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LOWER EXTREMITY > Hip - ANATOMY AND KINESIOLOGY part 2 > Flashcards

Hip - ANATOMY AND KINESIOLOGY part 2 Flashcards

1
Q

Center-edge angle
- indicate how much of the fem head is covered
“Angle of Wiberg”
- reference ( vertical)
- lateral aspect of the
acetabulum

ABN:
<____deg= ____
>____deg= ____(pincer)

A

“Angle of Wiberg”
- reference ( vertical)
- lateral aspect of the
acetabulum

ABN:
<25 deg= dysplasia
>39 deg= FAI (pincer)

FAI- Femoral Acetab impingement

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2
Q

Acetabular Anteversion angle

Ref: ____

> ____ degrees (Ant) = instability/
dislocation

< ____degrees (Post) = excessive
coverage

Normal acetabular anteversion angle is ____

A

Ref: post acetabulum & post and ant
acetabulum

> 20 degrees (Ant) = instability/
dislocation

< 15 degrees (Post) = excessive
coverage

Normal acetabular anteversion angle is 15° to 20°.

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3
Q

Femoral Head epiphysis

Young: ____

Adult: ____

Fx fem neck : ____ interruption of blood supply

A

Young: small branch obturator aa

Adult: med fem circumflex aa

Fx fem neck : interference/ complete interruption of blood supply

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4
Q

Angle of Anteversion

Inc anteversion= ____

Retroversion= ____

A

Inc anteversion= shaft femur rotate medially

Retroversion= shaft of femur rotate laterally

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5
Q

Angle of Torsion of Femur

  • Angle made by the femoral
    neck with the femoral
    condyle

Normal = ____°
* At birth, the mean angle is approximately ____°
* In the adult, the mean
angle is ____° to ____°

A
  • Angle made by the femoral
    neck with the femoral
    condyle

Normal = 13-15°
* At birth, the mean angle is
approximately 30°
* In the adult, the mean
angle is 8° to 15°

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6
Q

Angle of Anteversion

Angle >15°
what happens to the shaft of femur?

A

◦Shaft of the
femur rotated
medially

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7
Q

Angle of Anteversion

Excessive anteversion

Related Posture?

Possible Compensatory

Postures?

A

Related Posture:
Toeing in
Subtalar pronation
Lateral patellar subluxation
Medial tibial torsion
Medial femoral torsion

Possible Compensatory
Postures:
Lateral tibial torsion
Lateral rotation at knee
Lateral rotation of tibia,
femur, and/or pelvis
Lumbar rotation on same side

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8
Q

Angle of Anteversion

Angle <13°

what happens to the shaft of femur?

A

◦Shaft of the
femur rotated
laterally

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9
Q

Angle of Anteversion
Excessive
retroversion

Related Posture?

Possible Compensatory Postures?

A

Related Posture
Toeing out
Subtalar supination
Lateral tibial torsion
Lateral femoral torsion

Possible Compensatory Postures
Medial rotation at knee
Medial rotation of tibia,
femur, and/or pelvis
Lumbar rotation on opposite
side

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10
Q

Craig’s test/ Ryder method

Test for Anteversion

Procedure:
(+):
Indication:

A
  • Prone with the knee flexed
    to 90°
  • Palpates greater trochanter
  • Passive IR and ER until
    greater troch is parallel to
    table or most lateral position.
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11
Q

Neck Shaft Angle

Normal?
Coxa Valga degrees?
Coxa Vara?

A

Normal - 120°-135°
Coxa Valga - >135°
Coxa Vara - <120°

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12
Q

Neck Shaft Angle

<drive>
</drive>

A
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13
Q

HIP JOINT

  • Multiaxial ball-and-socket joint
  • Synovial joint
  • Very stable joint
  • Femoral head is ____
  • Acetabulum is ____
A
  • Multiaxial ball-and-socket joint
  • Synovial joint
  • Very stable joint
  • Femoral head is convex
  • Acetabulum is concave
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14
Q

Coxa Valga: Longer
- limb ____
- hip ____
- Inc/dec? leverage abductor

A

Coxa Valga: Longer
- limb lengthening
- hip instab
- dec leverage abductor

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15
Q

Coxa Vara: Shorter
- limb ____
- increase ____
- Arthritic changes

A

Coxa Vara: Shorter
- limb shortening
- increase tensile forces- fem neck fx
- Arthritic changes

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16
Q

Compensatory: Valga
A. ipsi Valga- ____

B. C/L unaffected - ____

A

Compensatory: Valga
A. ipsi Valga- shorten the longer valga side
B. C/L unaffected - lengthen

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17
Q

Compensation: Vara
A. Ipsi Vara: ____

B. C/L : ____

A

Compensation: Vara
A. Ipsi Vara: to lengthen
B. C/L : shorten

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18
Q

PJM to Increase

Hip flexion

A

Posterior

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19
Q

PJM to Increase

Hip extension

A

Anterior

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20
Q

PJM to Increase

Hip internal rotation

A

Posterior

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21
Q

PJM to Increase

Hip external rotation

A

Anterior

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22
Q

PJM to Increase

Hip abduction

A

Inferior

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23
Q

PJM to Increase

Hip adduction

A

Superior

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24
Q

HIP Resting position

A

30° flexion, 30° abduction, slight ER

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25
Q

HIP Close pack position

A

Extension, abduction, IR

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26
Q

HIP Capsular pattern

A

Flexion, abduction, and IR

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27
Q

HIP Capsular pattern

A

Flexion, abduction, and IR

28
Q

HIP ROM

Flexion
Extension
Abduction
Adduction
Lateral rotation
Medial rotation

A

Flexion - 110°-120°
Extension - 10°-15°
Abduction - 30°-50°
Adduction - 30°
Lateral rotation - 40°-60°
Medial rotation - 30°-40°

29
Q

HIP JOINT

Average Range of Motion Necessary

Shoe tying
Sitting (average seat height)
Stooping
Squatting
Ascending stairs (average stair height)
Descending stairs (average stair height)
Putting foot on opposite thigh
Putting on trousers

A

Shoe tying - 120° of flexion
Sitting (average seat height) - 112° of flexion
Stooping - 125° of flexion
Squatting - 115° of flexion, 20° abduction, 20° of
medial rotation
Ascending stairs (average stair height) - 67° of flexion
Descending stairs (average stair height) - 36° of flexion
Putting foot on opposite thigh - 120° of flexion, 20° of abduction, 20° of
lateral rotation
Putting on trousers - 90° of flexion

30
Q

Forces on the Hip

<drive>
</drive>

A

Forces on the Hip

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</drive>

31
Q

LIGAMENTS OF THE HIP

  1. ______femoral
  2. ______femoral
  3. ______femoral
A
  1. Iliofemoral
  2. Pubofemoral
  3. Ischiofemoral
32
Q

Iliofemoral Ligament

  • Strongest ligament
  • Inverted Y-shaped ligament
  • Superior band limits: ______
  • Inferior band limits: ______
  • Prevents ______ during standing
A
  • Strongest ligament
  • Inverted Y-shaped ligament
  • Superior band limits: adduction,
    extension
  • Inferior band limits: abduction,
    extension
  • Prevents overextension during
    standing
33
Q

Pubofemoral Ligament

  • Triangular shaped
  • Limits: ______
  • Ipsi/Conra? pelvic tilt
A
  • Triangular shaped
  • Limits: extension,
    abduction and ER
  • Ipsilateral pelvic tilt
34
Q

LIGAMENTS OF THE HIP

  • Spiral shaped
  • Limits: ______
A
  • Spiral shaped
  • Limits: extension,
    abduction and IR
35
Q

FEMORAL TRIANGLE

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A

FEMORAL TRIANGLE

<drive>
</drive>

36
Q

ADDUCTOR TRIANGLE

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</drive>

A
37
Q

MUSCLES OF THE HIP

Flexors
1. I
2. P
3. S
4. TFL
5. RF
6. P

A

Flexors
1. Iliacus
2. Psoas major
3. Sartorius
4. Tensor fascia lata
5. Rectus Femoris
6. Pectineus

38
Q

Iliacus

Nerve?
Action?

A

Nerve supply: Femoral (L1-L4)
A: Hip flexion, APT

39
Q

Psoas major

Nerve?
Action?

A

Nerve supply: Lumbar plexus
( L1-L3)
A: Hip flexion, APT

40
Q

THOMAS TEST

Procedure:
(+):
Indication:

A
  • Prone, PT flexes knee
  • Pt holds position

(+) leg rises off the table
* Tested leg pushed down=
inc lordosis
= Hip flexion contracture

(+) J sign/stroke- Abd
= Tight ITB

41
Q

Sartorius

Nerve?
Action?

A

Nerve supply: femoral ( L2-L3)
A: Flexion, abduction,
external rotation of the hip

42
Q

Tensor Fascia Lata

Nerve?
Action?

A

Nerve supply: SGN (L4-S1)
A: Flexion and abduction of
the hip, IR

43
Q

OBER’S TEST

Procedure:
(+):
Indication:

Knee flexed? Inc stress on what
structure?

A
  • S/L
  • Passively Abd + ext c knee
    ext/ flexed to 90
  • PT slowly lowers leg
    (+) Does not fall on table
    = ITB contracture

flexed knee: stress on Fem nn

44
Q

Rectus Femoris

Nerve?
Action?

Active : ______
passive insufficiency: ______

A

Nerve supply: Femoral (L2-L4)
A: Hip flexion, Extends knee

Active : too shortened
passive insufficiency: too elongated
“Rectus Femely”

45
Q

KENDALL TEST

  • aka RF contracture test
  • Patient does KTC and
    holds

Procedure:
(+):
Indication:

A
  • aka RF contracture test
  • Patient does KTC and
    holds

N: angle of test knee
should remain at 90 deg
(+) knee extends

46
Q

ELY’S TEST

Nerve?
Action?

A
  • PT flexes knee
    (+) Hip flexion on same side
    = RF tightness
47
Q

Pectineus

Nerve?
Action?

A

Nerve supply: Femoral ( L2-
L4)
A: Flexion, adduction, IR of
the hip

48
Q

Adductors
1. Adductor longus
2. Adductor brevis
3. Adductor magnus
4. Gracilis
5. Pectineus

Adductors:
Hip neutral: ______
Hip already flexed: ______

A
  1. Adductor longus
  2. Adductor brevis
  3. Adductor magnus
  4. Gracilis
  5. Pectineus

Hip neutral: Hip flexor
Hip already flexed: assist in hip extension

49
Q

Adductor longus

Nerve?
Action?

Add longus
______in extension
______in other position

A

Nerve supply: Obturator (L3-L4)
A: Adduction and flexion

Add longus:
ER in extension
IR in other position

50
Q

Adductor brevis

Nerve?
Action?

A

Nerve supply: Obturator ( L3-
L4)
A: Adduction

51
Q

Adductor Magnus

Nerve?
Action?

A

Nerve supply:
- Adductor portion: Obturator nn (L2-
L4)
- Hamstring portion: Sciatic nn (L4-S3)
A: Adduction

52
Q

Gracilis

Nerve?
Action?

A

Nerve supply: Obturator ( L2-L3)
A: Adduction of hip and flexion of
knee

“Phelps Gracilis”

53
Q

PHELP’S TEST

Procedure:
(+):
Indication:

A
  • Prone c knees
    extended -> Abd leg
  • Knees flexed 90 deg ->
    abd further

(+) abd increases
= Gracilis tightness

54
Q

Extensors
1. Gluteus maximus
2. Hamstrings
a) Biceps femoris
b) Semimembranosus
c) Semitendinosus
3. Adductor magnus

A

Extensors
1. Gluteus maximus
2. Hamstrings
a) Biceps femoris
b) Semimembranosus
c) Semitendinosus
3. Adductor magnus

55
Q

Gluteus Maximus

Nerve?
Action?

MMT: G max
- ______
- ______
- Pt will ______
- PT will ______
- further flexion of knee = greater use of hamstrings

A

Nerve supply: IGN (L5-S2)
A: Extension of hip, lateral rotation,
PPT

MMT: G max
- prone
- hip straight c knee flexed to 90
- Pt will extend hip
- PT will put ant force on the post thigh
- further flexion of knee = greater use of hamstrings

56
Q

Biceps Femoris

Nerve?
Action?

A

Nerve supply:
- Long head: Tibial portion of the sciatic
- Short head: Common peroneal of sciatic
A: Extension of the hip, flexion and lateral
rotation of the knee

57
Q

TAKING OFF THE SHOE TEST

Procedure:
(+):
Indication:

A
  • Take off the shoes of test side
  • Place the heel at med longitudinal arch of opp leg
  • (+) sharp pain at biceps fem - 1st or 2nd degree mm strain
58
Q

Abductors
1. Gluteus medius
2. Gluteus minimus
3. Tensor fascia lata

A

Abductors
1. Gluteus medius
2. Gluteus minimus
3. Tensor fascia lata

59
Q

Gluteus med

Nerve?
Action?

Anterior: ______
Post: ______
- as a whole: ______

A

Nerve supply: SGN ( L4-S1)
A: Abduction of the hip

Anterior: flexor and IR
Post: extensor and ER
- as a whole: abducts hip

60
Q

Semitendinosus and
Semimembranosus

Nerve?
Action?

A

Nerve supply: tibial portion of
Sciatic nn ( L4-S2)
A: Extension of the hip, flexion
and medial rotation of the knee

61
Q

Gluteus Minimus

Nerve?
Action?

A

Nerve supply: SGN ( L4- S1)
A: Abduction and internal
rotation of the hip

62
Q

Tensor Fascia Lata

Nerve?
Action?

A

Nerve supply: SGN (L4-S1)
A: Flexion and abduction of the
hip, IR

63
Q

External Rotators
1. Gluteus maximus
2. Sartorius
3. Piriformis
4. Gemellus superior
5. Gemellus inferior
6. Obturator internus
7. Obturator externus
8. Quadratus femoris

A
64
Q

Piriformis

Nerve?
Action?

A

Nerve supply: 1st and 2nd sacral
nn (L5-S2)
A: Internal and external rotation
of the hip

65
Q
A

LOWER EXTREMITY (3 decks)

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