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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
Q

describe the motion of both the contralateral and ipsilateral femur when the pelvis is hiked to the R

A

ipsilateral (R) = adducted

contralateral (L) = abducted

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26
Q

describe the motion of both the ipsilateral and contralateral femur when the pelvis drops to the R

A

ipsilateral (R) = abduction

contralateral (L) = adduction

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27
Q

describe the open pack and capsular pattern of the hip joint

A

open pack = 30° flexion, 30° abduction, neutral to slight ER

capsular pattern: equal loss of IR w/flexion and abduction

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28
Q

what muscles help with performing an anterior pelvic tilt?

A

hip flexors

back extensors

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29
Q

what muscles help with performing a posterior pelvic tilt?

A

abdominal muscles

hip extensors

30
Q

T/F: when performing a single leg raise, your abdominals are not involved. Why/Why not?

A

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
Q

what is the Tredelenberg sign?

A

contralateral hip drop during walking

indicates glute medius weakness on the stance leg

32
Q

in order to maximze a hamstring stretch, what should be done at the pelvis?

A

an anterior pelvic tilt

33
Q

in order to maximze a rectus femoris stretch, what should be done at the pelvis?

A

posterior pelvic tilt

34
Q

what is considered normal for tibiofemoral alignment?

A

femoral shaft 170-175° laterally from tibial shaft

35
Q

what is genu varum?

A

bowlegged

angle is >180°

36
Q

what is genu valgus?

A

knock knees

angle is <165°

37
Q

during genu varum, what tibiofemoral compartment is compressed?

A

medial compartment

38
Q

during genu valgus what tibiofemoral compartment is compressed?

A

lateral compartment

39
Q

what factors can lead to genu valgus?

A
  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
Q

what factos can lead to genu varum?

A
  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
Q

what might result from genu varum?

A
  1. increased medial compartment loading
  2. greater loss of medial joint space
  3. increased strain on LCL
42
Q

what might result of genu valgum?

A
  1. increased stress on MCL
  2. increased stress on lateral comparment
  3. excessive lateral tracking of patella
  4. increased stress on ACL
43
Q

what is genu recurvatum?

A

tibiofemoral hyperextension greater than 10°

stress is placed on posterior capsule and knee flexors

44
Q

where does the M/L meniscus attach?

A

medial = MCL, ACL, PCL and semimembranosus

lateral = ACL, PCL, popliteus

45
Q

what is the function of the meniscus?

A
  1. distribute weight bearing forces
  2. increase joint congruency
  3. shock absorption
46
Q

what motions does the ACL restrict?

A
  1. anterior translation of the tibia on femur
  2. knee hyperextension
  3. varus and valgus stresses
  4. tibial rotation medially and laterally
47
Q

what motions does the PCL restrict?

A
  1. posterior translation of the tibia on femur
  2. varus and valgus stresses
  3. tibial rotation medially
48
Q

what motions does the MCL restrict?

A
  1. valgus force
  2. lateral tibial rotation
  3. anterior translation of tibia on femur
49
Q

what motions does the LCL restrict?

A
  1. varus stresses
  2. tibial lateral rotation
50
Q

what osteokinematic motions are available at the tibiofemoral joint?

A
  1. flexion/extension
  2. abduction/adduction
  3. IR/ER
51
Q

describe the arthokinematics of the tibiofemoral joint during a CKC motion

A

convex femoral condyle moves on concave tibial plateau

opposite roll and glide

52
Q

describe the arthrokinematics of the tibiofemoral joint during an OKC movement

A

concave tibial plateau moves on convex femoral condyle

roll and glide in same direction

53
Q

what occurs during the screw home mechanism at the knee?

A

10° of tibial ER

needed for terminal knee extension

54
Q

what occurs during the unlocking mechanism of the knee joint?

A

popliteus IR the tibia prior to flexion

55
Q

what is the open pack position and capsular pattern of the tibiofemoral joint?

A

open pack = 25° flexion

capsular pattern = loss of flexion before extension

56
Q

prior to knee flexion, describe the joint congruency of the patella and femur

A

minimal joint congruency as the patella lies in the femoral sulcus during full extension

57
Q

how does the joint congruency of the patella and femur change as the knee flexes?

A

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
Q

how is the patella a necessary and significant structure?

A

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
Q

what static structures support the patella?

A
  1. M/L patellofemoral ligament
  2. M/L patellotibial ligament
  3. Trochlear groove
60
Q

describe the motions of the patella

A
  1. S/I glide
  2. M/L glide
  3. M/L tilt
  4. M/L rotation
61
Q

when does S/I glide of the patella occur?

A

superior = knee extension

inferior = knee flexion

62
Q

List from least to greatest, which movements put the greatest amount of compressive force on the patellofemoral joint

A
  1. walking (1.3x BW)
  2. climbing stairs (3.3x BW)
  3. squatting (7.8x BW)
63
Q

what is the Q angle?

A

an estimation of the line of pull of the quads

normal = 13-15°

64
Q

increased Q angle ___ ____ _____on the patell

A

increases lateral force

65
Q

list some local factors that limit lateral pull of the patella

A
  1. raised lateral facet of trochlear groove
  2. quadriceps (VMO in particular)
  3. medial patellar retinaculum fibers
  4. medial passive structures
66
Q

list some local factors that contribute to lateral pull of the patella

A
  1. tight IT band
  2. excession tension in lateral patellar retinacular fibers
  3. excessive tension in lateral passive structures
67
Q

list some global factors that contribute to lateral patellar pull

A
  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
Q

what is a recommendation for weight bearing exercises for someone with patellofemoral pain syndrome?

A

avoid deep flexion

69
Q

what is a recommendation for non-weight bearing exercises for someone with patellofemoral pain syndrome?

A

avoid final 30° of extension

70
Q

what forms the Q angle?

A

line connected ASIS to middle of patella

line connecting tibial tuberosity to middle of patella

Kinesiology (13 decks)

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