The Hip Overview Flashcards
How many degrees of freedom is in the hip?
3 degrees of freedom with 6 osteokinematic movements
Flexion, Extension, Abduction, Adduction, IR, ER
What is a capsular pattern?
A joint specific pattern of restriction of PROM which indicates capsular tightness
What is the position of capsular restriction?
flexion
abduction
medial rotation (IR)
If stabiize the pelvic bone (?) more extension and medial rotation
What is the closed pack position of the hip?
Extension
Medial rotation
Abduction-adduction (?)
What is the open pack position of the hip?
Flexion
External rotation
- max surface contact
What is the anatomical characterisitics of the hip?
Has 4 bones that makes it symbiotic with innominate
What type of joint is the hip?
congruent joint - ball and socket
- making it a slide and glide movements
What is the function of the hip?
Mobility and stability
Transmission of forces between the pelvis and LE
How much force is needed to dislocate the hip?
400 newton pounds :0
That’s ALOT BROTHER
What are the primary blood supply of the femoral head?
- ligamentum teres
- circumflex arteries
- superior and inferior gluteal arteries
What is the function of the labrum?
a fibrocartilaginous tissue that is meant for:
- cushion
- slide and glide
What are the anterior ligaments?
Iliofemoral (Y)
Pubofemoral
What are the posterior ligaments?
Ischiofemoral
Ligametum teres
What does the ligamentum teres assist with?
90 degree flexion that helps with IR/ER
What are the two types of muscles in the body?
Stabilizers and movers
What are the primary stabilizers
Hip rotators and psoas
What are the flexors of the hip?
Iliacus
TFL
Rec fem
Sartorius
adductor longus
pectineus
Assistance from:
- gracilis
- adductor brevis
- anterior glute min
What are the extensors of the hip?
Glute max
Hammies
Posterior adductor magnus
Assistance from:
- glute med
What are muscles of abduction?
Glute med
TFL
Superior glute max
Glute min
Assistance from:
- sartorius
- rec fem
- piriformis at 90 deg
What are the muscles of adductors?
Adductor group
pectineus
gracilis
pectineus
Assistance from:
- obturator externus
What are the muscles of medial rotators?
NO PURE ROTATORS
but
TFL
Glute min
Anterior fibers of glutee med
Adductor group
Semimembranosus/tendinosus
What are the muscles of lateral rotators?
Obturator interior/exterior
Gemeli
Quad fem
piriformis
glute max
posterior fibers of glute med
bicep femoris
Bolded = stabilizers
What is the flexion ROM and end-feel?
ROM = 110-120
End feel: tissue approximation/tissue stretch
What is the extension ROM and end-feel?
ROM: 10-15
End-feel: Tissue stretch
What is the abduction ROM and end-feel?
ROM: 30-50
End-feel: tissue stretch
What is the adduction ROM and end-feel?
ROM: 25-30
End-feel: tissue approximation and tissue stretch
What is the ER ROM and end-feel?
ROM: 40-60
End-feel: tissue stretch
What is the IR ROM and end-feel?
ROM: 30-40
End-feel: tissue stretch
What are some of the functional ROM at the hip?
What is the angle of inclination?
the angle between the shaft and neck
What are the normal angle of inclination?
125 degrees
taller person = larger angle
shorter person = smaller angle
What is coxa valga?
increase angle causes femoral head to be directed more superiorly in the acetabelum
What is the effects of coxa valga to the hip?
- Changes the orientation of the joint reaction force
- mechanical disadvantage
- increased overall length of UE
How does coxa valga change the orientation of the joint reaction force?
From vertical direction -> almost parallel to shaft
= increased stress across the joint (not specialized to take that force)
What is the mechanical disadvantage of coxa valga?
Moment arm of hip abduction is short
= contaction is more vigorous to stabilize the pelvis
produces another increase in joint reaction force
What is the cause of an overall length for coxa valga?
Decreases physiological angle of the knee
- more stress on medial aspect of the knee joint
- more likely to impinge the hip FAI
Coxa Vara
What is the orientation?
More horizontal orientation of femoral neck
Coxa Vara
Where is the direction of force?
Increased downward shear forces
Coxa Vara
What is an important change regarding angle of pull?
Increases the effective angle of pull and lever arm of hip abduction
Coxa Vara
What is reduced?
Compressive forces BUT increased shear and torsional forces @ fem head/neck junction
Coxa Vara
How is the knee affected?
causes lateral compressive forces at the knee
- medial tensile
What is the most likely outcome of coxa vara?
More likely to fracture
What are the anteversion?
anterior orientation of the neck = more hip IR
What kind of gait is associated with anteversion?
In-toeing gait
What is retroversion?
Increased femoral ER
What kind of gait is associated with retroversion?
Out-toeing gait
