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Kinesio 2 > Hip Biomechanics > Flashcards

Hip Biomechanics Flashcards

1
Q

What is normal hip flexion

A

0-120

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2
Q

What is normal hip extension

A

0-20

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3
Q

Is hip flexion done with the knee extended or flexed

A

Flexed

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4
Q

Is hip extension done with the knee extended or flexed

A

Extended

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5
Q

What does hip proper mean

A

The pelvis doesn’t move during hip motions

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6
Q

What is normal hip abduction

A

0-45

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7
Q

What is normal hip adduction

A

0-30

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8
Q

What are the 2 joint muscles you have to take into account for in the sagittal plane (2)

A
  1. Rectus femoris

2. Hamstrings

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9
Q

What are the 2 joint muscles you have to take into account for in the frontal plane (2)

A
  1. Gracilis

2. ITB

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10
Q

What limits hip ABD

A

The gracilis

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11
Q

What is IR of the hip with knee extended

A

0-55

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12
Q

What is IR of the hip with knee flexed

A

0-45

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13
Q

What is ER of the hip with the knee extended

A

0-55

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14
Q

What is ER of the hip with the knee flexed

A

0-45

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15
Q

What causes the decreased amount of hip IR/ER with the knee flexed

A

The posterior capsule is tension loaded limiting motion

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16
Q

What is the function of a joint capsule

A

Increase joint congruity to eliminate shear forces

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17
Q

What are the normal hip ranges during gait (4)

A
  1. Flexion: 30
  2. Extension: 10
  3. ADD/ABD: 5
  4. IR/ER: 5
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18
Q

What is it called if ABD/ADD and IR/ER increase to 15-20

A

Circumduction

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19
Q

True or False:

The hip has 3 degrees of freedom during gait

A

True

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20
Q

How much hip flexion is needed to sit down/rise from a chair

A

106

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21
Q

How much hip flexion is needed to ascend stairs

A

67

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22
Q

How much hip flexion is needed to descend stairs

A

36

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23
Q

Why do we need 106 degrees of hip flexion to sit down/rise from a chair

A

We are not able to get out of a chair with hip flexion at 90

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24
Q

What are the arthrokinematic motions during ABD in OKC

A

Superior roll and inferior glide

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25
Q

What are the arthrokinematic motions during ADD in OKC

A

Inferior roll and superior glide

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26
Q

What are the arthrokinematic motions during IR in OKC

A

Anterior roll and posterior glide or medial roll and lateral glide

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27
Q

What are the arthrokinematic motions during ER in OKC

A

Posterior roll and anterior glide or lateral roll and medial glide

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28
Q

What are the arthrokinematic motions during flexion in OKC

A

Spin (best evidence supports this)

Anterior roll and posterior glide

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29
Q

What are the arthrokinematic motions during extension in OKC

A

Spin (best evidence supports this)

Posterior roll and anterior glide

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30
Q

What causes flexion and extension to be spin (4)

A
  1. Depth of cavity
  2. Labrum
  3. Negative pressure of joint
  4. Ligamentous capsule and stability
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31
Q

True or False:

You do joint play to free up motion throughout the entire capsule for the hip

A

True

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32
Q

What does the hip equal

A

Femur

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33
Q

What does the pelvis equal

A

Os coxa

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34
Q

What bone are we talking about in OKC

A

Hip

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35
Q

What bone are we talking about in CKC

A

Pelvis

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36
Q

What hip motion does posterior tilting of the pelvis cause

A

Hip extension

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37
Q

What hip motion does anterior tilting of the pelvis cause

A

Hip flexion

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38
Q

What are the sagittal plane motions of the pelvis

A

Posterior and anterior tilting/tipping

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39
Q

What are the frontal plane motions of the pelvis

A

Hiking/elevation and dropping/depression

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40
Q

Why is elevation/depression of the pelvis considered hemipelvic motion

A

Because only one hemipelvis moves

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41
Q

What muscles causes right hip elevation

A

Right quadratus lumborum and left gluteus medius

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42
Q

What does contralateral hemipelvis elevation cause at the ipsilateral hip

A

ABD of ipsilateral hip

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43
Q

What does contralateral hemipelvis depression causes at the ipsilateral hip

A

ADD of ipsilateral hip

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44
Q

What is more common hemipelvic depression or elevation

A

Depression

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45
Q

What is hemipelvic depression called

A

Trendelenburg

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46
Q

When do you see hemipelvic elevation (3)

A
  1. Foot drop
  2. Leg length discrepancy
  3. Poor hip flexor strength
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47
Q

What hip are you pivoting about or around for the transverse plane motions of the hip

A

The hip of the leg you are standing on

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48
Q

What motions occur in the transverse plane at the hip

A

Forward and backward rotation

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49
Q

What is left forward rotation equal to

A

Left hemipelvis forwardly rotating about or around the right hip

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50
Q

What is left backward rotation equal to

A

Left hemipelvis backwardly rotating about or around the right hip

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51
Q

What is left forward rotation of the hip in terms of IR/ER for both hips

A

Left: ER
Right: IR

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52
Q

What is left backward rotation of the hip in terms of IR/ER for both hips

A

Left: IR
Right: ER

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53
Q

Do you use anterior/posterior for rotation and the hip

A

Negative on that one ghost rider

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54
Q

Which way do the pelvis and lumbar spine move in OKC lumbopelvic rhythm

A

The same direction

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55
Q

What does lumbopelvic rhythm strive to do in the closed CKC

A

Keep the head and trunk upright

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56
Q

Which way do the pelvis and lumbar spine move in CKC lumbopelvic rhythm

A

Opposite directions

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57
Q

What is Janda’s pelvic cross syndrome

A

Excessive anterior or posterior tilt of the pelvis

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58
Q

If you have anterior pelvic tilting in CKC what occurs at the lumbar spine

A

Lumbar extension

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59
Q

If you have psoterior pelvic tilting in CKC what occurs at the lumbar spine

A

Lumbar flexion

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60
Q

What is an adaptively lengthened muscle referred to as

A

A weak and inhibited muscle

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61
Q

What is an adaptively shortened muscle referred to as

A

A strong facilitated muscle

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62
Q

What is adaptively shortened and lengthened during anterior pelvic tilting in the CKC

A

Shortened: Hip flexors and erector spinae
Lengthened: Rectus abdominis and hamstrings

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63
Q

What is adaptively shortened and lengthened during posterior pelvic tilting in the CKC

A

Shortened: Rectus abdominis and hamstrings
Lengthened: Hip flexors and erector spinae

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64
Q

How much of the acetabulum do the pubis, ischium, and ilium make

A

Pubis: 1/5
ISchium: 2/5
Ilium: 2/5

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65
Q

When does full ossification of the acetabulum occur

A

15-25 years old

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66
Q

True or False:

The acetabulum has a horseshoe shaped articular area

A

True

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67
Q

What type of cartilage makes up the labrum of the acetabulum

A

Fibrocartilaginous

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68
Q

Why is fibrocartilage good

A

It has the ability to heal

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69
Q

Where is the transverse acetabular ligament located

A

The inferior part of the acetabulum

70
Q

What does the transverse acetabular ligament do (3)

A
  1. Spans articular gap of acetabulum
  2. Forms roof of tunnel
  3. Provides support
71
Q

Which way does the acetabulum face

A

Anterior, inferior, and lateral

72
Q

What is the center edge angle

A

Reference point from the center of the femoral head vertical and then reference point to edge of the acetabulum

73
Q

Which part of the acetabulum does the center edge angle go to

A

The boney part

74
Q

What does the labrum attempt to do

A

Provide structure to the acetabulum

75
Q

What are the 3 changes that occur to the acetabulum with age

A
  1. Ossification of the articulation of the 3 bones of the pelvis
  2. Decreased acetabular roundness (Wolff’s Law)
  3. Increased center edge angle
76
Q

What does ossification of the 3 pelvic bones do

A

Increases central stability

77
Q

What does decreased acetabular roundness do

A

Reduces co-aptation (mathcing) of femoral head and acetabulum

78
Q

What does decreased co-aptation of the acetabulum cause

A

Decreased mobility over time but more stability

79
Q

What does increased center edge angle cause

A

Increased superior stability due to Wolff’s Law

80
Q

True or False:

the younger you are the more likely you are to dislocate the hip superiorly due to the decreased center edge angle

81
Q

What is more spherical the acetabulum or the femoral head

A

Femoral head

82
Q

how is the femoral head oriented

A

Anterior, medial, and superior

83
Q

IS the femoral head and acetabulum a perfect match

84
Q

Is the hip better for mobility or stability

85
Q

How much congruency does the femoral head and acetabulum have

86
Q

What does the ligamentum teres carry

A

Acetabular branch of obturator artey

87
Q

Where does the ligamentum teres attach on the femoral head

A

Fovea Capitis

88
Q

How do you measure the angle of inclination

A

Draw a line through the head of the femur out the fovea capitis then draw another line through the shaft of the femur

89
Q

What does the angle of inclination contribute to

A

The normal valgus position of the knee

90
Q

What is the angle of inclination during early infancy, adulthood, and elderly years

A

Early infancy: 150
Adulthood: 125
Elderly years: 120

91
Q

Why does the angle of inclination change as we age

A

Due to compression (Wolff’s Law)

92
Q

What is considered coxa valga

A

Greater than 125

93
Q

What is considered coxa vara

A

Less than 125

94
Q

What does coxa valga cause (3)

A
  1. Increase leg length producing hip adduction
  2. Increases pre load to hip abductors
  3. Decreases moment arm of abductors
95
Q

Is there a force output change in the hip abductors with coxa valga and why

A

No because the increased preload and decreased moment arm balance each other out

96
Q

What does coxa vara cause (5)

A
  1. Decrease leg length
  2. Relative hip abduction
  3. Poor hip abductor length tension relationship
  4. Impingement may limit abduction ROM
  5. Stress concentration superior contact area
97
Q

What is stress concentration superior contact area

A

There is less contact between the femoral head and the acetabulum

98
Q

What does the stress concentration superior contact area cause

A

Less surface area to distribute force of the body weight through the femur putting patient at risk for early on set OA

99
Q

What is more concerning coxa valga or coxa vara

100
Q

Is valga congenital or traumatic

A

Truly congenital

101
Q

What are 2 ways to get coxa vara

A
  1. Fracture

2. Slipped capital femoral epiphysis

102
Q

Who is at greater risk of slipped capital femoral epiphysis

A

Adolescent males with a higher BMI

103
Q

What is the angle of version or torsion angle

A

How far anterior or posterior the femoral head is compared to the femoral condyles which are in the frontal plane

104
Q

How do you measure the torsion angle

A

Draw a reference line through the frontal plane that goes through the femoral condyles then draw another line through the greater trochanter, neck and femoral head

105
Q

What is the normal range for the torsion angle

106
Q

What causes the torsion angle

A

Fetal development

107
Q

What is anterversion or medial femoral torsion

A

The femoral head is anterior to the frontal plane

108
Q

How do you determine if someone has a congenital problem when it comes to torsion angle

A

Bilateral comparison

109
Q

How much anterversion are we ideally born with

A

30 degrees

110
Q

True or False:
If you are born with excessive femoral anteversion you will lose some of that anterversion but not enough to have a normal anterversion

111
Q

How do you compensate excessive femoral anteversion

A

Internally rotate hip

112
Q

What type of gait does excessive femoral anterversion cause if compensated or uncompensated

A

Compensated: Toe in gait
Uncompensated: Toe out gait

113
Q

What happens to the femoral head if the excessive femoral anteversion is not compensated

A

A significant amount of the femoral head will be exposed anteriorly

114
Q

True or False:

The majority of people with excessive femoral anteversion will have the compensated toe in gate

115
Q

What happens with excessive anteversion to improve congruency of the joint

116
Q

What is it considered if torsion angle is less than 8-15

A

Retroversion

117
Q

What is exposed if there is retroversion

A

Head of the femur posteriorly

118
Q

What happens with excessive retroversion to improve congruency of the joint

119
Q

What does compensated retroversion result in

A

Toe out gate

120
Q

What is the position of most congruency of the hip

A

30 flexion and ABD and slight ER

121
Q

Is the position of most congruency of the hip the open or closed pack position

A

Open pack even though that is normally not the case

122
Q

Why is the position of most congruency the open pack position of the hip

A

The soft tissue of the hip is slackened

123
Q

True or False:

The open pack position of the hip is used for post hip dislocation immobilization

124
Q

True or False:

High compressive loads may be necessary to achieve maximum congruency

125
Q

True or False:

Going into the open pack position causes the soft tissue of the hip to uncoil

126
Q

What tightens the hip ligaments

127
Q

What causes a flexion contracture

A

Resting on the Y ligament for a long period of time

128
Q

Why do people with flexion contractures rest on the Y ligament

A

Due to poor core strength

129
Q

What is the closed pack position of the hip

A

Extension and IR

130
Q

True or False:

The inferior angulation of the acetabulum is less than the superior angulation of the femoral neck

131
Q

What does the inferior angulation of the acetabulum being less than the superior angulation of the femoral neck result in

A

A significant portion of the head remains uncovered

132
Q

What does a significant portion of the head remaining uncovered potentially lead to

A

Decreased superior stability

133
Q

What happens because both the acetabulum and femoral neck face anteriorly

A

A significant portion of the anterior head is exposed

134
Q

What does a significant portion of the anterior head being exposed do

A

Decreased anterior stability

135
Q

True or False:

Anterior dislocation of the hip can result in vascular compromise of femoral vessels or femoral nerve palsy

136
Q

What will tension to the iliopsoas group do

A

Pull the lumbar curvature anteriorly increasing the lumbar lordosis

137
Q

What happens if the iliacus is tight

A

Increased anterior pelvic tilt

138
Q

What motion does the TFL cause

A

Flexion and IR

139
Q

What does the TFL do if the hip is already flexed

140
Q

What is the most important contribution of the TFL

A

Maintaining tension in the ITB to increase stability of femur

141
Q

True or False:

The ITB is considered to assist in relieving the femur or some of the tesile loads on the shaft

142
Q

True or False:

The TFL helps prevent bowing of the femur during single leg stance

143
Q

How much ADD should the Ober’s test get if ITB is normal

144
Q

What type of activity occurs on the side of compression of a bone

A

Osteoblastic activity

145
Q

What type of activity occurs on the side of tension of a bone

A

Osteoclastic activity

146
Q

True or False:

The gluteus medius is the deltoid of the hip

147
Q

What do all fibers of the gluteus medius do

148
Q

What do the anterior fibers of the gluteus medius do

A

Flexion and IR of hip

149
Q

What do the posterior fibers of the gluteus medius do

A

Extension and ER of hip

150
Q

What does gluteus medius weakness cause

A

Trendelenburg gait (hemipelvic depression of the contralateral side of gluteus medius)

151
Q

What can a tight gluteus medius cause

A

Tronchanteric bursitis due to increased friction

152
Q

What is more likely to happen weak or tight glutes medius

153
Q

True or False:

The peak isometric torque of the hip ADD exceeds that of the ABD

154
Q

What is the only hip ADD to cross the knee

155
Q

What does adaptive shortening of the hip ADDs causes

A

Hemipelvic depression and ADD

156
Q

What does adaptively shortened ADDs of the hip move

A

The pelvis on the femur

157
Q

True or False:

There is no muscle with a primary function of hip medial rotation

158
Q

What are the most significant muscles that contribute to IR of hip (2)

A
  1. TFL

2. Gluteus medius

159
Q

When does the piriformis cause hip IR

A

Hip flexion greater than 90

160
Q

What are the 6 primary muscles that cause ER of hip

A
  1. Obturator internus
  2. Obturator externus
  3. Superior gemellus
  4. Inferior gemellus
  5. Quadratus femoris
  6. Piriformis
161
Q

When does the piriformis cause ER of the hip

A

Hip flexion less than 90

162
Q

How much of the superincumbent BW do each femur bear

163
Q

True or False:

The magnitude of gravitational toques around each hip is identical but opposite directions

164
Q

Is hip abductor muscle force required to maintain equilibrium of the hip in bilateral stance

165
Q

How much of the BW does the femur bear in single leg stance

A

2/3 plus the weight of the unsupported limb

166
Q

How much of the BW does the trunk make up

167
Q

What is the equation for torque

168
Q

What is the compression force at the hip equal to

A

The body weight compression and the muscular force compression

169
Q

What is responsible for absorbing the compression force at the hip

170
Q

Read through all of the ABD force stuff in the notes cards are too hard to make

Kinesio 2 (5 decks)

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