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PTRS 745 Exam 2 > Hip > Flashcards

Hip Flashcards

1
Q

Q: Describe the transfer of forces in the hip.

A

From sacrum to pelvis to femur

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2
Q

Diagram: Articular Structures of the Hip (2)

A

Labrum, and synovial fluid act like shock absorber

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3
Q

Diagram: Ligament Structures of the Hip

A

Iliofemoral ligament = one of strongest in the body (with the help of the labrum)

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4
Q

Diagram: Posterior Musculature of the Hip (6)

A

Large muscles used for movement (walking)

Deep muscles:

  • mimic RC
  • hold you in extension to keep femoral head in socket
  • Can cause a posterior tilt
  • ER that act as extensors when contract together
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5
Q

Diagram: Anterior Musculature of the Hip (2)

A

All the adductors (which also do IR)

Constantly contracted, can effect posture - anterior tilt

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6
Q

Q: Which set of muscule balance the hip?

A

ER and IR

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7
Q

Content: External Rotators (6)

A
  1. Piriformis (< 60 degrees)
  2. Superior/inferior gemellus
  3. Obturator internus/externus
  4. Quadratus femoris
  5. Gluteus maximus
  6. Gluteus medius/minimus (flexed)
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8
Q

Q: Which ER might become tight and then weak and cause posterior tilt? (5)

A
  1. Superior gemellus
  2. Obturator internus
  3. Inferior gemellus
  4. Obturator externus
  5. Quadratus femoris
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9
Q

Content: Internal Rotators (8)

A
  1. Piriformis (at 90)
  2. Semitendinosus
  3. Semimembranosus
  4. Adductors
  5. Pectineus
  6. Tensor fasica latae
  7. Gluteus medius (extended)
  8. Gluteus minimus (extended)
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10
Q

Diagram: Bursae of the Hip (2)

A

Ischial and Iliopsoas

Ischial = can be inflammed with prolonged sitting/trauma

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11
Q

Q: How much flexion can be appreciated at the hip?

A

110-120 degrees

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12
Q

Q: How much extension can be appreciated at the hip?

A

10-15 degrees

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13
Q

Q: How much abduction can be appreciated at the hip?

A

30-50 degrees

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14
Q

Q: How much adduction can be appreciated at the hip?

A

30

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15
Q

Q: How much external rotation can be appreciated at the hip?

A

40-60 degrees

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16
Q

Q: How much internal rotation can be appreciated at the hip?

A

30-40 degrees

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17
Q

Q: Describe the roll and glide with hip flexion.

A

R = anterior

G = posterior

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18
Q

Q: Describe the roll and glide with hip extension.

A

R = posterior

G = anterior

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19
Q

Q: Describe the roll and glide with hip abduction

A

R = lateral (superior)

G = inferior

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20
Q

Q: Describe the roll and glide with hip adduction

A

R = medial (inferior)

G = superior

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21
Q

Q: Describe the roll and glide with hip IR.

A

R = medial (anterior)

G = posterior

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22
Q

Q: Describe the roll and glide with hip ER.

A

R = lateral (posterior)

G = anterior

23
Q

Q: Which hip motions have an end feel of tissue approximation (or stretch)? (2)

A
  1. Flexion
  2. Adduction
24
Q

Q: Which hip motions have an end feel of tissue stretch? (4)

A
  1. Extension
  2. Abduction
  3. IR
  4. ER
25
Q

Q: What functional range is required for shoe tying?

A

120 of flexion

26
Q

Q: What functional range is required for sitting (average seat height)?

A

112 of flexion

27
Q

Q: What functional range is required for stooping?

A

125 of flexion

28
Q

Q: What functional range is required for squatting?

A

115 of flexion

20 of abduction

20 of IR

29
Q

Q: What functional range is required for ascending stairs (average stair height)

A

67 of flexion

30
Q

Q: What functional range is required for descending stairs (average stair height)?

A

36 of flexion

31
Q

Q: What functional range is required for putting foot on opposite thigh?

A

120 of flexion

20 of abduction

20 of ER

32
Q

Q: What functional range is required for putting on pants?

A

90 of flexion

33
Q

Content: 3 types of femoral head orentation

A
  1. Coxa valgus
  2. Coxa varus
  3. Anteversion
34
Q

Content: Coxa valgus (4)

A
  1. Increase joint reaction force
  2. Muscles in mechanical disadvantage
  3. Modify angle at knee joint
  4. ~170 (greater than norm of 125)
35
Q

Content: Coxa varus (4)

A
  1. Decrease joint reaction force
  2. Increase the shear forces on the femoral head/neck
  3. Damage at the epiphyseal plate
  4. ~ 100 (less than norm of 125)
36
Q

Diagram: Coxa valugs and varus

A
37
Q

Q: What is normal femoral anteversion?

A

8-15 degrees

38
Q

Diagram: Hip Anteversion/Retroversion (2)

A

Anterversion = Increasing medial femoral torsion

Retroversion = Increasing lateral femoral torsion

39
Q

Q: What test is used to measure femoral anteversion?

A

Craig’s test

40
Q

Content: SE (for Hip) (4)

A
  1. Profile
  2. Location/distribution pain (body chart)
  3. Behavior of symptoms (agg./easing)
  4. Hx (injury/insidious)
41
Q

Content: OE (for Hip) (6)

A
  1. Observation
  2. Palpation
  3. AROM/PROM
  4. Length
  5. Strength
  6. Special tests
42
Q

Q: What are the degenerative changes seen in OA? (3)

A
  1. Articular cartilage break down/loss
  2. Capsular fibrosis
  3. Osteophyte formation on the joint margins
43
Q

Term: The shortest distance between the femoral head margin and the acetabulum

A

Minimal joint space

44
Q

Q: What is normal and hip OA joint space (in mm)?

A

Norm = ~4.5

Hip OA = < or equal to 2.5

45
Q

Content: Kellgren and Lawrence scale for Osteoarthritis (4)

A

Grade 1 = Doubtful narrowing of joint space and possible osteophytic lipping

Grade 2 = Definite osteophytes, definite narrowing of joint space

Grade 3 = Multiple moderate osteophyites, definites joint space narrowing, some sclerosis and possible deformity of contour

Grae 4 = Large osteophytes, marked joint space narrowing, severe sclerosis, and definited deformity of bone contour

46
Q

Diagram: Nonpharmacologic recommendations for the management of hip osteoarthritis (from the american college of RA)

A

Recommend: aerobic exercise, weight loss

Conditionally recommended: self manage, manual therapy, supervised exercise, thermal agents, walking aids

Not recommended: balance + strength, tai chi, manual therapy alone

47
Q

T/F: The optimal OA treatment program should consist of both medications and non-drug treatments.

A

True

48
Q

Content: Non-drug treatments for OA (11 - general idea)

A
  1. Education and self-management
  2. Reulgar telephone contact (promotting self-care)
  3. Physical therapy
  4. Aerobic, muscle strengthening and water-based exercises
  5. Weight loss
  6. Walking aids
  7. Footwear and insoles
  8. Knee braces (in case of OA)
  9. Heat and cold
  10. TENS
  11. Acupuncture
49
Q

T/F: Patients often see one health care provider and then receive a definitive diagnosis of a labral tear.

A

False: Seen by multiple health care providers before obtaining a definitive diangosis (can take 2 years)

50
Q

Content: Facts on Atraumatic Labral Tear (7)

  1. Gender
  2. Age
  3. Hx
  4. Pain
  5. Limp
  6. Dr’s seen
  7. Previous Dx
A
  1. 71% female
  2. Mean age = 38
  3. Typically no hx of trauma
  4. 86% in mod-severe pain
  5. 39% were limping
  6. On average has seen 3.3 practitioners over 21 mos
  7. Usually had diagnosis of “soft tissue injury”
51
Q

Content: OE for Labral Tears (5)

A
  1. Standing alignment: Posterior pelvic tilt and knee hyperextension
  2. Precision of both active/passive hip flexion
  3. In prone, pattern of hip extension (indicates relative participation of hmas and glute max)
  4. Muscle strength: hip ABD, glute max, iliopsoas, deep ER when not painful
  5. Gait with hyperEXT and ER
  6. Increased accessory/joint motion
52
Q

Content: Provocative Hip Tests (4)

A

lol “provocative”

  1. FABER test
  2. Scour test
  3. Resisted SLR (hip in 30 flexion)
  4. Flex-Add-IR (most appropriate for interior lesion = pain and clicking)
53
Q

Q: What is the normal angle of inclination of the femoral head?

A

125 degrees

PTRS 745 Exam 2 (12 decks)

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