Hip Complex Flashcards by Chavez Girls

What type of joint is the hip?

Synovial/diarthrodial ball & socket

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What are the 3 degrees of freedom of the hip?

Flexion/Extension
Abduction/Adduction
External Rotation/Internal Rotation

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The acetabulum is a lunate surface with a horse-shoe shaped periphery, articulates with __________ _________, & is covered with hyaline.

Femoral head

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What 2 things create a tunnel allowing fibroelastic fat carrying blood vessels deep into the acetabulum?

Acetabular notch
Transverse acetabular ligament

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What is the deepest portion of the acetabulum that does not articulate directly with the femoral head?

Acetabular fossa

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The acetabulum is ___ degrees inferior & ___ degrees anterior (anteversion).

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What is the term for a shallow acetabulum with decreased coverage & instability that’s often found in infancy (but can be asymptomatic in adults)?

Acetabular dysplasia

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What is the term for over coverage of the acetabulum leading to impingement?

Coxa profunda

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(Anteversion/Retroversion) leads to instability while (Anteversion/Retroversion) leads to over coverage.

Anteversion
Retroversion

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What is the angle that includes coverage of the femoral head & connects the lateral rim & center of the femoral head?

Center edge angle

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What is the typical range of the center edge angle? If it’s less, what does that indicate? How about more?

22-50
Less: Dysplasia
More: Impingement

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What is the measurement of acetabular depth, from line parallel to teardrops on X-ray to lateral acetabulum?

Acetabular inclination

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What is the typical range of acetabular inclination? If it’s more, what does that indicate?

32-45
More: Dysplasia

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What is the term for the ring of wedge-shaped fibrocartilage that deepens the socket & increases concavity?

Acetabular labrum

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What ligament does the acetabular labrum blend with?

Transverse acetabular ligament

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True or False: Femoral head & fovea are rounded with hyaline cartilage.

False (only head)

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What ligament is attached to the femoral fovea?

Ligamentum teres (ligament of head of femur)

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The femoral head faces in which directions with respect to femoral shaft & condyles?

Medially
Superiorly
Anteriorly

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What plane is the angle of inclination of the femur measured in?

Frontal

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How many degrees is the angle of inclination of the femur? Which population is it greater or less in?

125
Greater: Children
Less: Women

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What is the abnormality when there’s an increased angle of inclination of the femur?

Coxa valga

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Coxa valga is associated structurally with genu (valgum/varum).

Varum

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What is the abnormality when there’s a decreased angle of inclination of the femur?

Coxa vara

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True or False: Coxa valga has increased shear on neck, MA abductors, coverage –> instability, impingement.

False (vara)

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Coxa (valga/vara) increases risk of SCFE.

Vara

What plane is the angle of torsion of the femur measured in?

Transverse

Which angle measures the axis through the femoral head/neck & femoral condyles?

Angle of torsion

What is the range of angle of torsion & direction?

10-20 anteriorly

What range of angle of torsion correlates with anteversion?

15-20

What range of angle of torsion correlates with retroversion?

< 10-15

(Anteversion/Retroversion) has increased IR, decreased ER, & decreased stability.

Anteversion

Anteversion with angle of torsion would be anteversion (hip) or medial femoral torsion at the ________.

Knee

True or False: There's more articular surface on the acetabulum than the femur.

False

When standing, the femoral head is exposed in which 2 directions?

- Anteriorly - Superiorly

Most joint congruence occurs during which 3 motions especially with weight-bearing?

- Flexion - Abduction - External Rotation (slight)

What structure may add a partial vacuum that adds stability from atmospheric pressure?

Fossa

What 2 tests can be used to find acetabular dysplasia in infancy?

- Barlow - Ortolani

The joint capsule is irregular, dense fibrous tissue with ___ thickened capsular ligaments.

True or False: The joint capsule is thickest anterior-superiorly & thinnest posterior-inferiorly.

True

The joint capsule is attached from the acetabulum to the base of the femoral ________.

Neck

What carries blood vessels that provide nutrition to the femoral head/neck?

Retinacular fibers

The femoral neck is (intra/extra)capsular & greater/lesser trochanters are (intra/extra)capsular.

- Intra - Extra

Which hip bursae is trochanteric & reduces friction between posterior facet, glute max, ITB, & greater trochanter?

Lateral

Anterior hip bursae includes glute _______ bursa & iliopsoas bursa.

Med

Which hip bursae is ischiogluteal?

Posterior

Ligamentum teres is (intra/extra)articular & (intra/extra)synovial.

- Intra - Extra

Ligamentum teres attaches from acetabular notch under transverse acetabular ligament to where?

Femur fovea

What provides secondary blood supply to the femoral head?

Ligamentum teres

Ligamentum teres provides restraint for which motion at the hip when in > 90 degrees of hip flexion?

IR/ER

Which ligament is fan-shaped & goes from AIIS to intertrochanteric line?

Iliopsores ligament (Y ligament of Bigelow)

Iliopsores ligament is the primary stabilizing component of (anterior/posterior) hip.

Iliopsores ligament resists excessive (internal/external) rotation especially when hip is neutral or flexed.

External

Which ligament is from the pubic portion of the acetabular rim to the iliopectineal eminence?

Pubofemoral

Pubofemoral ligament forms a sling that supports (superior/inferior) femoral neck & connects fibers between iliofemoral & ischiofemoral.

Inferior

Pubofemoral ligament resists ER when the hip is __________.

Extended

Which ligament attaches to the posterior surface of the acetabular rim & labrum?

Ischiofemoral

Ischiofemoral ligament is the primary restraint to (internal/external) rotation.

Internal

What are the 3 motions that comprise close-packed position?

- Extension - Abduction (slight) - Internal Rotation

What are the 3 motions that comprise loose-packed position?

- Flexion (mid-range) - Abduction (slight) - Mid-rotation

True or False: Capsule & ligaments are taut in hyperextension & support 2/3 of body weight without muscular assistance.

True

Line of Gravity falls (anterior/posterior) to hip --> extension moment.

Posterior

The hip is most vulnerable to dislocation (posterior) in __________ & __________.

Flexion & adduction

What lines up against stress lines?

Trabeculae

Most weightbearing stresses in pelvis pass from where to the acetabulum?

Femoral head transfers forces to shaft --> creating bending moment across femoral neck resulting in:

- Superior compressive forces - Inferior tensile forces

What type of force is being created between HAT & GRF?

Shear

Which trabecular system resists vertical compressive forces through the femoral head?

Medial

Which trabecular system resists shear forces of bodyweight of HAT & GRF?

Lateral

Peak contact pressures during unilateral stance are located near the superior aspect of the acetabulum _________ which shows the greatest prevalence of degeneration.

Dome

True or False: Women have smaller contact area & higher peak stress during unilateral stance.

True

The primary weight-bearing area of the femoral head is (superiorly/inferiorly) & degenerative changes include loss of ball shape & flattening.

Superiorly

(Convex/Concave) femoral head on (convex/concave) acetabulum.

- Convex - Concave

The femoral head spins _________ with flexion & ________ with extension.

- Posteriorly - Anteriorly

The femoral head will roll ________ & glide ________ during hip abduction.

- Superior - Inferior

The femoral head will roll ________ & glide _________ during hip adduction.

- Inferior - Superior

The femoral head will roll __________, glide ________ during internal rotation.

- Anterior - Posterior

The femoral head will roll _________, glide ________ during external rotation.

- Posterior - Anterior

How many degrees of flexion occurs when the knee is extended? When the knee is flexed?

- 90 - 120

What range of extension occurs?

10-30

What range of abduction occurs? How about adduction?

Abd: 45-50 Add: 20-30

What range of internal rotation & external rotation occur?

42-50

Normal gait on level ground requires:

30 degrees of flexion 10 degrees of extension 5 degrees of both abduction & adduction 5 degrees of both internal & external rotation

If the opposite side of the pelvis hikes, the stance hips (abduct/adduct).

Abduct

Lateral pelvic shift in bilateral stance: (abduct/adduct) on shift side & (abduct/adduct) on opposite.

- Adduct - Abduct

Forward rotation: non-weight-bearing pelvis moves anteriorly & produces (internal/external) rotation of the weight-bearing hip.

Internal

Is there larger ROM when the head or leg moves through space to produce hip, pelvic, & spine motion?

Head

Sidelying leg lift: hip (adduct/abduct), lateral pelvic tilt, ________ side bend.

- Abduct - Lumbar

What 2 reflexes help head fixation upright & vertical?

- Tonic labyrinthine - Optical righting

Piriformis ER in (flexion/extension) & IR in (flexion/extension).

- Extension - Flexion

What group of hip muscles bring the swing limb forward during gait?

Flexors

What are the 4 primary hip flexors?

- Iliopsoas - Rectus femoris - TFL - Sartorius

Iliopsoas hip flexion: APT, lumbar _________, hip flexion in sitting.

Extension

Rectus femoris biggest contribution to hip flexion when the knee is __________.

Flexed

What motions does sartorius do at the hip? How about at the knee?

- Hip: Flexion, Abduction, External Rotation - Knee: Flexion, Internal Rotation

Which group of hip muscles can help flex the hip from extension & extend from flexion?

Adductors

What are the 5 hip adductors?

- Pectineus - Adductor brevis - Adductor longus - Adductor magnus - Gracilis

__________ is a 2 joint hip adductor that can help flex the hip if the knee is extended.

Gracilis

Glute max is a 1 joint hip extensor that can also (medially/laterally) rotate.

Laterally

When does glute max have the longest MA/peak efficiency for extension?

Hip flexed 70 degrees

What 3 muscles assist the hip extensors?

- Posterior glute med - Posterior adductor magnus - Piriformis