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Musculoskeletal > Internal Hip Pathologies > Flashcards

Internal Hip Pathologies Flashcards

1
Q

What is the position of the acetabulum?

A

lateral, inferior, and anterior

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2
Q

What is the position of the femoral head?

A

anterior, superior, and medially

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3
Q

The articular cartilage of the hip is thickest on the _____ portion of the femoral head.

What makes this special compared to the rest of the articular cartilage in the hip?

A

posterior/superior

It has less degeneration compared to the anterior/superior aspect which is more common for labral tears and osteophytes

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4
Q

definition: angle formed between the femoral head and acetabulum

A

angle of anteversion

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5
Q

What is the normal range of the angle of anteversion?

A

10-15 degrees

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6
Q

definition: angle of anteversion > 15 degrees

A

anteversion/ toe in

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7
Q

definition: angle of anteversion < 10 degrees

A

retroversion/toe out

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8
Q

The ___ portion of the acetabular labrum is continuous with the cartilaginous surface of the acetabulum

A

center portion of the acetabular labrum

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9
Q

The ___ portion of the acetabular labrum is continous with the hip joint capsule.

A

outer portion of the acetabular labrum

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10
Q

What part of the labrum is vascularized and innervated by sensory nerve fibers?

A

outer 1/3

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11
Q

The posterior aspect of the labrum is most stressed in hip ____.

A

hip flx

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12
Q

The anterior aspect of the labrum is most stressed with combined ___ and ___.

A

combined FLX and ADD

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13
Q

The 3 main ligaments of the hip are taut in ___ and loose in ___.

A

taut in hip EXT
loose in hip FLX

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14
Q

What ligament is the strongest ligament in the body?

A

iliofemoral ligament (Y ligament)

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15
Q

What does the iliofemoral ligament do?

A
  • reinforces the anterior portion of the hip joint
  • limites hip EXT and anterior gliding of the femur
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16
Q

What does the pubofemoral ligament do?

A
  • Reinforces the medial aspect of the hip joint
  • limits excessive hip EXT and ER
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17
Q

What does the iliofemoral ligament blend with?

A

iliopsoas muscle

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18
Q

What does the pubofemoral ligament blend with?

A

pectineus muscle

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19
Q

The ischiofemoral ligament wraps from the ____ aspect to ___aspect of the hip joint.

A

posterior to anterior aspect

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20
Q

What is the open packed position of the hip?

A

30 of flexion
30 abduction
slight ER

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21
Q

What is the close packed position of the hip?

A

Max extension, IR, & abduction

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22
Q

What is the capsular pattern of the hip?

A

FLX > IR > ABD

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23
Q

Describe hip flx and ext.

A

femoral head spins

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24
Q

describe hip ABD

A

femoral head rolls superiorly and glides inferiorly

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25
Q

describe hip ER

A

femoral head rolls posteriorly and glides anteriorly

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26
Q

describe hip IR

A

femoral head rolls anteriorly and glides posteriorly

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27
Q

definition: Progressive disease resulting in degenerative changes to the bony surfaces of the joint

A

hip OA

28
Q

What is the common population for hip OA?

A

age > 50

men = women

29
Q

What commonly causes hip OA?

A

abnormalities of loading through the hip joint

30
Q

What are aggravating activities for hip OA?

A
  • twisting trunk toward involved side, or turning/pivoting in direction of uninvolved side with walking
  • prolonged sitting (especially with ↑’d hip flexion angle)
  • sit to stand transfers
  • ↑↓stairs
  • getting in and out of car
  • difficulty putting on socks and shoes
31
Q

What is the common presentation of hip OA?

A
  • C-sign: pain referral to the groin, buttock, lateral thigh (and sometimes the anteromedial aspect of the knee)
  • clicking/popping
32
Q

Describe what a patient’s stance looks like when hip OA is present.

A

ipsilateral hip and knee positioned in slight FLX/ER

  • slightly on toes on symptomatic side (if severe OA)
33
Q

Describe what a patient’s gait looks like when hip OA is present.

A
  • antalgic w/ hip position in slight FABER
  • decreased stance phase on INVOLVED side
  • trendelenburg
  • decreased hip EXT at terminal stance
34
Q

Describe what a patient looks like while sitting when hip OA is present.

A

reclined position or leaning to the uninvolved side with hip ABD (on involved side)

35
Q

Early hip OA presents with loss of ______.

A

hip FLX and IR

36
Q

moderate hip OA presents with loss of ______.

A

hip FLX, IR, ABD

37
Q

Severe hip OA presents with loss of ______.

A

Hip ROM in all directions

38
Q

Those with hip OA will have (positive/negative) findings on the following tests:
- Femoral nerve stretch
- passive SLR
- slump
- neuro signs

A

negative

39
Q

Hip OA leads to the tightness of what muscles?

A

hip FLX and hamstrings

40
Q

Hip OA leads to the weakness of what muscles?

A

Hip EXT and ABD

41
Q

What is considered as the most specific test for internal hip pathology?

A

log roll test

42
Q

What is the CPR for diagnosing hip OA?

A
  1. self-reported pain with squatting
  2. Active hip FLX causing lateral hip pain
  3. scour test w/ ADD causes lateral hip/groin pain
  4. active hip EXT causes pain
  5. PROM IR < 25 degrees
43
Q

What is cluster 1 for diagnosing hip OA?

A
  • hip pain
  • hip IR < 15 degrees
  • hip FLX < 115 degrees
44
Q

What is cluser 2 for diagnosing hip OA?

A
  • hip pain
  • IR < 15 degrees
  • Pain with IR
  • morning stiffness < 60 minutes
  • > 50 y/o
45
Q

definition: Abnormal contact between the femoral head/neck and the acetabular rim

A

Femoral acetabular impingement (FAI)

46
Q

FAI is associated with ___ and ___ damage.

A

labral and chondral damage

47
Q

What are the three types of FAI?

A
  1. CAM
  2. Pincer
  3. mixed
48
Q

CAM type FAI is the abnormal bony overgrowth of ______ head/neck causing increased bony contact with acetabulum during combined ______.

A

femoral head/neck

combined FLX, ADD, IR

49
Q

Cam type FAI often leads to ____ labral and chondral lesions.

A

anterosuperior

50
Q

What population is Cam type FAI most commonly found in?

A

young, athletic males

51
Q

(true/false) many people with CAM type FAI are symptomatic.

A

false

52
Q

Pincer type FAI is the bony overgrowth of the _____ rim or deep socket causing increased bony contact with the femoral head.

A

acetabular rim or deep socker

53
Q

What motions are painful when Pincer Type FAI is present?

A

combined hip FLX, ADD, IR

54
Q

Cam type FAI predisposes an individual to developing hip ___ in the future

A

OA

55
Q

(true/false) Pincer type FAI has been shown to predispose an individual with developing hip OA in the future.

A

false

56
Q

What population is pincer type FAI most commonly seen in?

A

Active, middle-aged women

57
Q

FAI mixed type can lead to injury of the ___.

A

labrum

58
Q

What motions are painful when mixed Type FAI is present?

A

combined hip flx, add, IR

59
Q

What are aggravating positions for FAI?

A
  • rotational movements of the hip
  • sitting with increased hip FLX
  • walking
  • pivoting
  • athletic movements
60
Q

What is the most common cause of mechanical hip symptoms?

A

labral tear

61
Q

Labral tears are more common in ____ y/o.

A

< 40 y/o

62
Q

What is the most common portion of the labrum that is torn?

A

anterior labrum

63
Q

Where is pain present with FAI?

A
  • anterior groin
  • lateral trochanteric pain
  • aching or sharp
64
Q

Where is pain present with labral tears?

A
  • anterior groin
  • lateral thigh
  • medial knee
65
Q

Those with FAI may have pain with lumbar ___ AROM.

A

FLX b/c it decreases the angle at the hip.

Musculoskeletal (23 decks)

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