Hip

Question 1

what is the acetabulum formed by

Answer 1

ilium
ischium
pubis

aka innominate bones /pelvis

Question 2

how does the acetabulum open

Answer 2

outward, forward, downward

Question 3

what is the acetabular labrum made of

Answer 3

dense, horseshoe shaped fibrocartilage around the acetabulum and holds femoral head in acetabulum at extreme ROM, stabilizing the hip

Question 4

the labrum creates a seal for the central compartment - what does the seal resist

Answer 4

distraction of the femoral head from the socket by maintaining a negative intra-articular pressure allowing the head to float on cartilage

Question 5

purpose of acetabular labrum

Answer 5

• increases articular surface area and volume
  -provides proprioceptive feedback for dynamic stability
• creates a seal that resists distraction
• shock absorber
• stabilize hip during lateral rotation while preventing anterior translation

Question 6

MOI to labrum

Answer 6

hip hyperabduction
twisting
falling
hyperextension
dislocation
direct blow or MVA

Question 7

is the labrum avascular

Answer 7

yes except at its margins

poor healing potential

Question 8

which 3 ligaments is the hip supported by

Answer 8

1. iliofemoral
   2.ischiofemoral
2. pubofemoral

all 3 limit internal rotation of femur

Question 9

what ligament is called the Y ligament of Bigelow

Answer 9

iliofemoral ligament

• one of the strongest in the body
• prevents excessive extension & internal rotation & stabilizes the body and maintains upright posture
• limits anterior translation

Question 10

when does the iliofemoral ligament tighten

Answer 10

during external rotation and adduction

Question 11

what can lead to iliofemoral insufficiency

Answer 11

repeated forced external rotation of hip

Question 12

when does the ischiofemoral ligament tighten

Answer 12

during internal rotation and abduction

• weakest of the 3
• repeated forced IR of hip can lead to ischiofemoral insufficiency

Question 13

what does the pubofemoral ligament prevent

Answer 13

excessive abduction of femur and limits external rotation, espec in extension

-winds tightly on extension to stabilize hip
-tightens during external rotation and abduction

Question 14

when is ligamentum teres tightest

Answer 14

adduction, flexion, ER
*most unstable

lax in abduction & IR

Question 15

which ligament provides a physical attachment of head of femur to acetabulum

Answer 15

ligamentum teres

• acts like a sling wrapping around and pulling femoral head into acetabulum during rotational movements
• prevents inferior subluxation during abduction
• prevents posterior subluxation during internal rotation
  -prevents anterior dislocation during external rotation

Question 16

resting position of hip joint

Answer 16

30 flexion
30 abduction
slight external rotation

Question 17

closed packed position of hip

Answer 17

full extension, internal rotation, abduction

Question 18

capsular pattern of hip

Answer 18

flexion, abduction, internal rotation

Question 19

when is legg calve perthes disease common

Answer 19

boys 3-12
elderly women

Question 20

femoral neck stress fractures occur when

Answer 20

excessive stress is applied to trabecular bone in femoral neck

Question 21

posterior dislocation of hip =

Answer 21

slightly flexed, adducted, externally rotated

Question 22

causes of snapping hips

acetabular labral tears, loose bodies, cartilage defects or ligamentum teres tears =

Answer 22

1. slipping of iliopsoas tendon over osseous ridge of lesser trochanter or anterior acetabulum or iliofemoral ligament may ride over femoral head =

2.

Question 23

a lateral pelvic shift of more than 2 cm toward weight bearing side =

Answer 23

Trendelenburg gait / abductor lurch

Question 24

excessive posterior pelvic rotation in axial plane of more than 40 degrees toward affected hip as pt flexes hip and knee in attempt to obtain terminal hip extension in opposite leg is called ______

Answer 24

pelvic wink or butt wink

Question 25

what could excessive "toeing out" be due to

Answer 25

external hip neck retroversion or pelvic torsion toeing in = femoral neck anteversion

Question 26

flexion of hip=

Answer 26

110-120

Question 27

extension of hip=

Answer 27

10-15

Question 28

abduction of hip =

Answer 28

30-50

Question 29

adduction of hip =

Answer 29

30

Question 30

external rotation of hip=

Answer 30

40-60

Question 31

internal rotation of hip =

Answer 31

30-40

Question 32

during hip movement, if the pelvic force couples are normal, the pelvis and ASIS/PSIS will _________

Answer 32

not move if they do, indication of mm imbalance

Question 33

all passive movements are ______ stretch

Answer 33

tissue stretch

Question 34

where is the iliopectineal bursa

Answer 34

over anterior aspect of hip joint and pubis lies beneath iliopsoas mm as is crosses in front of the hip jt can be involved in anterior hip pain w pts w hip jt disease

Question 35

where is the trochanteric bursa

Answer 35

over greater trochanter reduces friction between IT and glute max

Question 36

which ligament provides attachment of the head of femur to acetabulum

Answer 36

ligamentum teres provides some vascular supply to head of femur

Question 37

under low loads joint surfaces are _________

Answer 37

incongruous under heavy loads, they become congruous providing maximum surface contact

Question 38

what structure rubs on the trochanteric bursa to irritate it

Answer 38

IT band

Question 39

what conditions has similar symptoms to pirformis syndrome

Answer 39

IT band friction syndrome

Question 40

left lateral pelvic tilt is most likely caused by

Answer 40

HT R QL

Question 41

what motion of the hip is occuring if the glute med is engaged in an eccentric contraction

Answer 41

adduction eccentric = going backwards from contraction concentric = abduction

Question 42

what encircles the femoral neck and acts as a biomechanical locking ring wrapped around the femoral neck

Answer 42

zona orbicularis (annular ligament) resists distraction forces on hip

Question 43

what ligament of the hip supports the *vascular system* (foveal artery) that supply's the femoral head

Answer 43

ligamentum teres

Question 44

if you are observing an affected hip, what will you usually see

Answer 44

hip is lowered to affected side and knee is bent to absorb the shock length of step on affected side is shorter entire trunk and leg swing forward together when standing, hip is slightly flexed

Question 45

flexion=

Answer 45

110-120

Question 46

extension =

Answer 46

10-15

Question 47

abduction =

Answer 47

30-50

Question 48

adduction =

Answer 48

30

Question 49

external rotation =

Answer 49

40-60

Question 50

internal rotation =

Answer 50

30-40

Question 51

femoral triangle borders

Answer 51

1. inguinal ligament (superior border) 2. adductor longus (medial border) 3. sartorius (medial border) floor: pectineus, iliopsoas, adductor longus

Question 52

what does the femoral triangle contain

Answer 52

femoral vein, artery & nerve, canal (deep lymph nodes)

Question 53

what is the purpose of a labrum

Answer 53

deepen and stabilize joints

Question 54

what provides a physical attachement of the head of femur to acetabulum

Answer 54

ligamentum teres

Question 55

what is the angle of inclination formed by the neck and shaft of femur (frontal plane)

Answer 55

125 adults 150 children

Question 56

increase in normal inclination is called coxa _____

Answer 56

valgum

Question 57

which plane does angle of torsion or angle of declination happen

Answer 57

transverse

Question 58

if a patient appears with a toe in gait and lack external rotation what is likely going on

Answer 58

anteversion

Question 59

what nerve would lateral hip pain might stimulate

Answer 59

L4

Question 60

clinical prediction rule for OA

Answer 60

1. limited active hip flexion w lateral hip P 2. active hip ext causes P 3. limited passive hip MR 4. squatting limited & P 5. scour test w adduction causes lateral hip / groin P 4/5 must be positive

Question 61

with a cane and hip injury which hand should it be held in

Answer 61

opposite hand to affected side to negate some form of gravity on affected hip use of cane can decrease load on hip up to 40%

Question 62

which plane of movement does hip flexion / extension occur in

Answer 62

sagittal

Question 63

which plane of movement does hip abduction occur in

Answer 63

frontal

Question 64

which plane of motion does internal/external rotation occur in

Answer 64

transverse (horizontal)