acetabulum
where is the 13% of forces in the acetabulum coming from during the swing phase
muscles
passive structures
what is the function of the acetabulum labrum
mechanical stability “grip”
deepens socket
keeps negative pressure, fluid sealed
what is the acetabular alignment
projects laterally, inf/ant inclination
what is dysplastic acetabulum
malformed, does not fully cover the femoral head
what can dysplastic acetabulum cause
chronic dislocation
OA
pain
what is the center edge angle
degree acetabulum covers femoral head
what is acetabular anteversion angle
extent to which the acetabulum faces anteriorly
what is the difference between acetabulum anteversion and femoral version (ante/retro)
femoral- axis of femur and transcondylar axis of knee
acetabulum- acetabular morphology
what ligaments reinforce the external capsule of the hip
iliofemoral
pubofemoral
ischiofemoral
what elongates the iliofemoral lig
hip EXT and full ER
what elongates the pubofemoral lig
hip ABD/EXT and some ER
what elongates the ischiofemoral lig
taught in IR and hip ABD
what is the iliocapsularis
deep hip flexor
lateral to iliacus
deep to rectus femoris and sartorius
how could a person with parapelgia stand upright
by leaning on the iliofemoral lig to make them taut and hold their body weight
what is the closed pack position of the hip
full EXT
slight IR and hip ABD
what is the position of max joint congruity of the hip
90 flexion
moderate ABD and ER
true/false
max jt congruity of the hip is equivalent to the closed pack position of the hip
false
closed pack position is not associated with the position of max congruity
what is the osteokinematics of the femoral on pelvic
femur moves on fixed pelvis
what is the osteokinematics of the pelvic on femoral
RT of pelvis on fixed femurs
what is the deg of motion of femoral on pelvic hip flexion
120-140
results in posterior tilt and lumbar flexion
how does the deg of motion change for hip flexion with LE extended
70-80 deg
due to hamstring tension
what is the deg of motion of femoral on pelvic hip extension
18-30 deg
what is the deg of motion of femoral on pelvic hip ABD
40-55 deg
what can limit motion of hip ABD
pubofemoral lig
adductor muscles
what is the deg of motion of femoral on pelvic hip ADD
20-25 deg
what can limit motion of hip ADD
ABD muscles
piriformis
ITB
what is the deg of motion of femoral on pelvic hip RT
IR- 30-45
ER- 32-50
what is ipsidirectional lumbopelvic rhythm
lumbar and spine move in same direction
what is maximized in ipsidirectional lumbopelvic rhythm
angular displacement of trunk
what is contradirectional lumbopelvic rhythm
lumbar and pelvis move in opposite direction
above lumbar stays stationary
used in walking
when is the pelvis in contradirectional lumbopelvic rhythm
walking
sitting with ant/post tilts
what is the contradirectional rhythm of hip flexion in sitting
ant pelvic tilt
lumbar spine ext
sacrum nutates (flexes)
what is the contradirectional rhythm of hip extension in sitting
post pelvic tilt
lumbar spine flx
sacrum counternutate (extends)
what is the contradirectional rhythm of R hip ABD of support leg with walking
L iliac crest hip hikes
L lateral flexion
what is the contradirectional rhythm of R hip ADD of support leg with walking
L iliac crest drops
R lateral flexion
how does the hip roll/slide with open chain arthrokinematocs
convex femur rolls/slides in opposite directions
what is the arthrokinematics of open chain exercise of hip flx
roll ant
slide post/inf
what is the arthrokinematics of open chain exercise of hip ext
roll post
slide ant/sup
what is the arthrokinematics of open chain exercise of hip IR
roll ant
slide post
what is the arthrokinematics of open chain exercise of hip ER
roll post
slide ant
what is the arthrokinematics of open chain exercise of hip ABD
roll sup
slide inf
what is the arthrokinematics of open chain exercise of hip ADD
roll inf
slide sup
what is the path of the arthokinematics while the hip is doing IR/ER
transverse
what is the path of the arthokinematics while the hip is doing ABD/ADD
longitudinal
what m are the primary hip flexors
iliopsoas
sartorius
rectus femoris
adductor longus
pectineus
when is the iliopsoas best recruited
prominent femoral-hip flexor
trunk/pelvis flexor over fixed thighs
swing phase of walk
frontal plane stability
when is the psoas minor best recruited
stabilize the underlying position of psoas major
what are the primary action of sartorius
hip flex, abd, er
what is the TFL innervation
superior gluteal n L4-S1
what is the ITB innervation
superior gluteal n L4-S1
inferior gluteal n L5-S2
what innervates the sartorius
femoral n L2-4
what m do the obturator n innervate
hip adductors
obturator externus
what m has isometric torque at hip
rectus femoris
what innervates the rectus femoris
femoral L2-4
what are the primary hip add
pectineus
adductor longus
gracilis
adductor brevis
adductor magnus
what m are in the superficial layers of hip adductors
pectineus
adductor longus
gracilis
what m has the longest moment arm to promote hip flx
rectus femoris
what m are in the middle layer of hip adductors
adductor brevis