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PT 521 Patient Management > Hip Lecture > Flashcards

Hip Lecture Flashcards

1
Q

Hip functions

A

Supports weight of load, arms, trunk
Static & Dynamic
Pathway for transmission of forces between pelvis & lower extremities

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2
Q

Mechanical stresses on hip

A 
Tensile, torsional, compressive loading
SLS: 2.4-2.6x
Walking: 1.3-5.8x
Stairclimbing: 3x
Running: 4.5+x
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3
Q

Compressive Forces

A

Body Weight

Muscular Activity

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4
Q

Process of differential diagnosis

A

85% of the info for accurate dx is acquired during the subjective exam

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5
Q

3 deciding questions:

A

appropriate for this pt
appropriate w/ additional referral
inappropriate for PT at this time

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6
Q

Categorizing sources

A 
Local neuro/mesculoskeletal
- Intra-articular
- Extra-articular
Remote/referred neuro/musculoskeletal
Systemic sources
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7
Q

Intra-articular causes

A

Ball & Socket articulation (femur/pelvis)
Impressive Load Transmission & ROM
Open & closed kinetic chain, compression/shear forces

Refer pain to anterior groin, buttock, greater trochanter, anterior thigh, medial knee

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8
Q

Intra-articular

A

Femur/Acetabulum - stress fx, bone bruise, chondral lesions, bone spurs/OA
Acetabular Labrum, tears
Transverse Acetabular Ligament - sprain/strain
Joint Capsule/synovium - strain or inflammation
Ligamentum Teres - tear/strain

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9
Q

Intra-articular: additional

A 
Local infection
Septic arthritis
Neoplasm (tumor)
Avascular necrosis
DDH, birth
LCP, 6-10 years
SCFE, 11-14 years
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10
Q

Extra-articular

A 
Ligament sprain
-Inguinal
-Iliofemoral
-Pubofemoral
-Ischiofemoral
Muscle Strain/Tear
-Superficial & deep flexors, adductors, extensors, rotators
Bursitis
Iliopsoas bursa
Trochanteric bursa
Ishiogluteal bursa
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11
Q

Referred sources

A 
Lumbar disc pahtology
Lumbar spine degenerative joint disease
Athletic pubalgia
Radiculopathy
Piriformis Syndrome
SIJ pathology
Genitourinary tract pathology
Abdominal wall pathology
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12
Q

Systemic Sources

A 
RA
Crohn's
Psoriasis
Reiter's
Systemic Lupus erythematosus
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13
Q

Musculocutaneus

A

OA

Muscle strain

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14
Q

OA

A

Primary OA vs Secondary

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15
Q

OA

A

Disorder of synovial joints w/ deterioration of articular cartilage and new bone formation

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16
Q

OA: Symptoms

A

Groin & thigh pain most common (98% intra)

17
Q

OA: 24 hours pattern

A

Morning stiffness

18
Q

OA: MOI

A

may/may not be related to h/o trauma

19
Q

OA: Limitations

A

Transitional movements w/ pain
Walking antalgic
Stiffness impaired donning shoes/socks

20
Q

OA: Findings

A 
Antalgic gait
Trendelenberg Test
Restricted ROM
Capsular: IR>Flexion>Abducion = Ext
Limited IR/ER/Flexion
Flexion
21
Q

Adductor Muscle Strain: subjective

A

MOI: overstretch or excessive load on muscle
Symptoms: sore, tight, tearing
Aggravating: adductor stretching, rapid stretch/contraction
Functional limits: walk, run, lunge
Hurdle, steps, stretch

22
Q

Adductor Muscle Strain: objective

A

edema/ecchymosis
tender to palpation
pain with manual resistance to suspected muscle
pain w/ stretching/ decrease muscle length

23
Q

Examination is driven by…

A

SINS

24
Q

Arrange examination by position:

A 
Stadning
Sitting
Supine
Side-lying
Prone
25
Q

MMT

A

5 - 55-60% max
4 - 40% max
3+ - 25 %

26
Q

Functional Tests

A

Timed activity & quality
Single leg squats
Single leg bridge

27
Q

Hip Abductor demand

A

Stabilizer
Trendelenberg: single limb standing
Compensations: contralateral pelvic drop
Ipsilateral trunk lean

28
Q

Hip Abductor: Impairments

A

LOB
Weakness of a muscle influence balance
Hip fatigue caused greater postural changes than from ankle fatigue

29
Q

Labral Tears

A

Capsular laxity
FAI
Acetabular dysplasia (15-22%)
Chondral lesions (73%)

30
Q

Labrum assists…

A

maintenance of negative intra-articular pressure for improved stability

31
Q

Labral tear: Pain location

A

Groin - 92-100
Lateral hip - 59
Ant thigh/medial knee 52
Buttock - 38

Sharp/Dull

32
Q

Labral tear: 24 hour pattern

A

activity - 91
night - 71
constant pain - 55

33
Q

Clicking/catching

A

58-100

painful locking - 89

34
Q

Labral tear: MOI

A

acute: 30%
trauma: 9%
gradual onset: 61%

35
Q

Labral tear: subjective

A 
antalgic gait - 89
stairs painful - 69
pivot pain - 70
pain w/ high impact - 62
pain w/ sitting - 61
36
Q

Labral tear: objective

A 
Limited ROM w/ w/o capsular pattern
IR>Flexion>Abduction = Extension
\+ FAI test
Hypermobile joint accessory
\+FABER
37
Q

Trochanteric bursitis

A
  • Reduces friction between ITB, glut med/min, greater trochanter
  • Excessive shear/compression bursa inflamed/painful
38
Q

Trochanteric bursitis: subjective

A

fall into lateral hip
repeititive flexion/extension activity

Symptoms: lateral hip pain

Aggravated:

  • Ipsilateral sidelying
  • Repeated Flexion/Extension in WB
39
Q

Trochanteric bursitis: objective

A

tender at greater troch
palpable/audible crepitus/popping w/ flexion/extension
Ober test for ITB

PT 521 Patient Management (25 decks)

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