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Anatomy > Hip and Lumbopelvic Clinical Correlations > Flashcards

Hip and Lumbopelvic Clinical Correlations Flashcards

1
Q

Meralgia Paresthetica

A
  • A sight of entrapment of the lateral cutaneous nerves
  • Causes paresthesia over lateral groin/thigh regions
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2
Q

What are some effects aging has on Lumbar vertebrae and discs?

A

-Decreased bone density/strength
- vertebral end plates bow inwards
-Increased compressive forces of periphery of vertebral body and zygapophyseal joints
- Spondylosis

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3
Q

What is Spondylolisthesis and what does it do/occur?

A

It is a facture of “ pars interarticularis” between superior and inferior facet
- Or a fracture of lamina
- Results in anterior slippage of top vertebra on the bottom vertebra
-Can compress spinal cord or cauda Equina

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4
Q

What is Stenosis and what are some causes?

A
  • Stenosis means narrowing/spinal stenosis= narrowing of vertebral canal
  • Spinal cord compression
  • Causes: bony growth, bulging disc
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5
Q

Foraminal Stenosis what is it and what are some causes?

A
  • Narrowing of intervertebral foramen
  • Nerve root compression
  • Causes: bony overgrowth, osteophytes, posterolateral disc bulges
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6
Q

What is a Disc Bulge? What are some reasons it occurs?

A
  • degeneration due to age
  • Habitual postural movement that causes loss of lumbar lordosis
  • Slouched, forward bending
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7
Q

Slipped Capital Femoral Epiphysis SCFE

A
  • Adolescents 10-17 years old
  • Femoral Head dislocates d/t weak epiphyseal plate
  • Cause:
    • Acute trauma
    • Repetitive microtrauma
  • Symptoms; Hip pain that radiates down knee
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8
Q

Femoral Neck Fracture

A
  • Most frequently fractured
  • Narrowest and weakest part of femur
    -Sits at angle to line of gravity and body weight
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9
Q

Femoral Proximal Femur

A
  • transcervical
  • intertrochanteric
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10
Q

Femoral Intracapsular fracture

A
  • Femoral head degeneration or necrosis d/t loss of blood supply
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11
Q

Greater Trochanter and Shaft fractures

A
  • Spiral
    -Comminuted
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12
Q

Distal Femur Fracture

A
  • Femoral condyle separation
  • Blood loss to lower leg
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13
Q

Total Hip Arthroplasty THA

A
  • osteoarthritis is main reason for this surgery
  • Acetabulum and Femoral head replaced with prosthetic components
  • Structures that were painful ( bone ends without cartilage) have been removed
    -PT is important for rehab after this surgery to restore movement and function
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14
Q

Hip Dislocation

A
  • Congenital
    • neonates ( 1.5/1,000)
    • Femoral head sits higher than acetabulum and limb appears shortened
      -Acquired
    • Posterior dislocation
      - Position: flex + adduction + IR
      - A-P force, tears posterior capsule
      • Anterior Dislocation
        - Position: extension + abduction + ER
        - Acetabulum usually fractures
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15
Q

Avulsion Fractures

A
  • Small Piece of bone torn away from rest of bone
    • Common at apophyses( Lack secondary ossification center)
      Causes:
  • Sudden acceleration/deceleration
    Sports
  • Football
    -soccer
    -hurdles
    -basketball
    -martial arts
    Common Sites On Pelvis
  • ASIS/AIIS
    -Ischial Tuberosity
  • Ischiopubic ramus
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16
Q

Hamstring Strain

A

-tear of proximal or distal hamstring tendons at their insertion points
-Common in sports/activates requiring hard running, kicking or quick starts
- Usually occurs due to inadequate warm up
- Hematoma results from torn blood vessels

17
Q

Trochanteric Bursitis

A
  • Glute MAx. and TFL fibers move back and forth over Greater Trochanter
    -Sport: running
  • Greater Trochanter TTP
  • Pain with resisted abduction of ER
  • Pain local but may radiate down IT band
18
Q

Ischial Bursitis

A

-Repetitive hip extension while seated
-Sports; Cycling , rowing
- Ischial tuberosity TTP
- Pain with sitting
- Pain local

19
Q

Trendelennburg

A

Gluteus Medius
- Abducts a free leg
- Stabilizes the pelvis on a fixed leg
Trendelenburg Sign
- Opposite side of pelvis drops with contralateral leg lifted
Causes:
- Superior Gluteal Nerve injury
- Spinal cord injury L4-S1
- Gluteus Medius Injury
Gluteus Medius weakness/atrophy
Trochanteric Bursitis

20
Q

Piriformis Syndrome

A
  • Compression of Sciatic nerve by piriformis
    Causes:
  • Excessive use of gluteal muscles
    -Trauma= piriformis spasm
  • 12% of population = fibular division runs through piriformis
    Complete section of Sciatic nerve= no hip extension & no knee flexion
    Incomplete section of sciatic Nerve
  • Inferior Gluteal nerve and Posterior Cutaneous nerve of thigh may be affected
21
Q

Hip and Thigh Contusions

A

“Hip Pointer”
- Contusion of iliac crest- Satorius attachment to ASIS
-May refer to avulsion fractures ( Satorius at ASIS of Rectus Femoris at AIIS)
“Charley Horse”
- Severe Cramping, pain, muscle stiffness
- Due to ischemia or contusion resulting in hematoma

22
Q

Psoas Abscess

A

Causes
- TB- Retroperitoneal pyogenic infection
- Crohn’s disease- regional enteritis of ileum
Fascia thickens, pus passes inferiorly to inguinal ligament and appears in superior thigh
Palpable in abdomen, may be observable in inguinal region
- mistaken for hernia

23
Q

Iliopsoas and Posterior Abdominal Pain

A

Iliopsoas has relations to : kidneys, ureters, cecum, appendix , sigmoid colon, pancreas, lumbar lymph nodes, nerve of posterior abdominal wall
- Adenocarcinoma of pancreas invades surrounding muscles (iliopsoas) causing excruciating pain
- Disease of intervertebral joints or SI joints causes iliopsoas spasm and protective reflex

24
Q

Groin Pull

A

Strain or tear of proximal attachment of flexor and adductor muscles
- Common in sports with:
- Quick starts/turns
- Extreme stretching

25
Q

Femoral Hernias

A

Protrusion of abdominal viscera through Femoral Ring into Femoral Canal
- May enlarge through Saphenous opening
More common in Females
- Wider pelvis, smaller inguinal canals
- Multiple pregnancies enlarge femoral ring and push fat into femoral canal

Anatomy (11 decks)

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