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Rec and Care > Final - Hip > Flashcards

Final - Hip Flashcards

1
Q

what is the pelvis

A

bony ring with 2 bones - sacrum and coccyx

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2
Q

4 functions of pelvis

A

support spine
transfer weight to lower limbs
provide attachment site for muscles
protection of pelvic organs

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3
Q

sacrum

A

triangular, connects to coccyx

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4
Q

4 ligaments supporting the sacroiliac joint

A

sacroiliac
iliolumbar
sacrospinal
sacrotuberal

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5
Q

3 motions of the sacroiliac joint

A

superior inferior
lateral medial
flex forward and backward

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6
Q

being able to move in three different ways means that the sacroiliac joint moves about

A

3 axis

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7
Q

strongest bone of the hip

A

femur

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8
Q

purpose of femur

A

max mobility and support during locomotion and weight bearing activity

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9
Q

proximal femur

A

articulates with acetabulum of pelvis to form hip jt

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10
Q

distal femur

A

condules articulate with tibial plateau for knee jt

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11
Q

Hip jt

A

synovial - multi axial
ball and socket
very stable with labrum

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12
Q

labrum

function

A

fibrocartilage that surrounds the acetabulum

deepens the socket and increase articular surface area by 10%

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13
Q

ROM hip flexion

A

135

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14
Q

ROM hip extension

A

30

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15
Q

ROM hip abduction

A

45-50

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16
Q

ROM hip adduction

A

20-30

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17
Q

ROM hip external rotation

A

45

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18
Q

ROM hip internal rotation

A

35

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19
Q

Hip jt capsule - 2

A

strong but loose

thick parts of fibrous layer makes the ligs - spiral apperance and run from femoral neck to acetabular rim

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20
Q

role of hip capsule

A

stability - during extension increases the spiraling and tighten the capsule to draw the head into acetabulum
mobility - flexion unwinds spiraling ligs and fibers

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21
Q

3 ant hip ligs - 3

A

oblique trajectory, winding around the femoral nect - lose in flexion and tight in extension - rotating plates with strings in between, tighter when the plate approximates one another
illiofemoral - ant and up
pubofemoral - ant and inf
ishiofemoral lig - pos

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22
Q

illiofemoral lig - 3

A

strongest
y
prevent hyperextension when standing - locks and restict internal and external rotation

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23
Q

pubofemoral lig - 2

A

blend with iliofemoral

restrict hip abduction and extention

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24
Q

ishiofemoral lig - 2

A

weakest

excessive internal rotation and adduction

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25
Q

bursa - 2

A

greater trochanteric - between greater trochanter and deep fibers of glute max
women running or poor gait
ischial - glute muslces and ischial tub

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26
Q

ant muscles of the hip - 5

A 
psoas 
iliacus 
tensor fascia lata 
satorius 
quads
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27
Q

psoas - 3

A

lumber vertebrae to femur
hip flexion
major goes to the front of your spine - trunk flexor and hip flexor

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28
Q

tight hip flexors can give you

A

back pain

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29
Q

illiacus - 2

A

blends with psoas tendon

acts with psoas major - hip flexion

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30
Q

tensor fascia lata - 2

A

upperanterolat of thigh, inserts into ITB

hip stabilization and hip abduction

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31
Q

satorius - 3

A

longest muscle
ASIS to anteromedial tib
faber

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32
Q

quads - 2

A

Vastii MLI

knee extension

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33
Q

RF - 2

A

Hip flexion and knee extension

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34
Q

5 medial hip muslces

A

pectineus
adductor brevis and longus
adductor magnus,
gracilis

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35
Q

pectineus

A

hip flexion and adduction

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36
Q

adductor longus, magnus, and gracilis

A

adduction

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37
Q

adductor brevis

A

hip adduction and hip flexion

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38
Q

4 pos gluteal muscles

A

gluteus maximus, medius, minimus, and piriformis

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39
Q

glute max

A

main hip extensor

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40
Q

glute med

A

abduction

41
Q

glute min

A

hip medial rotation

42
Q

piriformis

A

lat hip rotation

43
Q

weak groin often gets confused with

A

imbalance of glute max and med

44
Q

3 hamstrings

A

semimembranosis
semitendinosis
biceps femoris

45
Q

semimembranosis and semi tendinosis - 3

A

hip extension, med tib rotation, knee flexion

46
Q

biceps femoris

A

hip extension, knee flexion and lat tib rotation

47
Q

what to strengthen for spondylosis

strategy

A

spondylosis - weak glute max can activate hip extenders for back
technique then weight

48
Q

comprehensive movement tests for the hip - 3

A

sit to stand
squat
step

49
Q

What do you look for in hip injuries - 3

A

diff in compensation
alignment
callus

50
Q

two types of muscles you are looking to treat

A

long and weak

short and tight

51
Q

rectus femoris/illiopsoas differentiation test - 3

A

hip flexors and RF
lay supine and knee bent over and pull one knee to chest
90 degrees or tightness

52
Q

Thomas test - 4

A

RF/ hip flexor contracture
supine, leg extended, one knee to chest
flat or tightness
*put hand under their back

53
Q

FABER test - 4

A

flexion, abduction, external rotation
- Hip/SI jt
- supine and FABER
asymptomatic - dont change

54
Q

obers

A 
contracture of TFL/ITB
lie on unaffected side 
abduct thigh as far as possible 
drop in adduction 
not full adduction (past table) - contracture 
false neg - side flexed
55
Q

nobels compression

A

obers with finger on side of knee and flex/extend

56
Q

tripod test

A

hamstring contracture
sit at edge of table - passively/actively raise one leg
- lean back to accomodate - tight hamstrings

57
Q

long sit with straight back

A

you need a good back

58
Q

trendelenburgs sign

A

abductor/glute med

stand and look for pelvis to remian level - drop = weakness on opposite side (stance)

59
Q

what to strengthen for greater trochanteric

A

glute med

60
Q

straight leg raise

A

supine

active/passive hip flex ROM for hams

61
Q

neurotension from straight leg raise

A

supine
hip flex passively up to 45 then dorsiflex and lift head
- psychiatica/disc herniation/pressure on nerve in lumbar area

62
Q

femoral nerve tension

A

prone

lift heel to bum

63
Q

Groin strain
MOI - 3
S&S - 3
Management - 4

A

poor flexibility and strength
hip extension, lat rotation and abduction
general pain, weakness, “twinge” during movement/after
PIER, flexibility, strengthen adductors
protect with hip spica

64
Q

pain with abduction, flexion and tender over adductors

A

groin strain

65
Q

half marathoner with increased left lap hip pain, full ROM and strength and point tender over greater trochanter

A

greater trochanteric bursitis

66
Q

Greater trochanteric bursitis
MOI: Chronic vs acute
S&S - 5
management - 5

A

weak glute med - more you walk the worse it is
irritation of greater trochanter from ITB/glute attachment
landing on greater trochanter
pain over greater trochanter, difficulty walking, pain with lying on affected side, pain sitting, localized swelling
PIER, protection from further, stretches, strengthening, proprioceptive and stability

67
Q

hip across illiac crest - obvious discomfort and pain

A

hip pointer

68
Q

hip pointer
MOI
S&S- 6
Management - 4

A

blow - pinching of soft tissues
immediate pain, muscle spasm, transitory paralysis of trunk, pain with trunk rotation and hip flexion, bruising and tenderness, ok when you flex forward but terrible backwards
PIER, rule out fracture, rest from sport, protective pad

69
Q

hit across right quad and only weight bearing on left, no ROM at knee due to pain and muslce spasm

A

quad contusion

70
Q

how to walk away from a quad contusion

A

cant bend to 90 dont run on it, single leg squat and you can go

71
Q 
quad contusion 
MOI 
S&S 
G1 
G2 
G3 
Management
A

impact on thigh that compresses muscle against femur
pain, loss of function, tissue bleeding, limping, swelling, tenderness
intramuscular bruise, milkd hemorrhage, little pain, no swelling, mild point tenderness, full ROM
mod pain, swelling and pt tender, cant flex beyond 90, limp
pain, swelling, hematoma, ROM 45-90, limp, fascia may be split and muscle protrudes, divit for fascia damage
put knee in flexion with ic pack and add compression- passive stretch to avoid muscle shorten and ensure normal ROM
ice for hemorrahge
crutches above G2
protect from further damage with pads
painfree ROM ex with gentle isometric strength and stretches
webbing tape - till no more potential energy in tape and moves swelling
milk massage
ultrasound

72
Q

myositis ossificans tramatica
MOI
S&S
Management

A

bony growth into muscle
severe/repeated blows and dont let swelling go away, disrupt muscle fibers and periosteum, running off, too vig treatment - direct massage
pain, weakness, swelling, decreased muscle function, point tenderness
decrease ROM, conservative, may require surgical intervention to remove bone (after 1 year)

73
Q

quad strain
MOI
S&S
management

A

sudden stretch/contraction, may be related to muscle weakness
bleeding, pain, pt tenderness, spasm, loss of function, possible bruising and deformity, reduced ROM and strength, TOP
PIER, NWB with crutches, gentle ROM, pressure with neoprene sleeve

74
Q

TOP

A

tender on palpation

75
Q 
hamstring strains 
MOI 
S&S - G1 
G2
G3
management - 3
A

lots
lots, general 6040 quad ham, improper firing of hams and quads (weak hams), quick change from knee stabilizer to hip extensor, poor strength, deceleration of hams
muslce soreness during movement, point tender, stiff/sore after
partial tear, sudden tear/snap with severe pain, loss of function, possible palpable defect
rupture of tendinous/muscle, major hemorrhage and disability, severe edema, tender, loss of function, ecchymosis and palpable/visible defect
PIER, rest, no explosive stretching

76
Q

Caution with glute and ham injuries

A

overestimate and wait one week longer because ppl always try to rush back and reinjury rate is high - closed kinetic chain ex for hamstrings

77
Q

months of right hip pain, pain with pivoting, radiate to groin and stiffness/catching, clicking internal rotation

A

hip labral tear

78
Q

what do people confuse labral tears with

A

groin strain

79
Q

hip labral tear
MOI: Acute and chronic
S&S
management

A

dislocation
repetitive movements - running, pivoting
asymptomatic, catching, locking, clicking, pain/stiffness, loss of motion
improve ROM, hip strengthening/stability, activity modification, surgery may be warranted but difficult

80
Q

legg calve perthes disease
MOI
S&S - 3
management - 4

A

flat femur head
insidious, children 3-12, more boys, loss of blood to head - avascular necrosis
general leg pain - knee or hip. limping (exaggerated with running), loss of hip ROM, no response to rest or soft tissue treatment
xrays - physician
rest and brase
may be surgery
may have hip pathology later in life - osteoarthritis

81
Q

slipped capital femoral epiphysis
MOI
S&S
management

A

more common in boys 10-17, obesity/rapid growth- too much weight for skeleton
abnormal movement along growth plate
gradual onset, no MOI, altered gait, restricted movement
rest, NWB, left untreated - legg calve perthes and surgery

82
Q

4 major regions of the brain

A

cerebral hemispheres
diencephalon - thalamus, hypothalamus, epithalamus and pituitary gland
brain stem
cerebellum

83
Q

3 layers of the meninges

A

covers brain and spinal cord

  • dura mater
  • arachonoid mater
  • pia mater
84
Q

cranial nerves

A

12 pairs, 2 from forebrain and 10 from midbrain and brain stem

85
Q

major vessels of the head and face

A

carotid
internal
external
vertebra

86
Q

SS of skull fractures

A

battle sign

blood or CSF may leak from nose or ear canal

87
Q

focal cerebral injuries

A

intercranial bleed
50% mortality rate
localized collection of blood or hematoma - alterations in neurological function

88
Q

intracerebral hematoma

A

serious
focal injury with small hemorrage within cortex, brainstem or cerebellum
LOC then alert - neurological exam normal but dizziness and nausea

89
Q

epidural hematoma

A

blow to head or skull fracture causes tear of meningeal arteries - arterial BP and accumulation makes the creation of hematoma extremely fast
LOC, symptoms worsen, headpain, dizziness, nausea, dilation of 1 pupil or sleepiness
life threatening
rare
almost always skull fracture
will be caught by SCAT 5 in their cerebral function
LOC at the time and lucid interval when they feel normal but conditions worsen so dont go to bed
10-20 mins declind in mental status occurs - increase headahce, drowsiness, nausea, vomiting, decreased lvl of consciousness, dilated pupil on side of hematoma, contralateral weakness and decerebrate posture
EMS
ABC
surgery to decompress and control arterial bleeding

90
Q

subdural hematoma

A 
more frequent than epi 
acceleration force of head
venous bleed - SS more slowly 
simple - no injury to cerebrum or complex - yes 
inercranial pressure -
20 vs 50% mortality 
LOC 
life threatening in 1-2 hrs 
symptoms may not become apparent for hours, days or weeks 
EMS 
ABC 
shock
91
Q

cerebral contusion

A 
focal 
microhemorrahaging 
strike to frontal lobe 
LOC 
normal neurological exam but headahce, dizziness, nausea 
ER
92
Q

SS of second impact syndrome

management

A

may be no LOC
15 seconds to several mins - worsen rapidly with dilated pupils, loss of eye movement , LOC to coma, respiratory failure
prevent injury from occuring, observe athletes as they come off the field of play
EMS

93
Q

stitches

A

more than 1.25 in length and 0.3 cm in depth

94
Q

3 -oculomotor nerve

A

constriction of pupil - equal round and reactive to light

95
Q

4 -trochlear nerve

A

sup/inf movement of eye

96
Q

6- abducens nerve

A

lateral eye movements

97
Q

8- vestibulocochlear nerve

A

hearing and equilibrium - right or left

98
Q

2- optic

A

vision

Rec and Care (11 decks)

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