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Spring 2022 classes > Lower extremities exam 3- hip > Flashcards

Lower extremities exam 3- hip Flashcards

1
Q

normal angle of inclination

A

125 deg

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2
Q

coxa vara def

A

decreased angle of inclination

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3
Q

coxa valga

A

increased angle of inclination

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4
Q

how does the angle of inclination change throughout a human’s lifespan

A

start w/ high and decreases as weight bearing begins

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5
Q

def angle of inclination

A

angular relationship of femoral head and femoral shaft of frontal plane (at hip joint_)

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6
Q

angle of torsion def

A

angular relationship of femoral head and femoral shaft in the transverse plane= amount of twist on the femur

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7
Q

angle of torsion normal degree

A

15-20

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8
Q

angle of torsion anteversion

A

greater than 20

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9
Q

angle of torsion retreoversion

A

less than 15

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10
Q

hip/femoral anteversion degree

A

greater than 20

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11
Q

what may femoral anteversion lead to

A

increase of Q angle, internal femoral rotation, squinting patella

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12
Q

hip/femoral retroversion degrees

A

less than 15

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13
Q

what does femoral retroversion lead to

A

femoral ER, laterally positioned patella, toe out gait

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14
Q

bones of hip and pelvis

A

ilium, pubis, ischium, sacrum, coccyx, femur

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15
Q

what 3 bones make up the pubis

A

superior rami, inferior rami, symphysis

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16
Q

where is the ishium located anatomically

A

at the fold of the buttcheek where hamstrings insert

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17
Q

innominate bone made up of what 3 hip structures

A

illium, ishium, pubis

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18
Q

what makes up the socket of the hip joint

A

acetabulum and labrum

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19
Q

what bone makes up the tail bone

A

coccyx

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20
Q

what quad muscle crosses at the hip

A

rectus femoris

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21
Q

what are the anterior muscles of the hip

A

rectus femoris, sartorius, illiopsoas

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22
Q

medial muscles of hip

A

adductors, gracilis

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23
Q

lateral muscles at the hip

A

gluteus medius, IT band, piriformis, quadratus femoris, obturator internus, obturator externus, gemellus superior, gemellus inferior

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24
Q

posterior muscles at the hip

A

glutes and hamstrings

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25
Q

trochanteric bursa purpose

A

provides lubrication for where gluteus maximus passes over greater trochanter, IT band, hip abductors

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26
Q

gluteofemoral bursa def

A

separates gluteus maximus from origin of vastus lateralis

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27
Q

ischial bursa def

A

weight bearing structure when person is SEATED provides cushioning

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28
Q

iliopsoas bursa

A

LARGEST bursa in the body, covers AIIS, illiac fossa, lesser trochanter

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29
Q

muscles involved in hip flexion

A

illiacus, psoas, sartorius, rectus femoris, pectineus, adductor brevis, adductor longus, adductor magnus, gluteus medius, gluteus minimus

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30
Q

muscles involved with hip extension

A

adductor magnus, gluteus maximus, gluteus medius, biceps femoris, semimembranosus, semiteninosis

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31
Q

what can the clinican do to isolate the glute instead of allowing the hamstring to fire?

A

have patient lay prone and flex the knee to prevent hamstring from working

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32
Q

muscles involved with abduction

A

sartorius, tfl, piriformis, gluteus maximus, gluteus minimus, gemellus superior, gemellus inferior, obturator internus

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33
Q

muscles involved with adduction

A

pectineus, adductor brevis, adductor longus, adductor magnus, gracilis, gluteus maximus

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34
Q

muscles involved with internal rotation

A

tfl, gluteus medius, gluteus minimus, semimembranosis, semitendinosus

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35
Q

muscles involved with external rotation

A

psoas, illiacus, sartorius, adductor brevis, gluteus maximus, gluteus medius, piriformis, inferior gemellus, obturator internus, quadratus femoris

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36
Q

what’s the artery at the hip

A

femoral artery

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37
Q

what does the femoral triangle include

A

sartorius, adductor longus, inguinal ligament

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38
Q

L1 DTR

A
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39
Q

L1 & L2 DTR which nerve

A

femoral nerve

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40
Q

what nerves are involved with the lumbar plexus

A

femoral, obturator, sacral

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41
Q

special test for angle of torsion set up

A

prone w/ knee flexed to 90, one hand palpates greater trochanter and uses a goniometer to measure.

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42
Q

special test for angle of torsion do

A

rotate femur until greater trochanter is maximally prominent, angle is measured by lower leg while knee remains flexed to 90

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43
Q

special test for angle of torsion + test

A

angle greater than 15 deg created after femur moved= femoral retroversion. angle greater than 20 deg created after femur moved= anteversion

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44
Q

q angle degrees m/f

A

18 deg F, 13 deg M

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45
Q

q angle def

A

relationship b/w ASIS, midpoint of patella and tibial tuberosity

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46
Q

leg length discrepancy special test *true

A

ASIS to medial malleolus

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47
Q

leg length discrepancy special test *apparent

A

umbilicus to medial malleolus

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48
Q

trendelenburg test set up

A

patient standing w/ weight evenly distributed on both feet, iliac crests or posterior superior iliac spines should be visible

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49
Q

trendelenburg test do

A

patient lift leg opposite of side being tested

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50
Q

+ trendelenburg test

A

pelvis lowers on non-weight bearing side

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51
Q

what does + trendelenburg test indicate

A

glute medius weakness

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52
Q

thomas test setup

A

patient supine, passively flex knee to chest and opposite leg rests on table

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53
Q

+ thomas test

A

involved leg rises off table OR involved knee moves into extension

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54
Q

+ thomas test indicates

A

tightness of iliopsoas OR rectus femoris

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55
Q

ely’s test set up

A

patient prone, passively flex knee

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56
Q

ely’s test +

A

hip on side flexes causing it to rise from the table

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57
Q

ely’s test + indicates

A

tightness of rectus femoris

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58
Q

faber(patrick’s) test set up

A

patient supine with involved foot crossed over opposite thigh, one hand on ASIS and other on medial flexed knee

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59
Q

+ patrick’s test

A

reproduction of symptoms at hip

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60
Q

patrick’s test indicative of

A

impingement at hip, labral tear,

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61
Q

what test should be done for the labrum of hip

A

faber (opposite) and anterior impingement (anterior), hip scouring (internal and external rotation), trendelenburg

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62
Q

piriformis test set up

A

patient laying on side, top leg positioned w/ hips at 60 deg flexion and knee flexion, stabilize pelvis and apply downward pressure at knee

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63
Q

piriformis test +=

A

pain

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64
Q

piriformis test + indicates

A

piriformis tightness or piriformis syndrome

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65
Q

anterior impingement test set up

A

patient supine, flex IR and adduct hip, rotate leg out

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66
Q

+ anterior impingement test

A

pain or reproduction of symptoms

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67
Q

anterior impingement test indicates

A

femoral acetabular impingement or labral tear

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68
Q

symptoms of anterior impingement test

A

pain, pop, click, lock, etc

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69
Q

hip scouring test set up

A

patient supine and fully flex hip and knee

70
Q

hip scouring test perform

A

apply pressure downward along shaft of femur to compress joint surfaces, femur internally and externally rotated w/ hip in multiple angles of flexion

71
Q

+ hip scouring test

A

pain, reproduction of symptoms

72
Q

+ hip scouring test indicates

A

labral tear or defect in articular cartilage of femur or acetabulum

73
Q

stress fracture test aka

A

fulcrum test

74
Q

stress fracture test set up

A

patient seated at end of table, one hand under mid to distal thigh, other hand applies downward pressure on proximal knee

75
Q

+ stress fracture test

A

pain

76
Q

what does + stress fracture test indicate

A

femoral stress fracture

77
Q

where may contusions of hip occur

A

illiac crest, greater trochanter, ischial tuberosity, coccyx

78
Q

hip pointer aka

A

contusion of illiac crest

79
Q

MOI hip pointer

A

direct trauma, fall

80
Q

s/s hip pointer

A

pain, tender, pain w/ flexion and rotation, sneeze and cough may increase pain, crepitus upon palpation

81
Q

tx hip pointer

A

protect w/ padding, RICE

82
Q

coccyx contusion MOI

A

direct trauma, falling, sit hard

83
Q

s/s coccyx contusion

A

pain w/ sitting, pt tender, swelling, discoloration

84
Q

tx coccyx

A

f/o fracture, donught pillow to sit, RICE

85
Q

hip strain MOI

A

overstretching, dynamic overload of muscle

86
Q

s/s hip strain

A

pain, swelling, palpable defect

87
Q

tx hip strain

A

crutches, appropriate ratio of stretch to strengthen

88
Q

tendonitis is common where in hip

A

hip flexors

89
Q

tendonitis MOI

A

overuse, repetitive hip flexion, run, kick, insidious onset

90
Q

s/s tendonitis

A

pain, swell, tender

91
Q

tx tendonitis

A

proper warm up, heat, RICE

92
Q

trochanteric bursitis MOI

A

acute blow, overuse, irritation

93
Q

risk factors trochanter bursitis

A

hip anteversion, increased Q angle, leg length discrepancy

94
Q

s/s trochanter bursitis

A

pain of greater trochanter, pain radiates to butt, pain w/ stairs, discomfort sleeping on side, red, tender, snapping

95
Q

tx trochanter bursitis

A

RICE, injection

96
Q

when should hip be reduced to prevent neurological problems

A

less than 6 hours after injury

97
Q

ischial bursitis MOI

A

acute blow, overuse, repeated shifting and moving while in seated position, rowing, prolonged sitting, biking

98
Q

ischial bursitis s/s

A

pain at ischial tuberosity, tender, pain w/ flexion

99
Q

tx ischial bursitis

A

RICE, activity modification

100
Q

legg calve perthes disease def

A

lesion of femoral head that causes degeneration and flattening of femoral head

101
Q

legg-calve perthes disease develops when in life

A

first decade (10 years)

102
Q

is legg calve perthes more common in girls or boys

A

boys

103
Q

MOI legg calve perthes

A

degenerative, single traumatic or multiple chronic events, disrupt blood supply, blood borne clotting factor, thyroid disease

104
Q

s/s legg calve perthes

A

hip or groin pain, limp, decreased ROM, leg may appear shorter

105
Q

what + test associated w/ legg calve perthes

A

+ trendelenburg test

106
Q

tx legg calve perthes disease

A

confirm w/ x-ray, PT, improve ROM, bracing, surgery

107
Q

what is most common hip disorder in adolescents

A

slipped capital femoral epiphysis

108
Q

slipped capital femoral epiphysis affects boys or girls more

A

boys

109
Q

unexplained hip and knee pain in kids could mean

A

slipped capital femoral epiphysis

110
Q

what causes slipped capital femoral epiphysis

A

femoral head remains in acetabulum and femoral neck displaces anteriorly causing toeing out

111
Q

what are 2 classifications of slipped capital femoral epiphysis

A

stable or unsable depending on if they are able to bear weight

112
Q

MOI slipped capital femoral epiphysis

A

gradual onset or abrupt maneuver

113
Q

risk factors slipped capital femoral epiphysis

A

overweight children w/ growth spurt

114
Q

s/s slipped capital femoral epiphysis

A

pain that gets worse with activity

115
Q

femoral stress fracture MOI

A

overuse due to rapid increase in frequency, intensity or duration

116
Q

risk factors of femoral stress fracture

A

female, decreased calcium/vit D intake

117
Q

s/s femoral stress fracture

A

deep aching pain, pain when rolling in bed, night pain, limits in extreme ROM

118
Q

what special test is for femoral stress fracture

A

+ stress fracture test

119
Q

tx femoral stress fracture

A

MRI, modify activity, progressive RTP

120
Q

osteitis pubis def

A

inflammation of public symphysis

121
Q

MOI osteitis pubis

A

overuse, run, kick

122
Q

s/s osteitis pubis

A

groin pain, tender at symphysis, spasm of adductor, pain w/ resisted hip adduction, pain w/ trunk flexion

123
Q

tx osteitis pubis

A

activity modification, nsaids

124
Q

hip dislocation is usually anterior or posterior

A

posterior

125
Q

MOI hip dislocation/subluxation

A

flexion and adduction w/ axial force, fall onto flexed knee w/ hip adducted, jump, stop or pivot, knee to dashboard

126
Q

s/s hip dislocation

A

immediate intense pain, femur and lower legs in flexion, inability to WB

127
Q

tx hip dislocation

A

immediate transport

128
Q

avascular necrosis of femoral head def

A

blood floor interrupted or reduced

129
Q

what is the major risk of avascular necrosis

A

bone death

130
Q

what is most common complication after hip dislocation

A

avascular necrosis of femoral head

131
Q

other causes of avascular necrosis

A

obesity, sickle cell, lupus, history of subluxations

132
Q

femoral acetabular impingement common population

A

middle aged athletic individuals

133
Q

def femoral acetabular impingement

A

abnormal stresses on surrounding soft tissue and bone resulting in labral tears, chondral degeneration, osteoarthritis

134
Q

cam lesions def

A

at femoral head, result from abnormally shaped femoral head repeatedly contacting acetabulum and surrounding labrum

135
Q

why might cam lesion develop

A

extensive sports participation during high growth period of adolescence

136
Q

pincer lesions more common in what population

A

middle-aged, active females

137
Q

pincer lesion may develop b/c

A

result when acetabulum is covering femoral head due to compression during flexion

138
Q

femoral acetabular impingement MOI

A

gradual onset, repeated compressive forces from abnormally shaped head

139
Q

risk factors femoral acetabular impingement

A

slipped capital femoral epiphysis, legg calve perthes

140
Q

s/s femoral acetabular impingement

A

grain pain extends to lateral thigh, pain made worse by activity in flexion, antalgic gait, deep pain

141
Q

what + tests for femoral acetabular impingement

A

FABER and anterior impingement

142
Q

tx femoral acetabular impingement

A

avoidance of aggravating activities including excessive IR and adduction

143
Q

labral tear MOI

A

acute, twisting, falling, mis-step, hyperextension, hyperabduction, dislocation, subluxation, repeated weight bearing

144
Q

predisposing conditions of labral tear

A

slipped capital femoral epiphysis, FAI, capsular laxity

145
Q

s/s labral tear

A

deep pain in anterior or medial hip, running distance limited

146
Q

tx labral tear

A

attempt at conservative treatment, MRI, surgery if necessary

147
Q

athletic pubalgia aka

A

sports hernia

148
Q

sports hernia cause

A

unbalanced tension b/w upward pull of rectus abdominis and downward lateral pull of adductor muscle group

149
Q

MOI athletic pubalgia

A

insidious, repetitive twisting, cutting, running, kicking

150
Q

s/s athletic pubalgia

A

deep lower abdominal or groin pain, symptoms return after period of rest, pain w/ palpation of pubic ramus, adductors, pain w/ sit up, pain w/ cough or sneeze

151
Q

tx athletic pubalgia

A

MRI, attempt at conservative treatment, surgery

152
Q

MOI snapping hip syndrome

A

insidious, internal or external snapping

153
Q

internal vs external snapping hip syndrome

A

iliopsoas contacting femoral head or other structure vs IT band catching greater trochanter

154
Q

risk factors snapping hip syndrome

A

dancers in teens or 20s

155
Q

s/s snapping hip syndrome

A

pain and snapping during running, jumping, cross stepping activities, pt has ability to recreate and palpate popping when hip moves from flexion to extension, bursitis

156
Q

tx snapping hip syndrome

A

RICE, activity modification, NSAIDS

157
Q

where does sciatic nerve usually pass through piriformis (under or over)

A

under piriformis

158
Q

what % of population has piriformis problems

A

15%

159
Q

where does sciatic nerve pass through to cause piriformis syndrome

A

through the piriformis muscle

160
Q

who is piriformis syndrome more common in

A

women

161
Q

piriformis syndrome MOI

A

congenital, overuse, repetitive kicking, running

162
Q

s/s piriformis syndrome

A

pubic pain, spasm, tightness, tender, numb and tingle, burn, cough, sneeze causes pain

163
Q

+ test for piriformis syndrome

A

piriformis test

164
Q

tx piriformis syndrome

A

proper ratio of stretching and strengthening, steroid injection, surgical relase

165
Q

hip osteoarthritis MOI

A

age, repetitive trauma, degernation of surfaces

166
Q

s/s hip osteoarthritis

A

pain w/ weight bearing, referred pain to low back or knee

167
Q

+ test for hip osteoarthritis

A

hip scour

168
Q

tx hip osteoarthritis

A

activity modification, weight loss, NSAIDS, calcium, vit D supplements, hip replacement surgery

169
Q

hip fracture MOI

A

car accident, high impact activity, direct trauma

170
Q

s/s hip fracture

A

immediate pain, loss of function, deformity

Spring 2022 classes (21 decks)

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