Hip Flashcards
What does play a secondary role in stabilizing hip?
acetabular labrum, during lateral rotation while preventing anterior translation
weakest of the 3 of the AF joint ligament?
ischiofemoral ligament, helping stabilize the hip in extension
what does pubofemoral ligament do?
prevents excessive abduction of the femur and limits extension.
AF joint resting, close pack and capsular pattern
30 flexion, 30 abduction, slight lateral rotation
Full extension, medial rotation and abduction
Flexion, abduction, medial rotation
what is the name of the ligament attached to the head of femur
ligamentum teres
dull, deep, aching hip pain
arthritis, paget disease
sharp, intense, sudden, associated with weight bearing
fracture
tingling that radiates
radiculopathy, spinal stenosis, meralgia paresthetica
Increased pain while sitting with the affected leg crossed
trochanteric bursitis
pain at sitting, legs not crossed
Ishiogluteal bursitis
pain after standing, walking
Hip arthrosis
Pain on attempted weight bearing
occult fracture, severe arthrosis
unremitting long duration
paget disease, metastatic carcinoma, severe arthrosis
internal snapping of hip
slipping of the iliopsoas tendon over the osseous ridge of the lessoer trochanter or anterior acetabulum or iliofemoral ligament may be riding ovver the femoral head.
Iliopsoas tendon snapping, iliofemoral ligament snapping, hamstring syndrome, iliopsoas bursal/capsular thickening
Snapping hip sign test
or extension test
snapping occur at45 degree when flexed hip from flexion moving to extension with abduction and laterally rotation. snap can be palpated anteriorly in the inguinal region
external snapping of the hip
tight iliotibial band or gluteus maximus tendon riding over the greater trochanter of the femur. This can be felt more lateral, during hip flexion and extension, especially if the hip is held in medial rotation.
Posterior iliotibial band, anterior gluteus maximus, trochanteric bursitis
intra articular snapping
Labral or ligmentum tears, loose bodies, synovial chondromatosis, displaced fractures, capsular instability
normally 20-40 years old, a sharp pain into the groin and anterior thigh especially on pivot movement.
trochanteric bursitis
abnormal running mechaics with the feet crossing midline, wide pelvis and genu valgum or running on tracks with no banking
CDH stands for
Congenital dislocation of the hip
Hip scour test is as known as
quadrant or scouring test, to check irregularity in the movement, apprehension, etc. This also causes impingement of the femoral neck against the acetabular rim and pinches the adductor longus, pectineus, iliopsoas, sartorius, TFL
FEBER is AKA
Patrick’s test, Figure 4 test, Jansen’s test. Positive is knee above other knee, indicates iliopsoas spasm, SI joint pathology
Anterior Labral Tear test AKA
FADDIR (Flexion, adduction and internal rotation test, anterior apprehension test. Test for anterior-superior impingement syndrome, anterior labial tear, and iliopsoas tendinitis.
+Pain, reproduction of the sx, with or without click or apprehension
coxa vera
less than 120 degree
coxa valga
more than 135 degree
popliteal angle
The angle along the shaft of femur crossing along the shaft of tibia (hamstring tightness). Les than 125 degree, hamstrings were considered to be tight
sciatic nerve lesion Sx
high steppage gait with an inability to stand on the heel or toes. Sensory altration in the entire foot except instep and medial malleolus along with mm atrophy.
Piriformis sx is called
sign of Pace and Nagel (paoin and weakeness on abduction and lateral rotation of the hip). Burning pain and hyperesthesia may be felt in the sacral and or gluteal region as well as in the sciatic nerve distribution
The pain on passive medial rotation of the extended hip is called
Freiberg sign (piriformis)
Superior gluteal nerve
L4 to S1
compressed between Piriformis and inferior border of gluteus minimus muscle
Acute gluteal pain that increases with ambulation. Hip is often medially rotated and there is weakness of the hip abductors, resulting in a Trendelenburg gait Tenderness may be palpated just lateral to the greater sciatic notch
Femoral nerve
L2 to L4
Compressed during childbirth or with anterior dislocation of the femur or may be traumatized during hernia surgery, stripping of varicose veins, hip surgery or fractures
not able to flex the thigh on the trunk or extend the knee, deep tendon reflex is lost, wasting of the quad is most evident, sensory loss of medial aspect of distal thigh (anterior femoral cutaneous nerve) and medial aspect of the leg and foot (saphenous nerve)
Obturator nerve
L2 to L4 may be compressed as it leaves the pelvis and enters the leg in the obturator tunnel. Injury to the nerve may be caused by pelvic or hip surgery, pregnancy (obstetric palsy) fractures, tumors cause of groin pain in athletes. Adduction, knee flexion (gracilis), lateral rotation (obturator externus) affected. Sensory deficit is small, middle medial part of the thigh, may be from sysmphysis pubis to medial aspect of the knee
hip pointer
a strain or contusion of muscles that insert into the crest (athletes)
clinical prediction role for hip osteoarthritis
- limited active hip flexion with lateral hip pain
- active hip extension causes pain
- Limited passive hip medial rotation (25% or less)
- squatting limited and painful
- scour test with adduction causes lateral hip or groin pain
Strongest ligament of the body and what it does
iliofemoral ligament (Y ligament of Bigelow), prevent excessive extension and significant role in stabilizing and maintaining upright posture at the hip while limiting anterior translation.
