Hip Flashcards
What are the 3 bones of the pelvis?
Ilium, Ischium, Pubis
What is the position of the acetabulum?
50 degrees inferior and 20 degrees anterior
What is acetabular dysplasia
Shallow acetabulum
Retroversion- acetabulum is more posterior leading to _____ coverage
over-coverage (opposite of instability)
Anteversion- acetabulum is Positioned more anteriorly leading to _________
Instability
What is coxa profunda
overcoverage of the acetabulum leading to impingement
The center edge angle of the hip is between the _______ and center of femoral head
lateral rim of acetabulum
The angle of acetabular inclination is measured from parallel to the teardrops and the _______
typically :
lateral acetabulum
32-45
Note: if it’s too large it’s indicative of dysplasia
Functions of acetabular labrum
deepen socket
maintain negative pressure
contains nerve endings
T or false: The femoral fovea is covered w/ hyaline cartilage
false
The femoral head faces….
Faces medially, superiorly, anteriorly
Cova valga is associated with structual genu______
Coxa Vara is associated with structural genu _____
Varum
Valum
Coxa vara _______ the frontal plane measurement
decreases the angle of
Larger MA for abductors
increased bending/shear
Cova valga ________ the frontal angle
increases
decreases MA for abductors
instability and femoroacetabular impingement
Kids with CP tend to have coxa _______
valga AND present with genu Valgum
Whereas normally you see Coxa Valga paired w/ genu varum
The normal femoral angle of torsion is…
anteversion is……
Retroversion is…..
10-20 (how much the femur is angled anteriorly)
Anteversion over 15-20 (angled even more anteriorly)
Retroversion Under 10-15 (angled less anteriorly)
Anteversion is associated wth ______ hip rotation
retroversion is associated with ______ hip rotation
Anteversion- medial hip rotation
Retroversion- lateral hip rotation
note: these are both measures of the angle of torsion in the transverse plane
Most joint congruence at the hip occurs in…
Flexion, abduction, and slight lateral rotation (frog position)
FABER
In standing the femoral head is exposed on what sides
anteriorly and superiorly
The femoral neck is intracapsular and the greater and lesser trochanter are ________
extracapsular
The hip joint capsule is thickest _____ and thinnest _______
anteriorly
Posteriorly
What bursa reduces friction of the glute max, ITB, and greater trochanter
lateral bursa
Ligamentum teres is _____articular and _____synovial
intra-articular
extra-synovial
note: attaches acetabular notch to fovea of femur
What motion does ligamentum teres restrain?
Medial and lateral hip rotation when in over 90 degrees of hip flexion
What hip ligament resists excessive lateral rotation, especially w/ hip in neutral or flexion
Iliofemoral ligament ( Y ligament)
note: primary stabilizing component of anterior hip)
AIIS to intertrochanteric line
What does the pubofemoral ligament do?
resists lateral rotation when hip is in extension
What ligament is the primary restraint to hip medial rotation?
ischiofemoral ligament
What is the close packed position of the hip?
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
the joint capsule and ligaments support ______ of bodyweight without muscular assistance
2/3
line of gravity falls ______ to hip creating a ________ moment
posterior
extension
The hip is most vunerable to dislocation in _____ and ___________ resulting in ______ dislocation
flexion
adduction
posterior
Note: dashboard injury from car crash
Femoral head transfers forces to the shaft, creating a bending moment with superior _______ forces, and inferior ___________ forces
Tensile
Compressive
The medial trabecular system is for …..
the lateral trabecular system is for…..
medial- resists compressive forces coming up through femoral head
lateral- resists shear force of bodyweight on femoral head
peak contact pressures of femoral head are located….
superior aspect of acetabular dome
-higher peak stress in women due to smaller
-dome shows greatest degeneration
The femoral head spins ________ with flexion
the femoral head spins ___________ with extension
posterior
anterior
Note: for flexion/ext there is only a spin and not a roll
for hip abduction the femoral head rolls ________ and glides ______
roll superior glide inferior
for hip medial rotation the femoral head rolls ________ and glides __________
anterior
posterior
for hip lateral rotation the femoral head rolls ________ and glides _____________
posterior
anterior
Normal gait on level ground requires how much movement?
flexion-
ext-
ab/ad
med/lat rot
30 flex
10 ext
5 abd/add
5 lat/med rot
When you have anterior pelvic tilt you have hip ________
flexion
When you have posterior pelvic tilt you have hip ________
extension
If the hip opposite of the stance leg drops, the stance leg hip goes into _______
Adduction
If the hip opposite of the stance leg hikes(rises), the stance leg hip goes into _______
abduction
with lateral pelvic shift in bilateral stance, you have _____ on the shift side and ______ on opposite side
Adduction
Abduction
When the non-weight bearing pelvis moves anteriorly, this produces _____ rotation on the weight bearing hip
medial rotation
Non-weight bearing pelvis moves posteriorly
* Produces _______ rotation of weight bearing hip
Lateral rotation
close chain fwd bending begins with _____, then ______, lastly ______
- spinal flx
- anterior pelvic tilt
- hip flexion
with a sidelying leg lift, you first see ______, then ______, then ________
hip abd, lateral pelvic tilt, lumbar side bend
the piriformis _____ rotates in extension and ______ rotates in flexion
laterally
medially
the illiopsoas does _____ pelvic tilt
anterior
what muscle is the largest contributor to hip flexion when the knee is flexed
rectus femoris
The pectineus and gracilis are both hip _______
adductors
note: gracilis can help flex hip if knees extended
hip ______ (muscle group) stabilize pelvis in reverse action to counteract adduction moment
abductors
True or false: obturator externus and quadratus femoris are effective lateral rotators regardless of hip flexion
true
True or false: there are no primary medial rotators of the hip
True
anterior glute med
anterior glute min
TFL
and Adductors
all contribute to……
Medial rotaton
stance hip must support compression from ______ and compression from ______ muscles that counteract the adductor moment
Head/Arm/Trunk(HAT)
abductor
note: generally 2-3x of bodyweight in unilateral stance
lateral lean of trunk towards stance leg _______ MA of head,arms,trunk
decreases
note: use of cane ipsilaterally transfers some bodyweight to cane
how do you help hip drop with an AD?
cane on same side as hip drop
Cam impingement
Pistol grip deformation that pushes on anterior/superior labrum
pincer impingement
overcoverage of acetabulum compressing superior labrum
Femoral-acetabular impingement presentation
groin pain, hip pain, low back pain
pain may be dull/aching
dull pain with turning/squating/twisting
hip joint stiffness
T or F: labral tears often occur with Femoral-acetabular impingement
T
Increased stresses with what two movements lead to hip labral tear?
ABD/ER
Decreased central edge angle, acetabular retroversion, or coxa vara are associated with…
hip labral tear
Hip fractures due to bending forces of femoral neck is associated with those over the age of…
40
Coxa valga is associated with genu __________
varum
Coxa vara is associted with genu ______
valgum
hip anteversion is associated with the toes pointing ________
medially
hip retroversion is associated with toes pointing __________
laterally
(coxa vara or coxa valga) Which one decreases shear to the femoral neck and decreases the MA of the hip abductors
Coxa valga
Coxa Vara increases shear and also increases the MA of the abductors
Which one between hip anteversion and retroversion reduces stability at the head of the femur?
anteversion
note: anteversion also causes increased joint pressures
Slipped capital femoral epiphysis happens in what direction?
posterior and inferior slippage of proximal femoral epiphysis on the metaphysis
Sway back posture is associated with ____ pelvic tilt
posterior
