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SCS Mine > Hip > Flashcards

Hip Flashcards

1
Q

pectineus

A

femoral, accessory obturator nerve
L2-3

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2
Q

psoas major

A

femoral nerve
L2-3

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3
Q

iliacus

A

L1
attaches distal at pectineal line

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4
Q

sartorius

A

attaches at ASIS-> superior medial surface of tibia

femoral nerve

L2-3

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5
Q

rec fem

A

AIIS -> quad tendon

femoral nerve, L2-4

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6
Q

vastus lateralis

A

prox: greatecr trochanter and lateral lip of linea aspera

femoral nerve L2-4

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7
Q

vastus medialis

A

intertrochanteric line & medial lip of linea aspera

femoral nerve L2-4

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8
Q

vastus intermedius

A

anterior/lateral surfaces of femur shaft

femoral nerve L2-4

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9
Q

adductor longus

A

body of pubis inferior to pubic crest–> middle third of linea aspera

obturator nerve (anterior branch), L2-4

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10
Q

adductor brevis

A

body and inferor ramus of pubs–> pectineal line & proximal linea aspera

obturator (anterior) L2-4

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11
Q

adductor magnus

A

adductor part: inferior pubic rami/ischium rami-> linea aspera medial, gluteal tuberosity
hamstring part: ischial tuberosity-> adductor tubercle

adductor part:: obturator (posterior) L2-4
hamstring: tibial nerve

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12
Q

gracilis

A

body/inferior ramus of pubis-> superior part of medial surface of tibia

obturator nerve (anterior) L2-3

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13
Q

obturator externus

A

obturator nerve (posterior) L3-4

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14
Q

quadratus femoris

A

lateral ischial tuberosity -> quadrate tubercle on intertrochanteric crest

nerve to quadratus femoralis & inferior gemellus
L5-S1

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15
Q

obturator internus

A

trochanteric fossa (distal attachment)

nerve to obturator internus & superior gemellus
L5-S1

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16
Q

glut med

A

ilium between anterior & posterior gluteal lines –> anterior surface of greater trochanter

superior gluteal nerve L4-S1

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17
Q

piriformis

A

anterior sacrum/sacrotuberous ligament –> superior border of greater trochanter

nerve to piriformis

L5-S2

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18
Q

gemellus superior

A

ischial spine -> trochanteric fossa
nerve to obturator internus & gemellus superior L5-S1

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19
Q

ligamentum teres

A

superior part of femoral head, attaches to transverse ligament. strong instrinsic stabilizer

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20
Q

femoral head vascular supply

A

MFCA- medial femoral circumflex artery

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21
Q

transverse ligament

A

inferior border of acetabular fossa
attaches to anterior inferior portion of labrum

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22
Q

angle of inclination

A

angle between neck and shaft of femur

125-130 deg in adults

coxa valga vs vara

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23
Q

coxa valga

A

displaced more superiorly

140 deg

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24
Q

coxa vara

A

100 deg

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25
Q

anteversion- normal & increased

A

normal: 12-15 deg

increased: increased IR or toe in gait

increased pronation, medial femoral/tibial torsion, lateral patellar subluxation

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26
Q

retroversion

A

toe out or increased ER, supination
may compensate with medial rotation at knee, lumbar rotation on opposite side

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27
Q

craigs test

A

8-15 deg is normal

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28
Q

hip joint ligament capsule

A

iliofemoral
ischiofemoral
pubofemoral

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29
Q

iliofemoral

A

starts at AIIS, 2 distinct bands

restricts hip extension & ER

30
Q

ischiofemoral

A

posterior acetab rim, along iliofemoral –> medial femoral neck

restricts IR
restricts add when hip is flexed

31
Q

pubofemoral

A

superior pubic ramus-> intertrochanteric line

restricts hyperabd & ER

32
Q

snapping psoas vs ITB

A

snapping- clunk occurs as hip comes from flex+abd+ER into Ext +IR, eminates from groin
-can hear across room

ITB: symptoms more lateral, TFL moves over greater trochanter with hip rotation
-see across room

33
Q

log roll test

A

most SP for intra articular
NOT SN
reproduce anterior groin pain

34
Q

FABER
ASLR
Dial test
Ober

A

FABER- anterior hip pain- joint problem; SI- feel more posterior

Dial- anterior laxity
Increased ER vs other when lying in extension supine

35
Q

athletic pubalgia vs sporst hernia

A

passive flexion+IR would exacerbate joint problem but not sports hernia

36
Q

alpha angle

A

between midline of femoral neck, and lien from center of femoral head to junction that first deviates from spherity of femoral head

> 50 may indicate CAM
(normal 45)

37
Q

center edge angle

A

normal = 20-25 deg *** borderline hip dysplasia NOT normal
less = dysplasia

38
Q

CAM FAI - anatomy

A

poor shape of femoral head

39
Q

Pincer FAI - anatomy

A

extra rim/overhang

may be associated with retroversion

40
Q

SCFE (slipped capital femoral epiphysis)

A

teens
sudden displacement of femoral neck from CFE- failure of growth place occurs due to shear forces

head typically stays in place due to ligamentum teres while neck comes up and outward

41
Q

glut min

A

ilium–> anterio surface of greater trochanter (same as glut med)

superior gluteal nerve

L4-S1

42
Q

TFL

A

ASIS & anterior part of iliac crest –> IT tract

superior gluteal nerve

L4-S1

43
Q

glut max

A

posterior ilium, dorsal surface of sacrum/coccyx, sacrotuberus ligament –> IT tract & gluteal tuberosity

inferior gluteal nerve

L5-S2

44
Q

biceps femoris

A

long head origin: ischial tuberosity
short head origin: linea aspera/lateral supracondylar line

attachment: lateral side of fibular head, tendon split by LCL

n: long head tibial nerve, short head common peroneal

L5-S2

45
Q

semitendinosus

A

ischial tuberosity–> medial surface of superior part of tibia

tibial nerve L5-S2

46
Q

semimembranosus

A

ischial tuberosity–>posterior part of medial tibial condyle; reflected attachment form oblique popliteal ligament

tibial nerve L5-S2

47
Q

stress fracture

A

risk factors: female, previous fracture
sudden increase in volume

vague thigh pain that may radiate to hip/knee

patellar pubic percussion
fulcrum test 1 SP & 1 SN

48
Q

hip AVN special testing

A

hip ext <15
hip ER <60
pain with IR

49
Q

Cam vs pincer M vs F

A

Cam- often young athletic male
pincer- often active middle age women

50
Q

FAI special testing

A

FADDIR: SN 0.91-.99
Flexion IR test: .96 SN

51
Q

CPG - intervention for FAI

A

most have level evidence F (manual, education, ther ex, neuro re ed)

52
Q

hip labral special testing

A

fitzgerald test SN 0.7-.98
Thomas test SN .11-.89, SP .67-.92
Impingement provocation test SN 1.0

53
Q

hip OA special testing

A

resisted hip abd (pain) SP .9
FABER (groin pain) - not great test
Scour - not great test

54
Q

CPR for hip OA

A

-squatting aggravating
-+ scour for groin/lateral hip pain
-active hip flexion causing lateral hip pain
-passive IR </=25 deg
-Active hip ext causing hip pain

3+ = SP .86
4/5 = SP 0.98

55
Q

OA CPG interventinos level of evidence

A

manual A
flexbility, strength, endurance: A
modalities: B
pt edu: B
functional, gait, balance training: C

56
Q

athletic pubalgia - 4 regions

A

adductor
hip flexor
inguinal
pubic

57
Q

risk factors for athletic pubalgia

A

previous groin injury
higher level of play
decreased hip abd/add strength
lower level of sport specific training

MOI- kicking, change of direction, stretching, sprinting/running

58
Q

inguinal athletic pubalgia- testing/symptoms

A

-TTP inguinal canal
-resistance testing of ab muscles = pain (sit up, thomast + reisted hip flexion, vaslavla/coughing)

59
Q

hip flexor related athletic pubalgia testing

A

resisted hip flexion 90 .79 SP
thomas test resisted knee ext SP .82
thomas test + passive hip ext or knee flex SP .75/.89

60
Q

adductor related athletic pubalgia testing

A

single adductor testing
bilateral adducotr
resisted outer range adduction
squeeze test (0 and 45 deg)
^^ most with sp >0.9

61
Q

greater trochanteric pain syndrome (GTPS) testing

A

SLS for 30 sec
external derotation SN .88
obers
FABER - lateral hip pain
FADER + resistance
ADD + resistance
*all .85-0.9+ SP

62
Q

hip OA guidelines

A

hip pain
flexion <110
IR <15
pain with IR
AM stiffness <60 min
>50 y/o

63
Q

ludloff sign

A

ilipsoas strain or avulsion fracture

pain with hip flexion when seated

64
Q

test for various layers of impingement at hip

A

trochanteric sub-spine impingement: 30 deg flexion, 30 deg abd * IR

S/l hip ext: poserior impingement

ER & extension: ischiofemoral impingement

flexion, abd & ER: superior-lateral acetabular impingement

65
Q

what muscle targets glutes and minimizes activation of TFL

A

clamshells

66
Q

crossover sign (xray)

A

suggests pincer impingement at rim due to acetabulum projecting laterally

67
Q

gilmore groin

A

athletic pubalgia - tear in external oblique aponeurosis and conjoint tendon

68
Q

Hip OA Clusters
I
II

A

I:
hip pain
IR <15 deg
flexion < 115

II, if IR > 15:
pain with IR
age >50
AM stiffness >60 min

69
Q

Hip OA CPR

A

squatting is aggravating
flexion ROM-> lateral hip pain
scour+add->lateral/groin pain
extension ROM pain
IR <25

*If all 5 = 98 SP

70
Q

SCFE

A

frog leg xray, Kleins line

epihphysis in acetabulum + metaphysis moves anterosuperior

71
Q

Freibergs test

A

Passive internal rotation of the extended hip places tension on the piriformis, which would result in a positive Freiberg’s test.

SCS Mine (29 decks)

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