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Dutton's Orthopaedic Examination, Evaluation, and Intervention: Hip Joint Complex > The Hip > Flashcards

The Hip Flashcards

1
Q

The hip joint is classified as

A

ball and socket joint

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2
Q

How many planes of motion does the hip joint move in?

A

3
Sagittal (flexion/extension)
Frontal (abduction/adduction)
transverse (internal/external rotation)

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3
Q

All three axes of hip motion pass through

A

the center of the femoral head

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4
Q

Os Coxa is made up of

A

three individual bones

ilium, ischium, pubis

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5
Q

Acetabulum

A

site where the ilium, ischium, and pubis fuse together

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6
Q

A majority of acetabular development is completed by

A

the age of 8

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7
Q

Acetabular rim

A

aka labrum

deepens the acetabulum thereby increasing the stability of the hip joint

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8
Q

The whole of the acetabulum is covered with hyaline cartilage except

A

the fovea capitis

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9
Q

The pelvic girdle is composed of which three joints

A

hip (acetabularfemoral)
sacroiliac
public symphysis

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10
Q

Iliac crest contusion

A

contusion to the site of or an avulsion of the quadratus lumborum and or abdominal muscles from the crest
very painful/disabling if periosteum is involved

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11
Q

With an iliac crest contusion, Patient experiences:

A

pain when laterally flexing away from the side of injury

pain with abduction of both legs together in side-lying position

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12
Q

Bucket handle fracture

A

superior and inferior public rami fractures with a separation or fracture of the contralateral SI joint

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13
Q

Sprung Pelvis

A

separation of the pubic symphysis and both SI joints

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14
Q

Straddle Fracture

A

bilateral superior pubic rami and ischopubic fractures

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15
Q

Most common areas for pelvis avulsion fractures

A

ASIS
AIIS
Ischial Tuberosity

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16
Q

Femur

A

Strongest and longest bone in the body

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17
Q

two thirds of the femoral head is covered in

A

a smooth layer of cartilage except for the fovea capitis

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18
Q

The fovea capitis is the attachment for what?

A

ligamentum teres

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19
Q

Inclination angle

A

angle between the femoral shaft and neck

approximately 125- 130 degrees

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20
Q

The inclination angle in a tall person is

A

valga

larger

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21
Q

The inclination andle in a short person is

A

vara

smaller

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22
Q

Femoral Head dislocation

A

dashboard injury to the knee will cause a posterior hip dislocation if the hip is adducted at the time of injury

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23
Q

the greater trochanter

A

serves as the insertion site for several muscles that act on the hip joint

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24
Q

the lesser trochanter

A

located on the posterior-medial junction of the neck and shaft of the femur
created from the pull of the iliopsoas muscle

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25
Q

angle of Anteversion

A

the angle that the femoral neck makes with the acetabulum

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26
Q

normal angle of anteversion

A

8-15 degrees

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27
Q

Femoral Anteversion

A

aka medial femoral torsion

the angle between femoral neck and the transcondylar axis is greater than 15 degrees

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28
Q

What type of gait do you see with femoral anteversion

A

toe-in gait

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29
Q

Increased medial femoral torsion leads to

A 
OA
dysplasia of the acetabulum
susceptibility to anterior femoral dislocation
knee joint misalignment problems
patellar dislocations
excessive lumbar lordosis
external tibia rotation
foot pronation
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30
Q

Femoral retroversion

A

aka lateral femoral torsion

the angle between the femoral neck and the transcondylar axis is less than 15 degrees

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31
Q

why type of gait fo you see with femoral retroversion

A

toe out

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32
Q

lateral femoral head torsion may lead to

A

low back/SI pathologies
internal rotation of the tibia
supination of the feet

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33
Q

Legg-calve-perthes disease

A

avn of the femoral capital epiphysis before closure of the growth plate

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34
Q

Who predominately experiences legg-calve-perthes diseaes

A

males (5:1)

ages 3-12

35
Q

Four stages of Legg-Clave-Perthes disease

A

avascularization
revascularization
repair
deformity

36
Q

Primary causes of Legg-Calve-Perthes

A

trauma
hereditary
nutritional
circulatory

37
Q

which test will be positive with Legg-Calve- Perthes?

A

trendelenberg

38
Q

Legg-Calve Perthes is bilateral in what percentage of cases?

A

10

39
Q

How do the odds of experiencing Legg-Calve-Perthes change with a smoker’s household?

A

change of experiencing this pathology increases from 1 in 1200 to 1 in 100

40
Q

Three extra-articular ligaments in the hip

A

iliofemoral ligament of Bertin/Bigelow
Pubofemoral Ligament
Ischiofemoral ligament

41
Q

Iliofemoral Ligament

A

made up of two parts: inferior(medial) portion and a superior(lateral) portion
strongest ligament in the body

42
Q

Which muscle does the iliofemoral ligament blend with

A

iliopsoas

43
Q

Pubofemoral Ligament

A

blends with the inferior band of the iliofemoral and pectineus muscle

44
Q

Ischiofemoral ligament

A

winds posteriorly around the femur and attaches anteriorly, strengthening the capsule

45
Q

What hip ligament in most commonly injured?

A

ischiofemoral

46
Q

All extra-articular hip ligaments tighten with:

A

hip extension

47
Q

the lateral band of the iliofemoral ligament limits:

A

adduction

48
Q

the medial band of the iliofemoral ligament limits:

A

external rotation

49
Q

the pubofemoral ligament limits

A

abduction

50
Q

the ischiofemoral ligament limits:

A

internal rotation

51
Q

Iliopsoas

A

the most powerful of the hip flexors

52
Q

iliopsoas is made up of:

A

iliacus and psoas major

53
Q

Pectineus

A

adducts, flexes, and internally rotates the hip

54
Q

Rectus femoris

A

combines the movements of hip flexion and knee extension

55
Q

Tensor fascia latae

A

assists in flexing, abductiong, and internally rotating the hip

56
Q

Sartorius

A

the longest muscle in the body

responsible for flexion, abduction, and external rotation of the hip as well as some degree of knee flexion

57
Q

Gluteus maximus

A

largest and most important extensor and external rotator of the hip

58
Q

gluteus medius

A

main abductor of the hip

59
Q

anterior portion of gluteus medius

A

flexes, abducts and internally rotates the hip

60
Q

the posterior portion of gluteus medius

A

extends and externally rotates the hip

61
Q

Gluteus minimus

A

the major internal rotator of the femur

62
Q

Some causes of weak gluteus medius muscles?

A 
fracture of the greater trochanter
slipped capital femoral epiphysis
congenital hip dislocation
poliomyelitis
meningomyelocele
L5 nerve root lesion
63
Q

Slipped femoral capital epiphysis

A

slipping of the neck of the femoral head as the head remains in the acetabulum

64
Q

Who most commonly experiences a Slipped femoral capital epiphysis

A 
tendency to be with overweight adolescents
adolescents 10-15
more males than females
more black than white
left hip more then right
65
Q

who would you see a bilateral Slipped femoral capital epiphysis in?

A

females

66
Q

What is the common etiology with a Slipped femoral capital epiphysis

A

trauma 50% of the time

67
Q

What will you see on xray with a Slipped femoral capital epiphysis

A

an alteration in klein’s line

68
Q

Piriformis

A

an external rotator of the hip at less than 60 deg

at 90 deg of hip flexion, piriformis reverses its action and becomes an internal rotator/abductor of the hip

69
Q

Small external rotators

A

obturator externus and internus
superior and inferior gemelli
quadratus femoris

70
Q

Hamstrings

A

made up of biceps femoris, semimembranosus, and semitendinosus

71
Q

Action of biceps femoris

A

extends the hip, flexes the knee, and externally rotates the tibia

72
Q

action of semimembranosus and semitendinosus

A

extends the hip, flexes the knee, and internally rotates the tibia

73
Q

Hip adductors

A

adductor magnus, longus, and brevis, and the gracilis

74
Q

Iliopsoas bursa

A

aka iliopectineal
located under the inguinal ligament, between the iliopsoas tendon and the iliopectineal eminence of teh superior pubic ramus

75
Q

What commonly causes inflammation of the psoas bursa?

A

O/A of the hip

76
Q

Where is the subtrochanteric bursa?

A

between the greater trochanter and the TFL

77
Q

Borders of the femoral triangle

A

the inguinal ligament, adductor longus, and the sartorius

78
Q

the floor of the femoral triangle is formed by

A

portions of the iliopsoas and pectineus

79
Q

The posterior gluteal region receives innervation by way of:

A

the subcostal, iliohypogastric nerves and the dorsal rami of L1 L2 and L3 and the cluneal nerves of S1 S2 and S3

80
Q

Normally the sciatic nerve passes

A

inferior to the piriformis muscle (88% of people)

81
Q

The external iliac artery becomes the femoral artery as it passes underneath

A

the inguinal ligament

82
Q

the branches of the femoral artery

A

lateral femoral circumflex artery

medial femoral circumflex artery

83
Q

The lateral circumflex artery supplies

A

anterior portion of the of the femoral neck and the anterior hip joint capsule

84
Q

the medial femoral circumflex artery supplies

A

perforates and supplies the posterior hip joint capsule and synovium

Dutton's Orthopaedic Examination, Evaluation, and Intervention: Hip Joint Complex (2 decks)

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