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Ortho Hip > Hip Examination > Flashcards

Hip Examination Flashcards

1
Q

What are the flexor muscles of the hip? What nerves innervate them?

A 
Iliopsoas
Sartorius
TFL
Rectus Femoris
Adductor Longus
Pectineus

femoral nerve

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2
Q

What are the extensor muscles of the hip? What nerves innervate them?

A 
Gluteus Maximus
Adductor Magnus (posterior)
Biceps femoris(long)
Semitendinosis
Semimembranosus

inferior gluteal, obturator, and sciatic nerves

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3
Q

What are the external rotators of the hip? What nerves innervate them?

A 
Gluteus Maximus
Piriformis
Obturator Internus
Gemellus Superior
Gemellus Inferior
Quadratus Femoris

Inferior gluteal nerve and nerves to piriformis, obturator, gemellus superior and inferior, and quadratus femoris.

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4
Q

What are the adductor muscles of the hip? What nerve innervates them?

A

Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus (anterior/posterior)

Obturator nerve

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5
Q

What are the abductor muscles of the hip? What nerve innervates them?

A 
gluteus medius (all)
gluteus minimus (all)
TFL

superior gluteal nerve

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6
Q

What type of joint is the hip? how many degrees of freedom does it have?

A

multiaxial ball and socket joint

3 degrees of freedom

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7
Q 
What are normal ROM for hip:
flexion?
extension?
abduction?
adduction?
ER?
IR?
A 
flexion- 110-120 degrees
extension- 10-15 degrees
abduction- 20-50 degrees
adduction- 20 degrees
external rotation- 40-60 degrees
internal rotation- 20-40 degrees
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8
Q

What’s the closed pack postion of the hip?

A

full extension, slight abduction, slight IR

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9
Q

What’s the loose pack postion of the hip?

A

30 degrees flexion, 30 degrees abduction, slight ER

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10
Q

What’s the capsular pattern of the hip?

A

flexion, abduction, IR

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11
Q

What’s a normal angle of inclination?

What forces will be experienced with coxa vara/valga

A

125 degrees

105 or less = coxa vara
increased downward sheer across femoral neck, decreased compression, and decreased functional length of hip abductor muscles

140 or more = coxa valga
increased limb length, decreased sheer, increased compression over decreased available weight bearing surface, increased functional length of hip abductor muscle

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12
Q

What is normal anteversion? How do you test it?

A

8-15 degrees

craig’s test.
pt prone, feel for where greater trochanter is most lateral and measure bisection of tibia against vertical.

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13
Q

What are general observations you need to make for someone with hip complaint?

A

age, sex, weight, fitness level, independence, assistive device.

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14
Q

What should you ask in the subjective examination?

A

Where is the pain?
What position makes it increase or decrease?
What does it feel like?
Describe how it changes during a 24 hour period.
Motion problems?
Mechanism of Injury?

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15
Q

What is the possible source of groin pain?

A

hip

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16
Q

What is the possible source of anterior medial thigh pain?

A

hip

17
Q

What is the possible source of posterior pain?

A

Lumbar spine

18
Q

What is the possible source of lateral thigh pain?

A

Lumbar spine

19
Q

What is the possible sources of lateral hip pain?

A

trochanteric bursitis
gluteus medius strain
L4 Nerve root pain

20
Q

Classically, what pain is in the anterior groin area and radiates to the medial thigh?

A

hip

groin

21
Q

what is the “c-sign” characteristic of?

A 
joint pathology
(often misunderstood as a lateral disorder)
22
Q

Stiffness in the AM or after sitting that disappears within half an hour is characteristic of what?

A

osteoarthritis

23
Q

Stiffness in the AM that usually lasts longer than 1 hour is characteristic of what?

A

rheumatoid arthritis

24
Q

Hip stiffness in the am and stiffness after sitting and pain with WB can be characteristic of what?

A

avascular necrosis

25
Q

What do you want to know in the subjective examination of recent trauma?

A 
mechanism of injury
force
direction
weight bearing
age of the patient
pain
popping
swelling
function
26
Q

What do you want to know in the subjective examination of chronic pain?

A 
pain
positions
previous history
chronic effusion
weakness
gait
clicking, grinding, or popping
function
27
Q

What are some red flags?

A

unexplained weight loss, fatigue
fever
loss of appetite
bowel/bladder changes
night pain unrelated to movement
severe pain
hip pain in men 18-24 yoa of unknown etiology-testicular cancer
pain at mcBurney’s point (1/3-1/2 distance from R ASIS to umbilicus tenderness coupld be appendicitis)
blumberg’s sign- rebound tenderness for visceral pathology (supine, push down deep and slow perpendicular to an abdomincal region away from painful region, then lift up quickly, positive sign= pain on release)

28
Q

What are the systemic causes of hip pain?

A 
RA
Crohn's disease
Reiter's syndrome
SLE
psoriasis
bone tumors
inflammatory bowel or PID
sickle cell anemia
hemophelia
urogenital problems
ankylosing spondylitis
29
Q

How do you screen for a sports hernia?

A

Positive signs =
palpation of a marble sized lump along the path of the inguinal ligament
pain with exertion, cough, menstruation
radiating pain into the groin, ipsilateral thigh, flank, or lower abdomen
pain with cutting, turning, stride out

30
Q

nontraumatic causes of hip pain? and how should you examine this?

A

use a pain diagram and have patient elaborate on each area

  • osteoarthritis
  • overuse injuries (muscle strain/ stress fracture)
  • femoral anterior impingement
  • inflammation (bursitis, tendonitis)
  • hernia(inguinal, femoral)
  • gout
  • referred pain (lumbar spine, SIJoint, knee)
  • Infectious diseases
  • vascular diseae (avascular necrosis)
  • childhood disorders (congenital dysplagia, legg-calve-perthes disease, SCFE)
  • systemic
  • myofascial pain
  • neurological (nerve entrapment)
31
Q

What are examples of traumatic injuries?

A 
acetabular labral tears
femoral subluxation/dislocation
femoral fracture
pelvic fracture
avulsion fractures
soft tissue contusions
myositis ossificans

Ortho Hip (2 decks)

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