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Kinesiology > Hip and Knee > Flashcards

Hip and Knee Flashcards

1
Q

What is the normal angle of inclination for the hip?

A

~125°

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2
Q

what is coxa valva?

A

pathological increased angle of inclination (>125°)

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3
Q

what is coxa vara?

A

pathological decreased angle of inclination (<125°)

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4
Q

what are some factors that can contribute to an increased risk of slipped capital femoral epiphysis?

A

high BMI
coxa vara

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5
Q

how does a high BMI and coxa vara increase the risk for slipped capital femoral epiphysis?

A

Coxa vara results in the head and neck being closer to a right angle which decreases the dispersion of force resulting in more force coming down onto the head of the femur. A high BMI enhances that because it is even more force coming down.

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6
Q

what is considered a normal degree of anteversion at the hip?

A

8-20°

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7
Q

excessive anteversion reduces _________

A

hip stability

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8
Q

what is excessive anteversion associated with? (mobility)

A

increased hip IR

decreased hip ER

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9
Q

excessive retroversion may cause __________

A

hip impingement

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10
Q

excess retroversion is associated with what? (mobility)

A

increased hip ER

decreased hip IR

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11
Q

List some common acetabular abnormalities

A
  1. acetabular dysplasia
  2. coxa profunda (acetabular over coverage)
  3. anteversion
  4. retroversion
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12
Q

what is a CAM lesion?

A

extra bone at anterior-superior region of femoral head and neck junction

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13
Q

what is a pincer deformity?

A

abnormal bony extension of anterior lateral rim of acetabulum

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14
Q

what motions would provoke an impingement with either a CAM lesion or a Pincer deformity?

A

Hip IR with flexion

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15
Q

List structures that support the hip

A
  1. strong joint capsule
  2. iliofemoral ligament
  3. pubofemoral ligament
  4. Ischiofemoral ligament
  5. transverse acetabular ligament
  6. acetabular labrum
  7. ligamentum teres
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16
Q

which ligaments of the hip provide protection to blood vessels?

A

transverse acetabular ligament

ligamentum teres

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17
Q

what is the trabecular system? Why do we have it?

A

it is a structural adaptation to weight bearing.

it allows us to provide structural resistance to bending force

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18
Q

where is the joint capsule strong and weak at the hip?

A

strong = anterosuperiorly

weak = posterior and inferiorly (dislocations are more common in these directions)

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19
Q

what is the role of the acetabular labrum?

A

since it is wedge shaped it deepens concavity and improves congruency at the hip

acts as a seal to maintain negative intraarticular pressure

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20
Q

what motion can potentially injury the ligamentum teres?

A

excessive ER can strain/potentially tear it

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21
Q

describe the arthrokinematics of the hip during an OKC motion

A

Convex on Concave

opposite roll and slide

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22
Q

describe the arthrokinematics of hip IR/ER during an OKC motion

A

IR = anterior roll, posterior glide

ER = posterio roll, anterior glide

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23
Q

describe the arthrokinematics of the pelvic during an CKC movement

A

Concave on Convex

roll and glide in same direction

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24
Q

What osteokinematic movements are available at the pelvis?

A

A/P pelvic tilt

lateral pelvic tilt (pelvic hike/drop)

Forward/backward rotation

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25
describe the motion of both the contralateral and ipsilateral femur when the pelvis is hiked to the R
ipsilateral (R) = adducted contralateral (L) = abducted
26
describe the motion of both the ipsilateral and contralateral femur when the pelvis drops to the R
ipsilateral (R) = abduction contralateral (L) = adduction
27
describe the open pack and capsular pattern of the hip joint
open pack = 30° flexion, 30° abduction, neutral to slight ER capsular pattern: equal loss of IR w/flexion and abduction
28
what muscles help with performing an anterior pelvic tilt?
hip flexors back extensors
29
what muscles help with performing a posterior pelvic tilt?
abdominal muscles hip extensors
30
T/F: when performing a single leg raise, your abdominals are not involved. Why/Why not?
FALSE abdominal wall muscles contract to neutralize the hip flexor's pull on the pelvis into an anterior tilt. This is important in preventing a lordotic curve in the lumbar spine during a straight leg raise
31
what is the Tredelenberg sign?
contralateral hip drop during walking indicates glute medius weakness on the stance leg
32
in order to maximze a hamstring stretch, what should be done at the pelvis?
an anterior pelvic tilt
33
in order to maximze a rectus femoris stretch, what should be done at the pelvis?
posterior pelvic tilt
34
what is considered normal for tibiofemoral alignment?
femoral shaft 170-175° laterally from tibial shaft
35
what is genu varum?
bowlegged angle is \>180°
36
what is genu valgus?
knock knees angle is \<165°
37
during genu varum, what tibiofemoral compartment is compressed?
medial compartment
38
during genu valgus what tibiofemoral compartment is compressed?
lateral compartment
39
what factors can lead to genu valgus?
1. previous injury 2. genetic predisposition 3. high BMI 4. laxity of ligaments 5. abnormal alignment and muscle weakness at either end of the LE
40
what factos can lead to genu varum?
1. previous injury 2. genetic predisposition 3. laxity of ligaments 4. abnormal alignment and muscle weakness at either end of the LE 5. thinning of articular cartilage on medial side
41
what might result from genu varum?
1. increased medial compartment loading 2. greater loss of medial joint space 3. increased strain on LCL
42
what might result of genu valgum?
1. increased stress on MCL 2. increased stress on lateral comparment 3. excessive lateral tracking of patella 4. increased stress on ACL
43
what is genu recurvatum?
tibiofemoral hyperextension greater than 10° stress is placed on posterior capsule and knee flexors
44
where does the M/L meniscus attach?
medial = MCL, ACL, PCL and semimembranosus lateral = ACL, PCL, popliteus
45
what is the function of the meniscus?
1. distribute weight bearing forces 2. increase joint congruency 3. shock absorption
46
what motions does the ACL restrict?
1. anterior translation of the tibia on femur 2. knee hyperextension 3. varus and valgus stresses 4. tibial rotation medially and laterally
47
what motions does the PCL restrict?
1. posterior translation of the tibia on femur 2. varus and valgus stresses 3. tibial rotation medially
48
what motions does the MCL restrict?
1. valgus force 2. lateral tibial rotation 3. anterior translation of tibia on femur
49
what motions does the LCL restrict?
1. varus stresses 2. tibial lateral rotation
50
what osteokinematic motions are available at the tibiofemoral joint?
1. flexion/extension 2. abduction/adduction 3. IR/ER
51
describe the arthokinematics of the tibiofemoral joint during a CKC motion
convex femoral condyle moves on concave tibial plateau opposite roll and glide
52
describe the arthrokinematics of the tibiofemoral joint during an OKC movement
concave tibial plateau moves on convex femoral condyle roll and glide in same direction
53
what occurs during the screw home mechanism at the knee?
10° of tibial ER needed for terminal knee extension
54
what occurs during the unlocking mechanism of the knee joint?
popliteus IR the tibia prior to flexion
55
what is the open pack position and capsular pattern of the tibiofemoral joint?
open pack = 25° flexion capsular pattern = loss of flexion before extension
56
prior to knee flexion, describe the joint congruency of the patella and femur
minimal joint congruency as the patella lies in the femoral sulcus during full extension
57
how does the joint congruency of the patella and femur change as the knee flexes?
once it gets above 90° the middle portion of the patella isn’t making contact with the femur anymore, its mostly medial and lateral surfaces
58
how is the patella a necessary and significant structure?
it functions as pulley for the quad it increases the internal moment arm of the knee extensor mechanism = we need less force to extend
59
what static structures support the patella?
1. M/L patellofemoral ligament 2. M/L patellotibial ligament 3. Trochlear groove
60
describe the motions of the patella
1. S/I glide 2. M/L glide 3. M/L tilt 4. M/L rotation
61
when does S/I glide of the patella occur?
superior = knee extension inferior = knee flexion
62
List from least to greatest, which movements put the greatest amount of compressive force on the patellofemoral joint
1. walking (1.3x BW) 2. climbing stairs (3.3x BW) 3. squatting (7.8x BW)
63
what is the Q angle?
an estimation of the line of pull of the quads normal = 13-15°
64
increased Q angle ___ \_\_\_\_ \_\_\_\_\_on the patell
increases lateral force
65
list some local factors that limit lateral pull of the patella
1. raised lateral facet of trochlear groove 2. quadriceps (VMO in particular) 3. medial patellar retinaculum fibers 4. medial passive structures
66
list some local factors that contribute to lateral pull of the patella
1. tight IT band 2. excession tension in lateral patellar retinacular fibers 3. excessive tension in lateral passive structures
67
list some global factors that contribute to lateral patellar pull
1. excessive genu valgum increases Q angle 2. weakness of hip ER or abductor muscles 3. tightness of hip IR or adductor muscles 4. excessive pronation of subtalar joint
68
what is a recommendation for weight bearing exercises for someone with patellofemoral pain syndrome?
avoid deep flexion
69
what is a recommendation for non-weight bearing exercises for someone with patellofemoral pain syndrome?
avoid final 30° of extension
70
what forms the Q angle?
line connected ASIS to middle of patella line connecting tibial tuberosity to middle of patella

Kinesiology (13 decks)

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