Final Exam Hip and Pelvis Flashcards
The body of the ilium forms the __ 2/5 of the ___
superior
acetabulum
The ischium = a body, which contributes to the __ and the __
acetabulum
ramus
The ischium forms the __ 2/5 of the __
posterior
acetabulum
__ and __ form the ischial tuberosity
Ischium
ramus
Pubis forms the __ __ of the acetabulum
anterior 1/5
What 3 things fuse together within the acetabulum?
Ilium, Ischium, Pubis
How is the acetabulum angled?
Laterally, inferiorly, anteriorly
The Acetabular rim (aka __) __ the acetabulum, thereby increasing __ of the hip joint
labrum
deepens
stability
3 joints of Pelvic girdle
Hip joint (acetabularfemoral) SI joint Pubic Symphisis
___ marks the widestpoint on the iliac crests
iliac tubercle
Iliac Crest contusion: Contusion to the site of or an __ of the __ __ and/or the __ muscles from the crest.
avulsion
quadratus lumborum
abdominal
Inspection: __ __ should be level with he __ __.
Greater trochanters
pubic tubercles
Bucket handle fx: Superior and inferior __ __ fractures with a __ or __ of the __ SI joint
pubic rami
separation
fracture
contralateral
What is a sprung pelvis?
Separation of the pubic symphysis and both SI joints
What is a straddle fx?
Bilateral superior pubic rami and ischiopubic fractures
Avulsion fx of the pelvis: Most common areas are???
ASIS
AIIS
Ischial Tub.
Approximately __ of the femoral head is covered with a smooth layer__ except for a depression, the __ __, which serves as the attachment of the __ __
2/3
cartilage
fovea capitis
ligamentum teres
The angle between the femoral shaft and the neck is called the ___ angle. This angle is approximately __-__ degrees but can vary with body types
inclination
125-130
Dashboard injury to the knee will cause a __ hip dislocation if the hip is __ at the time of injury.
posterior
adducted
The __ bone in the femoral neck and head is specially designed to withstand __ load. The design incorporates both primary and secondary __ and __ patterns
trabecular
high
compressive
tensile
The lesser trochanter, located on the __ junction of the neck and shaft of the femur, is created from the pull
of the __ muscle
posterior-medial
iliopsoas
The angle that the femoral
neck makes with the acetabulum is called the angle of __ (normal is __-__°)
anteversion
8-15
Femoral Anteversion: The angle between femoral neck and the transcondylar axis is greater than __ degrees. Pt has a __ __ gait
15
toe in
What are some conditions that may result from increased femoral head torision? (Anteversion)
OA Dysplasia of the acetabulum Susceptibility to ant. femoral dislocation knee joint misalignment problems patellar dislocations Excessive lumbar lordosis external rotation of tibia pronation of feet
Femoral retroversion: The angle between the femoral neck and the transcondylar axis is __
than 15 degrees. Pt has __ __gait.
less
toe out
Decreased femoral head torsion may result in which conditions?
Low back or SI pathologies
Internal rotation of tibia
Supination of feet
Legg-Calve-Perthes Disease is an avulsion of the __ __ epiphysis before closure of the growth plate. Male __:__ predominance. Ages __-__
femoral capital
5:1
3-12
Legg-Calve-Perthes: History of painful __, reduced __, muscle __. Positive __ test.
limp
mobility
atrophy
Trendelenburg
Primary causes of Legg-Calve-Perthes
Trauma
Hereditary
Nutritional
Circulatory
4 stages (2-8 years) of Legg-Calve-Perthes
Avascularization
Revascularization
Repair
Deformity
Legg-Calve-Perthes peak incidence is five years within a range of __-__ years. Bilateral in __%. First sign may be joint __ as shown by __ displacement of femoral head.
2-14
10%
effusion
lateral
2 parts of iliofemoral ligament
Inferior (medial)
Superior (lateral)
__ ligament is the strongest in the body. Ligament is oriented __-__ and blends with __ muscle
Iliofemoral
superior-laterally
Iliopsoas
Pubofemoral ligament blends with the __ band of __, and the __ muscle. Orientation is __-__
inferior
iliofemoral
pectineus
inferior-medial
Ischiofemoral ligament winds __ around the __, and attaches __, strengthening the __. This ligament is more commonly __ than other hip ligaments.
posteriorly femur anteriorly capsule injured
Extra-articular hip ligaments all tighten with hip __. Lateral band of Iliofemoral limits __. Medial band limits __ __.
extension
adduction
external rotation
Pubofemoral ligament limits __
abduction
Ischiofemoral Ligament limits __ of the __
internal rotation
hip
Iliopsoas function
Most powerful hip flexor
Pectineus fxn
Adductor, flexor, and internal rotator of the hip
Rectus Femoris fxn
flexion at hip and extension at knee
TFL action
assists in flexing, abducting and internally rotating the hip
Sartorius Action
Flexion, abduction and ext. rot. of the hip, and some degree of knee flexion
Glut. Max fxn
Largest and most important extensor and external rotator of the hip
Glut medius fxn
Main hip abductor
Anterior Glut. Medius fxn
flex, adduct, and int. rot. hip
Posterior Glut. Medius fxn
Extend and ext. rot. hip
Glut. Minimus fxn.
Major internal rotator of the femur
What are some possible causes of weak gluteus muscle?
Fx of greater trochanter Slipped capital femoral epiphysis congenital hip dislocation poliomyelitis meningomyocele nerve root lesion
Slipped Femoral Capital Epiphysis: Slipping of the __ as it remains in the __. Usually adolescents aged __-__.Usually Males or females? Blacks or whites? Left or right hip?
head acetabulum 10-15 males blacks Left
Slipped Femoral Capital Epiphysis is more common with __ adolescents. Usually onset of __ with __ pain referred to the __. Etiology is trauma __% of the time. Alteration in __ __
overweight limp hip knee 50 klein's line
Piriformis function
External Rotator of he hip at less than 60 degrees of flexion
-At 90 degrees of hip flexion, it reverses it’s action becoming an internal rotator and abductor
What are small external rotators of the hip?
Obturator externus and internus
Sup. and Inf. Gemelli
Quadratus Femoris
Biceps femoris action
extend hip, flex knee, externally rotate tibia
semimembranosus/tendinosus action
extend hip, flex knee, internally rotate tibia
What are the adductors of the hip?
Adductor magnus, longus, and brevis
Gracilis
Where is iliopsoas bursa located?
under inguinal ligament, between iliopsoas tendon and iliopectineal eminence of sup. pubic rami
OA of the hip commonly causes inflammation of the __ bursa.
psoas
Subtrochanteric bursa is located between the __ __ and ___
Greater trochanter
TFL
WHat are the femoral triangle borders?
Sup: Inguinal Ligament
Med: Adductor Longus
Lat: Sartorius
What forms the lateral side of the floor of femoral triangle?
portions of iliopsoas
What forms the medial side of the floor of femoral triangle?
Pectineus
What are the neurovascular structures that pass through the femoral triangle from medial to lateral?
Femoral Vein, artery, and nerve
Postl Gluteal region receives cutaneous innervation by way of the __ nerve, __ nerve, dorsal rami of (3) and the __ __ rami (__ nerves) of (3)
subcostal iliohypogastric L1-L3 dorsal primary cluneal S1-S3
Anterior region of the hip has it’s cutaneous supply divided around the __ ligament. The area superior to the ligament is supplied by the __ nerve. The area inferior is supplied by the __ nerve, the __ branch of __ nerve, and __ nerve.
inguinal iliohypogastric subcostal femoral genitofemoral Ilioinguinal
Normally, the sciatic nerve passes __ to piriformis (__% of the time)
inferior
88
The peroneal division of sciatic nerve passes through the piriformis muscle __% of the time
11
Both divisions of the sciaticnerve pass through the piriformis muscle __% of the time
0.1%
External iliac artery becomes he __ artery as it passes __ the__ ligament
femoral
underneath
inguinal
Most of the femoral head is supplied by which artery?
Lateral epiphyseal
Acute Phase Intervention
Principles of PRICE are applied
- Protection
- Rest
- Ice
- Compression
- Elevation
Goals of acute phase
Protect injury site
restore pain-free ROM
Improve patient comfort by decreasing pain
retard muscle atrophy
Minimize detrimental effects of immobilaztion and activity restriction
patient to be independent with home exercise program
Goals of functional phase
Attain full ROM
Restore normal joint kinematics
improve muscle strength to within normal limits
improve neuromuscular control
restore normal force couple relationships
