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KIN 440 > Hip and Thigh Assessment > Flashcards

Hip and Thigh Assessment Flashcards

1
Q

Hip region includes:

A
  • spine
  • pelvis
  • joint
  • thigh
  • butt
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2
Q

Hip joint is the _____, most ____ joint.

A
  • largest

- stable

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3
Q

Pain can be referred to the hip region by…

A
  • the SI joints
  • by the L-spine –> nerve root
  • by the knee, ankle, foot
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4
Q

Unless there was direct trauma to the hip, examine…

A
  • all joints along with the hip joint

- add LE quadrant scan (new assessment)

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5
Q

Acetabulofemoral joint (hip) includes:

A
  • ball & socket joint

- head of femur with acetabulum of pelvis (ilium, pubis, ischium)

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6
Q

Hip joint maximum stability due to:

A
  • bony configuration (deep ball & socket)
  • strong ligaments & capsule
  • deep labrum
  • strong muscles
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7
Q

Hip joint mobility is due to:

A

strong muscles

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8
Q

Hip function:

A
  • support weight of body (stability vs mobility)
  • retaining balance in static postures (sit, stand)
  • retaining balance in dynamic postures (functional movement)
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9
Q

Hip joint is what type of joint? Motion in which planes?

A
  • multi-axial ball & socket joint

- motion in all 3 planes (frontal, sagittal, longitudinal)

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10
Q

Movements of the hip joint:

A
  • flexion
  • extension
  • lateral or external rotation
  • medial or internal rotation
  • abduction
  • adduction
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11
Q

Degrees of ROM needs to be taken for:

A
  • flex-extension
  • abd-adduction
  • external-internal rotation
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12
Q

____ of hip affects ROM. Why?

A
  • position

- static stabilizers

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13
Q

Capsule:

A
  • dense
  • strong
  • increases stability in all ranges
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14
Q

Ligaments:

A

strengthens joint

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15
Q

2 types of ligaments:

A
  • extracapsular

- intracapsular

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16
Q

Extracapsular ligaments attach ____ to ____ in ___ shape twisting around the joint.

A
  • pelvis
  • femur
  • Y
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17
Q

Extracapsular ligaments prevents _____ ____ in ____ ranges.

A
  • excessive ROMs

- all

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18
Q

Functions of extracapsular ligaments:

A
  • standing = prevents trunk from falling back

- sitting = relaxed (pelvic tilts back)

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19
Q

Intracapsular ligament functions:

A
  • channels small artery to head of femur

- prevents further displacement if dislocated

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20
Q

Acetabular labrum:

A

ring shaped fibrocartilaginous lip

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21
Q

Bursa:

A

fluid filled sacs

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22
Q

Bursas aid ____, but can be _____.

A
  • mobility

- injured

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23
Q

Bursae in the hip:

A
  • iliopsoas bursa
  • trochanteric bursa
  • gluteus medius bursa
  • ischiogluteal bursa
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24
Q

2 types of nerves going through the hip:

A
  • spinal nerves

- peripheral nerves

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25
Q

Spinal nerves of hip:

A
  • L1 - L5

- S1 - S4

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26
Q

Peripheral nerves of hip:

A
  • femoral nerve (rec. fem. M.)

- sciatic nerve (hamstrings)

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27
Q

Vascular arteries in hip:

A

femoral artery

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28
Q

Neurovascular location (site) at hip:

A

femoral triangle

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29
Q

Femoral triangle:

A
  • superior border: inguinal ligament
  • medial border: adductor longus
  • lateral border: sartorius
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30
Q

Femoral artery location acronym:

A
  • NAVEL
  • nerve
  • artery
  • vein
  • empty space
  • lymphatic
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31
Q

Common hip conditions for newborns:

A

congenital dislocated hip (dysplasia)

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32
Q

Common hip conditions for 2-8 years:

A

avascular necrosis

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33
Q

Common hip conditions for 10-14 years:

A

slipped epiphysis

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34
Q

Common hip conditions for 14-25 years:

A
  • stress fractures

- synovitis

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35
Q

Common hip conditions for 20-40 years:

A
  • avascular necrosis
  • synovitis
  • rheumatoid arthritis
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36
Q

Common hip conditions for 45-50 years:

A
  • osteoarthritis

- synovitis

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37
Q

Common hip conditions for 65+ years:

A
  • osteoarthritis

- stress fractures

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38
Q

____ changes (may ____) with age.

A
  • ROM

- decrease

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39
Q

Activity forces on the hip:

A
  • standing = 0.3 x BW
  • gait/walk = 2-5 x BW
  • run/jump = 4.5+ x BW
40
Q

No MOI for hip:

A

to be safe & effective, complete a LE quad scan

41
Q

If MOI given for hip:

A
  • consider the forces or stresses

- still complete quad scan (safe)

42
Q

Fall on outside (lateral) side of pelvis =

A

greater trochanteric bursitis

43
Q

Land on knee =

A
  • sublux
  • labral tear
  • contusion
44
Q

Repetitive activities =

A
  • tissue stress reaction

- fracture

45
Q

Common unusual sounds & sensations at the hip:

A
  • snapping hip
46
Q

Snapping hip causes:

A
  • psoas tendon over lesser trochanter
  • labrum tear
  • ITB over greater trochanter
  • bursa inflamed
  • etc.
47
Q

Pain in groin and/or front of the thigh =

A
  • labral tears

- impingement (capsule, bursa)

48
Q

Pain in lateral hip =

A
  • bursitis
  • gluteus medias
  • L4
49
Q

Pain in buttock =

A
  • lumbar spine

- labral tears

50
Q

Consider ______ pain to the hip region. See …

A
  • referred pain

- LE quadrant scan

51
Q

Local observations for hip:

A
  • swelling
  • warm
  • redness
  • pain
  • bursitis?
52
Q

Global observations for hip:

A
  • gait: compensating (stride length, foot position, limp)

- postures and alignments

53
Q

2 components of postures and alignments:

A
  • muscle (tone, girth, atrophy)

- bony landmarks: spine to femur (to LE)

54
Q

Increased lumbar lordosis =

A

hip joint problem = flexion muscle contracture

55
Q

Pronated foot =

A

LE long bone rotation = hip rotation

56
Q

7 postural influences at the hip:

A
  • effectiveness of musculature at the hip
  • limb length
  • gait
  • foot posture
  • spine posture
  • UE posture
  • bony structure
57
Q

Muscles involved in antero-posterior tilting:

A
  • iliopsoas & hip flexors
  • abdominal musculature & lumbar spine extensors
  • gluteus maximus & hamstrings
58
Q

Muscles involved in lateral tilting:

A

hip abductors

59
Q

Anterior pelvic tilt:

A
  • lordotic back

- pelvis tilts forward and pulls lumbar spine into hyperlordosis

60
Q

Posterior pelvic tilt:

A
  • flat back

- pelvis tilts backward and pulls lumbar spine flat

61
Q

Forward shifted pelvis:

A
  • swayback
  • pelvis shifts forward and tilts backward
  • upper trunk shifts backward to compensate
  • hip joints hyper-extended
  • knees hyper-extended
62
Q

Neutral pelvic tilt:

A

balanced posture

63
Q

Explain the effect of pelvic tilt on length of stride:

A
  • normal pelvic angle = normal length of stride, foot picked up and put down around the same height
  • flat pelvic angle = shorter length of stride, foot picked up higher than foot put down
64
Q

Describe the relationship of pelvis/hip position with LE:

A
  • pelvis tilts forward
  • hip internally rotates
  • leg internally rotates
  • knee moves inward
  • overpronation of the foot
65
Q

Femoral anteversion and retroversion:

A
  • angle of the femoral neck in relation to the frontal plane of the femoral condyles
  • degree to which is rotated forwards (towards the front of the body) or rotated backwards (towards the back of the body)
  • anteversion = toe in
  • retroversion = toe out
66
Q

Femoral neck angle:

A
  • angle of inclination

- shaft of femur with long axis of femoral neck/head in frontal plane

67
Q

Changes in angle result in stress patterns where:

A
  • hip joint
  • knee joint
  • feet
68
Q

Coxa vara:

A
  • abnormally small femoral neck angle

- presents as genu valgum (knock knees)

69
Q

Coxa valga:

A
  • abnormally larger femoral neck angle

- presents as genu varum (bow-legged)

70
Q

How to observe asymmetries of pelvis and hip:

A
  • test for leg length discrepancy for LE (hip to ankle)
  • true shortening: anatomic or structural change in LE
  • functional shortening: compensation for change due to positioning rather than structure
71
Q

How to observe asymmetries in supine position:

A
  • compare height of knees in knee flexion with feet together
  • measure from ASIS to medial malleolus
  • level of bony landmarks (med. malleolus)
72
Q

Acceptable differences:

A

1-1.5 cm

73
Q

Manual muscle testing MMT at hip joint:

A
  • specific muscle testing (RROM, function of, strength of)
  • muscles of hip extension (glutes m. , hamstrings m. )
  • muscles of hip flexion (psoas m., rec fem m. )
74
Q

2 joint muscles at the hip joint:

A
  • rec fem muscle

- hamstring muscles

75
Q

Rec fem action:

A
  • hip flexion

- knee extension

76
Q

How to test rec fem muscle:

A
  • assess hip flexion with knee extended vs flexed
  • RF is a weak hip flexor when the knee is extended (shortened)
  • actions: recruit psoas major, iliacus, TFL
77
Q

Hamstring muscles action:

A
  • hip extension

- knee flexion

78
Q

How to test hamstring muscles:

A

assess hip extension with knee flexed vs extended

79
Q

Special tests are based on:

A
  • ROM principles

- understanding tissue specificity

80
Q

Tissue specificity includes:

A
  • joint positioning
  • end range and end feel in a ROM
  • kinetic chain relationships (length-tension relations, compensatory movements or positioning)
81
Q

2 special tests:

A
  • FABER

- FADIR

82
Q

FABER:

A
  • observe ROM in this position
  • bilaterally compare
  • knee flexion, hip abduction, hip external rotation
  • knee rest above leg? fall to table
  • pain?
  • where is pain?
83
Q

Possible causes of pain with FABER test:

A
  • SI joints
  • hip joint pathology
  • impingement
  • muscle strain or stretch
84
Q

FADIR:

A
  • observe ROM in this position
  • bilaterally compare
  • knee flexion, hip adduction, hip internal rotation
  • leg move across midline?
  • pain with IR?
  • anterolateral pain?
85
Q

Possible causes of pain with FADIR test:

A
  • SI joints

- hip joint pathology

86
Q

Typical hip evaluation through functional movement tests.

A
  • standing position, leg lift (stork)

- WB on single leg, client actively flexes knee to chest

87
Q

What to look for during stork test:

A
  • pelvis levels (drop on contralateral side)
  • trendelenburg sign
  • PSIS joint movement
88
Q

What can be a sign during stork test?

A
  • muscular weakness

- spine/joint(s) movement dysfunction

89
Q

Joint evaluation:

A

…

90
Q

What are you palpating for?

A
  • pain

- TICS

91
Q

TICS:

A

A repetitive movement that is difficult, if not impossible to voluntarily control

92
Q

What are you palpating?

A
  • your IOS
  • to rule in or rule out
  • bony landmarks
  • soft tissue (muscles, tendons, bursa)
  • joints
  • pulse
  • sensation of skin
93
Q

How can we position the client in the most effective way?

A
  • anterior (supine position)
  • posterior (prone position)
  • in position found
94
Q

IOS for MSK (bone and/or joint injury):

A
  • fracture
  • dislocation/subluxation
  • contusion
  • capsule injury
95
Q

IOS for MSK (soft tissue site, structure, severity):

A
  • sprain (of ligament)
  • strain (of muscle, tendon)
  • contusion (bone, soft tissue)
  • impingement, compression, tear (labrum, bursa)
  • neurovascular (sciatic nerve, femoral nerve, femoral artery)
96
Q

Exercises rehabilitation considerations:

A
  • rule out referral of pain
  • muscle imbalances addressed (joint flexibility/strength)
  • lumbo-pelvic stability (core)
  • malalignments
  • activity modifications (ADL considerations - mobility)

KIN 440 (10 decks)

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