hip Flashcards

1
Q

3 DOF (rotations)

A

Flex/ext

Abd/add

IR/ER

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2
Q

3 DOF arthrokinematic (translations)

A

Ant/post

Sup/Inf

Traction/compression

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3
Q

Version

A

Angle of head femur with respect to shaft in the transverse plane

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4
Q

Angle of inclination

A

Angle between head & neck and shaft femur in frontal plane

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5
Q

Alpha angle

A

Size between femoral head with respect to acetabulum

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6
Q

Coxa vera

A

Hip bends inward (genu valgum)

<125 degrees

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7
Q

Coxa valga

A

Hip bends upwards (genu varum)

> 125 degrees

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8
Q

Range normal values for angle inclination:
Infants
Adults
Elderly

A

Infants: 165-170
Adults: 125
Elderly: <120

Decreases 2-8 degrees per yr

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9
Q

Why does angle inclination dec?

A

Gravity

Pelvic width (women)

Puberty

Wt bearing

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10
Q

Femur lat side (convex) resists what type of load?

A

Traction

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11
Q

Femur med side (concave) resists what type of load?

A

Compression

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12
Q

What is the effect of weight-bearing on the femoral shaft and neck?

A

Traction, compression

Inc angle inclination, dec bending mvt

Coxa valga dec bending moment of femur

Coxa vera inc bending moment (inc moment arm = risk for fracture)

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13
Q

Trabecular configuration of the proximal femur main system:

A

Arcuate bundle: resists bending moment

Vertical bundle: resists compressive moment

Loc: head neck femur

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14
Q

Trabecular configuration of the proximal femur accessory system:

A

Reinforces muscle attachment sites

First & second bundle

Loc: between neck shaft (greater trochanter)

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15
Q

What are the effects of femoral inclination on bending moment?

A

Inc angle inclination, dec bending moment —> dec risk fracture (Coxa valga)

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16
Q

Coxa vera trade off

A

Favors joint stability

Inc risk hip fracture (inc bending moment)

(Hip abd force= more advantageous)

(Dec func length)

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17
Q

Coxa valga trade off

A

Favors dislocation

Dec risk fracture (dec bending moment)

(Hip abd force= dec mechanical advantage)

(Inc func length)

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18
Q

Version

A

Twist of femoral shaft

Bisects head neck femur and frontal plane

(Typically viewed from above)

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19
Q

Angle anteversion normal range

A

Range: 8-30 degrees

Avg: 15 degrees

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20
Q

Excessive femoral anteversion

A

> 30 degrees

Neck points anteriorly

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21
Q

Retroversion

A

<15 degrees (approaching 0 degrees)

Goes below frontal plane

Neck points medially

22
Q

What is the compensation for excessive anteversion?

A

In toeing (excessive IR)

23
Q

What are the mechanical consequences excessive femoral anteversion? (structure-func rel)

A

Inc femoral anteversion

Dec moment arm abd

Restored by IR hip

24
Q

What are the mechanical consequences excessive femoral anteversion?

A

Frontal plane: dec abd moment arm

Transverse plane: in toeing

25
Q

Pincer impingement

A

Bony growth extends roof acetabulum

26
Q

Cam impingement

A

Alpha angle measures how spherical and large head of femur is

27
Q

Cam deformity and pathological cam deformity ranges

A

Cam deformity: >60 degrees

Pathological: >80 degrees
-> more severe and causes dysfunction

28
Q

Acetabular angle of opening in transverse and frontal plane are:

A

Version

Center edge angle

29
Q

Acetabular center edge angle, range

A

Degree to which acetabulum covers femoral head

Angle: line down ilium-center femoral head and line between edge lat acetabulum and center of femoral head

35-40 degrees

30
Q

Low CE angle means

A

Reduced acetabular coverage of femoral head (greater risk dislocation) (less contact area w/in joint)

31
Q

High CE angle means

A

Overcoverage —> impingement

Eg: Osteoarthritis

32
Q

Acetabular anteversion range

A

10-30 degrees

33
Q

Excessive acetabular anteversion consequences

A

Hip vulnerable to ant subluxation/dislocation

34
Q

Retroverted acetabular anteversion consequences

A

Impingement (stability)

Bc angle = close to 0/ is negative (acetabulum faces lat)

35
Q

Iliofemoral lig

A

Y lig (limits hyperext)

Resists end-range hip ext

Acts synergistically with iliopsoas (passively)

36
Q

Pubofemoral lig

A

Limits hip abd, ext and ER

37
Q

Ischiofemoral lig

A

Superficial fibers: limit IR, esp slight abduction

Deep fibers: limit and range hip flexion

38
Q

T/F flexion spine goes with ant tilt

A

T

39
Q
A

Closed chain

(Standing leg=reference leg)

40
Q

Non WB

A

Convex on concave

41
Q

WB

A

Concave on convex

42
Q

Synergist of ant tilt

A

Hip flexors: iliopsoas, sartorius, erector spinae

43
Q

Synergist post tilt

A

Hip ext: rectus abdominis, external oblique, gluteus maximus, hamstrings

44
Q

Abdominal ex

A

Straight leg raise

45
Q
A

Lumbar ext oppose post tilt (ant tilt:arch back)

Greater stretch hamstrings

46
Q
A

Add longus as extensor: flexion (secondary ext)

Add longus as flexor: ext (secondary flex)

47
Q

What are the best hip flexors?

A

Longest moment arm

48
Q
A

Hip

49
Q
A

MA change w/ hip position

50
Q

End feels hip movement

A

Musc = springy

Ligament = firm