Hip Joint Flashcards
1
Q
Describe the innominate
A
- ilium, pubis, ischium
- connects the pubic symphysis anteriorly & the sacrum posteriorly
2
Q
Describe the innominate functions
A
- common attachment
- force transmitter
- organ support
3
Q
Describe the anatomy of the femur
A
- the head goes hard lateral, inferior, and medial
- curved so that the anterior side is convex & tension while posterior side is concave & compression forces
- linea alba splits into medial & lateral supracondylar lines
4
Q
How many degrees of freedom does the hip joint have
A
- 3 DOF
5
Q
Describe the angle of inclination
A
- normal at birth: about 165 degrees
- normal in adulthood: about 125 degrees
- Coxa Vara: about 105 degrees
- Coxa valga: about 140 degrees
6
Q
Describe the angle of torsion
A
- normal: about 15 degree
- at birth: about 40 degrees
- anteversion is considered greater than 15 degrees
- retroversion is considered less than 15 degrees
7
Q
What is the typical compensation for excessive anteversion
A
- walking with toes pointed inward
8
Q
What does excessive anteversion tend to be linked with
A
- cerebral palsy
9
Q
Describe the acetabulum
A
- faces anterior, inferior, and lateral
- fossa is not usually in contact with the femur
- the superior & anterior portions have the greatest cartilage thickness which reflects loading patterns during gait
10
Q
Describe the center edge angle
A
- how much does the acetabulum cover the femoral head
- normal: 35 degrees
11
Q
Describe lower center edge angle
A
- the acetabulum is not covering as much of the femoral head
- consequences include less joint compaction during normal loading, can dislocate, less of an interface can increase contact pressures, stability problems, exposure, & can wear and tear
12
Q
Describe high center edge angle problems
A
- mobility problems
- decrease ROM
- impingement issues
13
Q
What motions does the iliofemoral ligament limit
A
- limits hip extension
- external rotation
- internal rotation when in hip extension
14
Q
What motions does the ischiofemoral ligament limit
A
- limits internal rotation
- extension
- inferior fibers limit flexion
15
Q
Describe what happens to the ligaments during hip extension
A
- hip extension creates a spring like mechanism of the ischiofemoral & iliofemoral ligaments
- can use passive restraint for hip control by relying on ligamentous structures
16
Q
What is the position of max articular congruence
A
- flexion
- abduction
- external rotation
17
Q
What is the close packed position for the hip joint
A
- extension
- slight abduction
- slight internal rotation about 5 to 10 degrees
18
Q
What is the position the tensions iliopsoas
A
- internal rotation
19
Q
What is the position for high risk posterior dislocation
A
- adduction & flexion
20
Q
Describe femoral on pelvic rotation in the sagittal plane
A
- 120 degrees passive flexion
- about 70 to 80 degrees with straight knee
- about 20 degrees of extension
21
Q
Describe femoral on pelvic rotation in the frontal plane
A
- 40 to 45 degrees of abduction
- 25 degrees of adduction
22
Q
Describe femoral on pelvic rotation in the transverse plane
A
- 35 degrees of internal rotation
- 45 degrees of external rotation
23
Q
What limits hip abduction
A
- adductors
- pubofemoral
24
Q
What limits hip adduction
A
- glute medius
- periformis
- tensor fascia latae
- mechanical restrictions on the medial aspect of the hip
25
What limits hip internal rotation
- ischialfemoral ligament
- periformis
- some external rotation muscles
26
What limits hip external rotation
- iliofemoral
- pubofemoral ligament
27
Describe pelvic of femoral rotation in the sagittal plane
- anterior tilt: about 30 degrees in sitting
- posterior tilt: about 10 to 20 degrees
28
Describe pelvic on femoral rotation in the frontal plane
- about 30 degrees of abduction
29
Describe pelvic on femoral rotation in the transverse plane
- internal rotation moves the opposite iliac crest anteriorly
30
Define nulling
- means to off set something
31
Define contradirectional
- when the pelvis tilts forward the upper spine is moving the opposite way for relative joint angles
32
Is the femoral head and acetabulum concave or convex
Femoral head: convex
Acetabulum: concave
33
Primary hip flexors
- psoas major
- iliacus
- tensor fascia latae
- sartorius
- rectus femoris
- adductor longus
- pectineus
34
Secondary hip flexors
- gracilis
- glute minimus (anterior fibers)
- adductor brevis
35
How does a hip flexor contractor change the line of gravity
- puts it anterior to the ankle
- posterior to the knee
- anterior to the hip
36
Primary hip adductors
- pectineus
- adductors (longus, brevis, & magnus)
37
Secondary hip adductors
- biceps femoris (long head)
- glute maximus
- quadratus femoris
- obturator externus
38
When do hip adductors act as adductors, flexors, & extensors
- adductors when in 40 to 70 degrees of flexion
- extensors when in more than 70 degrees of flexion
- flexors when just below 40 degrees of flexion
39
Primary hip internal rotators
- none
40
Secondary hip internal rotators
- glute medius/minimus
- tensor fascia latae
- adductor longus/brevis
- pectineus
- semimembranosus
- semitendinosus
41
Stance side internal rotator muscles act to move the swing side hip/pelvis forward during gait (True/False)
- True
42
Hip internal rotators moment arm increase as the hip does what
- moment arm increases as the hip goes further into flexion
43
Primary hip extensors
- glute maximus
- biceps femoris (long head)
- semimembranosus
- semitendinosus
- adductor magnus (posterior head)
44
Secondary hip extensors
- glute medius (posterior fibers)
- adductor magnus (anterior head)
45
What muscles are coupled to create posterior tilt of the pelvis
- hip extensors and abdominals
46
What limits posterior tilt ROM and anterior tilt ROM
- capsular ligaments limit posterior tilt
- lumbar facets limit anterior tilt
47
What moment arms increase and decrease during a "good morning"
- hamstring moment arm increases
- glute moment arm decrease
48
Primary hip abductors
- glute medius/minimus
- tensor fascia latae
49
Secondary hip abductors
- piriformis
- sartorius
- rectus femoris
- glute maximus (anterior/superior fibers)
50
Primary hip external rotators
- glute maximus
- piriformis
- obturator internus
- gemellus superior/inferior
- quadratus femoris
- sartorius
51
Secondary hip external rotators
- glute medius/minimus
- obturator externus
- biceps femoris
52
In single limb support hip external rotator muscles rotate the contralateral side posteriorly (True/False)
- True
