figures table and new

Question 1

describe how the femoral head shape changes with development

Answer 1

children have a conical shaped femoral head that changes into a spherical shaped femoral as weight bearing increases
- weight bearing changes from the edges to deep into the joint

Question 2

Describe how the femoral neck angle changes with development

Answer 2

Femoral neck angle starts out at about 150 degrees but decreases to 120-130 as we age. Coxa vara less than 120 degrees

Question 3

what is the center edge angle of the hip

Answer 3

x-ray measurement for the depth of the acetabulum

• angle between a vertical line from the center of the head and line from the center of the femoral head to the edge of the acetabulum
• normal is 25-30, greater than 30 marked arthritic changes, less than 25 may indicate hip dysplasia

Question 4

how does the retroversion angle change with development

Answer 4

children start with about 40 degrees and we grow men will decrease to about 10 and women to about 15

Question 5

Describe the vascularization of the hip labrum

Answer 5

• outer margins are well vascularized

- superior labrum less vascularized than other parts

Question 6

What are the three layers of the hip capsule

Answer 6

1. longitudinal from bone to bone
2. transverse circular fibers around the capsule creating “zona obicularis” or the narrow region in the middle of the capsule (chinese finger cuff)
3. arcuate - loop at the insertion reenforcing capsule and labrum

Question 7

Describe the branches of the iliofemoral ligament

Answer 7

1. pars inferioris - iliac outer wall to the intertrochanteric line anteriorly
2. pars superioris - same starting point to the front of the greater trochanter

Question 8

what is the inguinal canal and what structure if found there

Answer 8

1. distal end of the inguinal ligament
2. connect the abdomen to the scrotum or labia majora
3. male contains spermatic cord and ioloinguinal nerve
4. female contains the round ligament of the uterus and ilioinguinal nerve

Question 9

Where is the AIIS relative to the ASIS

Answer 9

about 2 cm distal and 1 cm medial to ASIS

Question 10

describe the innervation of the pubic symphysis

Answer 10

• anterior - L2-4 and refers pain to the groin

- posterior - S3-S5 genital pain

Question 11

Describe the peak forces on the joint surfaces during gait

Answer 11

1.8 to 3.8 body weight and increases with greater degrees of anteversion

Question 12

Describe the joint loading pattern of the hip during stance a propulsion

Answer 12

1- stance dorsal lateral region takes most of the load

2- ventrolateral region in propulsion

Question 13

legg-calve-perthes

Answer 13

avascular necrosis (AVN) of the proximal femoral head resulting from compromise of the tenuous blood supply to this area. LCPD usually occurs in children aged 4-10 years. The disease has an insidious onset and may occur after an injury to the hip

Question 14

Osteochondritis dissecans

Answer 14

joint disorder in which cracks form in the articular cartilage and the underlying subchondral bone.
- 15-25 years old

Question 15

what is the active straight leg raise test

Answer 15

• test for mechanical stability
• supine, lift one leg off the table, if it produces pain, mechanically stabilize the pelvis and repeat the leg raise, if this resolves the pain this suggest mechanical pathology of the pelvis or lumbar spine

Question 16

What is the CPR for hip OA

Answer 16

3 of 5

1. squatting increases symptoms
2. active hip flexion causes lateral hip pain
3. scour test positive for pain
4. active hip extension increases pain
5. PROM IR less than 25 degrees

Question 17

What is SCFE

Answer 17

Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in teens and pre-teens who are still growing.
- the ball at the head of the femur slips off the neck of the bone in a backwards direction.
- The condition usually develops gradually over time and is more common in boys than girls.
- male 13-15, female 11-13
= non capulsuar

Question 18

Describe treatment for LCPD

Answer 18

• decrease risk of future OA

- hip traction in abduction, serial casting, and orthosis to maintain hip in abduciton and IR during weight bearing

Question 19

what is the sign of the buttock

Answer 19

• painful SLR and
• painful hip flexion
  Suggestive other hip pathology or space occupying lesion

Question 20

what percentage of people have a sciatic nerve passing through their piriformis?

Answer 20

14%

Question 21

Describe the differential for pudendal nerve entrapment

Answer 21

• can be entrapped between the sacrubus and sacrospinous ligament, pudendal canal or in in tis course as it crossed the faliciform process of the sacrotuberous ligment
• lower quadrant glut pain with burning pain in the perineal region with sitting that improves with standing

Question 22

What is a sports hernia

Answer 22

• Sports hernias often occur where the abdominals and adductors attach at the pubic bone. Traditional hernias occur in the inguinal canal.
• The soft tissues most frequently affected by sports hernia are the oblique muscles in the lower abdomen. Especially vulnerable are the tendons that attach the oblique muscles to the pubic bone. In many cases of sports hernia, the tendons that attach the thigh muscles to the pubic bone (adductors) are also stretched or torn.

Question 23

Signs and symptoms of hip labral tear

Answer 23

1. groin pain
2. low back or SIJ pain
3. difficulyt with activities requiring hip rotation
4. subjective reports of weakness and decreased stability
5. decreased ROM
6. painful clickign
7. difficulty transitioning from sit to stand
8. difficulty with prolonged sitting

Question 24

What type of MRI can be used to ID labral tears

Answer 24

Gadolinium enhanced MRI

Question 25

what disease process is a must to know? 5 signs

Answer 25

LEgg Clave Perthes disease

1. aspeptic bone necrosis
2. 3-10 years old
3. hip motion limit in capsular pattern
4. groin anterior thigh or knee pain
5. femoral head can colapse
6. draimen sign movement associated with muscle guarding cause abduction with flexion
7. frog leg position with radiographs

Question 26

what is osteochondritis and who gets it

Answer 26

• cartilage and subchondral bone inflammation

- 15-25 year olds

Question 27

what is the difference between CAM and PINCER FAI

Answer 27

CAM femoral head change

PINCER acetabular change

Question 28

What PROM would you expect to produce pain with pubic symphysis pathology

Answer 28

45 degree flexion with add