Exam 1: Hip and Pelvis Flashcards by Madelynn Kahl

What are the four design considerations of the hip

Stability in the upright position
Ability to raise and control trunk
Ability to balance on one leg
Walk with feet underneath body

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What direction does the acetabulum face?

laterally, anteriorly, and inferiorly

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What direction does the head of the femur face?

anteriorly, medially, and superiorly

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What is wolff’s law

The body will adapt based on the stresses placed on it

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What is the purpose of the alignment of trabecula?

They are aligned depending on stress and tension to provide maximum strength and a base for the femoral head and acetabulum.

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The (shoulder/hip) is a weight bearing joint

hip

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What type of joint is the hip

ball and socket joints

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The (shoulder/hip) has a deeper socket

hip. the acetabulum is deeper than the glenoid

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The (shoulder/hip) has more bony support

hip

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The (shoulder/hip) is designed for mobility and the (shoulder/hip) is designed for stability/larger forces

shoulder; hip

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What is the max ROM and functional ROM of flexion and extension of the hip

Max: 140
Functional: 50-60

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What is the max ROM of adduction and abduction of the hip

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__ - __ times a person’s body weight is placed through the hip with functional activities

1.8-4.3

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One legged stance places __-__ times the person’s BW on the femoral head

5-6

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When is the highest load placed on the hip

when ascending stairs

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What is the closed pack position of the hip

Combined extension, internal rotation, and adduction

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What is the open packed position of the hip

30 degrees of flexion, 30 degrees of abduction, slight ER

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What is the capsular pattern of the hip

gross limitation of flexion, IR, and some abduction

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Should distraction of the hip be done in the open packed or closed pack position and why

open packed, because if you distract in the closed pack, it will be felt more in the lumbar spine and can be used to relieve back pain

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What three bones form the acetabulum

ilium, ischium, and pubic bones

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How is the acetabulum reinforced?

It is covered with articular cartilage called a labrum

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What is the name of the ligament to the head of the femur and what is its significance

The ligamentum teres will tear if the hip is dislocated, which can cause avascular necrosis

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The femoral head and acetabulum have (small/large) amounts of trabecular bone

large

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Approximately __% of the head of the femur articulates with the acetabulum

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What is the normal angle of inclination

125

What degree of angulation causes coxa vara

less than 120

What degree of angulation causes coxa valga

greater than 135

coxa (vara/valga) shortens the limb and leads to genu valgum or knocked knees

vara

Coxa vara increases the effectiveness of the ____, reduces the load on the femoral ___ and increases the load of the femoral ___.

abductors, head, neck

A person with coxa vara will (supinate/pronate) more

pronate

A person with coxa ___ is more likely to fracture a hip

vara

coxa (vara/valga) lengthens the limb and leads to genu varum or bow legged

valga

coxa valga reduces the effectiveness on the ____, increases the load on the femoral ___, and reduces the load on the femoral ____

abductors, head, neck

What is the normal angle of torsion

8-15

A decreased angle of torsion is known as

retroversion or duck feet

An increased angle of torsion is known as

anteversion or pigeon toes

Where does the hip joint capsule attach too

the entire periphery of the acetabulum and the femoral neck

What were the results of Kapandji and the piriformis

The piriformis is stretched or "the function of the piriformis is inversed" when the hip is flexed 60 degrees or more because of its higher attachment on the GT and sacrum than other ER's

Why is there a percentage of patients who develop neurodynamic dysfunction with dysfunction of gluteal muscles

It is due to the close proximity of the sciatic nerve to the intrinsic hip ERs and the hamstrings

__% of patients with hamstring strains develop adverse Neurodynamics

50% of patients with hamstring strains develop adverse _____

neurodynamics

What is normal ROM for hip flexion and what is needed for normal gait

ROM: 120 Gait: 40-60

What is the end feel of hip flexion

soft - tissue approximation

What are the primary movers for hip flexion

iliopsoas, rectus femoris, sartorius

Iliopsoas, rectus femoris, and sartorius are the primary movers for hip ____

flexion

Which two muscle groups are affected by knee positions during hip flexion. State whether the movement is active or passive

Active by rectus femoris | Passive by hamstring restriction

What is normal ROM for hip extension and what is needed for normal gait

ROM: 10-20 Gait: 15-20

What is the end feel for hip extension

firm - capsular

gluteus maximus and hamstrings are the primary movers for hip ____

extension

What are the primary movers for hip extension

gluteus maximus and hamstrings

Which two muscle groups are affected by knee positions during hip extension. State whether the movement is active or passive

active by hamstrings | passive by rectus femoris

What is normal ROM for hip abduction and what is needed for gait

ROM: 45 Gait: 7

What is the end feel for hip abduction

firm - capsular

Gluteus medius and gluteus minimus are the primary movers for hip ____

abduction

what are the primary movers for hip abduction

glute medius and minimus

What is normal ROM for hip adduction and what is needed for gait

ROM: 30 Gait: 5

What is the end feel for hip adduction

firm - capsular

The adductor longus, magnus, and brevis are primary movers of hip ____.

adduction

What are the primary movers of hip adduction

Adductor longus, magnus, and brevis

What is normal ROM for hip ER and what is needed for gait

ROM: 45-50 Gait: 9

What is the end feel for hip external rotation

firm - capsular

The sartorius, glute maximus, posterior fibers of glute medius, and six ER's are the primary movers of hip ___.

external rotation

What are the 9 primary movers for hip external rotation (Hint: there's 6 ER's)

piriformis, superior gemellus, inferior gemellus, obturator internus, obturator externus, Quadratus femoris, sartorius, gluteus maximus, and posterior fibers of glute medius

What is normal ROM for hip IR and what is needed for gait

ROM: 45 Gait: 4

What is the end feel for hip IR

firm - capsular

The adductor longus, magnus and brevis as well as gluteus medius, and minimus are primary movers for hip ____

What are the primary movers for hip internal rotation

adductor longus, magnus, and brevis | Glute med and min

What direction of mob would you perform to improve flexion

posterior/dorsal

What direction of mob would you perform to improve extension

anterior/ventral

What direction of mob would you perform to improve abduction

inferior/caudal

What direction of mob would you perform to improve adduction

lateral

What direction of mob would you perform to improve IR

posterior and lateral

What direction of mob would you perform to improve ER

True or False: Performing flexion and extension mobs also give you affects to IR and ER

true, this means that rotation mobs aren't really done in isolation

Which muscles control the ability to balance on one leg

glute med and min

What causes trendelenburg gait

weak glute med and min

Extension of the hip tends to (laterally/medially) rotate the femur so (lateral/medial) rotators need to neutralize this effect

laterally; medial

True or False: IR is performed against resistance because of its muscular support

False, it doesn't have a lot of support so it is not tested against resistance

Are medial or lateral rotators weaker

medial

What are four assisting muscles of hip IR

semimembranosus, semitendinosus, TFL, and hip adductors

ER is a natural movement in gait to accommodate ___ ___

pelvic rotation

What age group is likely to be diagnosed with congenital dislocations or septic arthritis

0-2

What age group is likely to be diagnosed with LCPD

4-8

What age group is likely to be diagnosed with SCFE or apophysitis

9-15

What age group is likely to be diagnosed with osteochondritis dissecans, overuse injuries, strains, or osteitis pubis

14-25

What age group is likely to be diagnosed with RA or AVN

30-50

What age group is likely to be diagnosed with DJD and hip fractures

55+

What are the movements of the pelvis

anterior/posterior tilt left and right lateral tilt left and right rotation

State the position of the spinal joints and hip joints with an anterior tilt of the pelvis

Spine: hyperextension Hip: slight flexion

State the position of the spinal joints and hip joints with a posterior tilt

Spine: slight flexion Hip: complete extension

State the position of the spinal joints and hip joints with a lateral left tilt

Spine: slight lateral flexion to the right R Hip: ADD L Hip: ABD

State the position of the spinal joints and hip joints with a lateral right tilt

Spine: slight lateral flexion to the left R Hip: ABD L Hip: ADD

State the position of the spinal joints and hip joints with a rotation to the left

Spine: right rotation R Hip: slight ER L Hip: slight IR

State the position of the spinal joints and hip joints with a rotation to the right

Spine: left rotation R Hip: slight IR L Hip: slight ER

If the spine is flexed, the pelvis is ___ ___

posteriorly rotated

If the spine is hyperextended, the pelvis is ___ ___

anteriorly tilted

If the spine is lateral flexed to the left, the pelvis is laterally tilted to the ___

left

If the spine is rotated to the left, the pelvis is rotated to the ___

left