Hip and Pelvis MSK

Question 1

iliofemoral ligament limits what

Answer 1

strongest lig in body, limits external rotation (with hip in flexion), extension and abduction

Question 2

femoral neck fx Garden staging

Answer 2

stage 1: incomplete fx line, non displaced
stage 2: complete fx line, non displaced
stage 3: complete fx line and partially displaced
stage 4: complete and fully displaced (capsule completely torn)

Question 3

Most common hip fx

Answer 3

intertrochanteric hip fx, extracapsular

Question 4

compression side fx

Answer 4

more common and satble along inferior femoral neck, can be rehabbed, NWB and gradually increase activity

Question 5

Tension side fx

Answer 5

less stable, NEED SURGERY

Question 6

Grade 2 SCFE

Answer 6

33-50%

Question 7

Risk fx for SCFE

Answer 7

GH deficiency, thyroid disease, clasically in obese males

femoral head is displaced posteriorly and inferiorly.

Question 8

knuckle of bone coming off of femoral head

Answer 8

CAM lesion

Question 9

acetabulum extends too far and pincers the femoral head / neck on ROM

Answer 9

Pincer lesion

Question 10

Femoroacetabular impingement

Answer 10

Pincer and CAM lesions, labral tears occur due to this

Question 11

iliopsoas bursitis and tendonitis

Answer 11

active flexion against resistance recreates pain

Question 12

internal snapping hip syndrome

Answer 12

iliopsoas tendon snapping over iliopectineal eminence

Question 13

external snapping hip

Answer 13

TFL snapping over greater trochanter, lateral thigh pain, log roll hip and you can sense their lateral thigh snapping

Question 14

greater trochanteric bursitis AKA

Answer 14

subluteus maximus bursitis

Question 15

hip flexor strain/iliopsoas strain

Answer 15

attempting to flex hip while it is being forcefully extended (soccer, kicking)

Question 16

Hamstring strain

Answer 16

proximal hams, due to eccentric stretching of the muscle against a stronger hip flexion and knee extension forces ; classic example water skiing, posterior thigh bruising, need to r/o ischial tuberosity avulsion fracture

The myotendinous junction is the most common area of hamstring injury.

Question 17

adductor strain

Answer 17

eccentric injury (trying to adduct thigh) while it is being (most commonly adductor longus)

Question 18

piriformis syndrome on physical exam

Answer 18

pain & numbness/ tingling down the leg with FAIR testing…. . Piriformis syndrome would cause lateral buttock pain closer towards the greater trochanter.

Question 19

myositis ossificans

Answer 19

HO in an area of muscle usually due to trauma and hematoma formation, hematoma breaks donwn and leads to HO fobone formation , usually the quads of young, active males, usually self limiting, palpable mass in muscle, tx with ROM PT, surgery 10-12 months of maturity if still symptomatic

Question 20

Pubofemoral ligament limits what

Answer 20

The pubofemoral ligament limits excessive abduction and extension of the hip.

Question 21

Ischiofemoral (posterior aspect) limits what

Answer 21

limits internal rotation

Question 22

ligament capitus femurus

Answer 22

extends from acetabulum into the femoral head and carries a BLOOD SUPPLY to that area

Question 23

Hip flexors (3)

Answer 23

iliopsoas, rectus femoris, sartorius

Question 24

iliopsoas insertion

Answer 24

lesser troch (Femur)

Question 25

sartorius insertion and function

Answer 25

pes anserine bursa on tibia | functions to flex the knee and flexes and laterally rotates the hip

Question 26

rectus femoris insertion

Answer 26

patella (quad tendon formation)

Question 27

Hip extensors (4)

Answer 27

glut med, semimembranosis, semitendinosus, bivceps femoris, and obviously glut max

Question 28

hip abductors

Answer 28

glut medius, glut minimus, tensor fascia lata

Question 29

glut med and min insertion

Answer 29

anterior facet greater trochanter....abducts and MEDIALLY rotates the hip

Question 30

Hip adductors

Answer 30

adductor longus, magnus, brevis, gracilis, pectineus (only one that is femoral nerve innervation)

Question 31

hip internal rotators

Answer 31

TFL, medial hamstrings (semimem/tend), adductor longus, glut med

Question 32

hip external rotators

Answer 32

piriformis, GOGO muscles (superior gemellus, obturator internus, inferior gemellus, obturator externus), quad femoris (GOGO hands with piriformis and quad femoris) The obturator externus and quadratus femoris are the two hip external rotators that can assist in hip adduction.

Question 33

Cane

Answer 33

use it on the good sided hip, advance the cane at the same time you advance the arthritis hip

Question 34

ASIS (anterior sartorial iliac spine)

Answer 34

sartortius comes off of ASIS , avulsion fx of asis if sartorial tear

Question 35

AIIS, what comes off of it

Answer 35

Rectus femoris (joints quads in thigh/knee)

Question 36

How to diagnose leg length discrepancy

Answer 36

CT scanogram

Question 37

Posterior hip precautions

Answer 37

avoid flexion past 90, adduction past midline, internal rotation

Question 38

Femoral neck fx (intracapuslar) Garden staging

Answer 38

Stage 1: incomplete fx line, nondisplaced Stage 2: complete fx line (all the way across the bone, nondisplaced Stage 3: Complete and partially displaced Stage 4: complete and fully displaced (capsule completely torn)

Question 39

Most common hip fx

Answer 39

intertrochanteric hip fx (extracapsular)

Question 40

TFL function and innervation

Answer 40

Hip internal rotator and abductor...superior gluteal nerve

Question 41

AIIS avulsion fx treatment

Answer 41

RIce, rectus femoris attachment, can be caused by forceful hip flexion during eccentric portion of movement

Question 42

Glut max attaches to

Answer 42

TFL

Question 43

IT band friction syndrome causes

Answer 43

are sudden change in training intensity, poor shoe support, tight IT band, weak hip abdductors, disparity between quadricep and hamstring strength, and excessive foot pronation.

Question 44

Grailis function

Answer 44

Flexes the knee, adducts the thigh, and helps to medially rotate the tibia on the femur

Question 45

Lumbosacral plexus formed from

Answer 45

composed of ventral rami from T12-S3 and is found on the anterior surface of the quadratus lumborum and lies posterior to the psoas muscle

Question 46

originates at the ischial spine, inserts onto the greater trochanter and abducts the flexed hip?

Answer 46

superior gamellus

Question 47

+ fulcrum test

Answer 47

femoral stress fracture