Practical exam - hip Flashcards
What is the classification of the hip joint?
synovial
ball and socket
multi axial
simple
What is the normal ROM of hip flexion?
0-120 degrees
What is the normal ROM hip extension?
0-20 degrees
What is the normal ROM abduction?
0-45 degrees
What is the normal ROM adduction?
0-30 degrees
What is normal ROM for medial rotation?
0-40 degrees
What is the normal ROM for lateral rotation?
0-60 degrees
Limiting factors to hip flexion?
Contact of thigh with abdominal wall
Tension in opposing muscles: Extensors (gluteus max, hamstrings)
Limiting factors to hip extension?
Ligaments: all capsular ligaments
Tension in opposing muscles: flexors (iliopsoas)
Limiting factors to hip abduction?
Ligaments:
pubofemoral, iliofemoral (medial/inferior band)
Inferior joint capsule
Tension in the adductors - adductor magnus
Limiting factors to hip adduction?
Ligaments:
iliofemoral (lateral/superior band), ischiofemoral
Tension in opposing muscles: Abductors - gluteus max, min, med , tensor fascia lata
Limiting factors to medial rotation of the hip?
Ligaments:
ischiofemoral
Tension in opp. muscles: Lateral rotators - Piriformis, obturator internus, gemellus sup + inf.
Limiting factors to lateral rotation of the hip?
Ligaments:
iliofemoral, pubofemoral
Tension in medial rotators - anterior part of glut. med. and min., tensor fascia lata, iliopsoas.
What is important to note in a positive Trendelenburg test?
The sound side sags
What does a positive thomas test suggest?
Can indicate the presence of a fixed flexed deformity at the hip which can be measured with goniometer.
FFD can be caused by shortening of the soft tissue on the anterior of the hip joint.
Shortened structures can include muscles (psoas major, rectus femoris, etc.) or the soft tissue of the capsule.
What does a true leg length discrepancy indicate?
An issue below the level of the greater trochanter.
Such as an impacted healed fracture or a loss of joint space due to pathology or deformity such as OA or polio.
What does an apparent leg length discrepancy indicate?
An issue above the greater trochanter.
Such as in the lower back or pelvis.
What does the femoral triangle consist of?
Inguinal ligament
Adductor longus
Sartorius
What is the role of the sartorius?
Hip flexion
abduction
lateral rotation
What main muscles flex the hip?
Psoas major
Iliacus
Pectineus
Rec. fem
sartorius
What main muscles extend the hip?
Glut. max
Hamstrings
What main muscles adduct the hip?
Adductor magnus
Adductor longus
Adductor brevis
Gracillis
Pectineus
What main muscles abduct the hip?
Glut. max
Glut. med
Glut. min
Tensor fascia lata
What muscles medially rotate hip?
Anterior part of glut. med
Anterior part of glut. min
Tensor fascia lata
Iliopsoas
What muscles laterally rotate the hip?
Gluteus max.
Piriformis
Obturator internus + externus
Gemellus superior
Gemellus inferior
Quadratus femoris