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Orthopedic Diagnosis > Lecture: The Hip > Flashcards

Lecture: The Hip Flashcards

1
Q

the hip articulation is formed b/w the head of the __ and the __ of the pelvic bone.

A
  • femur

- acetabulum

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2
Q

hip joint transmits truly impressive loads, both __ & __.

also provides a wide range of __ __ movement.

A
  • tensile
  • & compressive
  • lower limb
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3
Q

hip joint is classified as a __ & __ joint.
permits motion in 3 planes:
all 3 of these axes pass thru the center of the __ __.

A
  • ball & socket
  • (1)sagittal (flex/ext around a transverse axis)
  • (2)frontal (abd/add around an ant.-post. axis)
  • (3)transverse (int/ext rot. around a vertical axis)
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4
Q

os coxa (hip bone), initially begins as 3 ind. bones:

A
  • ilium
  • ischium
  • pubis
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5
Q

the body of the ilium forms the __ 2/5ths of the acetabulum.
the ischium is a __ that contributes to the acetabulum & __, forming the __ 2/5th’s of the acetabulum.
ischium + ramus form the __ tuberosity.

A
  • superior
  • body; rams
  • posterior
  • ischial
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6
Q

pubis is the smallest of the hip bones.
consisting of a __ and __ & __ rami.
it forms the __ 1/5th of the acetabulum.

A
  • body
  • inferior & superior
  • anterior
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7
Q

the majority of acetabular development is completed by age?

and the __ increases thru puberty

A
  • eight

- depth

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8
Q 
the acetabulum is angled laterally, \_\_ & \_\_.
acetabular rim (labrum) fxn:
the whole of the acetabulum is covered with \_\_ cartilage, except the fovea capitis, b/c?
A
  • inferiorly & anteriorly
  • (deeps the acetab.) increasing its stability of the hip jt.
  • hyaline
  • serves as an attachment site for ligaments
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9
Q

pelvic girdle is composed of 3 joints:

A
  • sacroiliac
  • hip joint (acetabularfemoral)
  • pubic symphysis
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10
Q

ASIS should be in same horizontal plane, if not= __ __.

which test?

A
  • pelvic obliquity

- leg length discrepancy

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11
Q

the __ tubercle marks the __ point on the iliac crests.

A
  • iliac

- widest

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12
Q

iliac crest contusion:
aka?
contusion at site or an avulsion of the __ __ and/or __ muscles from the crest.
very painful, even disabling if __ is involved.
pt. experiences pain when __ bending __ from the side of injury.
etiology?

A
  • hip pointer
  • quadratus lumborum and/or abdominal
  • periosteum
  • side; away
  • trauma
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13
Q

greater trochanters are to be level with?

congenital hip dislocation or hip __ could heal improper and make the levels unequal; which test?

A
  • pubic tubercles
  • fracture
  • Allis Sign
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14
Q

Bucket Handle Fracture: __ & __ pubic rami frxs w/ a separation or frx of the __-__ SIJ.
MOI?

A
  • superior & inferior
  • contra-lateral
  • high speed falls (motorcycle, bicycle)
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15
Q

Sprung Pelvis: separation of the __ symphysis & __ SIJ’s.

MOI?

A
  • pubic
  • both
  • genitourinary injuries, severe constipation (organ rupture), possibly from multiple births.
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16
Q

Straddle Fracture: __lateral __ pubic rami, & ischiopubic fractures.
MOI?

A
  • bilateral
  • superior
  • falling on butt from high place or w/ great force, or from long time sustained micro trauma (i.e. riding a tractor for years)
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17
Q

most common areas of the pelvis for avulsion fractures are:

A
  • ASIS
  • AIIS
  • ischial tuberosity
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18
Q

approximately _/_rds of the femoral head is covered with a smooth layer of __, except __ __, (attachment site of __ __)

A
  • 2/3
  • cartilage
  • fovea capitis
  • ligamentum teres
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19
Q

the angle b/w the femoral shaft and the neck is called?
average degree of angle? (varies b/c of diff. body types)
in a tall person the angle is __ (aka __).
the opposite is true with shorter individuals, __.

A
  • inclination angle
  • 125-130
  • larger; valga
  • vara
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20
Q

dashboard injury to the knee will cause __ hip dislocation if the hip is __ at the time of injury.

A
  • posterior

- adducted

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21
Q

the trabecular bone in the femoral neck and head is specifically designed to withstand __ __.
and incorporates both primary & secondary __ & __ patterns.

A
  • high loads

- compressive & tensile

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22
Q

greater trochanter serves as the __ site for several muscles that act on the __ joint.
the lesser trochanter is created from the pull of the __ muscle.

A
  • insertion
  • hip
  • iliopsoas
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23
Q

the angle the femoral neck makes with the acetabulum is called the angle of __.
normal is?

A
  • anteversion

- 8-15deg.

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24
Q

femoral ANTeversion is when the angle is >__.
= a toe __ gait.
this increased femoral head torsion may result in:

A
  • > 15deg.
  • in
  • osteoarthritis
  • susceptible to ant. femoral dislocation
  • knee joint misalignment problems
  • patellar dislocations
  • excessive lumbar lordosis
  • external rotation of the tibia
  • pronation of the feet
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25
Q

femoral RETROversion is when the angle is <__.
=a toe __ gait.
this decreased femoral head torsion may result in:

A
  • <15deg.
  • out
  • low back or SI pathologies
  • internal rotation of the tibia
  • supination of the feet
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26
Q 
Legg-Calve-Perthes Disease:
\_\_ necrosis of the femoral capital \_\_ b4 closure of the \_\_ plate.
\_\_ = 5:1 predominance 
ages: \_\_-\_\_, peaking at \_\_ years old.
bilateral in \_\_ %.
history of:
positive in which test?
primary causes:
4 stages:
A

-avascular; epiphysis; growth
-male
-2-14; 5
-10
-painful limp, reduced mobility & muscle atrophy
-trendelenberg test
-trauma, hereditary, nutritional, circulatory
(happens in 1 in 1200, smoking increases that to 1 in 100)
-1=avascularization, 2=revascularization, 3=repair, 4=deformity

27
Q

3 extra-articular ligaments help provide stability at the hip joint:
(tighten with hip ext.!)

A
  • iliofemoral ligament
  • pubofemoral ligament
  • ischiofemoral ligament
28
Q 
the iliofemoral ligament consists of \_\_ parts:
it is the \_\_ ligament in the body.
oriented superior & \_\_.
blends with the \_\_ muscle.
limits what movement?
A
  • 2 (inf/med. & sup/lat.)
  • strongest
  • lateral
  • iliopsoas
  • lat=adduction & med=ext. rot.
29
Q

pubofemoral ligament is oriented inferior & __.
blends with the inferior band of the __ & the __ muscle.
limits what movement?

A
  • medial
  • iliofemoral & pectineus
  • abduction
30
Q

ischiofemoral ligament winds __ around the femur, and attaches __, strengthening the capsule.
this ligament is more commonly __ that the other hip ligs.
limits what movement?

A
  • posteriorly
  • anteriorly
  • injured
  • internal rotation of the hip
31
Q

iliopsoas muscle comprised of 2 parts:
innervated by:
the most __ of the hip flexors.
what tests?

A
  • iliacus & psoas major
  • femoral nerve
  • powerful
  • thomas & ely sign
32
Q

pectineus muscle:
action:
innervated by:

A
  • adductor
  • flexor
  • & internal rotator of the hip
  • femoral nerve
33
Q 
rectus femoris muscle:
combines movements of:
main \_\_ muscle.
innervated by:
what test?
A
  • flexion at the hip
  • & extension at the knee
  • quad.
  • femoral nerve
  • ely sign +
34
Q

tensor fascia latae (TFL)
assists in:
innervated by:
what test?

A
  • flexing
  • abducting
  • & internally rotating the hip
  • superior gluteal nerve
  • ober +
35
Q

sartorius
responsible for:
__ muscle in the body.
innervated by:

A
  • flexion
  • abduction
  • & ext. rot. of the hip
  • & some deg. of knee flex.
  • longest
  • femoral nerve
36
Q

gluteus maximus
__ & most __ hip extensor & external rotator of the hip.
innervated by?
tested in which nerve root?

A
  • largest; important
  • inferior gluteal nerve
  • S1
37
Q 
gluteus medius
main \_\_ of the hip.
weakness of this M. is + on what test?
anterior portion action:
posterior portion action:
innervated by?
tested in which nerve root?
A
  • abductor
  • trendelenburg
  • flexes, abducts & internally rotates hip
  • extends & externally rotates hip
  • superior gluteal nerve
  • L5
38
Q

gluteus minimus
the major __ __ of the FEMUR
innervated by?
tested in which nerve root?

A
  • internal rotator
  • superior gluteal nerve
  • L5
39
Q

what are causes for a weak gluteus muscle?

A
  • fractures of the greater trochanter
  • slipped capital femoral epiphysis
  • congenital hip dislocation (allis sign)
  • poliomyelitis
  • meningomyelocele
  • nerve root lesion
40
Q

slipped femoral capital epiphysis:
slipping of the __ on the femoral head, as the head remains in the __.
adolescent ages:
tends to be more in which gender?
tends to be more in which race?
tends to be more in which hip?
bilateral is more common in __?
has a tendency to be more common in __ adolescents.
onset of limp with __ pain referred to the __.
etiology is __ 50% of the time.
alteration in __ line (normal 120).

A
  • neck; acetabulum
  • 10-15
  • males
  • blacks
  • left
  • females
  • overweight
  • hip; knee
  • trauma
  • Klein’s
41
Q

Piriformis:
an __ rotator of the hip at LESS than __ degrees of hip FLEXion.
at __ degrees of hip flexion, the piriformis reverses muscle action becoming an __ rotator & __ of the hip.

A
  • external
  • 60
  • 90
  • internal & abductor
42
Q

small external rotators of the hip:

A
  • obturator externus & internus
  • superior & inferior gemelli
  • & quadratus femoris
43
Q

hamstrings made up of: (3)

A
  • biceps femoris
  • semimembranosus
  • semitendinosus
44
Q

biceps femoris
action:
innervation?

A
  • extends the hip
  • flexes the knee
  • & INT. rot. the tibia
  • fibular branch of sciatic n. (tibial nerve)
45
Q

semimembranosus & semitendinosus
action:
innervation?

A
  • extends the hip
  • flexes the knee
  • & INT. rotates the tibia
46
Q

hip adductors: (4)

A
  • adductor magnus
  • adductor longus
  • adductor brevis
  • gracilis
47
Q

adductor longus is frequently __ during strenuous activity.
if pulled, called?
most __ adductor.
innervation:

A
  • pulled
  • groin pull (strain)
  • prominent
  • post. division of obturator nerve
48
Q

there are more than a __ bursae in the hip region.
the iliopsoas (iliopectineal) bursa is located under the __ ligament, b/w the iliopsoas __ and the iliopectineal __ of the superior pubic rams.
osteoarthritis (OA) of the hip commonly causes __ of the __ bursae.
the __ bursae is located between the greater trochanter & __.

A
  • dozen
  • inguinal
  • tendon
  • eminence
  • inflammation
  • psoas
  • subtrochanteric; TFL
49
Q 
femoral triangle
aka?
superior border?
medial border?
lateral border?
the floor is formed by:
A
  • scarpa’s triangle
  • inguinal ligament
  • adductor longus
  • sartorius
  • portions of the iliopsoas on the lateral side
  • & pectineus on the medial side
50
Q

inguinal ligament is located b/w __ & the __ __.

unusual __ along the ligament could indicate an inguinal __.

A
  • ASIS & pelvic tubercle
  • bulges
  • hernia
51
Q

femoral artery is normally quite __.

A

-strong

52
Q

femoral nerve lies __ to the femoral artery.
aka?
__ branch of lumbar plexus.
formed by branches of ventral rami, from __-__ spinal N.

A
  • lateral
  • saphenous n.
  • largest
  • L2-L4
53
Q

femoral vein is __ palpable.

A

-not

54
Q

apex-inf. = adductor canal

aka?

A

-hunter’s canal

55
Q

sciatic nerve is located b/w __ __ & __ __.
tenderness may be due to a disc __ or __.
problem w/sciatic n. may be due to its relationship w/__ M.
it is the __ & __ nerve in the body.

A
  • greater trochanter & ischial tuberosity
  • pathology or trauma
  • piriformis
  • largest & longest
56
Q

normally the sciatic nerve passes __ to the piriformis m.
__%.
OR the common peroneal division of the sciatic n. will pass either: __ the piriformis (__%)
__ to the piriformis (__%)
OR both divisions pass __ the piriformis m. (__%)

A
  • inferior; 88%
  • thru; 11%
  • superior; 9%
  • thru; .1%
57
Q

the external __ artery becomes the femoral artery as it passes __ the inguinal ligament.

A
  • iliac

- underneath

58
Q

the anterior portion of the femoral neck & the anterior portion of the capsule of the hip joint are supplied by:

A

-lateral femoral circumflex artery

59
Q

the medial femoral circumflex artery perforates & supplies:

A
  • the posterior hip joint capsule

- & synovium

60
Q

the hip is a common area of __ & __ pain.

A
  • local

- & referred

61
Q

weight loss, fatigue, fever & loss of appetite should be sought out b/c they are clues to a:
other examples include:

A
  • systemic illness
  • insidious onset of symptoms, evidence of radiculopathy, blower and/or bladder changes, night pain unrelated to movement and severe pain.
62
Q

use P.R.I.C.E. during what phase?

and what does ‘price’ stand for?

A
  • acute

- protection, rest, ice, compression & elevation

63
Q

osteoarthritis: (__ common for of arthritis)
aka?
primarily a disorder of __ cartilage & __ bone.
men & women __ affected.
after age?
deep, __ joint pain, after __ or weight bearing, relieved by?
__ may be present on movement.
seen on x-rays as __ of joint space, __ bony deposits in joint space, or joint deformity due to __ or articular damage.
non-inflammatory usually involving __ to a __ joints.

A
  • most
  • degenerative joint disease
  • hyaline; subchondral
  • equally
  • 40
  • aching; exercise; rest
  • crepitation
  • narrowing; cyst-like
  • degeneration
  • one; few

Orthopedic Diagnosis (20 decks)

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