Final Exam Hip and Pelvis Flashcards by B Burr

The body of the ilium forms the __ 2/5 of the ___

superior

acetabulum

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The ischium = a body, which contributes to the __ and the __

acetabulum

ramus

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The ischium forms the __ 2/5 of the __

posterior

acetabulum

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__ and __ form the ischial tuberosity

Ischium

ramus

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Pubis forms the __ __ of the acetabulum

anterior 1/5

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What 3 things fuse together within the acetabulum?

Ilium, Ischium, Pubis

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How is the acetabulum angled?

Laterally, inferiorly, anteriorly

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The Acetabular rim (aka __) __ the acetabulum, thereby increasing __ of the hip joint

labrum
deepens
stability

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3 joints of Pelvic girdle

Hip joint (acetabularfemoral)
SI joint
Pubic Symphisis

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___ marks the widestpoint on the iliac crests

iliac tubercle

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Iliac Crest contusion: Contusion to the site of or an __ of the __ __ and/or the __ muscles from the crest.

avulsion
quadratus lumborum
abdominal

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Inspection: __ __ should be level with he __ __.

Greater trochanters

pubic tubercles

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Bucket handle fx: Superior and inferior __ __ fractures with a __ or __ of the __ SI joint

pubic rami
separation
fracture
contralateral

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What is a sprung pelvis?

Separation of the pubic symphysis and both SI joints

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What is a straddle fx?

Bilateral superior pubic rami and ischiopubic fractures

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Avulsion fx of the pelvis: Most common areas are???

ASIS
AIIS
Ischial Tub.

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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

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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

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Dashboard injury to the knee will cause a __ hip dislocation if the hip is __ at the time of injury.

posterior

adducted

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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

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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

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The angle that the femoral

neck makes with the acetabulum is called the angle of __ (normal is __-__°)

anteversion

8-15

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Femoral Anteversion: The angle between femoral neck and the transcondylar axis is greater than __ degrees. Pt has a __ __ gait

toe in

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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

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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

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