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Ther Ex 2 > Hip > Flashcards

Hip Flashcards

1
Q

what is the order of progression?

A
  1. mobility
  2. control (stability)
  3. load (strengthening)
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2
Q

goal is to provide _____ stability

A

dynamic

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3
Q

___ and ___ is needed for good dynamic stability

A

good proprioception and kinesthesia

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4
Q

if there isn’t good NM control, the body will take the _______

A

path of least resistance

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5
Q

how should strengthen training be approached for recovery?

A

restoring and building isolate strength and then integrating it into stability and functional training

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6
Q

when is the quad more active in open chain?

A

as knee flexion decreases

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7
Q

when is the quad more active in close chain?

A

increase in knee flexion

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8
Q

what are the stabilizers of the hip joint?

A

glute med
glute min
glute max
piriformis
superior and inferior gemelli
obturator internus
obturator externus

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9
Q

how is the acetabulum oriented?

A

anterior, lateral, inferior

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10
Q

how is the femur oriented?

A

anterior, medial, superior

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11
Q

what is a normal angle of inclination?

A

125 deg

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12
Q

what is a coxa vara angle of inclination?

A

<110 deg

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13
Q

what is a cox valga angle of inclination?

A

> 140 deg

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14
Q

angle of inclination is a ____ plane measurement

A

frontal

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15
Q

what is the most congruent position of the hip?

A

flexion, abduction, and ER (quadruped)

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16
Q

what is open pack position of the hip?

A

30 deg flex, slight (5) ER, and 30 deg abduct

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17
Q

what is closed pack position of the hip?

A

extension, some abduction, and IR

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18
Q

normal hip flexion ROM

A

120 deg
90 with knee extended

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19
Q

normal hip extension ROM

A

10-30 deg

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20
Q

which muscles limit extension hip ROM?

A

rectus femoris
TFL

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21
Q

normal hip abduction ROM

A

45-50 deg

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22
Q

normal hip adduction ROM

A

20-30 deg

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23
Q

normal hip ER & IR ROM

A

42-50 deg
90 deg in flexion

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24
Q

which muscles limit abduction hip ROM?

A

gracilis

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25
which muscles limit adduction hip ROM?
TFL ITB
26
which structures limit extension hip ROM?
anteversion and retroversion of femur
27
which hip motion unloads the L spine?
IR
28
how much hip motion is needed for gait?
flex - 30 deg ext - 10 deg abd/add - 5 deg ER/IR - 5 deg
29
how much hip ROM is needed for squatting?
flex - 115 deg IR - 20 deg abd - 20 deg
30
how much hip ROM is needed for shoe tying?
120 deg flexion
31
how much hip ROM is needed for sitting?
112 deg flexion
32
how much hip ROM is needed for stooping?
125 deg flexion
33
how much hip ROM is needed for ascending stairs?
67 deg flexion
34
how much hip ROM is needed for descending stairs?
36 deg flexion
35
how much hip ROM is needed for putting foot on opposite thigh?
120 flex, 20 deg abd, 20 deg ER
36
how much hip ROM is needed for putting on pants?
90 deg flex
37
if opposite side of pelvis hikes, stance hip _____
abducts
38
lateral pelvic shift: _____ on shift side and ____ on opposite side
shift - adduction opposite - abduction
39
anterior (forward) pelvic rotation produces ____ rotation of stance hip
medial
40
anterior fibers of glute med mm action? posterior?
anterior - IR (when hip flexed) posterior - ER (when hip extended)
41
what mm is the main compensator for weak hip ER?
TFL
42
T/F: there are no primary medial rotators
T
43
what does Ober's test assess?
tight ITB and/or decreased hip IR ROM
44
tendon vs peritendon injury treatment
tendon - eccentric loading peritendon - cross friction massage
45
pain with bursa vs. tendon vs. peritendon injury
bursa - compression tendon - contraction peritendon - elongation
46
T/F: deep hip rotator go anterior
F
47
coxa valga causes knee
varus
48
prime mover of hip
glute max
49
____ mm pulls femoral head forward and the _____ pulls it back
forward - TFL back - hamstrings
50
PAILS procedure
done before RAILS ISOMETRIC contraction of the agonist mm in a LENGTHENINED position slowly build up for 20-100%
51
RAILS procedure
done immediately after PAILS ISOMETRIC contraction in SHORTENED position (antagonist mm) rapid contraction (no build up)
52
benefits of PAILS/RAILS
bypass stretch reflex creates cortical mapping increase neural drive to tissue cause cellular adaptation in tissue increase blood flow to PAILS & RAILS tissue
53
when is glut max most efficient?
in 30 deg abduction
54
position for posterior glute med assessment
abduction, ER, extension
55
glute min only _____
abducts
56
position of deep rotator assessment
abduction and ER
57
what exercises can be used for lumbar-hip dissociation?
bent knee fall out supine marches
58
function of hip IR
drive forces into ground
59
when does hip IR occur?
extending towards 0 deg from flexed flexed from 60-100 deg
60
IR in open chain causes ___ rotation of innominate and ____ of the sacrum
posterior rotation nutation
61
hip OA CPG
insidious onset, 1st with WB anterior or lateral hip pain with WB morning stiffness <1 hr hip IR ROM < 24 deg hip IR and flex 15 deg < nonpainful side increased hip pain with passive IR
62
hip OA CPR (sutlive)
self-reported squatting aggravates sx active hip flex causes lateral hip pain scour test with adduction --> lateral hip or groin pain active hip extension causes pain passive IR
63
younger males are more likely to have ___ impingement
cam
64
middle-aged active women are more likely to have ___ impingement
pincer
65
which type of impingement is more likely to be associated with OA
pincer
66
associated conditions with cam impingement
SCFE Legg-Calve-Perthes femoral head anteversion coxa profunda
67
associated conditions with pincer impingement
acetabular retroversion coxa profunda acetabular protrusions
68
FAI symptoms
moderate hip or groin pain stiffness decreased ROM click/catching giving way passive hip IR pain and limited passive hip flexion pain and limited Trendelenburg gait or abductor lurch
69
incidences of acetabular labral tears increases with ______
increased age
70
precursors of labral tear
FAI trauma capsular laxity hip dysplasia
71
signs/symptoms of labral tear
c/o anterior hip or groin pain click/lock/pop give way catching stiffness dull ache with running or stairs limited sit, twist, stairs, walk ability may have audible pop
72
special tests for labral tears
FADIR Quadrant Scour Fitzgerald
73
conditions associated with structural instability that can lead to labral tears
shallow acetabulum (dysplasia) excessive femoral anteversion inferior acetabulum insufficiency neck or shaft angle >140 deg
74
what commonly occurs with labral tears?
chondral lesions
75
age for Legg-Calve-Perthes
4-8 yo
76
age for SCFE
10-15 yo
77
what is affected with Legg-Calve-Perthes?
femoral head
78
main exam finding for Legg-Calve-Perthes
decreased IR and abduction
79
what is affected with SCFE?
femoral neck
80
T/F: SCFE is usually treated surgically
T
81
risk factors for SCFE
obesity hypothyroidism trauma radiation
82
exam findings for SCFE
decreased IR< abduction, and flexion LE goes into ER with passive hip flex hip TTP
83
WB status: THR: labral repair: microfracture, osteoplasty: plate: nail:
WB status: THR: day of labral repair: NWB initially microfracture, osteoplasty: 4-8 wk NWB plate: NWB nail: WBAT right away
84
posterior hip precaution
no: flexion >90 IR adduction beyond neutral (crossing leg)
85
anterior hip precautions
no: extension beyond neural ER beyond neutral no bridging or prone lying

Ther Ex 2 (5 decks)

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