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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
Q

which muscles limit adduction hip ROM?

A

TFL
ITB

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26
Q

which structures limit extension hip ROM?

A

anteversion and retroversion of femur

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27
Q

which hip motion unloads the L spine?

A

IR

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28
Q

how much hip motion is needed for gait?

A

flex - 30 deg
ext - 10 deg
abd/add - 5 deg
ER/IR - 5 deg

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29
Q

how much hip ROM is needed for squatting?

A

flex - 115 deg
IR - 20 deg
abd - 20 deg

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30
Q

how much hip ROM is needed for shoe tying?

A

120 deg flexion

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31
Q

how much hip ROM is needed for sitting?

A

112 deg flexion

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32
Q

how much hip ROM is needed for stooping?

A

125 deg flexion

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33
Q

how much hip ROM is needed for ascending stairs?

A

67 deg flexion

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34
Q

how much hip ROM is needed for descending stairs?

A

36 deg flexion

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35
Q

how much hip ROM is needed for putting foot on opposite thigh?

A

120 flex, 20 deg abd, 20 deg ER

36
Q

how much hip ROM is needed for putting on pants?

A

90 deg flex

37
Q

if opposite side of pelvis hikes, stance hip _____

A

abducts

38
Q

lateral pelvic shift: _____ on shift side and ____ on opposite side

A

shift - adduction
opposite - abduction

39
Q

anterior (forward) pelvic rotation produces ____ rotation of stance hip

A

medial

40
Q

anterior fibers of glute med mm action? posterior?

A

anterior - IR (when hip flexed)
posterior - ER (when hip extended)

41
Q

what mm is the main compensator for weak hip ER?

A

TFL

42
Q

T/F: there are no primary medial rotators

A

T

43
Q

what does Ober’s test assess?

A

tight ITB and/or decreased hip IR ROM

44
Q

tendon vs peritendon injury treatment

A

tendon - eccentric loading
peritendon - cross friction massage

45
Q

pain with bursa vs. tendon vs. peritendon injury

A

bursa - compression
tendon - contraction
peritendon - elongation

46
Q

T/F: deep hip rotator go anterior

A

F

47
Q

coxa valga causes knee

A

varus

48
Q

prime mover of hip

A

glute max

49
Q

____ mm pulls femoral head forward and the _____ pulls it back

A

forward - TFL
back - hamstrings

50
Q

PAILS procedure

A

done before RAILS
ISOMETRIC contraction of the agonist mm in a LENGTHENINED position
slowly build up for 20-100%

51
Q

RAILS procedure

A

done immediately after PAILS
ISOMETRIC contraction in SHORTENED position (antagonist mm)
rapid contraction (no build up)

52
Q

benefits of PAILS/RAILS

A

bypass stretch reflex
creates cortical mapping
increase neural drive to tissue
cause cellular adaptation in tissue
increase blood flow to PAILS & RAILS tissue

53
Q

when is glut max most efficient?

A

in 30 deg abduction

54
Q

position for posterior glute med assessment

A

abduction, ER, extension

55
Q

glute min only _____

A

abducts

56
Q

position of deep rotator assessment

A

abduction and ER

57
Q

what exercises can be used for lumbar-hip dissociation?

A

bent knee fall out
supine marches

58
Q

function of hip IR

A

drive forces into ground

59
Q

when does hip IR occur?

A

extending towards 0 deg from flexed
flexed from 60-100 deg

60
Q

IR in open chain causes ___ rotation of innominate and ____ of the sacrum

A

posterior rotation
nutation

61
Q

hip OA CPG

A

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
Q

hip OA CPR (sutlive)

A

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 </= 25 deg

63
Q

younger males are more likely to have ___ impingement

A

cam

64
Q

middle-aged active women are more likely to have ___ impingement

A

pincer

65
Q

which type of impingement is more likely to be associated with OA

A

pincer

66
Q

associated conditions with cam impingement

A

SCFE
Legg-Calve-Perthes
femoral head anteversion
coxa profunda

67
Q

associated conditions with pincer impingement

A

acetabular retroversion
coxa profunda
acetabular protrusions

68
Q

FAI symptoms

A

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
Q

incidences of acetabular labral tears increases with ______

A

increased age

70
Q

precursors of labral tear

A

FAI
trauma
capsular laxity
hip dysplasia

71
Q

signs/symptoms of labral tear

A

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
Q

special tests for labral tears

A

FADIR
Quadrant
Scour
Fitzgerald

73
Q

conditions associated with structural instability that can lead to labral tears

A

shallow acetabulum (dysplasia)
excessive femoral anteversion
inferior acetabulum insufficiency
neck or shaft angle >140 deg

74
Q

what commonly occurs with labral tears?

A

chondral lesions

75
Q

age for Legg-Calve-Perthes

A

4-8 yo

76
Q

age for SCFE

A

10-15 yo

77
Q

what is affected with Legg-Calve-Perthes?

A

femoral head

78
Q

main exam finding for Legg-Calve-Perthes

A

decreased IR and abduction

79
Q

what is affected with SCFE?

A

femoral neck

80
Q

T/F: SCFE is usually treated surgically

A

T

81
Q

risk factors for SCFE

A

obesity
hypothyroidism
trauma
radiation

82
Q

exam findings for SCFE

A

decreased IR< abduction, and flexion
LE goes into ER with passive hip flex
hip TTP

83
Q

WB status:
THR:
labral repair:
microfracture, osteoplasty:
plate:
nail:

A

WB status:
THR: day of
labral repair: NWB initially
microfracture, osteoplasty: 4-8 wk NWB
plate: NWB
nail: WBAT right away

84
Q

posterior hip precaution

A

no: flexion >90
IR
adduction beyond neutral
(crossing leg)

85
Q

anterior hip precautions

A

no: extension beyond neural
ER beyond neutral
no bridging or prone lying

Ther Ex 2 (5 decks)

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