Hip (Lecture and Lab) Flashcards
The hip is considered what type of joint with how many degrees of freedom?
Diarthrodial ball and socket; 3 DoF
T/F: The hip has more stability and less ROM than the shoulder.
True
Give the closed pack position of the hip.
Max extension, IR, and ABD: Terminal Stance
What is the hip capsular pattern?
Flexion>ABD>IR
What is the angle of inclination? What is normal for the hip?
Angle between the neck and shaft in the frontal plane. Newborn: 150 degrees, Adult: 125 degrees
Give the definition and value for coxa valga.
Excessive angle of inclination; >135 degrees
Explain coxa vara.
Decreased angle of inclination; <120 degrees
The line from the ASIS through the patella to the tibial tuberosity is the what?
Q- angle
What is the normal Q- angle for men and women?
Men: ~12
Women: ~18-20
Anteversion is what?
An increase in the angulation created in the transverse plane between the neck and shaft of the femur.
Give the characteristics of the LE with ante version.
1) Toed in gait
2) Increased Q Angle caused by increased external tibial torsion
3) pronated feet
4) May also see increased lumbar lordosis
What could be the cause if it the patient appears to have a leg length discrepancy due to foot pronation?
Anteversion may be unilateral
Internal rotation dramatically increases to what with anteversion?
60- 90
What is decreased with anteversion?
ER ROM with stretch weakness of ER’s
What is the decrease in angulation created in the transverse plane between the neck and shaft of the femur?
Retroversion
What clinical findings would you have with retroversion?
1) Toed out gait
2) Increased internal tibial torsion
3) Supination of the foot
4) Decreased Q angle
5) Increased ER with stretch weakness of IR’s
6) Genu varum and outward patellas
The Medial Circumflex Femoral Artery passes between what muscles to feed what general area?
Between Iliopsoas and pectinous to feed the back of the thigh, head and neck of femur.
The Lateral Circumflex Femoral Artery passes where to feed what general area?
Laterally deep to sartorius and rectus femoris to feed lateral side of the thigh and head of the femur.
What are the normal values for flexion and extension of the hip?
Flexion: 110-120
Extension: 10-15
Give the normal values of ABD and ADD of the hip.
ABD: 30-50
ADD: 30
What is the normal value for both IR and ER of the hip?
~45
ROM will diminish generally with age, but what motion is lost most?
Extension
Give the 5 reasons that the hip is stable.
1) Deep acetabulum with tight fitting femoral head
2) Vacuum effect of the ball & socket that resists distraction
3) A thick capsule and ligaments
4) Balance of adjacent muscles around the hip
5) WB produces stability of the hip joint
What muscles give the hip balance in the frontal plane?
ABD and ADD work each side of the hip. If the legs are even then the muscles are under equal tension.
If the ABD and ADD balance is off how will it appear?
Shows up as increased side to side motion of the hips
Discuss the muscular balance of the saigttal plane.
Balance of the hip flexors and extensors.
What causes an anterior tilt of the pelvis and also increase the anterior shear forces on L4/L5 & L5/S1?
A contracture of the hip flexors.
The transverse plane muscular balance is between the IR and ER muscles. What will overly powerful ER cause?
Toeing out
A unilateral contracture of the ER will cause?
Increase posterior rotation of the pelvis which causes an increase in ant/post motion in the other hip.
T/F: You test the ligaments of the hip separately with specific tests.
False; they don’t have specific tests, but you do test with ROM.
Where does the Iliofemoral ligament run?
From the AIIS to the intertrochanteric line
The pubofemoral ligament originates at the Iliopubic eminence and inserts where?
Near the lesser trochanter
The Ischiofemoral ligament inserts at the back of the femoral neck and originates where?
posteriorly from the the ischium below the acetabulum
The Iliofemoral and pubofemoral ligaments are ____ in extension and ____ in flexion.
Taut; lax
What is on slack during ABD? What is tight?
Slack: Upper Iliofemoral
Taut: Pubofemoral
The _________ ligament is taut in ADD and the _________ ligament is slack.
Iliofemoral ligament
Pubofemoral ligament
All anterior ligaments are taut in ____ and slack in _____.
ER;IR
What ligament is suspected to be tight in IR and extension?
Ischiofemoral Ligament
Give the 3 functions of articular cartilage.
1) Reduce Friction
2) Absorb compressive forces
3) Maintains jt height (provides stability)
What phase of joint lubrication occurs during swing through?
Hydrodynamic
What are the two joint surfaces doing during hydrodynamic phase?
Gliding and rolling past each other.
Which direction does the synovial fluid move during hydrodynamic?
The move past each other in the opposite direction
The second phase of joint lubrication is referred to as _________ and begins where?
Hydroelastic; begins at heel strike
What helps the femoral head to keep its shape even through compressive forces in the hip joint?
Cartilage in the superior femoral head and the posterior acetabulum.
What helps with force dissipation in the femur?
Trabecular formation
What happens with the synovial fluid as the WB continues through the stance phase?
Synovial fluid is pushed out
What is the Boundary Stage and why is it important?
Boundary Stage: Single layer of synovial fluid is providing lubrication. Occurs during the Squeeze Film Phase
After toe off the hip goes into the close packed position. What is the name of the stage and why is it important?
Close Pack Phase; important because this is the point of max congruence between the two surfaces
