Hip Joint Exam Flashcards
1
Q
What are some observable/palpable landmarks of the hip?
A
- anterior superior iliac spine (ASIS)
- iliac crest
- greater trochanter
- pubic tubercles
- posterior superior iliac spine (PSIS)
- ischial tuberosity
- sacroiliac joint
- inguinal ligament
- femoral artery
- sartorius mm
- adductor longus mm
- sciatic n
- femoral triangle
2
Q
What are the borders of the femoral triangle?
A
- Superior: inguinal ligament
- Medial: medial border of adductor longus
- Lateral: medial border of sartorius
3
Q
What are the flexors of the hip?
A
- iliopsoas mm
- sartorius mm
- rectus femoris mm
- tensor fascia lata/IT band
4
Q
What are the the extensors of the hip?
A
- Gluteus maximus mm
- Hamstrings - biceps femoris, semitendinosus, semimembranosus
5
Q
What are the abductors of the hip?
A
- sartorius
- gluteus maximus
- tensor fascia lata/IT band
6
Q
What are the external rotators of the hip?
A
- sartorius
- gluteus maximus
- gluteus medius
7
Q
ROM of hip: flexion
A
90 deg - knee extended
120-135 - knee flexed
8
Q
ROM of hip: extension
A
15-30
9
Q
ROM of hip: abduction
A
45-50 (knee extended)
10
Q
ROM of hip: adduction
A
20-30
11
Q
ROM of hip: internal rotation
A
30-40
12
Q
ROM of hip: external rotation
A
40-60
13
Q
What are the cutaneous innervations of the hip region?
A
- dermatomes - L1-3
- anterior femoral cutaneous n - L2-4
- lateral femoral cutaneous n - L2-3
- posterior femoral cutaneous n - S2
14
Q
What are the structures of the central compartment?
A
labrum, ligamentum teres, articular surfaces
15
Q
What are the structures of the peripheral compartment?
A
femoral neck, synovial lining
16
Q
What are the structures of the lateral compartment?
A
gluteus maximus, gluteus minimus, piriformis, IT band, trochanteric bursae
17
Q
What are the structures of the anterior compartment?
A
iliopsoas insertion, iliopsoas bursae
18
Q
Log roll
A
- nonspecific to central and peripheral compartments
- roll patient’s leg into internal and external rotation
- if (+): pain
- indicates central or peripheral compartment pathology
19
Q
What are some central compartment tests?
A
- C-sign
- labral loading
- labral distraction
- scour
- apprehension test - FABER (version 1)
20
Q
C-sign
A
- patient characteristically points to the source of pain with two fingers or cups just above the trochanter with the thumb and index finger
- indicates labral pathology
21
Q
Labral loading
A
- Flex the patient’s knee and hip to 90 degrees, load into the
femur towards the innominate. - if (+): pain
- indicates labral or cartilaginous pathology
22
Q
Labral distraction
A
- Distract patient’s femur away from innominate
- if (+): improvement of pain
- indicates labral or cartilaginous pathology
23
Q
Scour
A
- Flex and externally rotate patient’s hip. Load into socket and
articulate through annular range of motion. - if (+): pain
- indicates labral or articular cartilage pathology
24
Q
Apprehension - Faber - version 1
A
- Patient’s hip is flexed, aBducted & externally rotated.
- Doctor induces further external rotation by applying a posterior force at the knee.
- if (+): anterior subluxation of hip or apprehension/pain
- indicates anterior labral pathology
- NOTE: can also be (+) with impingement
25
What are some peripheral compartment tests?
- Ely's test
| - Rectus femoris test
26
Ely's test
- patient prone
- passively flex patient's knees
- if (+): ipsilaterally hip raises off table
- indicates rectus femoris contracture
27
Rectus femoris test
- Patient supine.
- One hip flexed up to the chest.
- The other leg
bent over the edge of the table
- if (+): knee flexion
28
What are some lateral compartment tests?
- jump sign
- straight leg raise test
- ober's test
- piriformis test
- trendelenburg
- Patrick's - FABER (version 2)
29
Jump sign
- Patient is seated, pressure is applied to greater trochanter
- if (+): patient withdraws or "jumps" with pressure
- indicates trochanteric bursitis
30
Straight leg raise test
- Raise the leg with knee extended, nonspecific test
- if (+): pain
- indicates: pain from 15-30 deg for lumbar disc etiology; pain laterally >15 for lateral compartment pathology (as IT band passes over the greater trochanter)
31
Ober's test
- patient lateral recumbent with doctor standing behind the patient
- doctor abducts the top leg and then lowers leg to the table while stabilizing hip
- if (+): inability to adduct
- indicates IT band contracture
32
Piriformis test
- patient supine with hip and knee flexed, one ankle crossed over contralateral knee
- patient abducts against resistance
- if (+): pain over posterior aspect of greater trochanter
- indicates piriformis spasm or pathology
33
Trendelenburg
- patient standing with doctor behind
- patient lifts one foot off ground
- if (+): weakness/inability to hold hips level
- indicates contralateral gluteus medius weakness (superior gluteal n)
- ex: patient lifts right foot, right hip drops thus left gluteus medius/sup gluteal n pathology
34
Patrick's - FABER (version 2)
- Patient’s hip is flexed, aducted and externally rotated.
- Doctor braces contralateral ASIS, patient externally rotates/abducts against resistance.
- if (+): pain or weakness
- indicates gluteus medius pathology
35
What are some anterior compartment tests?
- patrick's - FABER - version 3
- psoas test
- thomas test
36
Patrick's - FABER - version 3
- Patient’s hip is flexed, aBducted and externally rotated.
- Doctor braces contralateral ASIS.
- Patient internally
rotates/aDducts against resistance.
- if (+): anterior or medial groin pain/weakness
- indicates iliopsoas insufficiency or pathology
37
Psoas test
- Flex hip to 30° while patient further flexes against resistance.
- if (+): pain/inability or snapping
- indicates psoas contracture or pathology
38
Thomas test
- Patient supine and pulls knees to chest.
- One leg is lowered to
the table to test the flexibility of the hip flexors.
- if (+): inability to fully extend/extended leg raises off table
- indicates hip flexors contractions
39
What are structural dysfunctions at the hip?
- IT band restriction
- hip flexion/extension dysfunction
- hip external/internal rotation dysfunction
- hip abduction/adduction dysfunction
NOTE: dysfunctions are named for where they live (restricted to opp motion); always check bilaterally
