Hip Flashcards
What bones make up the acetabulum?
Ilium, ischium, pubis
Describe the hip jt
Ball and socket jt between the femur and the acetabulum
What part of the acetabulum is covered in hyaline cartilage and articulates with the head of the femur?
Lunate surface
What is the deepest part of the acetabulum
Acetabular fossa
Describe the acetabular notch.
60-70* opening in the inf. Acetabulum
How is the neck of the femur angled with respect to the femoral shaft and distal femoral condyles?
Angulated so head faces medially, superiorly and anteriorly
Angle of inclination of the femur
Between axis through femoral head/neck and longitudinal axis of the femoral shaft (frontal plane)
Typically 125°
Coxa valga
pathological increase in angle of inclination of the femur
>125 ̊
Coxa vara
pathological decrease in the angle of inclination at the femur
<125 ̊
What is the function of the angle of inclination of the femur?
Optimizes jt surface alignment
Coxa Vera and high BMI can result in what pathology in adolescents?
Slipped capital femoral epiphysis (SCFE)
Feature in the femoral neck (epiphysis)
What are the negative impacts of Coxa Vara?
Increased bending moment arm > increased bending moment > increased shear force femoral neck
Decreased functional length of hip abductor muscles
Negative impacts of Coxa valga
Decreased moment arm for hip abductor force
Alignment may favor jt dislocation
Positives of Coxa vara
Increased moment arm for hip abductor force
Alignment may improve jt stability
Positives of Coxa valga
Decreased bending moment arm > decreases bending moment > decreases shear force across femoral neck
Increased functional length of hip abductor muscle
What is the normal angle of inclination
125
Angle of torsion in the femur
Between axis through femoral head/neck and the distal femoral condyles (transverse plane)
15 ̊ of anteversion allows for optimal alignment and joint congruence
Norm=8 ̊ to 20 ̊
What is the ideal angle of torsion at the femur
15* anteversion
Excessive anteversion of the femur is found with…
Coxa valga
Excessive anteversion is associated with
Increased hip IR and decreased ER
Excessive anteversion (reduces or increases) hip stabilization
Reduces
Retroversion of the femur is associated with….
May cause….
Increased hip ER and decreased IR
may cause impingement
How may children display excessive anteversion? Why?
In-toeing gait
Improve jt congruency
In-toeing during gate may have what effects on the muscles and ligaments that cross the hip? How would this effect the ROM of the hip?
Shortens muscles and ligaments
Reduces ER of the hip
What is the position of the acetabulum?
Lateral with inferior and anterior tilt
What is determined by acetabular depth?
Femoral head coverage
Describe acetabular dysplasia
Shallow acetabulum
Describe Coxa profounda
Acetabular over-coverage (excessively covers the femoral head)
What is acetabular anteversion
20*
How forward facing the acetabulum is, measured by anterior over-coverage
What is the Cam deformity? How could it cause impingement (femoral acetabular impingement)
Extra bone growth at the anterior-superior region of the femoral head
Can press against the acetabulum during IR with flexion
What is the pincer deformity and how can it cause impingement?
Abnormal bony extension of the anterior-lateral rim of the acetabulum
Impingement with flexion with IR
Pincer deformity is often associated with…
Deep acetabulum or overly retroverted acetabulum
What is the function of the transverse acetabular lig
Protects the blood vessels that travel beneath it to get to the head of the femur
Closed packed position of the hip is….
Definition not position
The position where capsule and ligaments are most taunt, not where jt is most congruent.
Where is the hip most congruent?
Flexion, abd, slight er
Where is the position of max articular congruence in the hip utilized?
Diagnosis of hip dysplasia
Structural adaptations to wt bearing at the hip
Bending moment
Trabecular system
Tensile forces are applied ___________ to the neck of the femur from the weight of the upper body through the pelvis and GFR
Superiorly
Compression forces are applied ________ to the neck of the femur from the weight of the upper body and GFR
Inferiorly
Trabecullar systems in the hip provide ___________!
They are weakest and strongest where?
Structural resistance
Strongest where they cross at r angles
Weakest where they are thin and don’t cross
The hip jt capsule contributes largely to hip _____. Unlike the GH jt
Stability
The jt capsule of the hip is thicker _______________ and thin and looser ____________
Anterosuperior
Posteroinferior
The Iliofemoral ligament provides ________ and controls ________&_________
Anterior stability
IR an ER rotation
The pubofemoral lig controls
ER
The ishiofemoral lig primarily restrains
IR
What hip jt ligaments tighten with hyper extension
Ilioifemoral
Pubofemoral
Ischiofemoral
The function of the acetabular labrum
Deepens concavity
Acts as a seal to maintain negative intra- articular pressure
Function of Ligamentum teres
Blood flow to the femoral head and some lig function
What position can strain or tear the Ligamentum teres
Excessive ER
The Ligamentum teres is thought to have most function for what population
Children
Osteokinematics of the hip
Flex/ext
Abd/add
Er/ir
Arthrokinematics of flexion and ext at the hip
Flexion: anterior roll and posterior glide
Extension: posterior roll and anterior glide
Arthrokinematics of abd and add at the hip
Abd: superior roll inferior glide
Add: inferior roll and superior glide
Arthrokinematics of IR/ER at hip
IR: anterior roll and posterior glide
ER: posterior roll and anterior glide
When wt bearing, the femur is fixed so motion at the hip occurs by…
Movement of the pelvis on the femur
Osteokinematics of the pelvis on the femur
Anterior/posterior pelvic tilt
Lateral tilt
Forward/backward rotation
Lateral pelvic tilt occurs in the frontal plane resulting in either _________ or __________
Pelvic hike
Pelvic drop
In a left leg stance, a right pelvic hike results in ________________ at the left hip
Abduction
In a left leg stance, a right pelvic drop with result in ________ at the left hip
Adduction
Arthrokinematics of lateral pelvic tilt
Abduction: superior roll and glide
Adduction: inferior roll and glide
Arthrokinematics of ant/post pelvic tilt
Anterior tilt: anterior roll and glide
Posterior tilt: posterior roll and glide
Arthrokinematics of ckc abd/add of the hip
Abd: Superior roll and glide
Add: inferior roll and glide
Lateral pelvic tilt is seen in ___________ while lateral pelvic shift is seen when ___________
Single leg stance
When both feet are planted
Forward and backward rotation of the pelvis can be seen in a bilateral stance but mainly occurs in ___________ when ________
Single leg stance
Walking
Forward rotation of the pelvis results in _______________ of the stance hip
IR
Backward rotation of the pelvis results in _____________ of the stance hip jt
ER
Arthrokinematics of forward and backward rotation
Forward rotation: anterior roll and glide
Backward rotation: posterior roll and glide
Closed packed position of hip jt
Full extension with slight IR and abd
Open packed position of the hip jt
Moderate flexion, slight abd, neutral rotation
Capsular pattern of the hip jt
IR=FLEX= ABD
What muscle groups work together to produce anterior pelvic tilt? What is this relationship called?
Force couple between hip flexors and low back extensors
Anterior pelvic tilt is associated with an increase in….
Lumbar lordosis
What muscle groups work to produce a posterior pelvic tilt?
Force couple with hip extensors and abdominal muscles
Moderate to high power hip flexion is achieved by coactivation of
Abdominals and hip flexors
To anchor the pelvis for femur movement, the __________ must produce a strong enough ____________ to neutralize the ___________ exerted by hip flexors
Rectus abdominis
Posterior pelvic tilt
Anterior pelvic tilt
In a single leg stance, the hip abductors must produce (more/less) force to overcome body weight.
What lever is this?
More 1st class lever
Tight hamstrings can cause a posterior pelvic tilt, to augment that stretch perform an
Anterior pelvic tilt
To augment a stretch in the hip flexors, perform a
Posterior pelvic tilt
