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Biomechanics > Hip > Flashcards

Hip Flashcards

1
Q

Hip is union of what 3 bones?

A
  • ilium
  • pubis
  • ischium
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2
Q

Pelvis is referred to as?

A

osteoligamentous ring,

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3
Q

What 3 functions is the pelvis associated with?

A
  1. common attachment point for large muscles of lower extremity and trunk
  2. transmits weight of upper body and trunk to ischial tuberosities during sitting or to lower extremities during standing and walking
  3. supports organs involved with bowel, bladder and productive function
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4
Q

Shaft of femur displays slight:

A

anterior convexity

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5
Q

The stress along femur is dissipated through:

A

compression alongs its posterior shaft and through tension along its anterior shft

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6
Q

Bowing of femur allows:

A

femur to bear greater load than if femur were perfectly straight

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7
Q

What is the shape and configuration of developing proximal femur detemined by:

A
  1. differential growth of bone’s ossification centers
  2. force of muscle activation and weight bearing
  3. circulation
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8
Q

What is femoral dysplasia?

A

Abnormal growth and development resulting in mis-shaped proximal femur

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9
Q

What can affect the shape of proximal femur?

A

trauma or other acquired factors

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10
Q

What angulations of proximal femur define its shape:

A
  • angle of inclination

- torsional angle

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11
Q

What is the angle of inclination?

A

angle within frontal plane b/w femoral neck and medial side of femoral shaft

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12
Q

What is the angle of inclination at birth?

A

140 to 150 degrees

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13
Q

What is the normal adult angle of inclination?

A

125 degrees

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14
Q

Cox vara:

A

less than 125 degrees

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15
Q

Cox valga:

A

greater than 125 degrees

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16
Q

What does angle of inclination affect?

A

alters articulation between femoral head and acetabulum affecting hip mechanics

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17
Q

What can severe malalignment lead to?

A

dislocation or stress-induced degeneration of hip joint

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18
Q

What does femoral torsion describe?

A

relative rotation between bone’s shaft and neck

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19
Q

What is normal view of femoral neck?

A

from above, femoral neck projects about 15 degrees anterior to a ML axis through femoral condyles

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20
Q

What is normal anteversion?

A

femoral neck projects about 15° anterior to a ML axis through femoral condyles

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21
Q

What does normal anteversion and angle of inclination afford?

A

optimal alignment and joint congruence

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22
Q

Angle of torsion between neck and shaft of femur can be:

A
  1. normal anteversion
  2. excessive anteversion
  3. retroversion
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23
Q

What can excessive anteversion increase?

A

the likelihood of hip dislocation, articular incongruence, increased joint contact force and increased wear on articular cartilage
*all can lead to OA of hip

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24
Q

What can excessive anteversion in children lead to?

A

abnormal gait pattern called in-toeing

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25
Q

What is in-toeing?

A

a walking pattern with exaggerated posturing of hip internal rotation

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26
Q

What is the amount of in-toeing related to?

A

amount of femoral anteversion

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27
Q

In-toeing is a:

A

compensatory mechanism used to guide excessively anteverted femoral head more directly into acetabulum

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28
Q

Internal rotated position can lead to:

A

shortening of internal rotator muscles and ligaments

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29
Q

Shortening of internal rotator muscles and ligaments can reduce:

A

external rotation and ROM

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30
Q

What is seen in persons with cerebral palsy?

A

excessive femoral anteversion of 25-45 degrees

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31
Q

In anatomic position, how does the acetabulum project?

A

laterally from the pelvis with varying amount of inferior and anterior tilt

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32
Q

What are the two measurements used to describe extend to which acetabulum naturally covers and helps secure femoral head:

A
  1. center-edge angle

2. acetabular anteversion angle

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33
Q

A malshaped, dysplastic acetabulum that does not adequately cover femoral head can lead to what?

A

to chronic dislocation and ↑ stress, often leading to degeneration or OA

34
Q

What is the average center-edge angle?

A

35 degrees in radiograph of adults

35
Q

A lower central-edge angle does what?

A

decreases acetabular coverage of femoral head

36
Q

What does reduced acetabular coverage increase?

A

the risk of dislocation and decreases contact area within joint

37
Q

A center-edge angle of only 15 degrees:

A

reduces normal contact area by as much as 35%

38
Q

Acetabular anteversion angle measures:

A

extent to which acetabulum projects anteriorly within horizontal plane, relative to pelvis

39
Q

What is the normal acetabular anteversion angle?

A

about 20 degrees

40
Q

A hip demonstrating excessive acetabular anteversion is more exposed:

A

anteriorly

41
Q

When anteversion is severe:

A

hip is more prone to anterior dislocation and associated lesions of anterior labrum, especially at extremes of external rotation

42
Q

What is retroverted?

A

An acetabulum that projects directly laterally, or even slightly posterior-laterally, within horizontal plane

43
Q

What is taut in end range hip flexion (knee extended)

A

hamstrings

44
Q

What is taut in end range hip flexion (knee flexed)

A

inferior and posterior capsule; gluteus maximus

45
Q

What is taut in end range hip extension (knee extended)?

A

Primarily iliofemoral ligament, some fibers of the pubofemoral and ischiofemoral ligaments; psoas majo

46
Q

What is taut in end range hip extension (knee flexed)?

A

rectus femoris

47
Q

What is taut in end range abduction?

A

pubofemoral ligament; adductor muscles

48
Q

What is taut in end range adduction?

A

Superior fibers of ischiofemoral ligament; iliotibial band; and abductor muscles such as the tensor fasciae latae and gluteus medius

49
Q

What is taut in end range internal rotation?

A

Ischiofemoral ligament; external rotator muscles, such as the piriformis or gluteus maximus

50
Q

What is taut in end range external rotation?

A

Iliofemoral and pubofemoral ligaments; internal rotator muscles, such as the tensor fasciae latae or gluteus minimus

51
Q

What twists fibers within capsular ligaments to their most taut position?

A

full extension of hip, in conjunction with slight internal rotation and slight abduction

52
Q

What is full extension of the hip?

A

about 20 degrees beyond neutral position

53
Q

What is the close-packed position of the hip?

A

full extension, slight internal rotation and abduction

54
Q

The closed packed position elongates what?

A

most of the capsule

55
Q

What position is useful therapeutically during attempts to stretch entirety of hip’s capsular ligaments?

A

full hip extension, with slight internal rotation and slight abduction

56
Q

True or False: the hip is associated with position of maximal joint congruency

57
Q

When are the hip joint surfaces most congruently fit?

A

in about 90 degrees of flexion with moderate abduction and external rotation
-most of capsule and associated ligaments have unraveled to more slackened state, adding only little passive tension to joint

58
Q

Femoral on pelvic describes:

A

rotation of femur about a relatively fixed pelvis

59
Q

Pelvic on femoral describes:

A

rotation of pelvis, and often superimposed trunk, over relatively fixed femurs

60
Q

Flexion and extension occur in what plane?

A

sagittal (ML AOR)

61
Q

Abduction and adduction occur in what plane?

A

frontal plane (AP AOR)

62
Q

Internal and external rotation occur in what plane?

A

horizontal plane (vertical AOR)

63
Q

Femoral on pelvic movement?

A

convex on concave (opposite directions)

64
Q

How is the caudal end ox axial skeleton attached to pelvis?

65
Q

What is lumopelvic rhythm?

A

rotation of pelvis over femoral heads typically changes configuration of lumbar spine

66
Q

What is Ipsidirectional lumbopelvic rhythm?

A

pelvis and lumbar spine rotate in same direction

67
Q

What is the effect of ipsidirectional lumbopelvic rhythm?

A

maximize angular displacement of entire trunk relative to lower extremities—an effective strategy for increasing reach of upper extremities

68
Q

What happens during contradirectional lumbopevic rhythm?

A

pelvis rotates in one direction while lumbar spine simultaneously rotates in opposite direction

69
Q

Pelvic on femoral movement?

A

concave on convex-movement on same direction

70
Q

Primary hip flexors:

A 
Iliopsoas
Sartorius
Tensor fasciae latae
Rectus femoris
Adductor longus
Pectineus
71
Q

Primary hip adductors:

A 
Pectineus
Adductor longus
Gracilis
Adductor brevis
Adductor magnus
72
Q

Secondary hip flexors:

A

Adductor brevis
Gracilis
Gluteus minimus (anterior fibers)

73
Q

Secondary hip adductors

A 
Biceps femoris (long head)
Gluteus maximus (lower fibers)
Quadratus femoris
74
Q

Secondary hip internal rotators:

A 
Gluteus minimus (anterior fibers)
Gluteus medius (anterior fibers)
Tensor fasciae latae
Adductor longus
Adductor brevis
Pectineus
75
Q

Primary hip extensors

A 
Gluteus maximus
Biceps femoris (long head)
Semitendinosus
Semimembranosus
Adductor magnus (posterior head)
76
Q

Primary hip abductors

A

Gluteus medius
Gluteus minimus
Tensor fasciae latae

77
Q

Primary hip external rotators

A 
Gluteus maximus
Piriformis
Obturator internus
Gemellus superior
Gemellus inferior
Quadratus femoris
78
Q

Secondary hip extensors

A 
Gluteus medius (posterior fibers)
Adductor magnus (anterior head)
79
Q

Secondary hip abductors

A

Piriformis

Sartorius

80
Q

Secondary hip external rotators

A 
Gluteus medius (posterior fibers)
Gluteus minimus (posterior fibers)
Obturator externus
Sartorius
Biceps femoris (long head)

Biomechanics (13 decks)

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