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Musculoskeletal Exam 4 > Hip > Flashcards

Hip Flashcards

1
Q

What is the primary function of the hip?

A

To support the weight of the body

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2
Q

Structurally, the hip is suited for _______ first, then _______.

A

Stability, mobility

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3
Q

What are the muscles that attach to the ischial tuberosity?

A 
Semimembranosus
Semitendinosus
LH of Biceps Femoris
Adductor Magnus
Quadratus Femoris
Gemellus Inferior
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4
Q

Which way does the acetabulum face?

A

Laterally, inferiorly and anteriorly

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5
Q

What is the function of the acetabular labrum?

A

Further deepens the cavity and grasps the head of the femur

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6
Q

Which way is the head of the femur angled?

A

Medially, superiorly and anteriorly

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7
Q

Which way is the femoral neck oriented in respect to the shaft?

A

Externally rotated

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8
Q

Which muscles attach to the greater trochanter?

A

Piriformis
Gluteus medius, minimus
Obturator internus
Gemellus superior, inferior

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9
Q

Where is the articular cartilage and joint capsule thickest?

A

Anterosuperiorly, where maximal stress and weight bearing occurs

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10
Q

Where does the joint capsule attach posteriorly?

A

the lateral one-third of the femoral neck

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11
Q

Where does the joint capsule attach laterally?

A

over the femoral head and neck to attach to the intertrochanteric line anteriorly

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12
Q

Where does the joint capsule attach proximally?

A

to the pelvis, just lateral to the acetabular labrum

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13
Q

Which ligament is the strongest?

A

Iliofemoral ligament

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14
Q

Which ligament is the weakest?

A

Ischiofemoral ligament

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15
Q

Which ligament is tight with extension? Which limits it?

A

Ischiofemoral ligament, Pubofemoral ligament

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16
Q

Which prevents excess abduction?

A

Pubofemoral ligament

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17
Q

Which ligament is “Y” shaped?

A

Illiofemoral

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18
Q

What are the 3 bursae of the hip?

A

Iliopsoas bursa, trochanteric bursa, ischiogluteal bursa

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19
Q

What is contained within the femoral triangle?

A

Femoral nerve, artery and vein

Lymphatics

20
Q

What is the resting position for the hip joint?

A

30 flexion, 30 ABD, slight ER

21
Q

What is the closed-packed position for the hip?

A

Extension, IR, and ABD

22
Q

What is the capsular pattern for the hip?

A

Flexion, ABD, IR

23
Q

What are the forces on the hip while standing? Standing on one limb?

A
  1. 3 times body weight

2. 4 - 2.6 times body weight

24
Q

What are the forces on the hip while walking? Walking up the stairs? Running?

A

1.3 - 5.8 times body weight
3 times body weight
4.5 + times body weight

25
Q

Normal ROM and End-Feel for:

Flexion

A

110-120, tissue approximation or tissue stretch

26
Q

Normal ROM and End-Feel for:

Extension

A

10-15, tissue stretch

27
Q

Normal ROM and End-Feel for:

Abduction

A

30-50, tissue stretch

28
Q

Normal ROM and End-Feel for:

Adduction

A

25-30, tissue approximation or tissue stretch

29
Q

Normal ROM and End-Feel for:

External Rotation

A

40-60, tissue stretch

30
Q

Normal ROM and End-Feel for:

Internal Rotation

A

30-40, tissue stretch

31
Q

What is the normal angle of inclination?

A

125-130

32
Q

In coxa valga, a ______ in the inclination angle causes the femoral head to be directed more _______ in the acetabulum.

A

increase, superiorly

33
Q

What effects does coxa valga have on the available weight bearing surface? Overall leg length?

A

Decreases, results in increased stress applied across joint surface
Increases leg length, impacting other components of the kinematic chains

34
Q

What mechanical disadvantages occur due to coxa valga?

A

Hip abductors are at a disadvantage because there is a shortened moment arm. Hip abductors must contract more vigorously producing increased joint reaction forces

35
Q

In coxa vara, a _______ in the inclination angle causes the femoral head to be directed more ______ in the acetabulum.

A

Decrease, horizontal

36
Q

Coxa vara: _______ in downward shear forces on the femoral head, _______ in joint compression forces.

A

Increase, decrease

37
Q

What is the angle of torsion?

A

Rotation that exists between the shaft and the neck of the femur

38
Q

What is the normal angle of torsion?

A

8-15 anterior to the mediolateral axis to the femoral condyles

39
Q

What measurement qualifies anteversion? What is this associated with?

A

35, patient usually have more hip IR than ER and toe-in

40
Q

What measurement qualifies retroversion? What is this associated with?

A

Less than 5, patients usually have more hip ER than IR and toe-out

41
Q

Force Couples of the Hip for Posterior Tilt

A

Rectus abdominis and external obliques

Gluteus maximus and hamstrings

42
Q

What tests and measures are used for the hip?

A

Observation, AROM/PROM, MMTs, Gait, Loading Tests, High Step, Unilateral Stance

43
Q

What must be palpated?

A

ASIS, Pubic tubercle, iliac crest, greater trochanter, PSIS, ischial tuberosity, sciatic nerve

44
Q

What are the goals of the acute phase?

A

Protection of the injury site
Decreased pain/inflammation
Restore pain free ROM in entire kinematic chain
Improvement of pt comfort by decreasing pain/inflammation
Retardation of muscle atrophy
Min of detrimental effects of immobilization and activity restriction
Scar management, if appropriate
Maintenance of general fitness
Independence with HEP

45
Q

What are the functional goals?

A 
Restore normal joint kinematics
Attain full, pain free AROM
Improving muscle strength WNL
Improving neuromuscular control
Restore the normal strength and relationship if the muscle force couples

Musculoskeletal Exam 4 (3 decks)

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