Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards Prep - MSK > Hip > Flashcards

Hip Flashcards

1
Q

Hip Osteoarthritis CPG - Activity Limitation/Physical Performance Measures

A
  • Should use valid physical performance measure such as 6MWT, TUG, SLS, and others (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hip Osteoarthritis CPG - Physical Impairment

A
  • Document PROM, hip muscle strength, FABER over episode of care (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hip Osteoarthritis CPG - Outcome Measures

A
  • Activity Limitation
  • Use valid measures such as Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and others such as VAS (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hip Osteoarthritis CPG - Diagnosis

A
  • IR < 24 degrees or IR/Flex 15 degrees less than non painful side
  • passive IR increases pain
  • Morning stiffness after awakening
  • moderate ant or la hip pain when WBing
    (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hip Osteoarthritis CPG - flexibility, strengthening, and endurance

A
  • individualized exercises to address impairments
  • 1-5 x/week for 6-12 weeks with mild to mod hip osteoarthritis
    (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hip Osteoarthritis CPG - Manual Therapy

A
  • manual therapy for mild to mod hip OA that may include soft tissue mobs, thrust, and non thrust
  • 1-3x/week over 6-12 weeks
    (I)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Avascular necrosis - ROM

A
  • decreased in flex, IR, and abduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Avascular necrosis - diagnostic tests

A
  • x ray
  • bone scan
  • CT
  • and/or MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

symptoms of Avascular necrosis

A
  • pain in groin and/or thigh
  • tenderness with palpation at hip joint
  • coxalgic gait
  • pain that increases with WBing
  • night pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

injury of what ligament can cause Avascular necrosis

A

ligamentum teres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is coxalgic gait

A
  • pt leans toward affected side while pelts stays level or elevated on contralateral side due to normal abductors on affected side
  • lateral shift reduces forces exerted on stance leg
  • due to arthritis/avascular necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Avascular necrosis - medications

A
  • acetaminophen for pain
  • NSAID for pain/inflammation
  • corticosteroids are contraindicated since they may be causative factor
  • pts taking steroids for other conditions should have dosage decreased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PT goals for Avascular necrosis

A
  • joint/bone protection strategies
    -maintain/improve joint mechanics and connective tissue function
  • aerobiccapcity
  • post surgical intervention includes regaining functional flexibility, improving strength, endurance, coordination, and gait training
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

surgical options for Avascular necrosis

A

core decompression or replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is avascular necrosis bilateral?

A

50-80% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Coxa vara

A

angle of femoral neck with shaft of femur (angle of inclination) is <115 degrees
- “knock knee”
- compensates with gene valgum at knee
- foot forced pronation
- lateral knee joint compression, medial knee joint gapping
- VMO weakness, pes anserine, medial capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Coxa valga

A

angle of femoral neck with shaft of femur (angle of inclination) is >125 degrees
- “bow legged”
- compensates with genu varum at knee
- increased medial compression, increased stress on popliteus, LCL, Lat HS/gastroc/ITB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Coxa vara effect on foot

A
  • forced pronation = pain in arch of foot, medial malleolus, post tib tendonitis at insertion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Coxa valga effect on foot

A
  • tibial varus –> rapid pronation –> post tib tendonitis –> complaints of proximal medial leg symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does coxa vara usually result from

A

defect in ossification of head of femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

coxa vara and coxa valga may result from…

A

necrosis of femoral head occurring with septic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is femoral anteversion?

A

increased angle of torsion (angle between femoral head/neck and an axis through the distal femoral condyles)
- “pigeon toed”
- heel strike with pronated foot –> forefoot varus compensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is femoral retroversion

A
  • decreased angle of torsion
  • toes out
  • results in lateral contact with calcaneus –> excessive pronation during loading response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is angle of torsion supposed to be?

A

12-15 degrees in adult
- 25 degrees in infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is trochanteric bursitis

A
  • inflammation of deep tronchanteric bursa from a direct blow, irritation by/tight ITB, poor posture/biomechanics causing repetitive micro trauma, weak glute med
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Trochanteric bursitis clinical presentation

A
  • pain complains to lateral hip –> point to specific spot
  • local tenderness over greater trochanter
  • may have pain with resisted abduction
  • symptoms increase with walking, stair climbing, laying on effects side, and crossing legs
27
Q

trochanteric bursitis intervention

A
  • pt education on activity modification and positioning for relief
  • stretch tight structures causing postural deviations or asymmetries
  • strengthening weak muscles causing instability or faulty movement patterns
28
Q

trochanteric bursitis is common in pts with..

A

RA

29
Q

Psoas bursitis clinical presentation

A
  • pain anterior hip or thigh
  • aggravated by excessive hip flex
  • can be related to OA or iliopsoas muscle tightness
30
Q

Ischial bursitis clinical presentation

A
  • pain in buttock/posterior thigh
  • aggravated by stairs/incline walking (when hip is flexed and extensors are contracted)
  • avoidance of sitting on affected hip
31
Q

diagnostic test for bursitis

A
  • none
  • diagnosis made by clinical examination
32
Q

What two tests may be positive for ITB tightness

A
  • noble compression test
  • Ober’s test
33
Q

What does Craig’s test measure

A
  • femoral anteversion and retroversion
34
Q

Different angles of piriformis

A
  • ER of hip at < 60 degrees hip flex
  • IR of hip at > 90 degrees hip flex
35
Q

tightness, straining, or spasm of the piriformis can result in

A

compression of sciatic nerve and/or sacroiliac dysfunction

36
Q

signs and symptoms of piriformis syndrome

A
  • pain worse with sitting, stair climbing, crossing leg
  • restriction in IR
  • pain with palpation to piriformis
  • referral of pain to post thigh
  • weakness in ER
    • piriformis test
37
Q

What should you rule out when looking at piriformis syndrome

A

involvement of lumbar spine and/or SI dysfunction

38
Q

Pt goals for piriformis syndrome

A
  • treat strain or improve length of tight muscle
  • correct biomechanical asymmetries
  • pain reduction
  • functional training and resistance training
39
Q

Etiology of acetabular labral tears

A
  • FAI
  • dysplasia (acetabulum is too small for femoral head)
  • capsular laxity and degeneration
  • direct trauma
  • sports injury –> frequent ER of hip, sprinting
  • can occur with hyperextension, hyperextension with ER, or hyperabduction
  • 74% not associated with any specific event or cause; may be secondary to micro trauma
40
Q

FAI - CAM type

A

impingement of a large aspherical femoral head in a constrained acetabulum

41
Q

FAI - pincer type

A
  • over-coverage of the femoral head by a prominent acetabular rim
42
Q

Clinical presentation of acetabular labral tears

A
  • F>M
  • anterior hip/groin pain
  • clicking, catching, “sharp”, “giving out”
  • decreased ROM (most commonly decreased rotation)
  • may have + FABER
  • difficult to diagnose
43
Q

what is the gold standard diagnostic test for acetabular labral tears

A

arthroscopy

44
Q

Hip arthroscopy for labral tear - rehab considerations

A
  • brace 2-6 weeks
  • NWB or Foot flat WB 2-8 weeks
  • rehab can start POD 1-2; some surgeons wait
  • continuous ROM - 4 hrs
  • prone laying to reduce tightness of iliopsoas
45
Q

What is a sports hernia

A
  • tear of oblique aponeurosis –> thought to be stronger pull of adductors on pelvis vs oblique mm
46
Q

sports hernia is common in…

A

sports requiring kicking, rapid acceleration/deceleration and sudden change of direction (hockey, soccer, etc)

47
Q

sports hernia may be related to pathology in

A
  • adductor
  • iliopsoas
  • inguinal
  • pubis
48
Q

what should you rule out in sports hernia

A

hip involvement

49
Q

length of rehab period for sports hernia

A
  • 8-12 weeks
  • may come back with activity
  • surgery if conservative methods fail
50
Q

Slipped capital femoral epiphysis

A
  • posterior and inferior slippage of the femoral epiphysis on the femoral neck
  • occurs in early adolescent with growth spurt
  • common initial complain is hip and/or knee pain
51
Q

Legg Calve-Perthes Disease

A
  • idiopathic osteonecrosis of the epiphysis of the femoral head
  • 5x > in M
  • 3-12 yo
  • hip or groin pain, limp, decreased ROM in IR and ABD
  • work to restore ROM
52
Q

What is Coxa Saltans

A
  • snapping or clicking hip
53
Q

intra-articular causes of Coxa Saltans

A
  • loose bodies
  • subluxation of hip
54
Q

Extra articular causes of Coxa Saltans

A
  • ITB over greater troch
  • iliopsoas tension over labrum and femoral head (AKA iliopsoas impingement –> work on lengthening iliopsoas)
  • iliofemoral ligament over femoral head
  • biceps femoris over ischial tuberosity
55
Q

Hip resurfacing candidates

A
  • male; < 60 yo
  • normal functioning kidneys
  • active lifestyle
  • BMI < 30
56
Q

Anterolateral THA

A
  • anterior 1/3 of glute med and min released and repaired
  • no hip flex > 90
  • no hip ext, abd, ER past neutral
57
Q

Posterolateral THA

A
  • short ERs and pirifomis released and repaired (glute med intact)
  • no hip flex > 90
  • no IR, add past neutral
58
Q

hip convex/concave rule

A

convex moving on concave

59
Q

hip OPP/CPP

A

OPP: 30 degrees flexion, 30 degrees abduction, slight lat rotation
CPP: full extension, abduction, internal rotation

60
Q

hip capsular pattern

A

flex > IR > abd

61
Q

hip normal flex/ext

A

flex: 110-120
ext: 10-15

62
Q

hip normal abd/add

A

abd: 30-50
add: 30

63
Q

hip normal ER/IR

A

ER: 40-60
IR: 30-40

64
Q
A

Boards Prep - MSK (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions