Hip

Question 1

What are the 3 bones of the pelvis?

Answer 1

Ilium, Ischium, Pubis

Question 2

What is the position of the acetabulum?

Answer 2

50 degrees inferior and 20 degrees anterior

Question 3

What is acetabular dysplasia

Answer 3

Shallow acetabulum

Question 4

Retroversion- acetabulum is more posterior leading to _____ coverage

Answer 4

over-coverage (opposite of instability)

Question 5

Anteversion- acetabulum is Positioned more anteriorly leading to _________

Answer 5

Instability

Question 6

What is coxa profunda

Answer 6

overcoverage of the acetabulum leading to impingement

Question 7

The center edge angle of the hip is between the _______ and center of femoral head

Answer 7

lateral rim of acetabulum

Question 8

The angle of acetabular inclination is measured from parallel to the teardrops and the _______

typically :

Answer 8

lateral acetabulum

32-45

Note: if it’s too large it’s indicative of dysplasia

Question 9

Functions of acetabular labrum

Answer 9

deepen socket

maintain negative pressure

contains nerve endings

Question 10

T or false: The femoral fovea is covered w/ hyaline cartilage

Answer 10

false

Question 11

The femoral head faces….

Answer 11

Faces medially, superiorly, anteriorly

Question 12

Cova valga is associated with structual genu______

Coxa Vara is associated with structural genu _____

Answer 12

Varum

Valum

Question 13

Coxa vara _______ the frontal plane measurement

Answer 13

decreases the angle of

Larger MA for abductors

increased bending/shear

Question 14

Cova valga ________ the frontal angle

Answer 14

increases

decreases MA for abductors

instability and femoroacetabular impingement

Question 15

Kids with CP tend to have coxa _______

Answer 15

valga AND present with genu Valgum

Whereas normally you see Coxa Valga paired w/ genu varum

Question 16

The normal femoral angle of torsion is…

anteversion is……

Retroversion is…..

Answer 16

10-20 (how much the femur is angled anteriorly)

Anteversion over 15-20 (angled even more anteriorly)

Retroversion Under 10-15 (angled less anteriorly)

Question 17

Anteversion is associated wth ______ hip rotation

retroversion is associated with ______ hip rotation

Answer 17

Anteversion- medial hip rotation

Retroversion- lateral hip rotation

note: these are both measures of the angle of torsion in the transverse plane

Question 18

Most joint congruence at the hip occurs in…

Answer 18

Flexion, abduction, and slight lateral rotation (frog position)

FABER

Question 19

In standing the femoral head is exposed on what sides

Answer 19

anteriorly and superiorly

Question 20

The femoral neck is intracapsular and the greater and lesser trochanter are ________

Answer 20

extracapsular

Question 21

The hip joint capsule is thickest _____ and thinnest _______

Answer 21

anteriorly

Posteriorly

Question 22

What bursa reduces friction of the glute max, ITB, and greater trochanter

Answer 22

lateral bursa

Question 23

Ligamentum teres is _____articular and _____synovial

Answer 23

intra-articular

extra-synovial

note: attaches acetabular notch to fovea of femur

Question 24

What motion does ligamentum teres restrain?

Answer 24

Medial and lateral hip rotation when in over 90 degrees of hip flexion

Question 25

What hip ligament resists excessive **lateral rotation**, especially w/ hip in neutral or flexion

Answer 25

Iliofemoral ligament ( Y ligament) note: primary stabilizing component of anterior hip) AIIS to intertrochanteric line

Question 26

What does the pubofemoral ligament do?

Answer 26

resists lateral rotation when hip is in extension

Question 27

What ligament is the primary restraint to hip medial rotation?

Answer 27

ischiofemoral ligament

Question 28

What is the **close** packed position of the hip?

Answer 28

**Extension, slight abduction, medial rotation** *loose* packed: mid range flexion, slight abduction+ medial rotation (close packed and loose packed are not complete opposites) both closed and loose packed include **medial rotation and slight abduction**

Question 29

the joint capsule and ligaments support ______ of bodyweight without muscular assistance

Answer 29

2/3

Question 30

line of gravity falls ______ to hip creating a ________ moment

Answer 30

posterior extension

Question 31

The hip is most vunerable to dislocation in _____ and ___________ resulting in ______ dislocation

Answer 31

flexion adduction posterior Note: dashboard injury from car crash

Question 32

Femoral head transfers forces to the shaft, creating a bending moment with superior _______ forces, and inferior ___________ forces

Answer 32

Tensile Compressive

Question 33

The medial trabecular system is for ..... the lateral trabecular system is for.....

Answer 33

medial- resists **compressive** forces coming up through femoral head lateral- resists **shear** force of bodyweight on femoral head

Question 34

peak contact pressures of femoral head are located....

Answer 34

superior aspect of acetabular dome -higher peak stress in women due to smaller -dome shows greatest degeneration

Question 35

The femoral head spins ________ with flexion the femoral head spins ___________ with extension

Answer 35

posterior anterior Note: for flexion/ext there is only a spin and not a roll

Question 36

for hip abduction the femoral head rolls ________ and glides ______

Answer 36

roll superior glide inferior

Question 37

for hip medial rotation the femoral head rolls ________ and glides __________

Answer 37

anterior posterior

Question 38

for hip lateral rotation the femoral head rolls ________ and glides _____________

Answer 38

posterior anterior

Question 39

Normal gait on level ground requires how much movement? flexion- ext- ab/ad med/lat rot

Answer 39

30 flex 10 ext 5 abd/add 5 lat/med rot

Question 40

When you have anterior pelvic tilt you have hip ________

Answer 40

flexion

Question 41

When you have posterior pelvic tilt you have hip ________

Answer 41

extension

Question 42

If the hip opposite of the stance leg drops, the stance leg hip goes into _______

Answer 42

Adduction

Question 44

If the hip opposite of the stance leg hikes(rises), the stance leg hip goes into _______

Answer 44

abduction

Question 45

with lateral pelvic shift in bilateral stance, you have _____ on the shift side and ______ on opposite side

Answer 45

Adduction Abduction

Question 46

When the non-weight bearing pelvis moves anteriorly, this produces _____ rotation on the weight bearing hip

Answer 46

medial rotation

Question 47

Non-weight bearing pelvis moves posteriorly * Produces _______ rotation of weight bearing hip

Answer 47

Lateral rotation

Question 48

close chain fwd bending begins with _____, then ______, lastly ______

Answer 48

1. spinal flx 2. anterior pelvic tilt 3. hip flexion

Question 49

with a sidelying leg lift, you first see ______, then ______, then ________

Answer 49

hip abd, lateral pelvic tilt, lumbar side bend

Question 50

the piriformis _____ rotates in extension and ______ rotates in flexion

Answer 50

laterally medially

Question 51

the illiopsoas does _____ pelvic tilt

Answer 51

anterior

Question 52

what muscle is the largest contributor to hip flexion when the knee is flexed

Answer 52

rectus femoris

Question 53

The pectineus and gracilis are both hip _______

Answer 53

adductors note: gracilis can help flex hip if knees extended

Question 54

hip ______ (muscle group) stabilize pelvis in reverse action to *counteract adduction moment*

Answer 54

abductors

Question 55

True or false: obturator externus and quadratus femoris are effective lateral rotators regardless of hip flexion

Answer 55

true

Question 56

True or false: there are no primary medial rotators of the hip

Answer 56

True

Question 57

anterior glute med anterior glute min TFL and Adductors all contribute to......

Answer 57

Medial rotaton

Question 58

stance hip must support compression from ______ and compression from ______ muscles that counteract the adductor moment

Answer 58

Head/Arm/Trunk(HAT) abductor note: generally 2-3x of bodyweight in unilateral stance

Question 59

lateral lean of trunk towards stance leg _______ MA of head,arms,trunk

Answer 59

decreases note: use of cane ipsilaterally transfers some bodyweight to cane

Question 60

how do you help hip drop with an AD?

Answer 60

cane on same side as hip drop

Question 61

Cam impingement

Answer 61

Pistol grip deformation that pushes on anterior/superior labrum

Question 62

pincer impingement

Answer 62

overcoverage of acetabulum compressing superior labrum

Question 63

Femoral-acetabular impingement presentation

Answer 63

groin pain, hip pain, low back pain pain may be dull/aching dull pain with turning/squating/twisting hip joint stiffness

Question 64

T or F: labral tears often occur with Femoral-acetabular impingement

Answer 64

T

Question 65

Increased stresses with what two movements lead to hip labral tear?

Answer 65

ABD/ER

Question 66

Decreased central edge angle, acetabular retroversion, or coxa vara are associated with...

Answer 66

hip labral tear

Question 67

Hip fractures due to bending forces of femoral neck is associated with those over the age of...

Answer 67

40

Question 68

Coxa valga is associated with genu __________

Answer 68

varum

Question 69

Coxa vara is associted with genu ______

Answer 69

valgum

Question 70

hip anteversion is associated with the toes pointing ________

Answer 70

medially

Question 71

hip retroversion is associated with toes pointing __________

Answer 71

laterally

Question 72

(coxa vara or coxa valga) Which one decreases shear to the femoral neck and decreases the MA of the hip abductors

Answer 72

Coxa valga Coxa Vara increases shear and also increases the MA of the abductors

Question 73

Which one between hip anteversion and retroversion reduces stability at the head of the femur?

Answer 73

anteversion note: anteversion also causes increased joint pressures

Question 74

Slipped capital femoral epiphysis happens in what direction?

Answer 74

posterior and inferior slippage of proximal femoral epiphysis on the metaphysis

Question 75

Sway back posture is associated with ____ pelvic tilt

Answer 75

posterior