Hypermobility - exam 2 Flashcards
true or false. hypermobility is less common in LE
true
more stable due to depth of socket
what are traumatic causes of hypermobility?
fx and ligamentous tear
labral tear
what are atraumatic causes of hypermobility?
extreme motions in sports
labral tear with FAI/IPI
systemic connective tissue disorder
bone abnormality
what are bone abnormalities that could cause hypermobility?
shallow acetabulum
inferior acetabular insufficiency
excessive femoral version or torsion (only one you can pick up on clinically)
excessive femoral neck angle
what is femoral torsion?
in transverse plane, the angle between femoral condyles and femoral head and neck
–> femur gets twisted
what is excessive anteversion?
excessive retroversion?
toeing in
toeing out
what is femoral neck angle?
in the frontal plane, the angle between the shaft and neck
coxa valga:
- _______ angle of inclination
- leads to ________
larger
genu vara or bow legged position
coxa vara:
- _______ angle of inclination
- leads to _______
smaller
genu valga or knock kneed position
prevalence of hypermobility?
inconsistent gender differences
5-35% of those with hip joint P!
risk factors of hypermobility?
genetics
injury
nature of pt’s activities:
– running, ballet, golf, hockey, soccer
– excessive rotation, flexion & hyperextension
what are symptoms of hypermobility?
like impingement due to hypermobility plus:
- anterior groin or lateral hip P!
- popping, locking, snapping present
- feeling of instability, esp when squatting
hypermobility signs:
- ROM:
- combined motions:
- special tests:
- hip IR > 30 deg at 90 deg flx
- possible inconsistent block
- hip apprehension, abnormal femoral version or torsion
what is the hip apprehension special test?
in prone move hip into ext w ER and ABD while applying ant inf force on femur
specific to pubofemoral ligament test
what is the primary focus for Rx of hypermobility?
cartilage integrity and stabilization
local muscles of hip: piriformis, quadratus femoris, obturator externus/internus
what are the signs of hypermobility?
- ROM
-CM
like impingement due to hypermobility plus:
-ROM: hip IR >30º @ 90º flx
-CM: possible inconsistent block
what are the special test for hypermobility?
hip apprehension - in prone move hip into EXT w/ ER and aBd while applying antinf force on femur (specific to pubofemroal ligament test)
Abnormal femoral version or torsion
PT Rx: primary focus
cartilage integrity and stabilixaation
What are hip local mm’s.
glute med
piriformis
GOGOs
Quadraters Femoris
what is regional interdependence?
a theory that different body regions are ______________ and ________________ interdependent and
__________ may play a role
biomechanically; neurophysiological;
impairment in one region can contribute to impairment in another, particularly if persistent.
central mechanism (motor cortex)
-The predominant innervation to the ____________Z jts. is the _______ dorsal rami
-Predominant and MOST consistent innervation to ________ disc are the _____ dorsal root ganglia and the ________ and ______ sinuvertebral nn.
-Illiolumbar ligaments are innervated by ______ spinal nn.
L4-S1; L4
L4-S1 discs; L1-2; L4-5
L1-4 (sensory & motor)
If any of the L4-S1 joints are persistently hypermobile/unstable which mm. groups are more likely to excessively recruit due to the predominance of L1-L4 innervation & sensation
Hip Flexors (L1,2)
Hip aDductors (L3)
Knee Extensors (L3-4)
Ankle DFs (L4,5)
What are the hip muscles and their spinal innervation that can assist w/excessive recruitment?
Illiopsas (L1-4)
Illiocapuslaris (L2-4)
Rectus Femoris (L2-4)
What is the iliopsoas function and attachment?
primarily a hip flexor and trunk stabilizer; illiocapsularis
