KIN 440 > Hip and Thigh Assessment > Flashcards

Hip and Thigh Assessment Flashcards

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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
Spinal nerves of hip:
- L1 - L5 | - S1 - S4
26
Peripheral nerves of hip:
- femoral nerve (rec. fem. M.) | - sciatic nerve (hamstrings)
27
Vascular arteries in hip:
femoral artery
28
Neurovascular location (site) at hip:
femoral triangle
29
Femoral triangle:
- superior border: inguinal ligament - medial border: adductor longus - lateral border: sartorius
30
Femoral artery location acronym:
- NAVEL - nerve - artery - vein - empty space - lymphatic
31
Common hip conditions for newborns:
congenital dislocated hip (dysplasia)
32
Common hip conditions for 2-8 years:
avascular necrosis
33
Common hip conditions for 10-14 years:
slipped epiphysis
34
Common hip conditions for 14-25 years:
- stress fractures | - synovitis
35
Common hip conditions for 20-40 years:
- avascular necrosis - synovitis - rheumatoid arthritis
36
Common hip conditions for 45-50 years:
- osteoarthritis | - synovitis
37
Common hip conditions for 65+ years:
- osteoarthritis | - stress fractures
38
____ changes (may ____) with age.
- ROM | - decrease
39
Activity forces on the hip:
- standing = 0.3 x BW - gait/walk = 2-5 x BW - run/jump = 4.5+ x BW
40
No MOI for hip:
to be safe & effective, complete a LE quad scan
41
If MOI given for hip:
- consider the forces or stresses | - still complete quad scan (safe)
42
Fall on outside (lateral) side of pelvis =
greater trochanteric bursitis
43
Land on knee =
- sublux - labral tear - contusion
44
Repetitive activities =
- tissue stress reaction | - fracture
45
Common unusual sounds & sensations at the hip:
- snapping hip
46
Snapping hip causes:
- psoas tendon over lesser trochanter - labrum tear - ITB over greater trochanter - bursa inflamed - etc.
47
Pain in groin and/or front of the thigh =
- labral tears | - impingement (capsule, bursa)
48
Pain in lateral hip =
- bursitis - gluteus medias - L4
49
Pain in buttock =
- lumbar spine | - labral tears
50
Consider ______ pain to the hip region. See ...
- referred pain | - LE quadrant scan
51
Local observations for hip:
- swelling - warm - redness - pain - bursitis?
52
Global observations for hip:
- gait: compensating (stride length, foot position, limp) | - postures and alignments
53
2 components of postures and alignments:
- muscle (tone, girth, atrophy) | - bony landmarks: spine to femur (to LE)
54
Increased lumbar lordosis =
hip joint problem = flexion muscle contracture
55
Pronated foot =
LE long bone rotation = hip rotation
56
7 postural influences at the hip:
- effectiveness of musculature at the hip - limb length - gait - foot posture - spine posture - UE posture - bony structure
57
Muscles involved in antero-posterior tilting:
- iliopsoas & hip flexors - abdominal musculature & lumbar spine extensors - gluteus maximus & hamstrings
58
Muscles involved in lateral tilting:
hip abductors
59
Anterior pelvic tilt:
- lordotic back | - pelvis tilts forward and pulls lumbar spine into hyperlordosis
60
Posterior pelvic tilt:
- flat back | - pelvis tilts backward and pulls lumbar spine flat
61
Forward shifted pelvis:
- swayback - pelvis shifts forward and tilts backward - upper trunk shifts backward to compensate - hip joints hyper-extended - knees hyper-extended
62
Neutral pelvic tilt:
balanced posture
63
Explain the effect of pelvic tilt on length of stride:
- 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
Describe the relationship of pelvis/hip position with LE:
- pelvis tilts forward - hip internally rotates - leg internally rotates - knee moves inward - overpronation of the foot
65
Femoral anteversion and retroversion:
- 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
Femoral neck angle:
- angle of inclination | - shaft of femur with long axis of femoral neck/head in frontal plane
67
Changes in angle result in stress patterns where:
- hip joint - knee joint - feet
68
Coxa vara:
- abnormally small femoral neck angle | - presents as genu valgum (knock knees)
69
Coxa valga:
- abnormally larger femoral neck angle | - presents as genu varum (bow-legged)
70
How to observe asymmetries of pelvis and hip:
- 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
How to observe asymmetries in supine position:
- compare height of knees in knee flexion with feet together - measure from ASIS to medial malleolus - level of bony landmarks (med. malleolus)
72
Acceptable differences:
1-1.5 cm
73
Manual muscle testing MMT at hip joint:
- 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
2 joint muscles at the hip joint:
- rec fem muscle | - hamstring muscles
75
Rec fem action:
- hip flexion | - knee extension
76
How to test rec fem muscle:
- 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
Hamstring muscles action:
- hip extension | - knee flexion
78
How to test hamstring muscles:
assess hip extension with knee flexed vs extended
79
Special tests are based on:
- ROM principles | - understanding tissue specificity
80
Tissue specificity includes:
- joint positioning - end range and end feel in a ROM - kinetic chain relationships (length-tension relations, compensatory movements or positioning)
81
2 special tests:
- FABER | - FADIR
82
FABER:
- 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
Possible causes of pain with FABER test:
- SI joints - hip joint pathology - impingement - muscle strain or stretch
84
FADIR:
- observe ROM in this position - bilaterally compare - knee flexion, hip adduction, hip internal rotation - leg move across midline? - pain with IR? - anterolateral pain?
85
Possible causes of pain with FADIR test:
- SI joints | - hip joint pathology
86
Typical hip evaluation through functional movement tests.
- standing position, leg lift (stork) | - WB on single leg, client actively flexes knee to chest
87
What to look for during stork test:
- pelvis levels (drop on contralateral side) - trendelenburg sign - PSIS joint movement
88
What can be a sign during stork test?
- muscular weakness | - spine/joint(s) movement dysfunction
89
Joint evaluation:
...
90
What are you palpating for?
- pain | - TICS
91
TICS:
A repetitive movement that is difficult, if not impossible to voluntarily control
92
What are you palpating?
- your IOS - to rule in or rule out - bony landmarks - soft tissue (muscles, tendons, bursa) - joints - pulse - sensation of skin
93
How can we position the client in the most effective way?
- anterior (supine position) - posterior (prone position) - in position found
94
IOS for MSK (bone and/or joint injury):
- fracture - dislocation/subluxation - contusion - capsule injury
95
IOS for MSK (soft tissue site, structure, severity):
- sprain (of ligament) - strain (of muscle, tendon) - contusion (bone, soft tissue) - impingement, compression, tear (labrum, bursa) - neurovascular (sciatic nerve, femoral nerve, femoral artery)
96
Exercises rehabilitation considerations:
- rule out referral of pain - muscle imbalances addressed (joint flexibility/strength) - lumbo-pelvic stability (core) - malalignments - activity modifications (ADL considerations - mobility)
KIN 440
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