Hip Flashcards
What is the primary function of the hip?
To support the weight of the body
Structurally, the hip is suited for _______ first, then _______.
Stability, mobility
What are the muscles that attach to the ischial tuberosity?
Semimembranosus Semitendinosus LH of Biceps Femoris Adductor Magnus Quadratus Femoris Gemellus Inferior
Which way does the acetabulum face?
Laterally, inferiorly and anteriorly
What is the function of the acetabular labrum?
Further deepens the cavity and grasps the head of the femur
Which way is the head of the femur angled?
Medially, superiorly and anteriorly
Which way is the femoral neck oriented in respect to the shaft?
Externally rotated
Which muscles attach to the greater trochanter?
Piriformis
Gluteus medius, minimus
Obturator internus
Gemellus superior, inferior
Where is the articular cartilage and joint capsule thickest?
Anterosuperiorly, where maximal stress and weight bearing occurs
Where does the joint capsule attach posteriorly?
the lateral one-third of the femoral neck
Where does the joint capsule attach laterally?
over the femoral head and neck to attach to the intertrochanteric line anteriorly
Where does the joint capsule attach proximally?
to the pelvis, just lateral to the acetabular labrum
Which ligament is the strongest?
Iliofemoral ligament
Which ligament is the weakest?
Ischiofemoral ligament
Which ligament is tight with extension? Which limits it?
Ischiofemoral ligament, Pubofemoral ligament
Which prevents excess abduction?
Pubofemoral ligament
Which ligament is “Y” shaped?
Illiofemoral
What are the 3 bursae of the hip?
Iliopsoas bursa, trochanteric bursa, ischiogluteal bursa
What is contained within the femoral triangle?
Femoral nerve, artery and vein
Lymphatics
What is the resting position for the hip joint?
30 flexion, 30 ABD, slight ER
What is the closed-packed position for the hip?
Extension, IR, and ABD
What is the capsular pattern for the hip?
Flexion, ABD, IR
What are the forces on the hip while standing? Standing on one limb?
- 3 times body weight
2. 4 - 2.6 times body weight
What are the forces on the hip while walking? Walking up the stairs? Running?
1.3 - 5.8 times body weight
3 times body weight
4.5 + times body weight
Normal ROM and End-Feel for:
Flexion
110-120, tissue approximation or tissue stretch
Normal ROM and End-Feel for:
Extension
10-15, tissue stretch
Normal ROM and End-Feel for:
Abduction
30-50, tissue stretch
Normal ROM and End-Feel for:
Adduction
25-30, tissue approximation or tissue stretch
Normal ROM and End-Feel for:
External Rotation
40-60, tissue stretch
Normal ROM and End-Feel for:
Internal Rotation
30-40, tissue stretch
What is the normal angle of inclination?
125-130
In coxa valga, a ______ in the inclination angle causes the femoral head to be directed more _______ in the acetabulum.
increase, superiorly
What effects does coxa valga have on the available weight bearing surface? Overall leg length?
Decreases, results in increased stress applied across joint surface
Increases leg length, impacting other components of the kinematic chains
What mechanical disadvantages occur due to coxa valga?
Hip abductors are at a disadvantage because there is a shortened moment arm. Hip abductors must contract more vigorously producing increased joint reaction forces
In coxa vara, a _______ in the inclination angle causes the femoral head to be directed more ______ in the acetabulum.
Decrease, horizontal
Coxa vara: _______ in downward shear forces on the femoral head, _______ in joint compression forces.
Increase, decrease
What is the angle of torsion?
Rotation that exists between the shaft and the neck of the femur
What is the normal angle of torsion?
8-15 anterior to the mediolateral axis to the femoral condyles
What measurement qualifies anteversion? What is this associated with?
35, patient usually have more hip IR than ER and toe-in
What measurement qualifies retroversion? What is this associated with?
Less than 5, patients usually have more hip ER than IR and toe-out
Force Couples of the Hip for Posterior Tilt
Rectus abdominis and external obliques
Gluteus maximus and hamstrings
What tests and measures are used for the hip?
Observation, AROM/PROM, MMTs, Gait, Loading Tests, High Step, Unilateral Stance
What must be palpated?
ASIS, Pubic tubercle, iliac crest, greater trochanter, PSIS, ischial tuberosity, sciatic nerve
What are the goals of the acute phase?
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
What are the functional goals?
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
