lecure 5a: anatomy and Biomechanics review of the hip

Question 1

what is the rest position of the Hip joint

Answer 1

30° flexion, 30° abduction and slight ER

Question 2

what is the closed packed position for the hip joint

Answer 2

full extension , IR and abduction

Question 3

what is the capsular pattern of the hip joint

Answer 3

flexion , abduction , IR (but sometimes IR is limited)

Question 4

what is the articulation of the hip joint

Answer 4

convex head of femur articulates with convace acetabulum

Question 5

what is larger , the acetabulum or head of the femur? and how does the head of the femur face

Answer 5

head of the femur is larger

faves medially , superiorly anf anteriorly

Question 6

what is the major function of the hip joint

Answer 6

transmit forces b/t pelvis and LEs

Question 7

is the hip joint designed for stability or mobility

Answer 7

stability over mobility

Question 8

what is hip dysplasia

Answer 8

under coverage of femoral head by acetabulum

Question 9

what is an excessive bony development and/or overcoverage of femoral head by acetabulum

Answer 9

Femoro-acetabular impingement (FAI

Question 10

____ ____ is integral to successfully evaluating and treating hip dysfunctions

Answer 10

regional interdependence

Question 11

how does the acetabulum face

Answer 11

anteriorly , laterally and inferiorly and is convace

Question 12

what is the acetabulum covered by and what is it deepen and supported by >?

Answer 12

covered by articular cartilage and deepened and supported by labrum

Question 13

what is filled with a fat pad very important for shock absorption and proprioception

Answer 13

acetabular fossa

Question 14

where is the angle of inclination

Answer 14

in frontal plane b/t femorla neck anf shaft

Question 15

what is the normal angle of inclination for ..

adults
infants
elderly

Answer 15

• Adults: 125-139°
• Infants: 150°
• Elderly: 120°

Question 16

what is the angle of inclination for coxa valga and coxa vara

Answer 16

• Coxa Valga >139°
• Coxa Vara <125°

Question 17

what is the angle that is in horizontal plane b/t axis through femoral neck and axis through condyles

Answer 17

angle of torsion (anteversion)

Question 18

what is the normal range of angle of torsion (anteversion)

adults
infants

Answer 18

• Adults: 10-15º
• Infants: 30º

Question 19

what is excessive anteversion and what does it casues and what does it predispose

Answer 19

> 15°
casues toe in and IR hip
predispose OA and excessive anterior glide

Question 20

what is the difference between relative retroversion vs absolute retroversion and what does it cause

Answer 20

Relative retroversion <10º vs Absolute retroversion <0º

both causes toe out and ER hip

Question 21

where in the joint capsule of the hip is it thick and thin

Answer 21

thicken anteriorly and superiorly and thin and loose posteriorly and inferiorly

Question 22

what is the anterior capsule more predisposed to ? what about the posterior capsule?

Answer 22

anterior: more presidsposed to shortening and restriction

posterior: more predisposed for dislocation and laxity

Question 23

what direction is the hip most likely to dislocate

Answer 23

posteriorly

Question 24

what kind of cartilage is the acetabular labrum ? where does it attache to ? what does it increase and what does it disperse

Answer 24

fibrocartilage

attaches to acetabular margin
increase congruicey of articulation
disperses the load

Question 25

what is the only mm that **flexes** the hip at the edn range of hip flexion

Answer 25

iliopsoas

Question 26

what does the **iliopsoas** have to do w the effects of the spine

Answer 26

in upright positon , contraction of iliopsoas increases lumbar lordosis

Question 27

what is the action of the **rectus femoris**

Answer 27

flexes hip and extends knee

Question 28

what way does the RF pull the innominates

Answer 28

into anterior tilt

Question 29

what does the TFL mm do

Answer 29

flexes, IR and abducts the hip

Question 30

what does the sartorius do

Answer 30

flexes , ER and abducts the hip flexes and IR the knee

Question 31

what does the **glute med - posterior fibers** do

Answer 31

extended , abduct andER the hip

Question 32

what does the **glute med - anterior fibers and glute min** do

Answer 32

flex , abduct and IR of the hip

Question 33

what does the glute max do

Answer 33

extend and ER th whip • Superior fibers ABduct the hip • Inferior fibers ADDuct the hip

Question 34

where does 80% of the glute max insert into

Answer 34

ITB

Question 35

what mm is commonly atrophied in pts with sway back posture , spinal DJD and hip DJD

Answer 35

glute max

Question 36

what are considered the i**ntrinsic ERs** of the post , hip

Answer 36

piriformis obturator internus and externus superior and inferior gemelli quad fem

Question 37

what is a potential site of sciatic entrapment in the hip mm

Answer 37

piriformis

Question 38

what is considered the **medial** hamstrings and what does it do at the hip and knee

Answer 38

semimem and semitend * Extend and IR the hip * Flex and IR the knee

Question 39

what is considered in the **lateral** hamstrings and what does it do at the knee and hip

Answer 39

bicep femoris extended and ER the hip flexes and ER the knee

Question 40

what does the **pectineus** do at the hip

Answer 40

ADDucts, IR and flexes the hip

Question 41

what does the **gracillis** do at the hip and knee

Answer 41

* ADDucts the hip * IR and flexes the knee

Question 42

what does the adductor longus/brevis do and which is most commonly strained

Answer 42

adduct and flexes the hip adductor longus is most commonly traingin

Question 43

what does the **adductor magnus** do

Answer 43

* ADDucts the hip * Anterior fibers flex the hip * Posterior fibers extend the hip

Question 44

what is the **largest** and **most constant** bursae around the hip and cushions tendon from anterior structures on the hip capsule

Answer 44

iliopsoas bursa

Question 45

what bursa is located between ischium and glute max

Answer 45

ischiogluteal bursa

Question 46

what is the superior board , medial border , lateral border and the floor or the femoral triangle

Answer 46

• Superior border: inguinal ligament • Medial border: adductor longus • Lateral border: sartorius • Floor: portions of iliopsoas on the lateral side and pectineus on the medial side

Question 47

Several neurovascular structures pass through the femoral triangle

Answer 47

femoral vein , artery and nerve

Question 48

what is the hip joint primarily innervated by

Answer 48

L3

Question 49

nerves of mm that cross the hip joint also supply what

Answer 49

the joint capsule and the joint

Question 50

internal iliac a becomes the ____ artery as it passes underneath the ___ ligament

Answer 50

femoral inguinal

Question 51

what artery supplies the anterior portion of the femoral neck and anterior portion of the hip joint capsule ?

Answer 51

laterla femoral circumflex a

Question 52

what artery supplies the posterior portion of the hip joint capsule and the synovium

Answer 52

medial femoral circumflex a

Question 53

most of the **femoral head** , comprising its upper 1/2 or upper 2/3 , is supplied by ___ artery and a terminal branch for the medial femoral circumflex a

Answer 53

obturator

Question 54

supply to the femoral head from the ___ ___ artery is extremely variable

Answer 54

ligamentum teres

Question 55

what is the hip AROM of flexion and extesnion int he sagittal plane

Answer 55

flexion: 110-120 extension : 10-15

Question 56

what is the hip AROM for hip **abduction** and **adduction** in the frontal plane

Answer 56

abduction: 30-50 adduction: 25-30

Question 57

what is the hip AROM for IR and ER in the horizontal plane

Answer 57

IR: 30-40° ER: 4-60°

Question 58

what are the arthrokinematics of flexion and extension of the hip (NWB)

Answer 58

flexion: spine and posterior glide extesnion: spin and anterior glide

Question 59

what are the arthrokinematics of abduction and adduction of the hip (NWB)

Answer 59

abduction: interior/medial glide adduction: superior/lateral glide

Question 60

what are the arthrokinematics of IR and ER of the hip (NWB)

Answer 60

IR: posteriorl glide ER: anterior glide