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PCM 1 > OSCE 3 - Hip > Flashcards

OSCE 3 - Hip Flashcards

1
Q

borders of femoral triangle

A

Borders: Superiorly – Inguinal Ligament
Medially – Medial border of Adductor Longus
Laterally – Medial border of Sartorius

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2
Q

external rotators of hip

A

sartorius

glut. med.
glut. max

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3
Q

Hip ROM

A 
Flexion- 90 knee extended, 120
‐135 knee flexed
Extension  15‐30
Abduction  45‐50 knee extended
Adduction  20‐30
Internal rotation  30‐40
External rotation  40‐60
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4
Q

HIP flexion muscles and nerves

A

iliopsoas muscles
femoral nerve L2-4
verntal rami of lumbars L1-2

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5
Q

extension muscles and nerves

A

glut max

inf. gluteal L5, S1, S2

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6
Q

abduction

A

glut. med and min.

sup. gluteal L5, S1

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7
Q

adduction

A

adductor longus m.

obturator n. L2-4

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8
Q

Muscle grading on 5/5 scale

A

0 - no muscular contraciton
1 - barely detectable flicker/ trace of contraciton
2 - active movement w/ gravity eliminated
3 - active movement against gravity
4 - active movement against gravity and some resistance
5 - against full resistance w/o evidence of fatigue

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9
Q

hip compartments

A

central
peripheral
lateral
anterior/ iliopsoas

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10
Q

central contents

A

 Labrum
 Ligamentum Teres
 Articular surfaces

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11
Q

peripheral contents

A

femoral neck

synovial lining

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12
Q

lateral contents

A 
 Gluteus medius
 Gluteus minimus
 Iliotibial Band
 Trochanteric bursae
    Deep
    superficial
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13
Q

anterior/ iliopsoas contents

A

Iliopsoas insertion Iliopsoas Bursae

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14
Q

Log roll

A

nonspecific to central and peripheral compartments
roll the patient’s leg into internal and external rotation
+ test = pain
indicates: central or peripheral compartment pathology

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15
Q

central compartment tests

A 
c-sign
labral loading
labral distraction
scour
apprehension: FABER (1 of 3)
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16
Q

c sign

A

cups just above trochanter

indicates labral pathology

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17
Q

labral loading

A

patients hip and knee at 90 degrees, loading into femur towards innominate
+ test = pain
indicates: labral or cartilaginous pathology

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18
Q

labral distraction

A

distracting femur away from innominate
+ test = IMPROVEMENT of pain
indicates: labral or cartilaginous pathology

19
Q

scour

A

flexing and externally rotating patient’s hip
- loading into socket and articualting through annular range of motion
+ test = pain
indicates: labral or articular cartilage pathology

20
Q

apprehension: FABER for CENTRAL compartment

A

patient’s hip is flexed, aBducted and externally rotated
- doctor induces further external rotaiton by applying POSTERIOR force at knee
+ test = anterior subluxation of hip or apprehension/ pain
indicates: anterior labral pathology
can also be + with impingement

21
Q

peripheral compartment tests

A

Ely’s test

rectus femoris test

22
Q

ely’s test

A

patient prone, passively flex patient’s knees
+ test = ipsilateral hip raises off table
indicates: rectus femoris contracture

23
Q

rectus femoris test

A

patient supine
one hip flexed up to the chest
other leg bent over edge of table
+ test = knee flexion

24
Q

lateral compartment tests

A 
jump sign
straight leg raise test
ober's test
piriformis test
trendelenburg
patrick's FABER
25
Q

jump sign

A

patient seated, pressure applied to greater trochanter
+ test = patient withdraws/ jumps with pressure
indicates: trochanteric bursitis

26
Q

straight leg raise test

A

raise leg wtih knee extended, onspecific test
+ test = pain
indicates: pain from 15-30 = lumbar disc etiology
pain laterally >15 degrees - lateral compartment pathology (as IT band passes over greater trochanter

27
Q

ober’s test

A

patient lateral recumbent w// doctor standing behind patient
doctor abducts top leg and lowers leg to table while stabilizing hip
+ test = inability to adduct
indicates: IT band contracture

28
Q

piriformis test

A

patient supine with hip and knee flexed, one ankle crossed over contralateral knee. patient abducts against resistance
+ test = pain over posterior aspect of greater trochanter
indicates: piriformis spasm or pathology

29
Q

trendelenburg

A

patient standing, doctor behind
patient lefts one foot off ground
+ test = weakness/ inability to hold hips level
indicates: contralateral glut. med. weakness (superior glut. nerve)

30
Q

Patrick’s FABER for lateral compartment

A

patient’s hip flexed, aBducted and externall rotated
doctor braces contralateral ASIS, patient externally rotates/ aBducts against resistance
+ test = pain or weakness
indicates: glut. med pathology

31
Q

anterior/ iliopsoas compartment

A

Patrick’s FABER
Psoas Test
Thomas Test

32
Q

Patrick’s FABER for ANTERIOR compt.

A

patient’s hip flexed, abducted externall rotated, doctor braces contralateral ASIS
patient internally rotates/ aDducts against resistance
+ test = anterior or medial groin pain/ weakness
indicates: iliopsoas insufficiency or pathology

33
Q

Psoas Test

A

flex hip to 30 degrees while patient further flexes against resistance
+ test = pain/ instability or snapping
indicates: psoas contracture or pathology

34
Q

thomas test

A

patient supine, pulls knee to chest
one leg lowered to table to test flexibility of hip flexors
+ test = inability to fully extend/ extended leg raises off table
indicates: hip flexor contraction

35
Q

catching, locking a s/s of

A

central compartment

peripheral

36
Q 
instability or..
Pain
 Lumbar Spine
 Groin/ Medial
 Pelvic Rim
 Anterior to Posterior
 (L5-S1) radicular pattern
 In the a.m. or after a run
A

central compartment pathology

37
Q

central compartment potential patohlogies

A 
 Labral tears
 Ligamentum Teres Disruption
 Osteochondral defects
 Chondromalacia/ Osteoarthritis
 Loose Bodies
38
Q

Pain with hip movement
 Deep Hip
 Groin
 Limited range-of-motion

A

peripheral compt.

39
Q

peripheral compt. pathologies

A 
 Loose Bodies
 Impingement syndrome
 Pincer Type
 CAM Type
 Synovitis
40
Q 
Weakness
 Difficulty with lifting leg to climb stairs
 Pain
 Lateral hip
 Pelvic rim
 Radiating down leg to knee
 Knee pain
 Instability
A

s/s of lateral compartment

41
Q

lateral compartment pathologies

A 
 IT Band Syndrome
 Bursitis
 Rotator cuff Tendonopathies
 Gluteus Medius
 Gluteus Minimus
42
Q

 Pain
 Anterior hip
 Medial Groin
 Anterior deep thigh

A

s/s of anterior compt.

43
Q

iliopsoas compt. pathologies

A

 Psoas Tendonitis

 Iliopsoas Bursitis

44
Q

Snapping hip

A 
Can be internal or external
 Internal
 Psoas “snaps” over femoral
head
 External
 IT band “snaps” over trochanter

PCM 1 (17 decks)

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