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Musculoskeletal Injuries > Hip Assessment and Pathology > Flashcards

Hip Assessment and Pathology Flashcards

1
Q

What is the angle of inclination and what are the clinical manifestations of Coxa Vara and Coxa Valga

A

The angle of shaft, to the neck of the femur
Coxa Vara = >125 degrees (hip dysplasia more common)
Coxa Valga = <125 degrees (fractures more common)

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2
Q

What is the angle of torsion and what are the clinical manifestations of excessive anteversion and retroversion?

A

The rotation the head of femur must do to fit into the capsule
Excessive anteversion = >15 degrees, medial rotates the tibia causing toe in gate
Retroversion = <15 degrees, toe out gate and lateral rotation of tibia

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3
Q

True or false. The foot can point forward, but the femur can be internally rotated and the tibia can be externally rotated?

A

True!

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4
Q

What is hip ante torsion?

A

Head and neck of the femur is rotated anteriorly, excessive medial hip rotation and limited lateral hip rotation

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5
Q

What is hip retro torsion?

A

Head and neck of the femur is rotated posteriorly, causing excessive lateral hip rotation with limited medial rotation

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6
Q

What types of joint are the:

  • Femoracetabular joint
  • Pubic symphysis
  • Sacroiliac
A
  • Femoracetabular = synovial, multiaxial ball and socket
  • Pubic symphysis = secondary cartilaginous
  • Sacroiliac = anterior synovial, posterior fibrous
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7
Q

What are the main ligaments of the hip?

A 
Iliofemoral 
Pubofemoral
Ischiofemoral
Iliolumbar
Anterior and posterior ligaments
Sacrotubal ligaments
Sacrospinous
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8
Q

What muscles are responsible for hip flexion?

A 
o	Psaos major
o	Iliacus
o	TFL
o	Sartorius
o	Rectus femoris
o	Gluteus medius (anterior fibers)
o	Gluteus minimus
o	Adductor longus (assists)
o	Pectineus (assists)
o	Adductor brevis (assists)
o	Adductor magnus (assists)
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9
Q

What muscles are responsible for hip extension?

A 
o	Gluteus maximus (all fibers)
o	Biceps femoris (long head)
o	Semitendinosus
o	Semimembranosus
o	Adductor magnus (posterior fibers)
o	Gluteus medius (posterior fibers)
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10
Q

What muscles are responsible for hip medial rotation?

A 
•	Medial rotation
o	Gluteus medius (anterior fibers)
o	Gluteus minimus
o	TFL
o	Adductor magnus
o	Adductor longus
o	Adductor brevis
o	Pectineus
o	Gracilis
o	Semitendinosus (assists)
o	Semimembranosus (assists)
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11
Q

What muscles are responsible for hip lateral rotation?

A 
o	Gluteus maximus 
o	Piriformis
o	Quadratus femoris
o	Obturator internus/ externus
o	Gemellus superior/ inferior
o	Gluteus medius (posterior)
o	Psaos major
o	Iliacus
o	Sartorius
o	Bicep femoris (long head)
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12
Q

What muscles are responsible for hip abduction?

A 
o	Gluteus maximus
o	Gluteus medius
o	Gluteus minimus
o	TFL 
o	Sartorius
o	Piriformis when hip is flexed
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13
Q

What muscles are responsible for hip adduction?

A

o Adductor magnus, brevis, longus
o Pectineus
o Gracilis
o Gluteus maximus (lowest fibers)

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14
Q

What is hip OA and what are some signs?

A
  • Worn cartilage, bone spurs, reduced joint space

- Stiffness in the morning, pain over groin or lateral hip, catching

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15
Q

What are some objective signs of hip OA?

A
  • Global loss of ROM
  • Reduced Thomas test
  • Weakness of hip extensors and abductors
  • Tightness through hip adductors and hip flexors
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16
Q

What is femoroacetabular impingement?

A

Cam impingement = excessive bone on anterior neck of femur

Pincer impingement = acetabular has extended part like a pincer and it affects rotation

17
Q

What FAI predicts OA?

A

Cam deformative

18
Q

What three things need to be done to confirm an FAI?

A
  • Current signs
  • Clinical signs
  • Imaging confirmation
19
Q

What are subjective signs of an FAI?

A
  • Pain in anterior hip and groin especially in deep hip flexion
  • Clicking, catching, locking, stiffness, loss of ROM
  • Reduced hip flexion and internal rotation
20
Q

What percentage of athletes with groin pain have labral tears?

A

22%

21
Q

What percentage of people with hip pain have labrum tears?

A

55%

22
Q

What is lateral hip pain?

A

Underdeveloped gluteus muscles that cause the leg to adduct - placing more compressive load

23
Q

What are signs of lateral hip pain?

A

-Painful when lying on affected side, pain when sleeping on opposite side without support in legs, pain when sitting in a low chair, pain with running, pain and stiffness in the morning, positive trendelenburg, painful Obers or FADIR and FABER

24
Q

What rehab should you target in patients with lateral hip pain?

A

Glute muscles, TFL

25
Q

What percentage of hamstring injuries are biceps femoris long head?

A

80%

26
Q

What are the two types of hamstring injury mechanisms?

A

Dancers (type II) = over stretch

Sprinters (type I) = high force

27
Q

If Jim suffered a hamstring strain 2 days ago and he can walk fine now pain free. How long would he expect to miss out before returning to play?

A

2 weeks

28
Q

True or false. The more proximal the hamstring injury, the shorter sit out time?

A

False. The more proximal, the more tendon there is and less vasculature for recovery

29
Q

Where is the most common site of quadricep strain?

A

Distal musculotendinous junction of the rectus femoris

30
Q

True or false. Proximal rectus femoris injuries are straightforward rehab?

A

False, distal is.

31
Q

What is the difference between a tendinopathy and an enthesopathy?

A

A tendinopathy relates to the tendon of a muscle and an enthesopathy relates to the tendon joint part which connects to the bone

32
Q

What are typical signs of an adductor strain?

A

Gradual onset of pain which worsens with loading, pain with running or kicking, pain and weakness with groin squeeze test, reduced hip abduction flexibility, pain on palpation and during a sit-up

Musculoskeletal Injuries (14 decks)

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