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Year 1: 2019 PCM I Midterm > OSCE: Hip > Flashcards

OSCE: Hip Flashcards

1
Q

What are important anterior landmarks of the hip?

A
  • Level of L4: Iliac Crest (upper margin of pelvis)
  • Iliac Tubercle and Anterior Superior Iliac Spine (ASIS)
  • Greater Trochanter of Femur
  • Pubic Tubercle
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2
Q

What are important posterior landmarks of the hip?

A
  • Posterior Superior Iliac Spine (PSIS)
  • Greater Trochanter of Femur
  • Ischial Tuberosity
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3
Q

What is the normal ROM for hip flexion (knee flexed)?

What muscles are involved?

A

120-135o

Iliopsoas

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4
Q

What is the normal ROM for hip extension?

What muscles are involved?

A

15-30o

Gluteus Maximus

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5
Q

What is the normal ROM for hip abduction?

What muscles are involved?

A

45-50o

Gluteus Medius and Minimus

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6
Q

What is the normal ROM for hip adduction?

What muscles are involved?

A

20-30o

Medial Compartment Muscles: Adductor Longus, Brevis, and Magnus, Pectineus, Gracilis

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7
Q

What is the normal ROM for hip external rotation?

What muscles are involved?

A

40-60o

External and Internal Obturators, Quadratus Femoris, Superior and Inferior Gemelli

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8
Q

What is the normal ROM for hip internal rotation?

What muscles are involved?

A

30-40o

Iliopsoas

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9
Q

Labral Loading

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Central Compartment

  1. Flex the patient’s knee and hip to 90°
  2. Load into the femur towards the innominate

Positive Test (pain) indicates Labral or Cartilaginous Pathology

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10
Q

Labral Distraction

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Central Compartment

  1. Flex the patient’s knee and hip to 90°
  2. Distract femur away from the innominate

Positive Test (distraction of pain) indicates Labral or Cartilaginous Pathology

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11
Q

Scour

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Central Compartment

  1. Flex and externally rotate patient’s hip.
  2. Load into socket and articulate through annular range of motion.

Positive Test (pain) indicates Labral or Articular Cartilage Pathology

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12
Q

Apprehension Faber

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Central Compartment

  1. Patient’s hip is flexed, abducted and externally rotated.
  2. Physician induces further external rotation by applying a posterior force at the knee.

Positive Test (anterior subluxation of hip or pain) indicates Labral Pathology

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13
Q

Rectus Femoris Test

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Peripheral Compartment

  1. Patient supine.
  2. One hip is flexed up to the chest.
  3. The other leg is bent over the edge of the table.

Positive Test (knee flexion <90o) indicates Rectus Femoris Contraction

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14
Q

PACE/FAIR Test

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Lateral Compartment

  1. Patient is supine with knees and hips flexed.
  2. Patient abducts and externally rotates against physician.

Positive Test (pain) indicates Piriformis Pathology

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15
Q

Trochanteric Bursitis

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Lateral Compartment

  1. Patient seated.
  2. Pressure is applied to greater trochanter.

Positive Test (patient jump) indicates Trochanteric Bursitis

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16
Q

Straight Leg Raise Test

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Lateral Compartment

  1. Patient supine.
  2. Passively flex patient’s ipsilateral hip with knee extended.

Positive Test (pain over lateral leg at >15o) indicates IT Band contracture

  • Positive signs usually occur between 30-60˚ if cause is lumbosacral radiculopathy and/or sciatic neuropathy.
  • Positive signs at >70˚ is more likely mechanical low back pain due to muscle strain or joint disease.
17
Q

Piriformis Test

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Lateral Compartment

  1. Patient supine with hip and knee flexed, one ankle crossed over contralateral knee.
  2. Patient abducts against resistance.

Positive Test (pain over posterior aspect of greater trochanter) indicates Piriformis Spasm or Pathology

18
Q

Patrick’s Faber (Lateral Compartment)

How do you peform this test?

What does a positive test indicate?

A

Lateral Compartment

  1. Patient’s hip is flexed, abducted and externally rotated.
  2. Physician braces contralateral ASIS.
  3. Patient externally rotates/abducts against resistance.

Positive Test (pain) indicates Gluteus Medius Pathology

19
Q

Patrick’s Faber (Anterior Compartment)

How do you peform this test?

What does a positive test indicate?

A

Anterior Compartment

  1. Patient’s hip is flexed, abducted and externally rotated.
  2. Physician braces contralateral ASIS.
  3. Patient internally rotates/adducts against resistance.

Positive Test (pain) indicates Iliopsoas Insufficiency or Pathology

20
Q

Thomas Test

What compartment is this testing?

How do you peform this test?

What does a positive test indicate?

A

Anterior Compartment

  1. Patient supine and pulls knees to chest.
  2. One leg is lowered to the table to test the flexibility of the hip flexors.

Positive Test (extended leg raises off table) indicates Hip Flexor Contraction.

Year 1: 2019 PCM I Midterm (16 decks)

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