Hip

Question 1

Congenital hip dislocation

Answer 1

• Babies with shallow acetabulum and abnormal muscle tone
• Hip dislocates very easily
• Barlow test and Ortolani test

Question 2

Legg-Calve’-Perthes disease (coxa plana)

Answer 2

• Happens in young kids, causes limp
• Disrupted blood supply to femoral head
• Deformation and necrosis of femoral head
• Head dies, then revascularizes and remodels

Question 3

Slipped capital femoral epiphysis

Answer 3

• Ice cream falls off the cone
• Proximal epiphysis slips out of normal position
• Children during growing years

Question 4

Coxa valga

Answer 4

• Angle of inclination greater than 125°
• Causes genu varum (bowlegs)
• Contributes to congenital hip dislocation
• Greater wear and tear on the knee

Question 5

Coxa vara

Answer 5

• Angle of inclination less than 125°
• Causes genu valgum (knock-knees)

Question 6

Anteversion

Answer 6

• Angle of tosion of femoral head and femoral condyles greater than 15°
• limits IR

Question 7

Retroversion

Answer 7

• Angle of tosion of femoral head and femoral condyles less than 15°
• limits ER

Question 8

Osteoarthritis

Answer 8

Degeneration of the articular cartilage of the femoroacetabular joint causing pain,

Question 9

Hip fractures

Answer 9

• Mostly intertrochanteric or femoral neck Fx
• Often managed with hip replacement

Question 10

IT band syndrome

Answer 10

• Overuse injury causing lateral knee pain
• Friction of IT band as it slides over lateral femoral epicondyle

Question 11

Trochanteric bursitis

Answer 11

• Inflammation due to overuse
• Common in runner and cyclists

Question 12

Hamstring strain

Answer 12

• Pulled hamstring
• Overload of muscle or trying to contract too quickly
• Sports requiring rapid acceleration

Question 13

Acetabular labrum

Answer 13

• Fibrocartilage rim attached to acetabulum
• Increases depth of acetabulum and coverage for head of femur
• Increases stability, limits mobility

Question 14

IT band

Answer 14

• Insertion for TFL and glute max
• long, thick fascia band on superficial, lateral thigh

Question 15

What muscles insert at the pes anserinus?

Answer 15

Gracilis, sartorius, semimembranosus

Question 16

Ligamentum teres

Answer 16

• Attaches to both sides of acetabular notch and fovea of femoral head
• Small blood vessel to the fovea accompanies the ligament

Question 17

What 3 ligaments reinforce the joint capsule?

Answer 17

Iliofemoral, ischiofemoral, pubofemoral

Question 18

Iliofemoral ligament

Answer 18

• Y ligament/ligament of Bigelow
• Spans hip anteriorly in a spiral
• Attaches proximally to AIIS, then divides into 2 parts, both attaching distally to intertrochanteric line (inverted Y)
• Limits hip ext
• Reinforces anterior capsule
• Resists forces causing anterior dislocation

Question 19

Pubofemoral ligament

Answer 19

• Spans hip inferiorly in a spiral
• limits hip extension and abduction
• Reinforces inferior capsule

Question 20

Ishiofemoral ligament

Answer 20

• Spans hip poseriorly and superiorly in a spiral
• limits hip extension and IR
• Compensation of “hanging”

Question 21

Which ligament is not associated with any joint?

Answer 21

Inguinal ligament

Question 22

Inguinal ligament

Answer 22

• Attaches to ASIS and pubic tubercle
• Landmark to separate anterior abdominal wall from thigh
• External iliac artery and vein pass under and are renamed femoral artery and vein
• Iliopsoas and femoral nerve pass underneath

Question 23

Femoral triangle

Answer 23

Femoral artery, vein, and nerve