The Hip And Thigh: Exam 3 Flashcards
What is the rectus femoris?
Quad
Where is the rectus femoris?
Crosses the hip and knee
What does the rectus femoris do?
Extend the knee and flexes the hip
Where are the hamstrings?
Crosses the knee and hip joints
What does the hamstring do?
Extends hip and flexes the knee
What causes a quad contusion?
Exposed to traumatic blunt blow
Symptoms of quad contusion
- pain
- temporary loss of function
- immediate swelling
- palpable swollen area
Grade 1-4 contusion
Superficial to deep with increasing loss of function
Management of quad contusion
- RICE
- NAIDs and analgesics
- crutches
- ROM and Progressive resistance exercise
- heat and massage to prevent myositis ossificans
- conservative rehab
- ice with gentle stretching with a gradual transition to heat
Myosotis ossificans
Formation of calcium deposits or bone in the muscle fibers
What causes myositis ossificans
Repeated trauma or impacts to an area or improper care of contusion
Symptoms of MO
- x-ray shows @ 2-6 weeks
- pain, weakness, swelling, decreased ROM
- tissue tension and point tenderness
Management of MO
- conservative
- can require surgical removal due to pain and decreased ROM
What causes quad strain?
Sudden stretch, violent forceful contraction of hip and knee into flexion
Symptoms of quad strain
-pain and point tenderness, spasm, loss of function, little discoloration (decreased knee flexion)
What can happen with complete quad tear?
Patient will have disability discomfort and some deformity
Grade 1 quad strain
- tightness in front of thigh
- near normal ambulation
- limited swelling
- mild discomfort in palpation
Grade 2 quad strain
- abnormal gait cycle
- noticeable swelling with pain on palpation
- possible defect in muscle
What will produce pain in grade 2 quad strain?
Resistive knee extension
How will quad strain be splinted?
In extension
Grade 3 quad strain
- possibly unable to ambulate
- pain with palpation
- may be unable to perform knee extension
What will isometrics do to grade 3 quad strain?
Produce defect or bulging in muscle belly
Management of quad strain
- RICE
- NSAIDs
- analgesics
- Progress to isometrics and stretching
Grade 1 quad strain management
Neoprene sleeve can provide support
Grade 2 quad strain management
Ice and compression for 3-5 days with gradual increase in isometrics and pain free knee ROM exercises **limit passive stretching
Grade 3 quad strain management
- crutches 7-14 days
- restore normal gait
- compression for support
- may require 12 week to return to full activity
Hamstring muscle strain
Disruption of fiber hamstring musculature
What causes hamstring strain
Sudden forceful contraction (deceleration) or over stretch (knee hyperextension or hip flexion)
Where is the pain in a hamstring strain?
-muscle belly or point of attachment pain
Grade 1 hamstring strain symptoms
Soreness during movement and point tenderness
How much of the fibers are torn in grade 1 hamstring strain?
Less than 20%
Grade 2 hamstring strain symptoms
Partial tear, identified by sharp snap or tear, severe pain, loss of function
How much of the fibers are torn in grade 2 hamstring strain?
Less than 70%
Grade 3 hamstring strain symptoms
Rupture of tendinious or muscular tissue involving major hemorrhage and disability, edema, loss of function, ecchymosis, palpable mass or gap
How much fiber is torn in grade 3 hamstring strain?
More than 70%
What should you focus on in hamstring rehab?
Eccentrics
Management of hamstring strain
-RICE
When should activity be resumed in a grade 1 hamstring strain
Dont resume full activity until complete function is restored
Grade 2 and 3 hamstring strain management
Conservative with gradual return to stretching and strengthening
How does scarring affect hamstring injury?
Greater scarring mean greater chance of reinjury
What does femur fracture generally involve?
Shaft
What causes a femur fracture?
Requires a great deal of force
Symptoms of femur fracture
- pain, swelling, deformity
- muscle guarding
- leg with fracture may be shorter
Management of femur fracture initially
- treat for shock
- verify neurovascular status
- splint before moving
Management of femur fracture
Reduce following x-ray
Pain med and ice
What happens to soft tissue in femur fracture?
Extensive damage
What causes a femur stress fracture?
- overuse
- excessive downhill running or jumping activities
- endurance athletes
Symptoms of femur stress fx
- persistence pain in thigh/ groin
- x-ray or bone scan
- walk with antalgic gait
Management of femur stress fx
Remove from activity
What is trochanteric bursitis?
Inflammation over greater trochanter
Symptoms of T bursitis
- complain of lateral hip pain (can radiate down leg)
- tenderness over greater trochanter
Mamangement of T bursitis
- RICE
- look at biomechanics and Q angle
- corticosteroid injection possibly
How to avoid T bursitis
Runner should avoid inclined surface (as well as rehab)
When does dislocated hip happen?
Rarely in sports and from traumatic forces
Symptoms of hip dislocation
- flexed, adducted and internally rotated hip
- palpation reveals displaced femoral head
- serious concerns about neurovascualr structures
Management of hip dislocation
- immediate medical care
- 2 weeks immobilization and crutches for at least 1 month
