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KNPE 331 > Injuries of the Hip Thigh and Groin > Flashcards

Injuries of the Hip Thigh and Groin Flashcards

1
Q

what is a plica?

A

piece of fibrous tissue extending from joint capsule that is supposed to be absorbed during growth and development that sometimes gets left over and interferes with the joint

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2
Q

Where does the sartorius originate?

A

ASIS

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3
Q

Where does the rectus femoris originate?

A

AIIS

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4
Q

Where do hamstrings originate?

A

Ischial tuberosity

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5
Q

What muscles are in the hamstrings?

A

Biceps femoris (long and short), semitenidnosus, and semimembranosus

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6
Q

Where do external obliques originate?

A

outer surfaces of the ribs

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7
Q

Where do external obliques insert?

A

Anterior 1/2 of iliac crest and medially on linea alba

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8
Q

what is the action of the external obliques?

A

trunk rotation, flexion, side bending, and compressing abdominal viscera

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9
Q

What muscles are the hip flexors?

A

PP SIR
Psoas major/minor
Pectineus
Sartorius
Iliacus
Rectus femoris

all assisted by tensor fascia latae

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10
Q

what is special about the rectus femoris?

A

It is the only quad muscle that does hip flexion

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11
Q

What are the 4 quadriceps muscles?

A

Rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis

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12
Q

what are the hip adductors?

A

PAAAG
Pectineus
Adductor longus
Adductor brevis
Adductor magnus
Gracilis

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13
Q

Where does sartorius originate?

A

ASIS

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14
Q

Where does sartorius insert?

A

Medial proximal tibia as it is part of pes anserine group

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15
Q

What is the acetabular labrum?

A

fibrous cartilage that rims acetabulum and deepens the socket while increasing the stablity of the joint.
Has limited blood supply

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16
Q

What is a hip pointer injury?

A

A contusion of the iliac crest (specifically the periosteum that has alot of sensory nerves)/ Often results in external obliques and tensor fascia latae being affected as well as atheletes report pain with forced exhalation and bowel movements (function of external obliques)

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17
Q

What is the MOI of a hip pointer injury

A

Blunt trauma to the iliac crest

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18
Q

What are S and S with Hip pointer injury?

A

pain with trunk flexion, rotation, side bending/hip flexion, brusing and swelling over iliac crest, and muscle spasms

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19
Q

What is the acute management for a hip pointer injury

A

PIER (with pressure pad if tolerated) and lympth drainage to settle any spasms

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20
Q

What is RTP post hip pointer injury

A

donut pad with cover - possibly hip flexor wrap if hip flexion is affected

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21
Q

What is MOI for acetabular labral tear?

A

Acute plant and twist or hyperabduction (ie splits), overuse degeneration

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22
Q

What are S and S for acetabular labral tears?

A

pain, clicking/catching in hip or groin, decreased hip ROM< audible pop/sensation at time of injury, “C” sign descriptor of pain

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23
Q

what is the special test for an acetabular labral tear?

A

Scouring test

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24
Q

What is acute managment for acetabular labral tear?

A

ice, rest, pain managment

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25
Q

what are next steps in injury rehab of acetabular labral tear?

A

focusing on correct mechanics (ie building stable base - core and hip stability) and increasing proprioception. Refer to surgery in pain and mobility treatment isn’t effective

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26
Q

What does a scouring test test for?

A

hip labrum tears, capsulitis, oseteochondral defects (ie bone and cartilage defects), acetabular defects, osteoarthritis, avascular necrosis, and femoral acetabular inpingement syndrome`

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27
Q

what is capsilitis

A

inflammation of capsule leading to scar tissue

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28
Q

what is avascular necrosis?

A

bone death from decreased blood supplt

29
Q

what is femoral acetabular impingement syndrome?

A

irregular shape of one or both joint surfaces of acetabulym leading to labrum/cartilage tears

30
Q

What is MOI for ITB friction syndrome?

A

overuse from friction over lateral femoral condyle (by the knee) caused by continuous knee flexion and extension. Glute med weakness often contributes

31
Q

Next steps for ITB injury

A

Check Glut med and see if strengthening will help
Check foorwear and wear patterns - maybe a change in gate or shoe will help

32
Q

What is MOI for hipflexor tendonitis

A

overuse and repetitive flexion

33
Q

What is special test for hip flexor tendonitis?

A

Thomas test (lie on table, one leg bent, other leg straight- if leg is at 180 degrees, ++)

34
Q

what are S and S for hip flexor tendonitis

A

pain with active and resisted hip flexion, stretch pain with passive hip extension, tendorness on palpation to hip flexor (PP SIR) tendons

35
Q

what is acute management for hip flexor tendonitis

A

ice, rest/altered activity, hip flexor wrap

36
Q

What is MOI for hip flexor strain?

A

forceful hip extension and/or leg caught in hip extension

37
Q

What is MOI for quad strain

A

forceful quad contraction or hip extension with knee flexion

38
Q

What is MOI for hamstring strain

A

Excessive hip flexion with extended knee or eccenteric hamstring contraction in late stance phase of sprinting

39
Q

What is MOI for hip adductor strain?

A

quick cutting (overstretch with forceful contraction) or splits type motion

40
Q

what is a grade 1 muscle strain?

A

tissue is stretched, some fibers are disrupted, contractions are strong but painful

41
Q

What is a grade 2 muscle strain?

A

partial tear with many fibers disrupted, contractions are weak and painful

42
Q

What is a grade 3 muscle strain

A

complete tear, unable to contract and often pain free as nerve fibers were torn

43
Q

What are some S and S for strains of hip and thigh?

A

pull or pop sensation upon injur, weakness (for grade 2 and 3 strain), bruising due to increase blood supply (for grade 2 and 3 strain)

44
Q

what is acute management for hip and thigh strains?

A

PIER (pressure pad with wrap over affected tissues), non weight bearing if unable to walk normally, hip flexor/adductor wrap for daily wear if needed, lymph drainage to help with bruising, and educate so no reinjury

45
Q

What is RTP for hip and thigh strain?

A

Hip flexor/adductor wrap as needed

46
Q

What is MOI for thigh contusion?

A

blunt trauma

47
Q

What is S and S for thigh contusions

A

discolouration and muscle weakness (possibly)

48
Q

contusion means

A

bruise

49
Q

what are thigh contusions at risk for?

A

myositis ossificans (calcium deposit around bruise causing muscle to become hard)

50
Q

What is acute management for thigh contusion?

A

effleurage/lymph drainage, ice, NO DEEP TISSUE MASSAGE, protective padding with donut pad

51
Q

What is RTP for thigh contusion?

A

80% strength, FULL ROM, and able to do demands of sport without compensation

52
Q

how do you do a tomas test?

A

lie with back on table, one leg bent toward chest, other leg coming off the table.

Neg test: hamstring touch table, knee in approx 80 degrees of flexion, food straight (not rotated)
Positive test: hip flexion (ie leg can’t be flat on table) - + for hip flexor tension
hip flexion with knee extension (ie leg can’t be flat on table and leg is straight) + for rectus femoris
Hip abducted (inwards); tight iliotibia band
rotated tibia: tight ITB

53
Q

What is the noble compression test?

A

tests for iliotibial band syndrome (common overuse injury)
steps:
athelete lies on back with leg bent at 90
apply compression to lateral epicondyle and straighten leg
+ = pain

54
Q

How do you do a resisted mscle test for the psoas?

A

athelete lays on back, 30 degrees hp flexion, 10 degrees abduction, and slight external rotation
therapist stabilizes opposite side of pelvis
Therapist tries to pul athelete into extension, athelete matches pressure to stay in original position

55
Q

How do you do resisted muscle testing for the rectus femoris?

A

athelete sits with hip and knee art 90 (like in a chair), bring thigh into flexion
therapist applies pressure downwards into hip extension - athelete resists pressure to maintian original position

56
Q

How do you do resisted muscle testing for short adductors

A

athelet lies in crook position (supine with knees bent and feet on table)
therapist abducts with hands on knee and athelete matches pressure

57
Q

How do we do resisted muscle testing for long adductors

A

athelete lies supine table
therapist abducts with hands on ankles and athelete matches pressure

58
Q

hip extensor resisted muscle testing

A

athelte lies in prone position with 30 degrees hip extension, athelete holds
therapist applies pressure to put hip into flexion and athelete resisted

59
Q

What is resisted muscle testing for isolate glutes

A

athelete in prone position with hip extension and knee flexed to 90 - they try to hold
therapist tries to apply pressure into flexion - athelete resists!

60
Q

what is resisted muscle testing for hamstrings

A

athelete lies prone with 90 degrees knee flexion
medial ham - tibia is rotated internally
lateral ham - tibial is rotated externally
therapist applies pressure into knee extension and athelete resists

61
Q

why is glute med weakness important to treat?

A

glute med weakness is a common cause of aligment problems down the chain

62
Q

How do we test posterior fibers of glute medius?

A

post fibers control internal rotation of femur in weight earing
athelte start lying on non affected side, hip is in slight extension and external rotation
therapist, applying pressure at ankle, tries to push the hip into adduction
athelete resists

63
Q

Resisted muscle testing grade 0

A

no visible or palpable contraction

64
Q

resisted muscle testing grade 1

A

can see/feel contraction but there is no motion

65
Q

What is kendall’s resisted muscle test grade 2

A

muscle has full range of motion without gravity

66
Q

What is kendall’s resisted muscle test grade 3

A

gull range of motion against gravity

67
Q

What is kendall’s resisted muscle test grade 4

A

full ROM against gravity can fight moderate resistance

68
Q

what is kendall’s muscle testing grade 5

A

full ROM against gravity, can fight max resistance

69
Q

How is a quad/hamstring wrap with pressure pad done

A

start with load through muscle being wrapped, put pad on affected area, using herringbone tensor technique from distal to proximal, finish with pro/ultralight elastic taoe to secure

KNPE 331 (7 decks)

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