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OCS Cards > Hip > Flashcards

Hip Flashcards

1
Q

What landmark serves as inferior attachment for rectus abdominis, superior attachment for adductor longus?

A

Pubic tubercle

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2
Q

What is the attachment site of pectineus which can generate groin pain?

A

Pectin pubis

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3
Q

What is the typical site of a trauamtic avulsion of adductor magnus?

A

Ischial ramus and tuberosity / sits bones

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4
Q

What directions does the socket face in normal alignment?

A

Anteriorly, laterally and inferiorly

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5
Q

What angle does the hip start at with birth and then is reduced to by adulthood with WB? (Frontal angle)

A

150 deg to 120-130 deg

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6
Q

Which angulation of the hip is defined as < 120 deg in the frontal plane?

A

Coxa varus

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7
Q

Which angulation of the hip is defined as > 120 deg in the frontal plane?

A

Coxa valgus

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8
Q

In the transverse plane, where does the hip start in anterior rotation and then progress to with adulthood?

A

40 deg to approx 9 by adulthood (10-25 is considered normal)

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9
Q

What is referred to as excessive anterior rotation of the hip from the transverse plane?

A

Anteversion - toe in gait

ANTE IN

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10
Q

With Craig’s test, is medial or lateral rotation normal?

A

8-15 deg of medial/internal rotation = normal anteversion

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11
Q

With Craig’s test, if one finds neutral to more ER with centering the femur, is this anteverted or retroverted alignment?

A

Retroverted

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12
Q

True/false: the deep fibers of glute max attach on the shaft of the femur.

A

True - attaches on gluteal tubercle/tuberosity

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13
Q

What lies at the center of the head of the femur?

A

Teres ligament - neurovascular supply

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14
Q

Is the entire head of the femur covered by hyaline cartilage?

A

No; center head/teres ligament region is not

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15
Q

Where does the femoral head have the greatest contact in the acetabulum during WB?

A

Anterior and posterior walls - greatest amt of cartilage here

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16
Q

Does a dysplastic/shallow socket or a deep socket of the acetabulum result in ligamentous laxity?

A

Dysplastic/shallow socket

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17
Q

How is the labrum vascularized? (inner vs outer)

A

Similar to meniscus, outer edge well vascularized where inner is much less

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18
Q

Which region of the labrum is not well vascularized and can result in more traumatic and degenerative tears?

A

Superior portion

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19
Q

Does the labrum have sensory endings?

A

Yes - proprioceptive endings

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20
Q

Which ligament has two branches, pars inferioris and pars superioris?

A

Iliofemoral or Y ligament

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21
Q

What motions does the Y ligament restrict?

A

Extension, adduction, ER

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22
Q

In the transverse fiber system of the joint capsule, the circular encasement around the neck forms what aspect of the joint capsule?

A

Zona orbicularis - large stability factor in the hip joint

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23
Q

What motion does the pubofemoral ligament restrict?

A

Abduction, ER - contributes to extension (anterior positioning)

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24
Q

What direction / activity is the ischiofemoral ligament taut in?

A

In the upright position with quiet standing

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25
Q

What are the two main directions the hip can be dislocated into?

A

Anterior/inferior - posterior

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26
Q

Where does a Hill Sachs lesion occur in the hip?

A

Posterior to posterlateral region of the femoral head

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27
Q

What two muscles have contributing fibers to the conjoint tendon?

A

Internal oblique and transversus abdominis

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28
Q

What muscle contributes to the inguinal canal via its aponeurosis?

A

External oblique

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29
Q

The pubic symphysis is innervated in anterior / posterior fashion by which two groups of nerves?

A

Anteriorly by L2-4 (referred groin pain with lumbar)

Posterior by S3-S5 (referral to genital region)

30
Q

Pathomechanically, is there more force on the hip joint with a larger degree of anteversion or retroversion?

A

Anteversion - femoral surface experiences majority of pressure on superolateral surface

31
Q

What direction does the force on the acetabulum shift from and then to with gait?

A

IC/landing is posterolateral surface to propulsion on the anterolateral surface

32
Q

What are three pathological indicators for labral tears and/or loose bodies?

A

1) sharp pain
2) giving way
3) catching/clicking
4) locking

33
Q

What are differential diagnoses for groin pain with 1) coughing 2) sneezing 3) straining?

A

Hernia, pubic symphyseal afflication, tendinopathy of adductor magnus/rectus abdominis

34
Q

How many provocation tests need to be positive to include SIJ as potential diagnosis?

A

3

35
Q

Name the SIJ provocation tests - which is most sensitive, which is most specific?

A

1) SIJ distraction **most specific
2) SIJ compression
3) Thigh thrust ** most sensitive
4) Gaenslens
5) FABER
6) sacral thrust
7) ASLR

36
Q

When is the ASLR considered positive?

A

When patient feels weakness and/or pain that limits ability to adequately complete maneuver (lift at least 8 inches/20 cm) -> clinician applies compression to innominates and will result improved ability and less pain

37
Q

What isometric force should be applied to identify adductor longus and/or gracilis tendinopathy?

A

Hip in 0 deg flexion with adduction

38
Q

What isometric force should be applied to identify tendinopathy of the symphysis pubis?

A

Hip in 45 deg of flexion with adduction

39
Q

What isometric force should be applied to to identify tendinopathy of the pectineus muscle?

A

Hip in 90 deg flexion with adduction

40
Q

What is the capsular pattern for the hip OA?

A

IR > flexion > extension > abduction (variability with flex, exten, abd)

41
Q

What are the 5 predictor variables for OA for the hip?

A

1) self-reported pain with squatting
2) active hip flexion causes lateral hip pain
3) scour test with adduction causes lateral hip/groin pain
4) active hip extension causes pain
5) passive IR = 25 deg **biggest predictor
3 of 5 variables necessary

42
Q

Which gender has more severe cases of hip OA?

A

Women > men

43
Q

What two factors are predictors of good ambulation after THA?

A

Preoperative hip abduction and knee extension strength

44
Q

What is the Drehmann sign?

A

Obligatory abduction and ER with passive hip flexion

45
Q

What age group and gender is more greatly affected by SCFE?

A

Males > females (2:1)

13-15

46
Q

What disease is defined as aseptic bone necrosis of the femoral head, occurring between ages of 3-10?

A

Legg-Calve-Perthes Disease

47
Q

What is the clinical triad for labral tears?

A

1) pathological endfeel
2) sharp shooting pains
3) feeling of giving way

48
Q

What manual therapy technique is effective for management of loose bodies of any type?

A

High velocity traction/rotation mobilization/manipulation

49
Q

Which tendinous groups are prone to developing adaptive shortening causing limitations in ROM?

A

Myositis ossificans affects iliopsoas and adductors

50
Q

What is a noncapsular pattern of limitation with concurrent painful limited passive flexion with the knee extended/flexed?

A

Sign of the buttock - red flag for hip trauma/tumor/cancer etc

51
Q

Name 5 cancers which commonly metastasize to the hip/pelvis?

A

1) prostate
2) breast
3) renal cell
4) thyroid
5) lung

52
Q

Where is intraarticular snapping hip syndrome found?

A

Iliopsoas snapping over iliopectineal eminece

53
Q

Where is extraarticular snapping hip syndrome found?

A

Thickening of ITB at greater trochanter, iliopsoas at pectin pubis, glute max fibrosis in posterior hip, hamstring at ischial tuberoisty

54
Q

What muscular avulsion can lead to a labral tear?

A

Rectus femoris

55
Q

What is the biggest difference in assessment between hamstring pain and hamstring syndrome?

A

Resisted knee flexion in prone is pan free with hamstring syndrome, neural/dural assessment will be positive in syndrome

56
Q

What may persistent bursitis of the greater trochanter of the hip progress to in terms of diagnosis?

A

Calcific tendonitis of glute med

57
Q

What position is the hip put in for the Hip Lag Sign to be positive?

A

Sidelying; affected hip on top - 10 deg extension, 20 deg abduction, maximal IR with 45 deg of knee flexion - drops greater than 10 cm = positive

58
Q

What diagnosis is consistent with pain or burning in the perineal area that worsens with sitting, improves with standing?

A

Pudendal nerve entrapment

59
Q

What are three contributing factors for pudendal nerve entrapment?

A

Childbirth
Pelvic surgery
Bicycling (narrow saddle pressure)

60
Q

What MMT is valid, sensitive, specific to include a diagnosis of the pubic region?

A

Bilat resisted hip adduction

61
Q

How does one rule in/out a rectus abdominis strain with pain in groin region?

A

Perform resisted trunk flexion in supine

62
Q

In cases of symphyseal separation, how can one MMT to aid with ruling in this diagnosis?

A

Resisted hip adduction with hip in 45 deg of flexion

63
Q

What is the weakening or a tear in the transversalis fascia, conjoined tendon and/or internal oblique fibers?

A

Sports man’s hernia - athletica pubalgia

64
Q

What way is a sports man’s hernia/athletica pubalgia exacerbate?

A

Valsalva or exertion

65
Q

Where do most labral lesions occur due to compromised mechanical properties?

A

Anterior superior - posterior superior

Superior region

66
Q

Which form of FAI is due to a nonspherical femoral head/neck relationship?

A

CAM

67
Q

What form of FAI is due to too much acetabular coverage, causing pinching of the labrum between the rim and socket?

A

Pincer

68
Q

What form of FAI is typically associated with retroversion / profunda or protrusion?

A

Pincer

69
Q

Stress fractures are clinically diagnosed with three tests:

A

1) WB pain and NWB pain relief
2) One legged hop test
3) Fulcrum test: clinician exerts progressive downward force to distal thigh with forearm under proximal thigh - reproduce sxs

70
Q

Meralgia paresthetica is due to what cutaneous nerve entrapment?

A

Lateral femoral cutaneous - local and projected pain with sensory changes in the lateral thigh and knee

OCS Cards (23 decks)

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