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AET: Injury Prevention > The thigh, hip, groin, and pelvis > Flashcards

The thigh, hip, groin, and pelvis Flashcards

1
Q

What bones make up the general anatomy of the thigh, hip, groin, and pelvis?

A

Femure, innominates(pelvic girdle), sacrum and coccyx.

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2
Q

Where are the joint articulations of the hip/groin?

A

head of the femur, acetabulum of innominate.

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3
Q

what ligaments make up the hip?

A

ischiofemoral, pubofemoral, iliofemoral

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4
Q

where is the ischiofemoral ligament?

A

located posterior & superior to articular capsule.

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5
Q

What is the purpose of the ischiofemoral ligament?

A

prevents excessive internal rotation & adduction of the thigh

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6
Q

Where is the pubofemoral ligament?

A

anterior and inferior

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7
Q

what does the pubofemoral ligament do?

A

prevents excessive abduction of the thigh

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8
Q

What is the iliofemoral ligament considered and where does it attach?

A

considered strongest ligament in body;

runs from ASIS to intertrochanteric line on the anterior part of femur

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9
Q

What is the purpose of the iliofemoral ligament?

A

prevents hyper-extension and limits external rotation and adduction.

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10
Q

Where are the bursae of the thigh, hip and groin located?

A

iliopsoas- reduces friction between iliopsoas and articular capsule
deep trochanteric bursa- provides cushion between greater trochanter and gluteus maximus at its attachment to iliotibial tract
gluteofemoral bursa- separates gluteus maximus from origin of vastus lateralis
ichial bursa- weight bearing structure; cushions ischial tuberosities.

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11
Q

What muscles make up the medial compartment of the thigh?

A

pectineus, adductor magnus, adductor brevis, adductor longus, and gracilis.

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12
Q

What muscles make up the anterior compartment of the thigh?

A

sartorius, quadriceps femoris, vastus intermedius, rectus femoris, vastus lateralis, and vastus medialis.

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13
Q

What muscles make up the hamstring group?

A

Biceps femoris: long head & short head, semitendinosus and semimembranosus

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14
Q

What are the nerves of the thigh?

A

femoral nerve, obturator nerve, sacral plexus.

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15
Q

How does the hips, thigh and groin receive blood supply?

A

3 arteries: deep circumflex femoral, deep femoral, femoral

2 veins: superficial great saphenous, femoral

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16
Q

Where to the quadriceps insert?

A

common tendon to the proximal patella

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17
Q

which quad muscle crosses the hip? What does it do?

A

rectus femoris; extends the knee and flexes the hip

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18
Q

What are bi-articulate muscles?

A

The muscles cross two joints and produce forces dependent on position of the knee and hip

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19
Q

with functional testing when would you not perform AROM, PROM, RROM?

A

with a fracture

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20
Q

What can you expect during AROM for a strain or partial rupture?

A

decreased ROM and pain or weak and pain free.

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21
Q

What will you notice during functional testing for PROM?

A

swelling or spasms will restrict motion

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22
Q

What can you expect during functional testing of RROM if there is a fracture or 3rd degree sprain?

A

muscle weakness against isometric resistance suggesting nerve injury

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23
Q

What causes quadriceps contusions? how are they determined?

A

traumatic blunt blow; extent of force determines depth and functional disruption

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24
Q

What is an example of a quad contusion? MOI, S&S, and Management?

A

AKA: charlie horse
MOI- direct blow to thigh, compressing muscle against bone
SS- localized pain, bleeding, swelling & temporary loss of function-weakness.
Mgmt: PIER( knee flexion), protect (crutches), NSAIDs, therapy for pain, ROM & stretching exercises. protect upon RTP. DO NOT MASSAGE/HEAT

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25
Q

What are symptoms of a 1st degree contusion?

A 
little or no pain
mild hemorrhaging
no swelling
mild pt. tenderness
no disability in terms of ROM
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26
Q

what are symptoms of a 2nd degree contusion?

A 
mild pain
mild swelling
mild to moderate hemorrhaging
mild point tenderness
mild disability (>90 knee flexion)
limping
27
Q

what are S&S for 3rd degree contusions?

A

moderate pain and swelling
moderate disability (>45 but <90 of knee flexion)
obvious limping

28
Q

What are signs and symptoms of 4th degree contusions?

A

severe pain and swelling
severe disability (<45 of knee flexion)
potential muscle herniation
obvious limp or unable to wt bear.

29
Q

What is the management for contusions?

A

PIER, NSAIDs and analgesics
crutches for severe cases
aspiration of hematoma is possible
following exercise or re-injury, continued use of ice
follow up care consists of ROM, and PRE w/in pain free range
myositis ossificants
general rehab is conservative
ice w/ gentle stretching
gradual transition to heat following acute stage
elastic wrapping for support
exercises should be graduated from stretching to swimming to jogging- running
restrict exercise if pain occurs
may require surgery

30
Q

What is a quad strain?

A

sudden stretch, violent forceful contraction of the hip and knee into flexion
overstretching of the quads
can be very disabling

31
Q

What is a MOI for quad strain?

A

sudden overstretch or sudden, strong contraction

32
Q

What are S&S of quad strain?

A

pain, swelling, ecchymosis, spasms and disability.

- decreased ROM & strength of extensors

33
Q

How do you manage a quad strain?

A

PIER, protect(crutch/tensor), NSAID and later use of neoprene sleeve

34
Q

How many grades of a quad strain are there?

A

3

35
Q

What are symptoms of a first grade strain?

A

complain of tightness in front of thigh
near normal ambulation
swelling may be limited;
mild discomfort during palpation

36
Q

What are symptoms of grade 2 quad strains?

A 
abnormal gain;
may be splinted in extension;
swelling may be noticeable w pain on palpation
possible defect in muscle
IR knee extension will reproduce pain
37
Q

What are symptoms of a grade 3 strain?

A

possibly unable to ambulate
pain with palpation; may be unable to perform knee extension;
isometric contractions may produce defect or bulging in muscle belly

38
Q

How do you manage a grade 1 quad sprain?

A

neoprene sleeve/ tensor wrap to provide added support

39
Q

how would you manage a grade 2 quad strain?

A

ice and compression for 3-5 days with gradual increase in isometric exercise and pain free ROM exercises
limited passive stretching until later phases

40
Q

How would you manage a grade 3 quad strain?

A

crutches for 7-14 days;
restore normal gait;
compression for support;
may require 12 weeks until returning to full activity

41
Q

what is the most common thigh injury?

A

hamstring strain

42
Q

What are potential causes of hamstring strains?

A

hamstring/quad contract together;
change in role from hip extender to knee flexor;
fatigue, posture, leg length discrepancy, lack of flexibilty, strength imbalances.

43
Q

What factors might affect a hamstring strain?

A

tight muscles, leg length discrepancy, faulty posture, improper form or muscular imbalances.

44
Q

What are signs and symptoms of hamstring strains?

A

pain, swelling, eccymosis, spasms and disability (decrease ROM & strength of flexors).

45
Q

How would you manage a hamstring strain?

A

PIER, protect, NSAIDs & concentrate of flexibility, modatilites.

46
Q

How many grades of hamstring strains are there?

A

3

47
Q

What symptoms occur in a grade 1 hamstring strain?

A

soreness during movement;
point tenderness;
<20% fibers torn

48
Q

What symptoms occur in a grade 2 hamstring strain?

A 
partial tear;
identified by sharp snap or tear;
severe pain;
loss of function;
<70% of fibers torn
49
Q

What are symptoms of a grade 3 hamstring strain?

A

rupturing of tendinous or muscular tissue;
major hemorrhage and edema;
major disability & loss of function, ecchymosis;
palpable mass or gap;
>70 muscle fiber tearing

50
Q

How do you manage a grade 1 hamstring strain?

A

do not resume full activity until complete function restored

51
Q

how do you manage a grade 2/3 hamstring strain?

A

should be treated conservatively;
gradual return to stretching and strengthening in later stages of healing;
once pain free, isotonic leg curls can be introduced;
recovery may be required from months to a full year
greater scarring= greater recurrence of injury

52
Q

What is an adductor/hip flexor strain?

A

difficult problem to diagnose;
injury to one of the muscles in the regions;
occurs from running, jumping, twisting with hip external rotation or severe stretch

53
Q

What are S&S of adductor/hip flexor strains?

A

sudden twinge or tearing during active movement;

produce pain, weakness, and internal hemorrhaging

54
Q

How do you manage adductor/hip flexor strains?

A

RICE, NSAIDs & analgesics for 48-72 hrs;
determine exact muscle or muscles involved;
rest is critical; daily whirlpool and cryotherapy, moving into ultrasound;
delay exercise until pain free;
restore normal ROM and strength- provide support with wrap

55
Q

What causes inflammation at the site where the gluteus medius inserts or the IT band passes over the trochanter?

A

trochanteric bursitis

56
Q

What are S&S of trochanteric buristis?

A

complaint of lateral hip pain that may radiate down the leg;
palpation reveals tenderness over lateral aspects of greater trochanger;
IT-band and TFL tests should be performed

57
Q

How would you manage trochanteric bursitis?

A

RICE, NSAIDs and analgesics;
ROM and PRE directed toward hip abductors and external rotators;
must look at biomechanics and q-angle
runner should avoid inclined surfaces.

58
Q

What causes a dislocated hip?

A

traumatic force along the long axis of femur.

posterior dislocation with hip flexed and adductors and knee flexed

59
Q

S&S of hip dislocation:

A

flexed, adducted and internally rotated hip;
palpation reveals displaced femoral head posteriorly;
serious pathology: soft tissue, neurological damage and possible fracture.

60
Q

How would you manage a hip dislocation?

A

immediate medical care (blood and nerve supply may be compromised)
contractures may further complicate reduction
2 weeks immobilization and crutch use for at least one month

61
Q

What are some pelvic conditions?

A

pelvic region rotates along longitudinal axis when running, proportionate to the amount of arm swing;
also tilts as legs enage support and non-support;
combination of motion causes shearing changes in lordodic curve throughout activity

62
Q

What is a hip pointer?

A

Contusion of iliac crest or abdominal musculature;
results from a direct blow;
aggravated by almost all torso motion due to the attachment of abdominal obliques

63
Q

S&S of hip pointer:

A

pain, spasm, and transitory paralysis of soft tissue structures;
decreased rotation of trunk or thigh/hip flexion due to pain

64
Q

How do you manage hip pointers?

A 
RICE for 48hrs, NSAIDs
Bed rest 1-2 days
referral for xrays
ice massage, ultrasound, occasionally steroid injection
recovery 1-3 weeks

AET: Injury Prevention (11 decks)

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