Hip Flashcards

1
Q

3 functions of the pelvis

A
  • common attachment point for many large muscles of lower extremity and trunk
  • transmits weight of upper body and trunk either to ischial tuberosities during sitting or to lower extremities during standing and walking
  • supports organs involved with bowel, bladder, and reproductive functions
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2
Q

The femoral head projects _____ and slightly ______ for an articulation with acetabulum

A

medially

anteriorly

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3
Q

The shaft of the femur displays slight _____ convexity.

A

anterior

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4
Q

What is the angle of inclination?

A

The angle within frontal plane between the femoral neck and medial side of the femoral shaft

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5
Q

What is the angle of inclination at birth?

What is the normal adulthood value?

A

140°-150°

125°

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6
Q

Coxa vara describes an angle of inclination ____ than 125°.

Coxa valga describes an angle of inclination ____ than 125°.

A

less

greater

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7
Q

What is femoral torsion?

A

The relative rotation (twist) between the bone’s shaft and neck

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8
Q

Normally, the femoral neck projects about __° anterior to a ML axis through femoral condyles. What is this called?

A

15°

Anteversion

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9
Q

Excessive anteversion is described as greater than __°.

Retroversion is described as less than __°.

A

35°

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10
Q

Does excessive anteversion lead to toeing in or toeing out?

A

Toeing in

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11
Q

Excessive anteversion is common in what types of patients?

A

Persons with cerebral palsy

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12
Q

Describe acetabular alignment

A

It projects laterally from the pelvis with varying amount of inferior and anterior tilt

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13
Q

A dysplastic acetabulum often times leads to what?

A

chronic dislocation and increased stress, often times leading to degeneration or OA

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14
Q

What are the two measurements commonly used to describe the extent to which the acetabulum naturally covers and helps secure the femoral head?

A

Center-edge angle and acetabular anteversion angle

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15
Q

What is the average center-edge angle in adults?

A

35°

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16
Q

A significantly lower central-edge angle ____ acetabular coverage of femoral head which tends to lead to what?

A

Decreases

Increased risk of dislocation and decreases contact area within the joint

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17
Q

A central-edge angle of only 15° reduces normal contact area by as much as __%

A

35

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18
Q

What is the acetabular anteversion angle?

A

The angle at which the acetabulum projects anteriorly within horizontal plane, relative to pelvis

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19
Q

What is the average acetabular anteversion angle in adults?

A

20°

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20
Q

A hip demonstrating excessive acetabular anteversion is more exposed in what direction?

A

anteriorly

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21
Q

An acetabulum that projects directly laterally, or even slightly posterior-laterally, within horizontal plane is described as being abnormally _____.

A

retroverted

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22
Q

The center-edge angle defines the extent to which the acetabulum covers the ___ of the femoral head

A

top

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23
Q

The acetabular anteversion angle indicates the extent to which the acetabulum covers the ____ of the femoral head

A

front

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24
Q

Which tissues are taught during hip flexion with the knee extended?

A

Hamstrings

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25
Q

Which tissues are taught during hip flexion with the knee flexed?

A
  • Inferior and posterior capsule

- Gluteus maximus

26
Q

Which tissues are taught during hip extension with the knee extended?

A
  • Primarily iliofemoral ligament
  • Some fibers of the pubofemoral and ischiofemoral ligaments
  • Psoas major
27
Q

Which tissues are taught during hip extension with the knee flexed?

A

Rectus femoris

28
Q

Which tissues are taught during hip abduction?

A
  • Pubofemoral ligament

- Adductor muscles

29
Q

Which tissues are taught during hip adduction?

A
  • Superior fibers of ischiofemoral ligament
  • Iliotibial band
  • Abductor muscles such as the tensor fasciae latae and gluteus medius
30
Q

Which tissues are taught during hip internal rotation?

A
  • Ischiofemoral ligament

- External rotator muscles, such as the piriformis or gluteus maximus

31
Q

Which tissues are taught during hip external rotation?

A
  • Iliofemoral and pubofemoral ligaments

- Internal rotator muscles, such as the tensor fasciae latae or gluteus minimus

32
Q

What is the close-packed position of the hip?

A

Full extension, slight internal rotation and abduction

33
Q

Is the hip’s close-packed position associated with its position of maximal joint congruency?

A

NO

34
Q

In what position does the hip joint surfaces fit most congruently?

A

90° of flexion with moderate abduction and external rotation

35
Q

What are the 2 terms used to describe kinematics at hip?

A
  • Femoral-on-pelvic hip osteokinematics which describes rotation of the femur about a relatively fixed pelvis
  • Pelvic-on-femoral hip osteokinematics which describes rotation of the pelvis, and often superimposed trunk, over relatively fixed femurs
36
Q

What way does the pelvis tilt during flexion? What way does it tilt during extension?

A
Flexion = anterior
Extension = posterior
37
Q

What type of movement occurs at the hip joint during flexion and extension?

A

spin

38
Q

During abduction there is _____ roll and _____ slide

A

superior

inferior

39
Q

During adduction there is _____ roll and _____ slide

A

inferior

superior

40
Q

During internal rotation there is _____ roll and _____ slide

A

anterior

posterior

41
Q

During external rotation there is _____ roll and _____ slide

A

posterior

anterior

42
Q

What is lumbopelvic rhythm?

A

Configuration of the lumbar spine as a consequence of pelvic rotation

43
Q

Describe ipsidirectional lumbopelvic rhythm

A

movement in which lumbar spine and pelvis rotate in same direction, thus amplifying overall trunk motion

44
Q

Describe contradirectional lumbopelvic rhythm

A

movement in which lumbar spine and pelvis rotate in opposite directions

45
Q

Pelvic-on-femoral osteokinematics represent con___-on-con___ movement

A

concave

convex

46
Q

In pelvic-on-femoral osteokinematics the concave surface rolls and slides in ____ directions

A

similar

47
Q

What are the primary hip flexors?

A
  • Iliopsoas
  • Sartorius
  • Tensor fasciae latae
  • Rectus femoris
  • Adductor longus
  • Pectineus
48
Q

What are the secondary hip flexors?

A
  • Adductor brevis
  • Gracilis
  • Gluteus minimus (anterior fibers)
49
Q

What are the primary hip adductors?

A
  • Pectineus
  • Adductor longus
  • Gracilis
  • Adductor brevis
  • Adductor magnus
50
Q

What are the secondary hip adductors?

A
  • Biceps femoris (long head)
  • Gluteus maximus (lower fibers)
  • Quadratus femoris
51
Q

Are there any primary hip internal rotators?

A

NO

52
Q

What are the secondary hip internal rotators?

A
  • Gluteus minimus (anterior fibers)
  • Gluteus medius (anterior fibers)
  • Tensor fasciae latae
  • Adductor longus
  • Adductor brevis
  • Pectineus
53
Q

What are the primary hip extensors?

A
  • Gluteus maximus
  • Biceps femoris (long head)
  • Semitendinosus
  • Semimembranosus
  • Adductor magnus (posterior head)
54
Q

What are the secondary hip extensors?

A
  • Gluteus medius (posterior fibers)

- Adductor magnus (anterior head)

55
Q

What are the primary hip abductors?

A
  • Gluteus medius
  • Gluteus minimus
  • Tensor fasciae latae
56
Q

What are the secondary hip abductors?

A
  • Piriformis

- Sartorius

57
Q

What are the primary hip external rotators?

A
  • Gluteus maximus
  • Piriformis
  • Obturator internus
  • Gemellus superior
  • Gemellus inferior
  • Quadratus femoris
58
Q

What are the secondary hip external rotators?

A
  • Gluteus medius (posterior fibers)
  • Gluteus minimus (posterior fibers)
  • Obturator externus
  • Sartorius
  • Biceps femoris (long head)
59
Q

What are the 2 positive consequences of coxa vara?

A
  • increased moment arm for hip abductor force

- alignment may improve joint stability

60
Q

What are the 2 negative consequences of coxa vara?

A
  • there is increased bending in the moment arm which increases the shear force across the femoral neck
  • decreased functional length of the hip abductor muscles
61
Q

What are the 2 positive consequences of coxa valga?

A
  • there is decreased bending in the moment arm which decreases the shear force across the femoral neck
  • increased functional length of the hip abductor muscles
62
Q

What are the 2 negative consequences of coxa valga?

A
  • decreased moment arm for hip abductor force

- alignment may favor joint dislocation