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Kinesiology Term 1 > Hip Complex > Flashcards

Hip Complex Flashcards

1
Q

Hip Joint

A

Coxofemoral Joint

OR

Femoroacetabular Joint

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2
Q

Hip does what

A

Support weight of head, arms, trunk (HAT)

Structured primarily to serve weightbearing function

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3
Q

Hip joint articulation

A

Acetabulum of pelvis
AND
Head of femur

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4
Q

Hip Joint Classification

A

Diarthrodial
Synovial
Ball-and-Socket
3 DOF

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5
Q

Hip Osteokinematics

A

Flexion/Extension
Abduction/Adduction
Medial(IR)/Lateral(ER) rotation

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6
Q

Hip Open-packed Position

A

30 deg Flexion, 30 deg ABd, slight ER

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7
Q

Hip Closed-packed Position

A

Max extension, slight ABd, IR

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8
Q

Proximal Joint structure:
Pelvis 3 Bones

A

Ilium (2/5ths)
Ischium (2/5ths)
Pubis (1/5th)

All contribute/create to acetabulum

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9
Q

Full ossification of the pelvis happens between what ages?

A

20-25 years

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10
Q

Proximal Joint structure:
Acetabulum

A

Lunate surface
Acetabuluar notch
Acetabular fossa

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11
Q

Proximal:
Lunate surface

A

Horseshoe-shaped
Covered in a hyaline cartilage
Only to articulate with head of femur
Allows contact stress to be evenly distributed

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12
Q

Proximal:
Acetabular notch

A

Inferior aspect of the lunate surface
Transverse acetabular ligament-fibrous band connecting 2 inferior ends of lunate surface
Creates a fibro-osseous tunnel to acetabular fossa (fibroelastic fat covered with synovial membrane)

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13
Q

Proximal:
Acetabular fossa

A

Deepest aspect
Does NOT articulate with femoral head

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14
Q

Proximal:
Normal orientation of acetabulum

A

Faces lateral, inferior, slightly anterior*

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15
Q

Proximal:
Center edge angle of the acetabulum

A

Measures depth of acetabulum in the frontal plane
Normal: 25-40 degrees

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16
Q

Proximal:
Acetabular Dysplasia

A

<25 degrees
Abnormally shallow acetabulum
Lack of coverage of femoral head
Can lead to:
-Instability of the hip
-Increased loading of superior acetabular rim

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17
Q

Proximal:
Coxa Profunda/Acetabular Protrusio

A

> 40 degrees
Acetabulum excessively covers the femoral head
Can lead to:
-Mechanical ROM restriction
-Impingement between femoral head-neck junction and acetabulum

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18
Q

Proximal:
Anteversion

A

Acetabulum is positioned anteriorly in the transverse plane

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19
Q

More anteversion or less inclination:

A

Instability

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20
Q

Proximal:
Retroversion

A

Acetabulum is positioned posteriorly in the transverse plane

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21
Q

Distal:
More retroversion or more inclination:

A

Over coverage and impingement between acetabulum femoral head-neck junction

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22
Q

What does all of the acetabular abnormalities lead to?

A

Pathologies, including excessive cartilage wear and osteoarthritis

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23
Q

Proximal:
Acetabular Labrum

A

Wedge-shaped fibrocartilage ring
Attached to outer periphery of acetabulum by calcified cartilage
Nerve endings present:
-Proprioception (enhance stability)
-Pain (source/signal)
Transverse Acetabular Ligament

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24
Q

What happens when the labrum is compromised?

A

Friction stresses increases, deterioration of articular cartilage of hip joint =osteoarthritis

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25
Q

Proximal:
Functions of the acetabular labrum

A

Deepens socket
Increases concavity = femur head+acetabulum
Acts as a seal = stability

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26
Q

An abnormal shallow acetabulum increases what?

A

Stress on the surrounding capsule and labrum

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27
Q

Proximal:
Transverse Acetabular Ligament

A

A continuation of the acetabulum labrum
Serves as a tension band between anteroinferior and posteroinferior aspects of acetabulum
Protects blood vessels that travel beneath it

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28
Q

Acetabular labral tears are increasingly recognized as a source of:

A

hip pain and as a starting point for degenerative changes at the acetabular rim

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29
Q

What are some of the potential symptoms of a torn labrum?

A

anterior groin pain, clicking, locking, catching, instability, giving way, or joint stiffness

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30
Q

Distal Joint structure:
Femur

A

Head of femur
Neck of femur
Shaft of femur

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31
Q

Distal:
Head of femur

A

Covered in hyaline cartilage
2/3 of a sphere
Fovea- roughened pit serves as attachment site for ligamentum teres
Ligamentum teres-ligament of the head of the femur

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32
Q

T/F The radius of curvature of the femoral head is smaller in women than in men in comparison with the dimensions of the pelvis

A

True

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33
Q

Distal:
Neck of femur

A

Angulated so that the femoral head faces medially, superiorly, and anteriorly

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34
Q

Distal:
Angle of Inclination

A

Frontal plane
Between axis through femoral head & neck and longitudinal axis of femoral shaft
Normal: 125 degrees

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35
Q

T/F Women have a larger angle of inclination than men.

A

False; the angle of inclination is somewhat smaller than it is in men, owing to the greater width of the female pelvis.

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36
Q

Distal:
Coxa Valga

A

Pathological INCREASE >125 deg
Creates “longer limb”
Can be associated with:
-Decreased length of hip ABD MA
-Decreased joint instability (less articular surface contact) =can result in hip dislocation

37
Q

Distal:
Coxa Vara

A

Pathological DECREASE <125 deg
Creates a “shorter limb”
Can be associated with:
-Increased length of hip ABD MA
-Increased joint stability (more coverage)

SN: Shear, bending forces =likely to Fx

38
Q

Distal:
What can coxa vara and valga lead to?

A

abnormal lower extremity biomechanics
altered muscle function
gait abnormalities that contribute to pathologies such as labral pathology, hip and knee osteoarthritis, and slipped capital femoral epiphysis

39
Q

Slipped capital femoral epiphysis (SCFE)

A

Common adolescent hip disorder; weightbearing forces may slide the femoral head inferiorly.

Surgical intervention - complication of an unstable femoral epiphysis

40
Q

Distal:
Angle of torsion

A

Transverse plane
Axis through femoral head and neck and an axis through distal femoral condyles
Normal: 10-20 degrees ANTEVERSION in adults

41
Q

Distal:
Femoral anteversion

A

Pathological increase >20 deg
Reduces joint stability

42
Q

Distal:
Femoral retroversion

A

Pathological decrease <15 deg

43
Q

Excessive and decreased femoral anteversion in toe type gait

A

Excessive anteversion = Toe in
Decreased anteversion = Toe out

44
Q

Distal:
Accessory structures

A

~Joint Capsule
-Longitudinal fibers: attached proximal acetabular rim and labrum
-Oblique fibers: form collar around the femoral neck
-Zona orbicularis: Prevents distraction
-Thicker anterosuperior, weaker posteroinferior

45
Q

Distal:
Accessory structures

A

~Femoral neck: intracapsular
~Greater and lesser trochanters: extracapsular

46
Q

Distal:
Accessory structures

A

~Synovial membrane: lines capsule
-Retinacular fibers: carry blood vessels to supply head and neck

47
Q

Distal:
Accessory structures

A

~Bursae
-3 commonly described and associated with their corresponding musculature

48
Q

Distal:
Ligamentum Teres

A

Location: Acetabular notch | Fovea of femur

Function: Blood supply to femoral head | Checks hip rotation at >90 deg hip flexion

49
Q

Distal:
Iliofemoral (“Y”) Ligament

A

Location: Apex-AIIS | Intertrochanteric line of femur
(Anterior; inverted Y)

Function: Checks excessive ER

50
Q

Distal:
Pubofemoral Ligament

A

Location: Pubic portion of acetabular rim | Blends w/ iliofemoral and ischiofemoral ligaments
(Anterior)

Function: Controls ER in an extended position

51
Q

Distal:
Ischiofemoral Ligament

A

Location: POSTERIOR acetabular rim | Fibers spiral around femoral neck | Blend w/ capsule and insert on inner surface of greater trochanter

Function: Primary restraint to IR

52
Q

Optimal articular contact occurs with combined:

A

flexion, abduction, and lateral rotation (ER)

53
Q

When is the capsuloligamentous tension least?

A

The capsuloligamentous tension at the hip joint is least when the hip is in mid-range flexion, slight abduction, and mid-rotation.

54
Q

Distal:
Structural Adaptations of Femur

A

~Trabecular systems
-Line up in femur along lines of stress
-Structural scaffolding

55
Q

Distal:
Medial Trabecular system

A

-Medial cortex of upper femoral shaft
-Oriented along vertical COMPRESSIVE forces

56
Q

Distal:
Lateral Trabecular system

A

-Lateral cortex of upper femoral shaft
-Oblique orientation in response to SHEAR forces

57
Q

Distal:
Trabecular Secondary Systems

A

~Secondary systems: Compressive (med) and Tensile (lat)
~Femoral neck: Zone of weakness

58
Q

Hip Joint
Open Kinetic Chain

A

Convex femoral head
ON
Concave acetabulum

=Opposite Roll + Glide

59
Q

Hip Joint
Closed Kinetic Chain

A

Concave acetabulum
ON
Convex femoral head

=Same Roll + Glide

60
Q

Hip flexion Arthrokinematics
in Open Kinetic Chain

A

In sagittal plane

Anterior roll
Posterior glide

61
Q

Hip Extension Arthrokinematics
in Open Kinetic Chain

A

In sagittal plane

Posterior Roll
Anterior Glide

62
Q

Hip ABduction Arthrokinematics
in Open Kinetic Chain

A

In frontal plane

Superior Roll
Inferior Glide

63
Q

Hip ADduction Arthrokinematics
in Open Kinetic Chain

A

In frontal plane

Inferior Roll
Superior Glide

64
Q

Hip Internal Rotation (IR) Arthrokinematics
in Open Kinetic Chain

A

In transverse plane

Anterior Roll
Posterior Glide

65
Q

Hip External Rotation (ER) Arthrokinematics
in Open Kinetic Chain

A

In transverse plane

Posterior Roll
Anterior Glide

66
Q

Pelvic Anterior Tilt Arthrokinematics
in Closed Kinetic Chain

A

In sagittal plane / coronal axis

BIL Hip flexion if standing on both legs
Hip flexion only on WB leg when SLS

67
Q

Pelvic Posterior Tilt Arthrokinematics
in Closed Kinetic Chain

A

In sagittal plane / coronal axis

BIL Hip extension if standing on both legs
Hip extension only on WB leg when SLS

68
Q

Lateral Pelvic Tilt Arthrokinematics
in Closed Kinetic Chain

A

In frontal plane / A-P axis | SLS WB is axis; Non-WB is where movement happens

Pelvic Hike:
On Right = Left Hip ABd
On Left = R Hip ABd

Pelvic Drop:
On Right = Left Hip ADd
On Left = R Hip ADd

69
Q

Lateral Shift of Pelvis Arthrokinematics
in Closed Kinetic Chain

A

In frontal plane / A-P axis| BIL WB | Pelvic drop

R Pelvic Shift:
Right hip ADd
Left hip ABd

L Pelvic Shift:
Right side ABd
Left side ADd

70
Q

Forward / Backward Pelvic Rotation

A

In transverse plane / longitudinal axis | Axis is the WB Leg

Forward Rotation:
Right around Left = Medial rotation of Left Hip
Left around Right = Medial rotation of Right Hip

Backward Rotation:
Right around Left = Lateral rotation of Left Hip
Left around Right = Lateral rotation of Right Hip

71
Q

Pelvi-femoral Rhythm

A

Open kinetic chain

Continuous relationship between femur, pelvis, and spine to increase overall available ROM for distal segment

72
Q

Lumbopelvic Rhythm

A

Closed kinetic chain

Continuous relationship between spine, pelvis, and femur to increase overall available ROM for distal segment

73
Q

What are some examples of activities where the hip support HAT?

A

Static erect posture and dynamic postures like:
-ambulation/gait
-running
-stair climbing

74
Q

Hip joint structure is influenced more by what?

A

By the demands placed on the joint when the limb is bearing weight

75
Q

How many muscles cross the hip?

A

9; rectus femoris, iliacus, psoas major, tensor fascia latae, sartorius, pectineus, adductor longus, adductor magnus, and gracilis

76
Q

The major muscles that contribute most of the flexion torque

A

the rectus femoris, iliopsoas, tensor fascia latae, and sartorius

77
Q

Muscles assisting with hip flexion

A

the pectineus, adductor longus, adductor magnus, and gracilis

78
Q

The hip adductor muscle group lies on the anteromedial aspect of the thigh and includes

A

the pectineus, adductor brevis, adductor longus, adductor magnus, and the gracilis muscles.

79
Q

The primary hip extensors cross the joint posteriorly and include

A

the one-joint gluteus maximus muscle and the two-joint hamstrings muscle group (LH biceps femoris, semitendinosus, and semimembranosus)

80
Q

Muscles assisting hip extension

A

the posterior fibers of the gluteus medius, from the posterior fibers of the adductor magnus muscle, and from the piriformis muscle

81
Q

The prime muscles responsible for producing hip abduction lie on the lateral side of the joint and include

A

the gluteus medius and gluteus minimus muscles.

82
Q

Muscles assisting hip abduction

A

The superior fibers of the gluteus maximus, the sartorius, and the tensor fascia lata muscle only during simultaneous hip flexion.

83
Q

What are the 6 short muscles function primarily as lateral rotators of the hip joint and pass posterior to the joint axis in a mediolateral direction.

A

obturator internus and externus, the gemellus superior and inferior, the quadratus femoris, and the piriformis muscles.

84
Q

What are the primary muscles producing medial rotation of the hip?

A

There are no muscles with a primary function of producing medial rotation of the hip joint. The more consistent medial rotators are the anterior portion of the gluteus medius, gluteus minimus, and the tensor fascia lata muscles.

85
Q

When bilateral stance is not symmetrical, what muscle activity will be necessary either to control the side-to-side motion or to return the hips to symmetrical stance?

A

frontal plane muscle activity (abd/add; mainly abd)

86
Q

What happens if inadequate abduction torque is created (e.g., from a weakened gluteus medius)?

A

the pelvis will drop on the contralateral side.

87
Q

In a unilateral stance, what needs to be active in order to keep the pelvis level?

A

Hip abductors must be active

88
Q

Compensatory Lateral Lean of the Trunk

A

Reduces MA of the gravitational force by shifting the line of gravity closer to the hip joint

Kinesiology Term 1 (8 decks)

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