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EPHE 344 > Hip Groin Thigh Pelvis > Flashcards

Hip Groin Thigh Pelvis Flashcards

1
Q

bones fuse at what age?

A

17

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2
Q

the strongest ligament of the of the pelvis is?

A

iliofemoral

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3
Q

what is the only quad muscle that crosses the hip

A

rectus femorus

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4
Q

whats is the muscle that usually get really tight and makes ppl look like they have big butts

A

iliospoas

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5
Q

sciatic nerve innervates?
femoral nerve innervates?
obturator innervates?

A
  • posterior thigh
  • anterior thigh
  • adductor group
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6
Q

3 external iliac arteries

A
  • femoral (travels deep into the adductor canal)
  • deep femoral
  • femoral circumflex (femoral neck and hip)
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7
Q
  • the biggest vein in the body

- one femoral vein

A
  • great saphenous vein

- external iliac vein

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8
Q

? is part of the deep fascia that invests the thigh musculature

A

the fascia lata femoris

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9
Q

the compartments are thick anteriorly, posteriorly, and laterally, but thin?

A

on the medial side

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10
Q

the IT band is located laterally serving serving ad the attachment for?

A

tensor fascia lata and greater aspect of the gluteus maximum

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11
Q

where do the quadriceps insert?

A

in a common tendon to the proximal patella

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12
Q

Hamstrings cross the knee joint ? and all except the short of ? crosses the hip

A

posteriorly

- head of the biceps

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13
Q

Bi-articulate muscles produce forces dependent upon position of both?

A

the knee and hip

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14
Q

pelvis moves in how many planes?

A

3

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15
Q

hip moves in how many planes

A

3

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16
Q

muscles are most commonly injured in what region

A

hip and pelvis

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17
Q

why can a injury to one muscles be very disabling and difficult to distinguish

A

because there are numerous muscles that attach in that region

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18
Q

what usually gets hurt (ligaments or muscle)

A

muscle!

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19
Q

when the hip does dislocate what direction does it dislocate in?

A

backwards

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20
Q

3 injury prevention techniques

A

1) protective equipment
2) physical conditioning
3) shoes

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21
Q

2 chronic/ overuse injuries

A
  • trochanteric bursitis

- femoral stress fracture

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22
Q
  • Exposed to blunt trauma

- usually develop as a result of severe impact & resultant muscular compression

A

contusions

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23
Q

what determines the depth of functional disruption that occurs during a contusion

A

extent of the force and degree of thigh relaxation

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24
Q
  • Localized pain, bleeding, swelling & temporary loss of function
  • weakness (extending or flexing knee) can go all the way as deep as the femur
  • Graded 1-4 superficial to dee
A

quad contusions

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25
Q

what position do you have the quad in when icing

A

flexed to decrease bleeding to the area

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26
Q
  • RICE (knee flexion), protect (crutches), NSAIDS, therapy for pain
  • ROM and stretching
  • no massage or heat initially!
A

management of contusion

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27
Q

Little or no pain • Mild hemorrhaging • No swelling • Mild pt. Tenderness • No disability in terms of ROM
(what grade of contusion)

A

1st degree

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28
Q

Mild pain • Mild swelling • Mild to moderate hemorrhaging • Mild point tenderness • Mild disability (>90° knee flexion) • Limping
(what grade of contusion)

A

2nd degree

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29
Q

Moderate pain • Moderate swelling • Moderate disability (>45° but < 90° of knee flexion) • Obvious limping
(what grade of contusion)

A

3rd degree

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30
Q

Severe pain • Severe swelling • Severe disability (<45° of knee flexion) • Potential muscle herniation • Obvious limp or unable to wt. bear
(what degree of contusion)

A

4th degree

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31
Q

Direct blow to iliac crest or abdominal musculature

A

hip pointer (contusion)

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32
Q
  • Pain, spasm, swelling, transitory paralysis of soft structures
  • Decreased rotation of trunk or thigh/hip flexion
A

hip pointer (contusion)

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33
Q

management of hip pointer (contusion) (2)

A
  • RICE for 48hrs, ice massage, protection upon RTP

- May need physician referral to rule out fracture

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34
Q

Formation of ectopic bone following direct blow, repeated blunt trauma, or improper care of thigh contusion

A

myositis ossificans

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35
Q

Pain, weakness, swelling, point tenderness, decreased ROM & function

A

myositis ossificans

36
Q

after how many weeks do x rays start showing deposits during myositis ossificans

A

2-6 weeks

37
Q

management of myositis ossificans (3)

A
  • Manage conservatively
  • Compression shorts work well
  • Physician referral
38
Q

etiology of trochanteric bursitis

A

Inflammation gluteus medius insertion or where ITB passes over the trochanter; direct trauma

39
Q

Point tender over lateral greater trochanter; lateral hip pain that may radiate down the leg

A

trochanteric bursitis

40
Q

can sometimes here the IT band snapping over the hip

A

trochanter bursitis

41
Q

where does sciatic pain occur?

A

right inbetween the two hamstrings

42
Q

with trochanteric bursitis where does the pain radiate?

A

down the side of the leg

43
Q

management of trochanteric bursitis

- must look at what?

A

RICE, NSAID’s ; ROM directed toward hip abductors and external rotators
- biomechanics and Q angle

44
Q

Limited swelling and tightness • Near normal gait • Mild point tenderness & discomfort during palpation • Soreness during movement • <20% of fibers torn
(what grade of strain)

A

first grade

45
Q

Pain and swelling noted on palpation • May note palpable divot • Pain with resisted muscle testing • Limping • Muscle spasm • <70% of fibers torn
(what grade of strain)

A

second grade

46
Q

Rupturing tendinous or muscular tissue • Major hemorrhage & edema • Major disability and loss of function • Pain & palpable defect or mass • >70% of fibers torn
(what grade of strain)

A

third grade

47
Q

Sudden stretch, or violent forceful contraction of hip and knee into flexion

A

quadriceps strain

48
Q

S&S of quadriceps strain (7)

A
  • pain
  • swelling
  • delayed bruising
  • loss of function
  • decreased ROM
  • decreased strength of extensors
49
Q

management of quadriceps strain

2

A
  • RICE, crutches & wrap, later use of sleeve

- Progress to pain free ROM, isometrics and stretching

50
Q

how many weeks before RTP for a quadriceps strain

A

may require 12 weeks

51
Q

Sudden overstretch into hyperextension

A

hip flexor strain

52
Q

Pain, swelling, delayed bruising and disability, decreased ROM & extensor strength

A

hip flexor strain

53
Q

management of hip flexor strain (4)

A
  • RICE,
  • crutches
  • hip spica wrap,
  • Flexor wrap
54
Q

what way to you pull the wrap when wrapping a hip flexor?

A

medial to lateral

55
Q

Over flexing hip and over stetch; sudden explosive contraction/acceleration

A

hamstring strain

56
Q

4 other factors that can contribute to hamstring strain

A

1) fatigue
2) posture
3) leg length discrepancy
4) imbalances

57
Q

hamstring strain has the same sign and symptoms as a hip flexor strain. these are: (6)

A
  • pain
  • swelling
  • delayed bruising
  • spasm
  • disability
  • decreased ROM and extensor strength
58
Q

management of hamstring strain (3)

A
  • RICE
  • crutches
  • wrap
  • conservative treatment with gradual ROM & strengthening
59
Q

Overstretch into abduction; abduction, External rotation & hip extension

A

adductor strain

60
Q

Sudden twinge or tearing, pain, swelling, delayed bruising, decreased ROM & strength
(signs and symptoms of?)

A

adductor strain

61
Q

management of adductor strain (3)

A
  • RICE
  • rest is key (crutches)
  • hip spica wrap
62
Q

with a adductor strain you usually complain about the pain being where?

A

up high

63
Q

for wrapping a adductor strain you wrap which direction?

A

laterally to medially

64
Q

Violent twisting with or without impact, forceful contraction or via trunk forced over planted foot in opposite direction

A

hip sprain (super rare)

65
Q

sign of hip sprain ?

A

increased hip pain with a rotational movement

66
Q

management of hip sprain (4)

A
  • x rays to rule out fracture
  • RICE
  • Crutches
  • delay ROM and strengthening until pain free
67
Q

Rarely occurs in sport; traumatic force along long axis of the femur

A

hip dislocation

68
Q

a hip dislocation is in what direction usually? and what orientation is leg usually in?

A

posterior dislocation with hip flexed and adducted and knee flexed

69
Q
  • Flexed, adducted and internally rotated hip

- Deformity, pain, muscular spasm, neurological issues, possible fracture

A

hip dislocation

70
Q

what injury will they screaming pain and there leg will look longer?

A

hip dislocation

71
Q

management of hip dislocation (2)

A
  • call 911 (immediate medical attention)

- 2 weeks immobilization and crutch for at least 1 month

72
Q

why do you need to call 911 right away with a hip dislocation?

A

blood and nerve supply may be severed

73
Q

Requiring a great deal of force; fall from height, MVA, direct blow

A

femoral fracture

74
Q

signs and symptoms of a femoral fracture (5)

A
  • Pain, swelling, deformity (shorter appearance)
  • Muscle guarding,
  • hip is adducted and Externally rotated
75
Q

management of femoral fracture (4)

A
  • Call 911. Treat for shock, verify neurovascular status & vitals, splint before moving
  • analgesics
  • ice
  • surgury and immobilization
76
Q

with a femoral fracture why is it important to treat the injury as if it were life threatening ?

A

because if the femoral artery was cut, they only have 8 minutes to live

77
Q

Overuse (10-25% of all stress fractures); endurance athletes; excessive downhill running or jumping activities

A

femoral stress fracture

78
Q

Persistent pain in thigh/groin; antalgic gait; may have +ve Trendelenburg sign

A

femoral stress fracture

79
Q

what does the pelvis usually do when running if there is a femoral stress fracture?

A

drop to one side

80
Q

what fracture location tends to be more complicated and why?

A

lateral to femoral neck (more complicated) , shaft and medial # heal well with conservative management

81
Q

Repetitive stress on pubic symphysis and adjacent mm; seen in distance runners,soccer, football, and wrestling

A

osteitis pubis

82
Q

what condition is popular in pregnancy?

A

osteitis pubis

83
Q

Chronic pain and inflammation of groin; point tender, pain with running, sit-ups & squats

A

osteitis pubis

84
Q

an acute case of osteitis pubis may be caused from what?

A

bicycle seats

85
Q

management of osteitis pubis (3)

A
  • rest
  • NSAIDS
  • gradual return to activity
86
Q

6 components of rehabilitation

A

1) good physical conditioning
- -> CV fitness, muscle strength and endurance
2) flexibility
3) strength
4) neuromuscular control
5) joint mobilization
6) closed kinetic chain exercises

EPHE 344 (4 decks)

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