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Netter's Orthopaedics > Thigh/Hip > Flashcards

Thigh/Hip Flashcards

1
Q

Primary blood supply of the femoral head

A

Medial femoral circumflex artery

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2
Q

Anatomic axis of Femur

A

Line drawn along axis of femur

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3
Q

Mechanical axis of femur

A

line drawn between center of femoral head and intercondylar notch

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4
Q

Knee axis

A

line drawn along the inferior aspect of both femoral condyles

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5
Q

Vertical axis

A

Vertical line, perpendicular to ground

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6
Q

Lateral femoral angle

A

angle formed between the knee axis and the femoral axis

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7
Q

Complication of hip dislocation

A

femoral head AVN

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8
Q

Direction of hip dislocation most common?

A

Posterior

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9
Q

PE of ant vs post hip locations

A

Ant: ABducted, flexed, ER
Post: ADducted, flexed, IR

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10
Q

XR findings in hip dx

A

Fermoral heads appear different sizes

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11
Q

Thompson classification

A 
Posterior hip dx
I: No or minor post wall fx
II: Large posterior wall fx
III: Comminuted acetabular fx
IV: Acetabular floor fx
V: Femoral head fx
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12
Q

Epstein classification

A 
Anterior hip dx
I(ABC): superior
II(ABC): Inferior
A: No associated fx
B: Femoral head fx
C) acetabular fx
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13
Q

PE femoral neck fx

A

elderly most common, LE shortened abducted, ER

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14
Q

Garden classification

A 
Femoral neck fx
I: Incomplete fx; valgus impaction
II: Complete fx; nondisplaced
III: Complete fx; partial displacement, (varus)
IV: Complete fx, total displacement
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15
Q

Evans/Jensen classification

A 
Intertrochanteric
Type 1A: nondisplaced
Type 1B: 2 part displaced
Type 2A: 3 part, GT fragment
Type 2B: 3 part, LT fragment
Type 3: 4 part
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16
Q

Mortality of intertrochanteric fx

A

20% at 6 months

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17
Q

Winquis/Hansen classification

A 
Femoral shaft fx
0: no comminution
I: Minimal comminution
II: Comminuted >50% cortices intact, unstable
III: Comminuted:
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18
Q

Russell-Taylor classification

A

Subtrochanteric fx
Type 1: No piriformis fossa extension/involvement
A: Intact LT
B: detached LT
Type 2: Fracture involves the piriformis fossa
A: Intact LT
B: detached LT

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19
Q

AO/Muller classification

A

Distal femur fracture
A: extraarticular subtypes 1,2,3
B: unicondylar subtypes 1,2,3
C: bicondylar subtypes 1,2,3

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20
Q

Thigh impingement test

A

Supine: flex, adduct, IR hip. Pain may be indicative of FAI

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21
Q

Patrick/FABER

A

Flex, Abduct, ER, SI joint pathology

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22
Q

Log roll test

A

Supine, hip extended: IR/ER. Pain c/w hip arthritis

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23
Q

Stinchfield

A

Resisted straight leg raise, pain = hip pathology

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24
Q

Thomas sign

A

Supine; one knee to chest. If opposite thigh elevates off table, flexion contracture

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25
Ober sign
On side: flex and abduct hip. Extend and adduct hip, if stays in abduction, ITB contracture
26
Piriformis sign
On side: adduct hip. Pain in hip/pelvis indicates tight piriformis (compressing sciatic n)
27
90-90 straight leg
Flex hip and knee 90°, extend knee. >20° of flexion after full extension = tight hamstrings
28
Ely's test
Prone, passively flex knee. If hip flexes as knee is flexed, tight rectus femoris
29
Leg length
ASIS to medial malleolus. >1cm = positive
30
Meralgia test
Compression medial to ASIS. Pain = LFCN entrapment
31
Ortolani
Hips at 90°. Abduct hips. Clunk indicates relocation
32
Barlow
Hips at 90°, posterior force. Clunk indicates dislocation
33
Galeazzi test
Supine, flex hips and knees. Any discrepancy in knee hight= dislocated hip or short femur
34
Innervation of adductor magnus?
Obturator and sciatic
35
Hamstring tendon used in ACL repair?
SemiT
36
What nerve penetrates the psoas?
Genitofemoral branch of femoral nerve
37
When does femoral artery change name?
Changes to popliteal artery after adductor hiatus
38
What artery is at risk in anteromedial approach to hip?
Descending branch of the lateral femoral circumflex
39
Which artery runs under quadratus femoris
Medial femoral circumflex
40
Cam vs pincer FAI
Cam: femoral nonsphericity Pincer: Acetabulum overcoverage
41
Femoral neck stress fracture | Types, common pt, best imaging, best treatment
``` Tension: superior neck Compression: inferior neck Common in military recruits Need MR Treat tension type with percutaneous pinning ```
42
Snapping hip (coxa saltans)
3 types: External: ITB over GT Internal: psoas over femoral head or iliopectineal eminence Intraarticular: loose body.
43
Signs of OA
1: Joint space narrowing 2: Osteophytes 3: Subchondral sclerosis 4: Bony cysts
44
Modified Ficat classification
Osteonecrosis of femoral head 0: asymptomatic, nl XR and MR 1: SymptomaticL nl XR and MR 2: XR: sclerosis, no collapse 3: XR: sclerosis + collapse (crescent sign) 4: Flat femoral head, nl acetabulum 5: joint space narrowing, early DJD 6: Advanced DJD including acetabulum
45
Signs of RA
1: Joint space narrowing 2: Periarticular osteoporosis 3: Joint erosions 4: Ankylosis
46
Absolute and relative contraindications in THA
Absolute: Infection, medically unstable, neuropathic pain Relative: Young, active pts
47
Cause of osteolysis
Macrophage response to submicron sized wear particles.
48
Hilgenreiner's line
Horizontal line through tri-radiate cartilage.
49
Perkin's line
Vertical line through the lateral edge of acetabulum
50
Shenton's line
Curved line from the femur and pelvis
51
DDH
Abnormal hip development causing dislocation, subluxation, or laxity of the hip
52
Risk factors for DDH?
Female, first born, breech, family hx,
53
#1 cause of intoeing?
femoral anterversion
54
Legg-Calve-Perthes disease
idiopathic AVN of femoral head. 4-8 year old boys
55
Slipped capital femoral epiphysis (SCFE)
Displacement of the femoral epiphysis through the physis. 10-16, obese
56
Smith-peterson approach IN planes Dangers
Anterior hip IN plane: superficial - sartorius (femoral) + tensor fascia latae (superior gluteal nerve) Deep - Rectus femoris (femoral n) + Gluteus minimums (SGN) Dangers: LFCN, femoral N, ascending branch of the femoral circumflex a.
57
Ludloff approach IN planes Dangers
Medial hip interMUSCULAR planes: superficial: adductor longus (obturator) and gracillis (obturator) Deep: Adductor brevis: obturator + adductor magnus (sciatic and obturator) Dangers: Obturator n (ant div), medial femoral circumflex artery, obturator nerve (post. div), external pudendal artery
58
Watson-Jones approach IN planes Dangers
Anterolateral hip InterMUSCULAR planesL TFL (SGN) and gluteus medius (SGN) Dangers; Descending branch of LFCA, femoral n
59
Hardinge approach IN planes Dangers
Lateral hip IN planes: split gluteus medius (SGN) and vastus lateralis (femoral n) Dangers: superior gluteal a, femoral nerve, femoral artery and vein, superior gluteal nerve
60
Moore/southern approach IN plane Dangers
Posterior hip IN plane: split gluteus maximus (IGN) Dangers; Sciatic nerve, inferior gluteal artery, MFCA
61
Lateral thigh approach IN plane Dangers
IN plane: split vastus lateralis (femoral nerve) or elevate it. Dangers: descending branch of lateral femoral circumflex artery, perforators from profunda femoris, superior lateral geniculate artery.
62
Hip arthoscopy portals (3)
Anterior - LFCN, femoral n, ascending branch of LFCA Anterolateral - SGN Posterolateral - Sciatic n.

Netter's Orthopaedics (7 decks)

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