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PCM exam 1 > Hip Joint Exam > Flashcards

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
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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
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3
Q

What are the flexors of the hip?

A
  • iliopsoas mm
  • sartorius mm
  • rectus femoris mm
  • tensor fascia lata/IT band
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4
Q

What are the the extensors of the hip?

A
  • Gluteus maximus mm

- Hamstrings - biceps femoris, semitendinosus, semimembranosus

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5
Q

What are the abductors of the hip?

A
  • sartorius
  • gluteus maximus
  • tensor fascia lata/IT band
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6
Q

What are the external rotators of the hip?

A
  • sartorius
  • gluteus maximus
  • gluteus medius
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7
Q

ROM of hip: flexion

A

90 deg - knee extended

120-135 - knee flexed

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8
Q

ROM of hip: extension

A

15-30

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9
Q

ROM of hip: abduction

A

45-50 (knee extended)

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10
Q

ROM of hip: adduction

A

20-30

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11
Q

ROM of hip: internal rotation

A

30-40

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12
Q

ROM of hip: external rotation

A

40-60

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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
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14
Q

What are the structures of the central compartment?

A

labrum, ligamentum teres, articular surfaces

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15
Q

What are the structures of the peripheral compartment?

A

femoral neck, synovial lining

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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
Q

What are some peripheral compartment tests?

A
  • Ely’s test

- Rectus femoris test

26
Q

Ely’s test

A
  • patient prone
  • passively flex patient’s knees
  • if (+): ipsilaterally hip raises off table
  • indicates rectus femoris contracture
27
Q

Rectus femoris test

A
  • Patient supine.
  • One hip flexed up to the chest.
  • The other leg
    bent over the edge of the table
  • if (+): knee flexion
28
Q

What are some lateral compartment tests?

A
  • jump sign
  • straight leg raise test
  • ober’s test
  • piriformis test
  • trendelenburg
  • Patrick’s - FABER (version 2)
29
Q

Jump sign

A
  • Patient is seated, pressure is applied to greater trochanter
  • if (+): patient withdraws or “jumps” with pressure
  • indicates trochanteric bursitis
30
Q

Straight leg raise test

A
  • 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
Q

Ober’s test

A
  • 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
Q

Piriformis test

A
  • 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
Q

Trendelenburg

A
  • 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
Q

Patrick’s - FABER (version 2)

A
  • 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
Q

What are some anterior compartment tests?

A
  • patrick’s - FABER - version 3
  • psoas test
  • thomas test
36
Q

Patrick’s - FABER - version 3

A
  • 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
Q

Psoas test

A
  • Flex hip to 30° while patient further flexes against resistance.
  • if (+): pain/inability or snapping
  • indicates psoas contracture or pathology
38
Q

Thomas test

A
  • 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
Q

What are structural dysfunctions at the hip?

A
  • 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

PCM exam 1 (7 decks)

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