THE HIP

Question 1

palpate the ASIS

Answer 1

patient supine - hip bones

Question 2

palpate the PSIS

Answer 2

patient prone lying or standing

identify sacral dimples - palpate PSIS slightly laterally and inferiorly

Question 3

palpate the iliac crest

Answer 3

patient side lying with hips and knees flexed

identify ASIS and use index and middle fingers to palpate the full extendt of the crest to the PSIS

Question 4

palpate xiphoid process

Answer 4

patient supine identify clavicular notch of manubrium and run fingers distally to xiphoid

Question 5

palpate isoheal tuberosity

Answer 5

patient side lying
identify horizontal gluteal crease and move finger up 5cm
identify natal cleft and 5cm laterally.
get patient to flex knee to chest - palpate full extent under finger

Question 6

palpate the greater trochanter

Answer 6

patient side lying with knee and hips flexed
identify prominence on lateral surface.
palpate full U shape - identify this

Question 7

palpate the joint line of the hip

Answer 7

patient supine
identify ASIS and draw imaginary line to pubic tubercle
find mid line and move fingers 2cm laterally
find femoral pulse
move slightly laterally
passively rotate the patients leg to move the femoral head
this is the joint line

Question 8

what type of joint is the hip?

Answer 8

simple, multiaxial, ball and socket

Question 9

demonstrate full ROM for hip flexion

Answer 9

patient supine

as patient to bring knee to chest

Question 10

demonstrate full ROM for hip extension

Answer 10

patient side lying
support pelvis and lumbar spine
from nuetral ask to lift leg as high as possible off the bed

Question 11

demonstrate full ROM for hip abduction

Answer 11

patient supine - one leg placed over plinth to stool (fixes pelvis)
ask patient to keep their toes pointing upwards - move leg as far out as possible

Question 12

demonstrate full ROM for hip adduction

Answer 12

patient supine - one leg placed over plinth to stool (fixes pelvis)
ask patient to keep their toes pointing upwards - move leg as far in as possible

Question 13

demonstrate full ROM for medial rotation

Answer 13

patient supine - one leg placed over plinth to stool (fixes pelvis)
from neutral ask to move feet inwards as far in as possible

Question 14

demonstrate full ROM for lateral rotation

Answer 14

patient supine - one leg placed over plinth to stool (fixes pelvis)
from neutral ask to move feet outwards as far in as possible

Question 15

what is the limiting factors for hip flexion

Answer 15

contact of thigh with abdominal wall

Question 16

what is the limiting factors for hip extension

Answer 16

medial band of illeofemoral ligament
pubofemoral and isheofemoral ligaments
tension in flexors

Question 17

what is the limiting factors for hip abduction

Answer 17

pubofemoral ligament
medial band of illeofemoral ligament
tension in adductors

Question 18

what is the limiting factors for hip adduction

Answer 18

lateral band of ileofemoral ligament
ischeofermoral ligaments
tension in abductors

Question 19

what is the limiting factors for hip medial rotation

Answer 19

ischeofermoral ligament

tension in lateral rotators

Question 20

what is the limiting factors for hip lateral rotation

Answer 20

iliofemoral and pubofemoral ligaments

tension in medial rotators

Question 21

what is normal ROM for hip flexion

Answer 21

0-120

Question 22

what is normal ROM for hip extension

Answer 22

0-20

Question 23

what is normal ROM for hip abduction

Answer 23

0-40

Question 24

what is normal ROM for hip adduction

Answer 24

0-25

Question 25

what is normal ROM for hip medial rotation

Answer 25

0-40

Question 26

what is normal ROM for hip lateral rotation

Answer 26

0-60

Question 27

what is the special test for true shortening?

Answer 27

patient supine
measure from inferior edge of ASIS to medial malleolus
repeat 3 times

Question 28

what is true shortening?

Answer 28

damage below the joint - i.e. damage to greater trochanter, damage to articular cartilidge

Question 29

what is the special test for apparent shortening?

Answer 29

patient supine
measure from xiphoid process to medial malleolus
repeat 3 times

Question 30

what is apparent shortening

Answer 30

muscle contracture around the hip or damage to the SI joint

Question 31

how is the trendelenburg test carried out?

Answer 31

model stand by plinth, arms by side

ask to stand on normal leg and flex other knee

Question 32

what is a postive trendelenburg sign?

Answer 32

pelvis dropping on unsupported side - shows paralysis of glutes or inhibition due to pain

Question 33

what is the aim of trendelenburg test?

Answer 33

testing for function of hip abductors - glutes

Question 34

how to carry out thomas test?

Answer 34

patient supine
stand on affected side
hand under lumbar spine
flex hip to chest 
lumbar spine should flatten
other leg should remain in contact with plinth

Question 35

what is a positive thomas test?

Answer 35

opposite leg lift from plinth
lumbar spine not flattening

loss of extension at hip meaning FFD.

Question 36

what accessory movement can be done at the hip?

Answer 36

longitudinal caudad

Question 37

how to carry out longitudinal caudad at hip

Answer 37

patient supine
plinth low
grasp femur with pt leg straight
gently pull back

Question 38

why would a longditudinal caudad movement be carried out?

Answer 38

identify capsule strength

ability to cause hip flexion and rotation

Question 39

what are you looking for in hip flexion?

Answer 39

pain, resistance or spasm

in early mid or end range