The Hip And Thigh: Exam 3

Question 1

What is the rectus femoris?

Answer 1

Quad

Question 2

Where is the rectus femoris?

Answer 2

Crosses the hip and knee

Question 3

What does the rectus femoris do?

Answer 3

Extend the knee and flexes the hip

Question 4

Where are the hamstrings?

Answer 4

Crosses the knee and hip joints

Question 5

What does the hamstring do?

Answer 5

Extends hip and flexes the knee

Question 6

What causes a quad contusion?

Answer 6

Exposed to traumatic blunt blow

Question 7

Symptoms of quad contusion

Answer 7

• pain
• temporary loss of function
• immediate swelling
• palpable swollen area

Question 8

Grade 1-4 contusion

Answer 8

Superficial to deep with increasing loss of function

Question 9

Management of quad contusion

Answer 9

• 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

Question 10

Myosotis ossificans

Answer 10

Formation of calcium deposits or bone in the muscle fibers

Question 11

What causes myositis ossificans

Answer 11

Repeated trauma or impacts to an area or improper care of contusion

Question 12

Symptoms of MO

Answer 12

• x-ray shows @ 2-6 weeks
• pain, weakness, swelling, decreased ROM
• tissue tension and point tenderness

Question 13

Management of MO

Answer 13

• conservative

- can require surgical removal due to pain and decreased ROM

Question 14

What causes quad strain?

Answer 14

Sudden stretch, violent forceful contraction of hip and knee into flexion

Question 15

Symptoms of quad strain

Answer 15

-pain and point tenderness, spasm, loss of function, little discoloration (decreased knee flexion)

Question 16

What can happen with complete quad tear?

Answer 16

Patient will have disability discomfort and some deformity

Question 17

Grade 1 quad strain

Answer 17

• tightness in front of thigh
• near normal ambulation
• limited swelling
• mild discomfort in palpation

Question 18

Grade 2 quad strain

Answer 18

• abnormal gait cycle
• noticeable swelling with pain on palpation
• possible defect in muscle

Question 19

What will produce pain in grade 2 quad strain?

Answer 19

Resistive knee extension

Question 20

How will quad strain be splinted?

Answer 20

In extension

Question 21

Grade 3 quad strain

Answer 21

• possibly unable to ambulate
• pain with palpation
• may be unable to perform knee extension

Question 22

What will isometrics do to grade 3 quad strain?

Answer 22

Produce defect or bulging in muscle belly

Question 23

Management of quad strain

Answer 23

• RICE
• NSAIDs
• analgesics
• Progress to isometrics and stretching

Question 24

Grade 1 quad strain management

Answer 24

Neoprene sleeve can provide support

Question 25

Grade 2 quad strain management

Answer 25

Ice and compression for 3-5 days with gradual increase in isometrics and pain free knee ROM exercises **limit passive stretching

Question 26

Grade 3 quad strain management

Answer 26

- crutches 7-14 days - restore normal gait - compression for support - may require 12 week to return to full activity

Question 27

Hamstring muscle strain

Answer 27

Disruption of fiber hamstring musculature

Question 28

What causes hamstring strain

Answer 28

Sudden forceful contraction (deceleration) or over stretch (knee hyperextension or hip flexion)

Question 29

Where is the pain in a hamstring strain?

Answer 29

-muscle belly or point of attachment pain

Question 30

Grade 1 hamstring strain symptoms

Answer 30

Soreness during movement and point tenderness

Question 31

How much of the fibers are torn in grade 1 hamstring strain?

Answer 31

Less than 20%

Question 32

Grade 2 hamstring strain symptoms

Answer 32

Partial tear, identified by sharp snap or tear, severe pain, loss of function

Question 33

How much of the fibers are torn in grade 2 hamstring strain?

Answer 33

Less than 70%

Question 34

Grade 3 hamstring strain symptoms

Answer 34

Rupture of tendinious or muscular tissue involving major hemorrhage and disability, edema, loss of function, ecchymosis, palpable mass or gap

Question 35

How much fiber is torn in grade 3 hamstring strain?

Answer 35

More than 70%

Question 36

What should you focus on in hamstring rehab?

Answer 36

Eccentrics

Question 37

Management of hamstring strain

Answer 37

-RICE

Question 38

When should activity be resumed in a grade 1 hamstring strain

Answer 38

Dont resume full activity until complete function is restored

Question 39

Grade 2 and 3 hamstring strain management

Answer 39

Conservative with gradual return to stretching and strengthening

Question 40

How does scarring affect hamstring injury?

Answer 40

Greater scarring mean greater chance of reinjury

Question 41

What does femur fracture generally involve?

Answer 41

Shaft

Question 42

What causes a femur fracture?

Answer 42

Requires a great deal of force

Question 43

Symptoms of femur fracture

Answer 43

- pain, swelling, deformity - muscle guarding - leg with fracture may be shorter

Question 44

Management of femur fracture initially

Answer 44

- treat for shock - verify neurovascular status - splint before moving

Question 45

Management of femur fracture

Answer 45

Reduce following x-ray | Pain med and ice

Question 46

What happens to soft tissue in femur fracture?

Answer 46

Extensive damage

Question 47

What causes a femur stress fracture?

Answer 47

- overuse - excessive downhill running or jumping activities - endurance athletes

Question 48

Symptoms of femur stress fx

Answer 48

- persistence pain in thigh/ groin - x-ray or bone scan - walk with antalgic gait

Question 49

Management of femur stress fx

Answer 49

Remove from activity

Question 50

What is trochanteric bursitis?

Answer 50

Inflammation over greater trochanter

Question 51

Symptoms of T bursitis

Answer 51

- complain of lateral hip pain (can radiate down leg) | - tenderness over greater trochanter

Question 52

Mamangement of T bursitis

Answer 52

- RICE - look at biomechanics and Q angle - corticosteroid injection possibly

Question 53

How to avoid T bursitis

Answer 53

Runner should avoid inclined surface (as well as rehab)

Question 54

When does dislocated hip happen?

Answer 54

Rarely in sports and from traumatic forces

Question 55

Symptoms of hip dislocation

Answer 55

- flexed, adducted and internally rotated hip - palpation reveals displaced femoral head - serious concerns about neurovascualr structures

Question 56

Management of hip dislocation

Answer 56

- immediate medical care | - 2 weeks immobilization and crutches for at least 1 month