Final - Hip Flashcards
(98 cards)
1
Q
what is the pelvis
A
bony ring with 2 bones - sacrum and coccyx
2
Q
4 functions of pelvis
A
support spine
transfer weight to lower limbs
provide attachment site for muscles
protection of pelvic organs
3
Q
sacrum
A
triangular, connects to coccyx
4
Q
4 ligaments supporting the sacroiliac joint
A
sacroiliac
iliolumbar
sacrospinal
sacrotuberal
5
Q
3 motions of the sacroiliac joint
A
superior inferior
lateral medial
flex forward and backward
6
Q
being able to move in three different ways means that the sacroiliac joint moves about
A
3 axis
7
Q
strongest bone of the hip
A
femur
8
Q
purpose of femur
A
max mobility and support during locomotion and weight bearing activity
9
Q
proximal femur
A
articulates with acetabulum of pelvis to form hip jt
10
Q
distal femur
A
condules articulate with tibial plateau for knee jt
11
Q
Hip jt
A
synovial - multi axial
ball and socket
very stable with labrum
12
Q
labrum
function
A
fibrocartilage that surrounds the acetabulum
deepens the socket and increase articular surface area by 10%
13
Q
ROM hip flexion
A
135
14
Q
ROM hip extension
A
30
15
Q
ROM hip abduction
A
45-50
16
Q
ROM hip adduction
A
20-30
17
Q
ROM hip external rotation
A
45
18
Q
ROM hip internal rotation
A
35
19
Q
Hip jt capsule - 2
A
strong but loose
thick parts of fibrous layer makes the ligs - spiral apperance and run from femoral neck to acetabular rim
20
Q
role of hip capsule
A
stability - during extension increases the spiraling and tighten the capsule to draw the head into acetabulum
mobility - flexion unwinds spiraling ligs and fibers
21
Q
3 ant hip ligs - 3
A
oblique trajectory, winding around the femoral nect - lose in flexion and tight in extension - rotating plates with strings in between, tighter when the plate approximates one another
illiofemoral - ant and up
pubofemoral - ant and inf
ishiofemoral lig - pos
22
Q
illiofemoral lig - 3
A
strongest
y
prevent hyperextension when standing - locks and restict internal and external rotation
23
Q
pubofemoral lig - 2
A
blend with iliofemoral
restrict hip abduction and extention
24
Q
ishiofemoral lig - 2
A
weakest
excessive internal rotation and adduction
25
bursa - 2
greater trochanteric - between greater trochanter and deep fibers of glute max
women running or poor gait
ischial - glute muslces and ischial tub
26
ant muscles of the hip - 5
```
psoas
iliacus
tensor fascia lata
satorius
quads
```
27
psoas - 3
lumber vertebrae to femur
hip flexion
major goes to the front of your spine - trunk flexor and hip flexor
28
tight hip flexors can give you
back pain
29
illiacus - 2
blends with psoas tendon
| acts with psoas major - hip flexion
30
tensor fascia lata - 2
upperanterolat of thigh, inserts into ITB
| hip stabilization and hip abduction
31
satorius - 3
longest muscle
ASIS to anteromedial tib
faber
32
quads - 2
Vastii MLI
| knee extension
33
RF - 2
Hip flexion and knee extension
34
5 medial hip muslces
pectineus
adductor brevis and longus
adductor magnus,
gracilis
35
pectineus
hip flexion and adduction
36
adductor longus, magnus, and gracilis
adduction
37
adductor brevis
hip adduction and hip flexion
38
4 pos gluteal muscles
gluteus maximus, medius, minimus, and piriformis
39
glute max
main hip extensor
40
glute med
abduction
41
glute min
hip medial rotation
42
piriformis
lat hip rotation
43
weak groin often gets confused with
imbalance of glute max and med
44
3 hamstrings
semimembranosis
semitendinosis
biceps femoris
45
semimembranosis and semi tendinosis - 3
hip extension, med tib rotation, knee flexion
46
biceps femoris
hip extension, knee flexion and lat tib rotation
47
what to strengthen for spondylosis
| strategy
spondylosis - weak glute max can activate hip extenders for back
technique then weight
48
comprehensive movement tests for the hip - 3
sit to stand
squat
step
49
What do you look for in hip injuries - 3
diff in compensation
alignment
callus
50
two types of muscles you are looking to treat
long and weak
| short and tight
51
rectus femoris/illiopsoas differentiation test - 3
hip flexors and RF
lay supine and knee bent over and pull one knee to chest
90 degrees or tightness
52
Thomas test - 4
RF/ hip flexor contracture
supine, leg extended, one knee to chest
flat or tightness
*put hand under their back
53
FABER test - 4
flexion, abduction, external rotation
- Hip/SI jt
- supine and FABER
asymptomatic - dont change
54
obers
```
contracture of TFL/ITB
lie on unaffected side
abduct thigh as far as possible
drop in adduction
not full adduction (past table) - contracture
false neg - side flexed
```
55
nobels compression
obers with finger on side of knee and flex/extend
56
tripod test
hamstring contracture
sit at edge of table - passively/actively raise one leg
- lean back to accomodate - tight hamstrings
57
long sit with straight back
you need a good back
58
trendelenburgs sign
abductor/glute med
| stand and look for pelvis to remian level - drop = weakness on opposite side (stance)
59
what to strengthen for greater trochanteric
glute med
60
straight leg raise
supine
| active/passive hip flex ROM for hams
61
neurotension from straight leg raise
supine
hip flex passively up to 45 then dorsiflex and lift head
- psychiatica/disc herniation/pressure on nerve in lumbar area
62
femoral nerve tension
prone
| lift heel to bum
63
Groin strain
MOI - 3
S&S - 3
Management - 4
poor flexibility and strength
hip extension, lat rotation and abduction
general pain, weakness, "twinge" during movement/after
PIER, flexibility, strengthen adductors
protect with hip spica
64
pain with abduction, flexion and tender over adductors
groin strain
65
half marathoner with increased left lap hip pain, full ROM and strength and point tender over greater trochanter
greater trochanteric bursitis
66
Greater trochanteric bursitis
MOI: Chronic vs acute
S&S - 5
management - 5
weak glute med - more you walk the worse it is
irritation of greater trochanter from ITB/glute attachment
landing on greater trochanter
pain over greater trochanter, difficulty walking, pain with lying on affected side, pain sitting, localized swelling
PIER, protection from further, stretches, strengthening, proprioceptive and stability
67
hip across illiac crest - obvious discomfort and pain
hip pointer
68
hip pointer
MOI
S&S- 6
Management - 4
blow - pinching of soft tissues
immediate pain, muscle spasm, transitory paralysis of trunk, pain with trunk rotation and hip flexion, bruising and tenderness, ok when you flex forward but terrible backwards
PIER, rule out fracture, rest from sport, protective pad
69
hit across right quad and only weight bearing on left, no ROM at knee due to pain and muslce spasm
quad contusion
70
how to walk away from a quad contusion
cant bend to 90 dont run on it, single leg squat and you can go
71
```
quad contusion
MOI
S&S
G1
G2
G3
Management
```
impact on thigh that compresses muscle against femur
pain, loss of function, tissue bleeding, limping, swelling, tenderness
intramuscular bruise, milkd hemorrhage, little pain, no swelling, mild point tenderness, full ROM
mod pain, swelling and pt tender, cant flex beyond 90, limp
pain, swelling, hematoma, ROM 45-90, limp, fascia may be split and muscle protrudes, divit for fascia damage
put knee in flexion with ic pack and add compression- passive stretch to avoid muscle shorten and ensure normal ROM
ice for hemorrahge
crutches above G2
protect from further damage with pads
painfree ROM ex with gentle isometric strength and stretches
webbing tape - till no more potential energy in tape and moves swelling
milk massage
ultrasound
72
myositis ossificans tramatica
MOI
S&S
Management
bony growth into muscle
severe/repeated blows and dont let swelling go away, disrupt muscle fibers and periosteum, running off, too vig treatment - direct massage
pain, weakness, swelling, decreased muscle function, point tenderness
decrease ROM, conservative, may require surgical intervention to remove bone (after 1 year)
73
quad strain
MOI
S&S
management
sudden stretch/contraction, may be related to muscle weakness
bleeding, pain, pt tenderness, spasm, loss of function, possible bruising and deformity, reduced ROM and strength, TOP
PIER, NWB with crutches, gentle ROM, pressure with neoprene sleeve
74
TOP
tender on palpation
75
```
hamstring strains
MOI
S&S - G1
G2
G3
management - 3
```
lots
lots, general 6040 quad ham, improper firing of hams and quads (weak hams), quick change from knee stabilizer to hip extensor, poor strength, deceleration of hams
muslce soreness during movement, point tender, stiff/sore after
partial tear, sudden tear/snap with severe pain, loss of function, possible palpable defect
rupture of tendinous/muscle, major hemorrhage and disability, severe edema, tender, loss of function, ecchymosis and palpable/visible defect
PIER, rest, no explosive stretching
76
Caution with glute and ham injuries
overestimate and wait one week longer because ppl always try to rush back and reinjury rate is high - closed kinetic chain ex for hamstrings
77
months of right hip pain, pain with pivoting, radiate to groin and stiffness/catching, clicking internal rotation
hip labral tear
78
what do people confuse labral tears with
groin strain
79
hip labral tear
MOI: Acute and chronic
S&S
management
dislocation
repetitive movements - running, pivoting
asymptomatic, catching, locking, clicking, pain/stiffness, loss of motion
improve ROM, hip strengthening/stability, activity modification, surgery may be warranted but difficult
80
legg calve perthes disease
MOI
S&S - 3
management - 4
flat femur head
insidious, children 3-12, more boys, loss of blood to head - avascular necrosis
general leg pain - knee or hip. limping (exaggerated with running), loss of hip ROM, no response to rest or soft tissue treatment
xrays - physician
rest and brase
may be surgery
may have hip pathology later in life - osteoarthritis
81
slipped capital femoral epiphysis
MOI
S&S
management
more common in boys 10-17, obesity/rapid growth- too much weight for skeleton
abnormal movement along growth plate
gradual onset, no MOI, altered gait, restricted movement
rest, NWB, left untreated - legg calve perthes and surgery
82
4 major regions of the brain
cerebral hemispheres
diencephalon - thalamus, hypothalamus, epithalamus and pituitary gland
brain stem
cerebellum
83
3 layers of the meninges
covers brain and spinal cord
- dura mater
- arachonoid mater
- pia mater
84
cranial nerves
12 pairs, 2 from forebrain and 10 from midbrain and brain stem
85
major vessels of the head and face
carotid
internal
external
vertebra
86
SS of skull fractures
battle sign
| blood or CSF may leak from nose or ear canal
87
focal cerebral injuries
intercranial bleed
50% mortality rate
localized collection of blood or hematoma - alterations in neurological function
88
intracerebral hematoma
serious
focal injury with small hemorrage within cortex, brainstem or cerebellum
LOC then alert - neurological exam normal but dizziness and nausea
89
epidural hematoma
blow to head or skull fracture causes tear of meningeal arteries - arterial BP and accumulation makes the creation of hematoma extremely fast
LOC, symptoms worsen, headpain, dizziness, nausea, dilation of 1 pupil or sleepiness
life threatening
rare
almost always skull fracture
will be caught by SCAT 5 in their cerebral function
LOC at the time and lucid interval when they feel normal but conditions worsen so dont go to bed
10-20 mins declind in mental status occurs - increase headahce, drowsiness, nausea, vomiting, decreased lvl of consciousness, dilated pupil on side of hematoma, contralateral weakness and decerebrate posture
EMS
ABC
surgery to decompress and control arterial bleeding
90
subdural hematoma
```
more frequent than epi
acceleration force of head
venous bleed - SS more slowly
simple - no injury to cerebrum or complex - yes
inercranial pressure -
20 vs 50% mortality
LOC
life threatening in 1-2 hrs
symptoms may not become apparent for hours, days or weeks
EMS
ABC
shock
```
91
cerebral contusion
```
focal
microhemorrahaging
strike to frontal lobe
LOC
normal neurological exam but headahce, dizziness, nausea
ER
```
92
SS of second impact syndrome
| management
may be no LOC
15 seconds to several mins - worsen rapidly with dilated pupils, loss of eye movement , LOC to coma, respiratory failure
prevent injury from occuring, observe athletes as they come off the field of play
EMS
93
stitches
more than 1.25 in length and 0.3 cm in depth
94
3 -oculomotor nerve
constriction of pupil - equal round and reactive to light
95
4 -trochlear nerve
sup/inf movement of eye
96
6- abducens nerve
lateral eye movements
97
8- vestibulocochlear nerve
hearing and equilibrium - right or left
98
2- optic
vision
