hip & pelvis

Question 1

what 3 joints make up the pelvic girdle?

Answer 1

1. hip joint – movable (acetabular femoral joint)
2. sacroiliac joint – immovable, not palpable, center level w/ s2, iliac crests @ L4/5
3. pubic symphysis – immovable

Question 2

what type of joint is the hip joint?

Answer 2

ball & socket joint

congruous

Question 3

when observed from the spin, the lumbar portion of the spine normally exhibits a slight ________ curve

Answer 3

lordosis curve

Question 4

absence of the normal lordosis may suggest?

Answer 4

paravertebral muscle spasms

Question 5

what may be the cause of hyperlordotic/kyphotic lumbar spine?

Answer 5

• hyperlordosis may be caused by flexion deformity of the hip
• anterior abdominal muscles may be weak

Question 6

what can the gluetal fold symmetry indicate?

Answer 6

1. raise with hip extension
2. lower with hip flexion
3. asymmetry:
   — congenital dislocation
   — muscular atrophy
   — pelvic obliquity
   — leg length discrepancy

Question 7

what is it called if the iliac crests are not level?

Answer 7

pelvic obliquity

Question 8

which structure in the hip & pelvis serves as a point of origin or insertion for a variety of muscles?

Answer 8

iliac crest

Question 9

what is the widest point on the iliac crest?

Answer 9

iliac tubercle

Question 10

where is the greater trochanter located?

Answer 10

• anterior & lateral portion covered by tensor fascia lata & gluteus medius
• level w/ the pubic tubercles

Question 11

what is the name of the structures which are on the same level as the top of the greater trochanters?

Answer 11

pubic tubercles

Question 12

what tests increase intrathecal pressure?

Answer 12

1. milgram’s test
   – pt. supine, raise lets 2-3” off table & hold 30 sec
   + inability to perform test and/or low back indicates weak abdominal muscles or space occupying lesion.
2. valsalva’s maneuver
   _ instruct pt. to take a deep breath, hold, and bear down as if you’re having a difficult bowel mvmt
   + radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)

Question 13

what are the tests for the sacroiliac joint?

Answer 13

1. pelvic rock test aka “iliac compression test”
   + pain in either sacroiliac joint indicates sacroiliac joint lesion
2. gaenslen’s test
   + pain on the affected sacroiliac joint stressed into extension indicates general sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the sacroiliac joint
3. patrick or fabere’s test
   + pain in the hip region indicates hip joint pathology

Question 14

Is SI joint pathology common?

Answer 14

no, when found is usually in conjunction with either a severe or massive trauma involving the pelvis or infectious disease (e.g. tuberculosis)

Question 15

what other areas can refer pain to the lumbar spine?

Answer 15

hip, rectum, and pelvis

Question 16

what is the location of the PSIS?

Answer 16

directly underneath the visible dimples just above the buttocks

Question 17

where is the ischial tuberosity located, and how do you find it?

Answer 17

– level with the lesser trochanter of femur

– level with the gluteal fold

Question 18

what is the patient position for palpation of the ischial tuberosity?

Answer 18

patient is on their side with hip flexed

Question 19

an imaginary line drawn between the PSIS’s crosses which structure?

Answer 19

S2

Question 20

A line drawn across the top of the iliac crest crosses the spine between which spinour processes?

Answer 20

L4/L5

Question 21

How many clinical zones are there in the examination of the hip and pelvic region?

Answer 21

5

Question 22

name the 5 clinical zones

Answer 22

1. femoral trianble
2. greater trochanter
3. sciatic nerve
4. iliac crest
5. hip and pelvic muscles

Question 23

what are the borders of the femoral triangle?

Answer 23

superior - inguinal ligamnet (ASIS to pubic tubercle)
medial - adductor longus m.
lateral - sartorius m.
floor - adductor longus, pectineus, iliopsoas m.

Question 24

which structure is located between the ASIS’s and the pubic tubercles?

Answer 24

inguinal ligament

Question 25

from medial to lateral, what are the contents of the femoral triangle?

Answer 25

femoral vein - medial
femoral artery - middle
femoral nerve - lateral

Question 26

what is the longest muscle in the body?

Answer 26

sartorius muscle

Question 27

what muscle is frequently pulled in athletic activities?

Answer 27

adductor longus muscle

Question 28

enlarged lymph nodes within the femoral triangle may be a sign of?

Answer 28

– infection ascending from the lower extremity

–local pelvic problems

Question 29

according to hoppenfeld, what is the most medial structure within the femoral triangle?

Answer 29

lymph nodes

Question 30

inflamed bursa may be tender to palpation and feel?

Answer 30

boggy

Question 31

name the soft tissue structure which can produce an audible snap sound when an individual climbs or walks up stairs?

Answer 31

tensor fascia lata

Question 32

what is the patient position to palpate the greater trochanter?

Answer 32

patient is on their side

Question 33

what is the insertion of the gluteus medius muscle?

Answer 33

upper lateral trochanter

Question 34

what is the longest nerve in the body?

Answer 34

sciatic nerve

Question 35

where is the sciatic nerve located?

Answer 35

midway b/w greater trochanter and ischial tuberosity